Implementing the incident command system in the healthcare setting.

PubMed

Huser, T J

The author discusses a new requirement in NFPA 99 for healthcare facilities--the implementation of an Incident Command System in the event of a disaster. He offers suggestions on how facilities can change their disaster plans to meet this new standard.

Flight test evaluation of a separate surface attitude command control system on a Beech 99 airplane

NASA Technical Reports Server (NTRS)

Gee, S. W.; Jenks, G. E.; Roskam, J.; Stone, R. L.

1976-01-01

A joint NASA/university/industry program was conducted to flight evaluate a potentially low cost separate surface implementation of attitude command in a Beech 99 airplane. Saturation of the separate surfaces was the primary cause of many problems during development. Six experienced professional pilots who made simulated instrument flight evaluations experienced improvements in airplane handling qualities in the presence of turbulence and a reduction in pilot workload. For ride quality, quantitative data show that the attitude command control system results in all cases of airplane motion being removed from the uncomfortable ride region.

Medical events during the 2009 Los Angeles County Station Fire: lessons for wildfire EMS planning.

PubMed

Squire, Benjamin; Chidester, Cathy; Raby, Stephanie

2011-01-01

Little is known about the types of injuries and medical problems encountered by fire department personnel during suppression of large campaign-type wildland fires. Such information could help to plan for response to medical incidents during future wildfires. To describe the injuries and medical problems experienced by firefighters during the 2009 Los Angeles County Station Fire. This was a retrospective analysis of case records of patients treated during the Los Angeles County Station Fire. Data were abstracted from two sources: the incident command medical tracking sheet and prehospital patient care reports (PCRs). The sample included 183 patient contacts, of which PCRs were available for 65. For the remaining 118 patients, data were abstracted from the incident command medical tracking sheet. The most common chief complaint was extremity injury, accounting for 44 patient contacts (24% of all patients), with smoke inhalation second, at 32 patient contacts (17%). Of the 65 patients with PCRs, 31 (52%) were treated with oxygen, 26 (40%) had intravenous (IV) lines started, and 15 (23%) received an IV fluid bolus. Half of the patients were transported to an emergency department (ED); the remainder were treated on scene or self-transported to a non-acute care facility. Most firefighter injuries and illnesses encountered during the Los Angeles Station Fire were minor. The prevalence of injuries observed should be taken into consideration in creation of protocols and mandatory equipment lists for fireline paramedics. Furthermore, advanced training for paramedics in the diagnosis and treatment of minor medical conditions may be useful.

A Case Study in the Identification of Critical Factors Leading to Successful Implementation of the Hospital Incident Command System

DTIC Science & Technology

2015-06-01

California EMSA, National Incident Management System, NIMS, hospital preparedness program, Nursing Home Incident Command System, NHICS, Hospital...The International Journal of Trauma Nursing published an article in 2007 entitled “Organization of a Hospital-based Victim Decontamination Plan...Journal of Trauma Nursing 5, no. 4 (October– November 2007): 119–123. 32 Ellen Lanser May, “Scarred but Smarter: Lessons Learned from Florida’s 2004

Command and Control. Radiological Transportation Emergencies Course. Revision Three.

ERIC Educational Resources Information Center

Westinghouse Electric Corp., Carlsbad, NM.

This 12-section course is designed to explain the responsibilities of an incident commander at the scene of a Waste Isolation Pilot Plant (WIPP) transportation incident. It was created for the U.S. Department of Energy WIPP located near Carlsbad, New Mexico, which receives radioactive shipments. The course has two purposes: (1) to provide first…

A Work Station For Control Of Changing Systems

NASA Technical Reports Server (NTRS)

Mandl, Daniel J.

1988-01-01

Touch screen and microcomputer enable flexible control of complicated systems. Computer work station equipped to produce graphical displays used as command panel and status indicator for command-and-control system. Operator uses images of control buttons displayed on touch screen to send prestored commands. Use of prestored library of commands reduces incidence of errors. If necessary, operator uses conventional keyboard to enter commands in real time to handle unforeseeable situations.

C2-Related Incidents Reported by UAS Pilots

NASA Technical Reports Server (NTRS)

Hobbs, Alan; Cardoza, Colleen; Null, Cynthia

2016-01-01

It has been estimated that aviation accidents are typically preceded by numerous minor incidents arising from the same causal factors that ultimately produced the accident. Accident databases provide in-depth information on a relatively small number of occurrences, however incident databases have the potential to provide insights into the human factors of Remotely Piloted Aircraft System (RPAS) operations based on a larger volume of less-detailed reports. Currently, there is a lack of incident data dealing with the human factors of unmanned aircraft systems. An exploratory study is being conducted to examine the feasibility of collecting voluntary critical incident reports from RPAS pilots. Twenty-three experienced RPAS pilots volunteered to participate in focus groups in which they described critical incidents from their own experience. Participants were asked to recall (1) incidents that revealed a system flaw, or (2) highlighted a case where the human operator contributed to system resilience or mission success. Participants were asked to only report incidents that could be included in a public document. During each focus group session, a note taker produced a de-identified written record of the incident narratives. At the end of the session, participants reviewed each written incident report, and made edits and corrections as necessary. The incidents were later analyzed to identify contributing factors, with a focus on design issues that either hindered or assisted the pilot during the events. A total of 90 incidents were reported. This presentation focuses on incidents that involved the management of the command and control (C2) link. The identified issues include loss of link, interference from undesired transmissions, voice latency, accidental control transfer, and the use of the lost link timer, or lost link OK features.

Land Ahoy! Understanding Submarine Command and Control During the Completion of Inshore Operations.

PubMed

Roberts, Aaron P J; Stanton, Neville A; Fay, Daniel

2017-12-01

The aim of this study was to use multiple command teams to provide empirical evidence for understanding communication flow, information pertinence, and tasks undertaken in a submarine control room when completing higher- and lower-demand inshore operation (INSO) scenarios. The focus of submarine operations has changed, and submarines are increasingly required to operate in costal littoral zones. However, submarine command team performance during INSO is not well understood, particularly from a sociotechnical systems perspective. A submarine control-room simulator was built. The creation of networked workstations allowed a team of nine operators to perform tasks completed by submarine command teams during INSO. The Event Analysis of Systematic Teamwork method was used to model the social, task, and information networks and to describe command team performance. Ten teams were recruited for the study, affording statistical comparisons of how command-team roles and level of demand affected performance. Results indicated that the submarine command-team members are required to rapidly integrate sonar and visual data as the periscope is used, periodically, in a "duck-and-run" fashion, to maintain covertness. The fusion of such information is primarily completed by the operations officer (OPSO), with this operator experiencing significantly greater demand than any other operator. The OPSO was a bottleneck in the command team when completing INSO, experiencing similar load in both scenarios, suggesting that the command team may benefit from data synthesis tasks being more evenly distributed within the command team. The work can inform future control-room design and command-team ways of working by identifying bottlenecks in terms of information and task flow between operators.

Implementing the Hospital Emergency Incident Command System: an integrated delivery system's experience.

PubMed

Zane, Richard D; Prestipino, Ann L

2004-01-01

Hospital disaster manuals and response plans often lack formal command structure; instead, they rely on the presence of key individuals who are familiar with hospital operations, or who are in leadership positions during routine, day-to-day operations. Although this structure occasionally may prove to be successful, it is unreliable, as this leadership may be unavailable at the time of the crisis, and may not be sustainable during a prolonged event. The Hospital Emergency Incident Command System (HEICS) provides a command structure that does not rely on specific individuals, is flexible and expandable, and is ubiquitous in the fire service, emergency medical services, military, and police agencies, thus allowing for ease of communication during event management. A descriptive report of the implementation of the HEICS throughout a large healthcare network is reviewed. Implementation of the HEICS provides a consistent command structure for hospitals that enables consistency and commonality with other hospitals and disaster response entities.

Acceptance and utilisation of the Incident Command System in first response and allied disciplines: an Ohio study.

PubMed

Decker, Russell J

2011-10-01

In response to the terrorist attacks of September 11th, 2001, an effort was made to establish a common and uniform command structure for use by the nation's first responder organisations, as well as those disciplines generally expected to assist first responders during a major incident or disaster. The result was the issuance of the National Incident Management System1 or NIMS by the US Department of Homeland Security in 2004. Included in the NIMS document was an embracing of the Incident Command System or ICS, long utilised in the fire service for the effective management of emergency response. The NIMS doctrine also identified certain allied disciplines that needed to adopt this new system for responding to major events. Some of these disciplines included specialised first response units, such as, bomb squads and hazardous materials teams. Other partner disciplines not usually associated with emergency response to include public health and public works were also included. This study will attempt to look at a single component of NIMS, specifically the Incident Command System, and measure its acceptance and utilisation by first responder organisations and selected allied disciplines in the state of Ohio. This is particularly important at this time since the US government is being forced to reduce budgets significantly and determine which laudable policies and programmes will be cut.

Role of the dental team in mass fatality incidents.

PubMed

Fixott, R H; Arendt, D; Chrz, B; Filippi, J; McGivney, J; Warnick, A

2001-04-01

The process of dental identification for a mass fatality incident has unique aspects in comparison with that of a routine dental identification, outside of the obvious increase in the number of victims and responders. The dental team is a small part of a large effort to resolve the incident. Incident command structure applies to the dental team as a unit as well as to the entire organization of the response. Teamwork and planning are essential on all levels. Discussing the casework is limited to the public information officer; only the public information officer is authorized to talk to anyone outside the medical examiner's office. For the team, communication is essential between the team members and between the team and other morgue sections. Daily meetings not only update progress, but also identify and solve problems as they arise. Redundancy and cross-checking occur each step in each section. A core team of trained individuals provides a framework for the use of less experienced members. Use of a dental identification computer program is extremely beneficial, especially as the amount of fragmentation or number of victims increases. Because of the magnitude of the response, the physical and mental stresses require critical incident stress debriefing for all responders, regardless of their experience. The past and future service of the dental profession to the victims of mass fatality incidents and their families is an excellent example of the ideal of service on which the profession is based.

Occupational Safety and Health System for Workers Engaged in Emergency Response Operations in the USA.

PubMed

Toyoda, Hiroyuki; Kubo, Tatsuhiko; Mori, Koji

2016-12-03

To study the occupational safety and health systems used for emergency response workers in the USA, we performed interviews with related federal agencies and conducted research on related studies. We visited the Federal Emergency Management Agency (FEMA) and National Institute for Occupational Safety and Health (NIOSH) in the USA and performed interviews with their managers on the agencies' roles in the national emergency response system. We also obtained information prepared for our visit from the USA's Occupational Safety and Health Administration (OSHA). In addition, we conducted research on related studies and information on the website of the agencies. We found that the USA had an established emergency response system based on their National Incident Management System (NIMS). This enabled several organizations to respond to emergencies cooperatively using a National Response Framework (NRF) that clarifies the roles and cooperative functions of each federal agency. The core system in NIMS was the Incident Command System (ICS), within which a Safety Officer was positioned as one of the command staff supporting the commander. All ICS staff were required to complete a training program specific to their position; in addition, the Safety Officer was required to have experience. The All-Hazards model was commonly used in the emergency response system. We found that FEMA coordinated support functions, and OSHA and NIOSH, which had specific functions to protect workers, worked cooperatively under NRF. These agencies employed certified industrial hygienists that play a professional role in safety and health. NIOSH recently executed support activities during disasters and other emergencies. The USA's emergency response system is characterized by functions that protect the lives and health of emergency response workers. Trained and experienced human resources support system effectiveness. The findings provided valuable information that could be used to improve the occupational safety and health function in the Japanese system.

An Evaluation of the Frequency and Severity of Motion Sickness Incidences in Personnel Within the Command and Control Vehicle (C2V)

NASA Technical Reports Server (NTRS)

Cowings, Patricia S.; Toscano, William B.; DeRoshia, Charles

1998-01-01

The purpose of this study was to assess the frequency and severity of motion sickness in personnel during a field exercise in the Command and Control Vehicle (C2V). This vehicle contains four workstations where military personnel are expected to perform command decisions in the field during combat conditions. Eight active duty military men (U.S. Army) at the Yuma Proving Grounds in Arizona participated in this study. All subjects were given baseline performance tests while their physiological responses were monitored on the first day. On the second day of their participation, subjects rode in the C2V while their physiological responses and performance measures were recorded. Self-reports of motion sickness were also recorded. Results showed that only one subject experienced two incidences of emesis. However, seven out of the eight subjects reported other motion sickness symptoms; most predominant was the report of drowsiness, which occurred a total of 19 times. Changes in physiological responses were observed relative to motion sickness symptoms reported and the different environmental conditions (i.e., level, hills, gravel) during the field exercise. Performance data showed an overall decrement during the C2V exercise. These findings suggest that malaise and severe drowsiness can potentially impact the operational efficiency of the C2V crew. It was concluded that conflicting sensory information from the subject's visual displays and movements of the vehicle during the field exercise significantly contributed to motion sickness symptoms. It was recommended that a second study be conducted to further evaluate the impact of seat position or orientation and C2V experience on motion sickness susceptibility. Further, it was recommended that an investigation be performed on behavioral methods for improving crew alertness, motivation, and performance and for reducing malaise.

Spills of National Significance Response Management System

DOT National Transportation Integrated Search

1997-07-15

This Instruction contains guidance for establishing an Incident Command System : (ICS) Area Command Structure for a Spill of National Significance (SONS). : Reference (a), the National Contingency Plan (NCP), assigns responsibilities for : emergency ...

Introduction of an Emergency Response Plan for flood loading of Sultan Abu Bakar Dam in Malaysia

NASA Astrophysics Data System (ADS)

Said, N. F. Md; Sidek, L. M.; Basri, H.; Muda, R. S.; Razad, A. Z. Abdul

2016-03-01

Sultan Abu Bakar Dam Emergency Response Plan (ERP) is designed to assist employees for identifying, monitoring, responding and mitigation dam safety emergencies. This paper is outlined to identification of an organization chart, responsibility for emergency management team and triggering level in Sultan Abu Bakar Dam ERP. ERP is a plan that guides responsibilities for proper operation of Sultan Abu Bakar Dam in respond to emergency incidents affecting the dam. Based on this study four major responsibilities are needed for Abu Bakar Dam owing to protect any probable risk for downstream which they can be Incident Commander, Deputy Incident Commander, On-Scene Commander, Civil Engineer. In conclusion, having organization charts based on ERP studies can be helpful for decreasing the probable risks in any projects such as Abu Bakar Dam and it is a way to identify and suspected and actual dam safety emergencies.

Acceptability and perceived utility of drone technology among emergency medical service responders and incident commanders for mass casualty incident management.

PubMed

Hart, Alexander; Chai, Peter R; Griswold, Matthew K; Lai, Jeffrey T; Boyer, Edward W; Broach, John

2017-01-01

This study seeks to understand the acceptability and perceived utility of unmanned aerial vehicle (UAV) technology to Mass Casualty Incidents (MCI) scene management. Qualitative questionnaires regarding the ease of operation, perceived usefulness, and training time to operate UAVs were administered to Emergency Medical Technicians (n = 15). A Single Urban New England Academic Tertiary Care Medical Center. Front-line emergency medical service (EMS) providers and senior EMS personnel in Incident Commander roles. Data from this pilot study indicate that EMS responders are accepting to deploying and operating UAV technology in a disaster scenario. Additionally, they perceived UAV technology as easy to adopt yet impactful in improving MCI scene management.

Exploring the perception of aid organizations' staff about factors affecting management of mass casualty traffic incidents in Iran: a grounded theory study.

PubMed

Bazeli, Javad; Aryankhesal, Aidin; Khorasani-Zavareh, Davoud

2017-07-01

Traffic incidents are of main health issues all around the world and cause countless deaths, heavy casualties, and considerable tangible and intangible damage. In this regard, mass casualty traffic incidents are worthy of special attention as, in addition to all losses and damage, they create challenges in the way of providing health services to the victims. The present study is an attempt to explore the challenges and facilitators in management of mass casualty traffic incidents in Iran. This qualitative grounded theory study was carried out with participation of 14 purposively selected experienced managers, paramedics and staff of aid organizations in different provinces of Iran in 2016. Semi-structured interviews were conducted in order to develop the theory. The transcribed interviews were analyzed through open, axial and selective coding. Despite the recent and relatively good improvements in facilities and management procedure of mass casualty traffic incidents in Iran, several problems such as lack of coordination, lack of centralized and integrated command system, large number of organizations participating in operations, duplicate attempts and parallel operations carried out by different organizations, intervention of lay people, and cultural factors halt provision of effective health services to the victims. It is necessary to improve the theoretical and practical knowledge of the relief personnel and paramedics, provide public with education about first aid and improve driving culture, prohibit laypeople from intervening in aid operations, and increase quality and quantity of aid facilities.

Incident Management: Process into Practice

ERIC Educational Resources Information Center

Isaac, Gayle; Moore, Brian

2011-01-01

Tornados, shootings, fires--these are emergencies that require fast action by school district personnel, but they are not the only incidents that require risk management. The authors have introduced the National Incident Management System (NIMS) and the Incident Command System (ICS) and assured that these systems can help educators plan for and…

76 FR 24901 - Privacy Act of 1974; Department of Homeland Security United States Coast Guard-DHS/USCG-002...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-03

.... USCG Critical Incident Stress Management-related records: Work-Life staff, Peers, Incident commander... leadership personnel regarding alleged work place violence incidents; USCG Critical Incident Stress... Work-Life Offices who are responsible for providing services for the related programs described above...

Discussion Material for Small Unit Leaders: Issues of Battlefield Ethics and Leadership

DTIC Science & Technology

2008-01-01

they may feel comfortable approaching him and asking for clarification of the incident. Because they did not witness the incident, the Platoon...Company XO took command of the scene. Visibly angry, he shouted at the Squad Leader to take some Marines and “clear out those shooters.” The...west he heard shouts and then a brief period of high volume small arms fire. Running to the scene, the Platoon Commander saw a white taxicab with five

Command History 1971. Volume 2. Sanitized

DTIC Science & Technology

1971-01-01

2-71) (U) This inquiry was prompted by racial incidents oc•,urring on 17-15 December 1970 at Camp Baxter. baqse camp of the 5th Trans Comd, US Army...SUPCOM, Da Nang. Tile incident begam ot 17 December with a fist fight in the 329th Trans Co but quickly deteriorated into a racial gang fight. This...Directive for I’,41 tiry. A total of os witnesses were into erviwewad. Of these4 13 presented the view of the $t. Trans Co Commander and #taff and the

Enhanced Methodologies to Enumerate Persons Experiencing Homelessness in a Large Urban Area.

PubMed

Troisi, Catherine L; D'Andrea, Ritalinda; Grier, Gary; Williams, Stephen

2015-10-01

Homelessness is a public health problem, and persons experiencing homelessness are a vulnerable population. Estimates of the number of persons experiencing homelessness inform funding allocations and services planning and directly determine the ability of a community to intervene effectively in homelessness. The point-in-time (PIT) count presents a logistical problem in large urban areas, particularly those covering a vast geographical area. Working together, academia, local government, and community organizations improved the methodology for the count. Specific enhancements include use of incident command system (ICS), increased number of staging areas/teams, specialized outreach and Special Weapons and Tactics teams, and day-after surveying to collect demographic information. This collaboration and enhanced methodology resulted in a more accurate estimate of the number of persons experiencing homelessness and allowed comparison of findings for 4 years. While initial results showed an increase due to improved counting, the number of persons experiencing homelessness counted for the subsequent years showed significant decrease during the same time period as a "housing first" campaign was implemented. The collaboration also built capacity in each sector: The health department used ICS as a training opportunity; the academics enhanced their community health efforts; the service sector was taught and implemented more rigorous quantitative methods; and the community was exposed to public health as a pragmatic and effective discipline. Improvements made to increase the reliability of the PIT count can be adapted for use in other jurisdictions, leading to improved counts and better evaluation of progress in ending homelessness. © The Author(s) 2015.

Goal-oriented training affects decision-making processes in virtual and simulated fire and rescue environments.

PubMed

Cohen-Hatton, Sabrina R; Honey, R C

2015-12-01

Decisions made by operational commanders at emergency incidents have been characterized as involving a period of information gathering followed by courses of action that are often generated without explicit plan formulation. We examined the efficacy of goal-oriented training in engendering explicit planning that would enable better communication at emergency incidents. While standard training mirrored current operational guidance, goal-oriented training incorporated "decision controls" that highlighted the importance of evaluating goals, anticipated consequences, and risk/benefit analyses once a potential course of action has been identified. In Experiment 1, 3 scenarios (a house fire, road traffic collision, and skip fire) were presented in a virtual environment, and in Experiment 2 they were recreated on the fireground. In Experiment 3, the house fire was recreated as a "live burn," and incident commanders and their crews responded to this scenario as an emergency incident. In all experiments, groups given standard training showed the reported tendency to move directly from information gathering to action, whereas those given goal-oriented training were more likely to develop explicit plans and show anticipatory situational awareness. These results indicate that training can be readily modified to promote explicit plan formulation that could facilitate plan sharing between incident commanders and their teams. (c) 2015 APA, all rights reserved).

Trauma risk management (TRiM) in the UK Armed Forces.

PubMed

Greenberg, N; Langston, V; Jones, N

2008-06-01

Trauma Risk Management (TRiM) is a novel system of post incident management which intend to allow commanders to provide appropriate support to their subordinates in the aftermath of traumatic events. Given the current very considerable operational tempo being experienced by the majority of the UK Armed Forces, it is perhaps not surprising that TRiM has been in use in both Iraq and Afghanistan. Although TRiM originated from within the Royal Marines, it is now widely used in both the Royal Navy and Army; there are also plans to introduce it into specific components of the Royal Air Force such as for the RAF Regiment. This paper aims to explore the basis behind the TRiM system and to explore the evidence for its growing popularity within hierarchical organisations such as the military.

The Evolution Of Dual Status Command Authorities: A New Construct For Implementation

DTIC Science & Technology

2016-02-13

Unity of Command Tornados in Tuscaloosa, Alabama Highlight Command and Control Gaps The response in Tuscaloosa following a series of devastating... tornados that ripped through the city on 27 April 2011 illustrates how personality and not formal structures were the basis of response. Mayor Walter...Multijurisdictional Incidents None of the cases reviewed—Hurricanes Katrina and Sandy, the Tuscaloosa tornados , and the Boston Marathon bombings

Commander’s Handbook on Military and Civilian Law. Revision

DTIC Science & Technology

1992-01-01

Cuminal Law Divio 23-8 Commander’s Handbook The accused’s possession must be knowing and conscious. Therefore, if the accused didn’t know he or she...of violence and neglect in families, for example, experiencing or witnessing abuse as a child or the stress a family experiences due to the member’s

[Mass maritime casualty incidents in German waters: structures and resources].

PubMed

Castan, J; Paschen, H-R; Wirtz, S; Dörges, V; Wenderoth, S; Peters, J; Blunk, Y; Bielstein, A; Kerner, T

2012-07-01

The Central Command for Maritime Emergencies was founded in Germany in 2003 triggered by the fire on board of the cargo ship "Pallas" in 1998. Its mission is to coordinate and direct measures at or above state level in maritime emergency situations in the North Sea and the Baltic Sea. A special task in this case is to provide firefighting and medical care. To face these challenges at sea emergency doctors and firemen have been specially trained. This form of organization provides a concept to counter mass casualty incidents and peril situations at sea. Since the foundation of the Central Command for Maritime Emergencies there have been 5 operations for firefighting units and 4 for medical response teams. Assignments and structure of the Central Command for Maritime Emergencies are unique in Europe.

Data Quality for Situational Awareness during Mass-Casualty Events

PubMed Central

Demchak, Barry; Griswold, William G.; Lenert, Leslie A.

2007-01-01

Incident Command systems often achieve situational awareness through manual paper-tracking systems. Such systems often produce high latencies and incomplete data, resulting in inefficient and ineffective resource deployment. WIISARD (Wireless Internet Information System for Medical Response in Disasters) collects much more data than a paper-based system, dramatically reducing latency while increasing the kinds and quality of information available to incident commanders. Yet, the introduction of IT into a disaster setting is not problem-free. Notably, system component failures can delay the delivery of data. The type and extent of a failure can have varying effects on the usefulness of information displays. We describe a small, coherent set of customizble information overlays to address this problem, and we discuss reactions to these displays by medical commanders. PMID:18693821

Simulation and management games for training command and control in emergencies.

PubMed

Levi, Leon; Bregman, David

2003-01-01

The aim of our project was to introduce and implement simulation techniques in a problematic field of increasing health care system preparedness for disasters. This field was chosen as knowledge is gained by few experienced staff members who need to disperse it to others during the busy routine work of the system personnel. Knowledge management techniques ranging from classifying the current data, centralized organizational knowledge storage and using it for decision making and dispersing it through the organization--were used in this project. In the first stage we analyzed the current system of building a preparedness protocol (set of orders). We identified the pitfalls of changing personnel and loosing knowledge gained through lessons from local and national experience. For this stage we developed a database of resources and objects (casualties) to be used in the simulation in different possibilities. One of those was the differentiation between drills with trainer and those in front of computers enable to set the needed solution. The model rules for different scenarios of multi-casualty incidents from conventional warfare trauma to combined chemical/toxicological as well as, levels of care pre and inside hospitals--were incorporated to the database management system (we used Microsoft Access' DBMS). The hardware for management game was comprised of serial computers with network and possibility of projection of scenes. For prehospital phase the possibility of portable PC's and connections to central server was used to assess bidirectional flow of information. Simulation software (ARENA) and graphical interfase (Visual Basic, GUI) as shown in the attached figure. We hereby conclude that our system provides solutions which are in use in different levels of healthcare system to assess and improve management command and control for different scenarios of multi-casualty incidents.

32 CFR 700.873 - Inspection incident to commissioning of ships.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 5 2011-07-01 2011-07-01 false Inspection incident to commissioning of ships... The Commanding Officer Special Circumstances/ships in Naval Stations and Shipyards § 700.873 Inspection incident to commissioning of ships. When a ship is to be commissioned, the authority designated to...

32 CFR 700.873 - Inspection incident to commissioning of ships.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 5 2012-07-01 2012-07-01 false Inspection incident to commissioning of ships... The Commanding Officer Special Circumstances/ships in Naval Stations and Shipyards § 700.873 Inspection incident to commissioning of ships. When a ship is to be commissioned, the authority designated to...

32 CFR 700.873 - Inspection incident to commissioning of ships.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 5 2014-07-01 2014-07-01 false Inspection incident to commissioning of ships... The Commanding Officer Special Circumstances/ships in Naval Stations and Shipyards § 700.873 Inspection incident to commissioning of ships. When a ship is to be commissioned, the authority designated to...

Handbook of emergency management for state-level transportation agencies.

DOT National Transportation Integrated Search

2010-03-01

The Department of Homeland Security has mandated specific systems and techniques for the management of emergencies in the United States, including the Incident Command System, the National Incident Management System, Emergency Operations Plans, Emerg...

Accidental awareness during general anaesthesia - a narrative review.

PubMed

Tasbihgou, S R; Vogels, M F; Absalom, A R

2018-01-01

Unintended accidental awareness during general anaesthesia represents failure of successful anaesthesia, and so has been the subject of numerous studies during the past decades. As return to consciousness is both difficult to describe and identify, the reported incidence rates vary widely. Similarly, a wide range of techniques have been employed to identify cases of accidental awareness. Studies which have used the isolated forearm technique to identify responsiveness to command during intended anaesthesia have shown remarkably high incidences of awareness. For example, the ConsCIOUS-1 study showed an incidence of responsiveness around the time of laryngoscopy of 1:25. On the other hand, the 5th Royal College of Anaesthetists National Audit Project, which reported the largest ever cohort of patients who had experienced accidental awareness, used a system to identify patients who spontaneously self-reported accidental awareness. In this latter study, the incidence of accidental awareness was 1:19,600. In the recently published SNAP-1 observational study, in which structured postoperative interviews were performed, the incidence was 1:800. In almost all reported cases of intra-operative responsiveness, there was no subsequent explicit recall of intra-operative events. To date, there is no evidence that this occurrence has any psychological consequences. Among patients who experience accidental awareness and can later remember details of their experience, the consequences are better known. In particular, when awareness occurs in a patient who has been given neuromuscular blocking agents, it may result in serious sequelae such as symptoms of post-traumatic stress disorder and a permanent aversion to surgery and anaesthesia, and is feared by patients and anaesthetists. In this article, the published literature on the incidence, consequences and management of accidental awareness under general anaesthesia with subsequent recall will be reviewed. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

Fire Play: ICCARUS--Intelligent Command and Control, Acquisition and Review Using Simulation

ERIC Educational Resources Information Center

Powell, James; Wright, Theo; Newland, Paul; Creed, Chris; Logan, Brian

2008-01-01

Is it possible to educate a fire officer to deal intelligently with the command and control of a major fire event he will never have experienced? The authors of this paper believe there is, and present here just one solution to this training challenge. It involves the development of an intelligent simulation based upon computer managed interactive…

32 CFR 750.12 - Claims: Action when suit filed.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Navy, that comes to the attention of any official in connection with his official duties, shall be... report available at the headquarters, a request shall be made to the commanding officer of the appropriate Naval Legal Service Command activity for an investigative report into the incident. If there is...

Factors affecting fire suppression costs as identified by incident management teams

Treesearch

Janie Canton-Thompson; Brooke Thompson; Krista Gebert; David Calkin; Geoff Donovan; Greg Jones

2006-01-01

This study uses qualitative sociological methodology to discover information and insights about the role of Incident Management Teams in wildland fire suppression costs. We interviewed 48 command and general staff members of Incident Management Teams throughout the United States. Interviewees were asked about team structure, functioning, and decision making as a...

The hospital incident command system: modified model for hospitals in iran.

PubMed

Djalali, Ahmadreza; Hosseinijenab, Vahid; Peyravi, Mahmoudreza; Nekoei-Moghadam, Mahmood; Hosseini, Bashir; Schoenthal, Lisa; Koenig, Kristi L

2015-03-27

Effectiveness of hospital management of disasters requires a well-defined and rehearsed system. The Hospital Incident Command System (HICS), as a standardized method for command and control, was established in Iranian hospitals, but it has performed fairly during disaster exercises. This paper describes the process for, and modifications to HICS undertaken to optimize disaster management in hospitals in Iran. In 2013, a group of 11 subject matter experts participated in an expert consensus modified Delphi to develop modifications to the 2006 version of HICS. The following changes were recommended by the expert panel and subsequently implemented: 1) A Quality Control Officer was added to the Command group; 2) Security was defined as a new section; 3) Infrastructure and Business Continuity Branches were moved from the Operations Section to the Logistics and the Administration Sections, respectively; and 4) the Planning Section was merged within the Finance/Administration Section. An expert consensus group developed a modified HICS that is more feasible to implement given the managerial organization of hospitals in Iran. This new model may enhance hospital performance in managing disasters. Additional studies are needed to test the feasibility and efficacy of the modified HICS in Iran, both during simulations and actual disasters. This process may be a useful model for other countries desiring to improve disaster incident management systems for their hospitals.

Hurricanes Katrina and Rita: role of individuals and collaborative networks in mobilizing/coordinating societal and professional resources for major disasters

PubMed Central

Mattox, Kenneth L

2006-01-01

The medical support for the coordinated effort for Harris County Texas (Houston) to rescue evacuees from New Orleans following Hurricane Katrina was part of an integrated collaborative network. Both public health and operational health care was structured to custom meet the needs of the evacuees and to create an exit strategy for the clinic and shelter. Integrating local hospital and physician resources into the Joint Incident Command was essential. Outside assistance, including federal and national resources must be coordinated through the local incident command. PMID:16420647

CACTUS: Command and Control Training Using Knowledge-Based Simulations

ERIC Educational Resources Information Center

Hartley, Roger; Ravenscroft, Andrew; Williams, R. J.

2008-01-01

The CACTUS project was concerned with command and control training of large incidents where public order may be at risk, such as large demonstrations and marches. The training requirements and objectives of the project are first summarized justifying the use of knowledge-based computer methods to support and extend conventional training…

33 CFR 155.4040 - Response times for each salvage and marine firefighting service.

Code of Federal Regulations, 2014 CFR

2014-07-01

... within the inland waters or the nearshore or offshore area, you must submit in writing, in your plan, the... identified in your response plan for areas OCONUS. (c) Table 155.4040(c) provides additional amplifying... on scene. vii) Salvage plan Plan completed and submitted to Incident Commander/Unified Command. (viii...

33 CFR 155.4040 - Response times for each salvage and marine firefighting service.

Code of Federal Regulations, 2012 CFR

2012-07-01

... within the inland waters or the nearshore or offshore area, you must submit in writing, in your plan, the... identified in your response plan for areas OCONUS. (c) Table 155.4040(c) provides additional amplifying... on scene. vii) Salvage plan Plan completed and submitted to Incident Commander/Unified Command. (viii...

33 CFR 155.4040 - Response times for each salvage and marine firefighting service.

Code of Federal Regulations, 2013 CFR

2013-07-01

... within the inland waters or the nearshore or offshore area, you must submit in writing, in your plan, the... identified in your response plan for areas OCONUS. (c) Table 155.4040(c) provides additional amplifying... on scene. vii) Salvage plan Plan completed and submitted to Incident Commander/Unified Command. (viii...

32 CFR 705.20 - Use of Navy material and facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) The program support must be within the command's public affairs responsibility. (2) The loan of the equipment must not interfere with the military mission of the command. (3) Equipment must be available... one per quarter per group). (4) Incident to group visits by the Boy Scouts of America, Boys Clubs of...

32 CFR 705.20 - Use of Navy material and facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) The program support must be within the command's public affairs responsibility. (2) The loan of the equipment must not interfere with the military mission of the command. (3) Equipment must be available... one per quarter per group). (4) Incident to group visits by the Boy Scouts of America, Boys Clubs of...

32 CFR 705.20 - Use of Navy material and facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) The program support must be within the command's public affairs responsibility. (2) The loan of the equipment must not interfere with the military mission of the command. (3) Equipment must be available... one per quarter per group). (4) Incident to group visits by the Boy Scouts of America, Boys Clubs of...

32 CFR 705.20 - Use of Navy material and facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) The program support must be within the command's public affairs responsibility. (2) The loan of the equipment must not interfere with the military mission of the command. (3) Equipment must be available... one per quarter per group). (4) Incident to group visits by the Boy Scouts of America, Boys Clubs of...

32 CFR 705.20 - Use of Navy material and facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) The program support must be within the command's public affairs responsibility. (2) The loan of the equipment must not interfere with the military mission of the command. (3) Equipment must be available... one per quarter per group). (4) Incident to group visits by the Boy Scouts of America, Boys Clubs of...

Apollo Recovery Operations

NASA Technical Reports Server (NTRS)

Interbartolo, Michael

2009-01-01

Objectives include: a) Describe the organization of recovery force command and control and landing areas; b) Describe the function and timeline use of the Earth Landing System (ELS); c) Describe Stable 1 vs Stable 2 landing configurations and the function of the Command Module Uprighting System; d) Explain the activities of the helicopter and swimmer teams in egress and recovery of the crew; e)Explain the activities of the swimmer teams and primary recovery ship in recovery of the Command Module; and f) Describe several landing incidents that occurred during Apollo.

Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS).

PubMed

Yarmohammadian, Mohammad Hossein; Atighechian, Golrokh; Shams, Lida; Haghshenas, Abbas

2011-08-01

Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS) is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS). This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research instrument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Findings of study were categorized into three general categories including requirements (organizational and sub-organizational), barriers (internal and external) of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authorities in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable framework and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.

Essentials of disaster management: the role of the orthopaedic surgeon.

PubMed

Born, Christopher T; Monchik, Keith O; Hayda, Roman A; Bosse, Michael J; Pollak, Andrew N

2011-01-01

Disaster preparedness and management education is essential for allowing orthopaedic surgeons to play a valuable, constructive role in responding to disasters. The National Incident Management System, as part of the National Response Framework, provides coordination between all levels of government and uses the Incident Command System as its unified command structure. An "all-hazards" approach to disasters, whether natural, man-made, intentional, or unintentional, is fundamental to disaster planning. To respond to any disaster, command and control must be established, and emergency management must be integrated with public health and medical care. In the face of increasing acts of terrorism, an understanding of blast injury pathophysiology allows for improved diagnostic and treatment strategies. A practical understanding of potential biologic, chemical, and nuclear agents and their attendant clinical symptoms is also prerequisite. Credentialing and coordination between designated organizations and the federal government are essential to allow civilian orthopaedic surgeons to access systems capable of disaster response.

Operational Commanders: It’s Time to Take Command...of the Media

DTIC Science & Technology

2003-02-03

media companies should only send experienced military reporters to cover U.S. forces. This policy may even raise the journalistic standards of...2. Security Classification Authority: 3. Declassification/Downgrading Schedule: 4. Distribution/Availability of Report : DISTRIBUTION STATEMENT A...Ausiello, USN 10.Type of Report : FINAL 11. Date of Report : 03 February 2003 12.Page Count: 20 12A Paper Advisor (if any): 13.Supplementary Notation

Incident command structure using a daily management system and the Centers for Disease Control and Prevention's Patient Notification Toolkit drives effective response to an infection control breach.

PubMed

Schoonover, Heather; Haydon, Kristin

2018-06-14

When breaches in infection control occur, it is imperative that organizations respond in a manner that is effective, efficient, and rebuilds trust with patients. Readers will learn how the incident command structure, daily management system, and the Centers for Disease Control and Prevention's Patient Notification Toolkit were used to drive an effective response to an infection control breach-resulting in 92% of affected patients completing the recommended testing for hepatitis B, hepatitis C, and human immunodeficiency virus. © 2018 American Society for Healthcare Risk Management of the American Hospital Association.

Site management of health issues in the 2001 World Trade Center disaster.

PubMed

Bradt, David A

2003-06-01

The terrorist destruction of the World Trade Center led to the greatest loss of life from a criminal incident in the history of the United States. There were 2,801 persons killed or missing at the disaster site, including 147 dead on two hijacked aircraft. Hundreds of buildings sustained direct damage or contamination. Forty different agencies responded with command and control exercised by an incident command system as well as an emergency operations center. Dozens of hazards complicated relief and recovery efforts. Five victims were rescued from the rubble. Up to 1,000 personnel worked daily at the World Trade Center disaster site. These workers collectively made an average of 270 daily presentations to health care providers in the first month post-disaster. Of presentations for clinical symptoms, leading clinical diagnoses were ocular injuries, headaches, and lung injuries. Mechanical injury accounted for 39% of clinical presentations and appeared preventable by personal protective equipment. Limitations emerged in the site application of emergency triage and clinical care. Notable assets in the site management of health issues include action plans from the incident command system, geographic information system products, wireless application technology, technical consensus among health and safety authorities, and workers' respite care.

Disasters and mass casualties: I. General principles of response and management.

PubMed

Born, Christopher T; Briggs, Susan M; Ciraulo, David L; Frykberg, Eric R; Hammond, Jeffrey S; Hirshberg, Asher; Lhowe, David W; O'Neill, Patricia A

2007-07-01

Disaster planning and response to a mass casualty incident pose unique demands on the medical community. Because they would be required to confront many casualties with bodily injury and surgical problems, surgeons in particular must become better educated in disaster management. Compared with routine practice, triage principles in disasters require an entirely different approach to evaluation and care and often run counter to training and ethical values. An effective response to disaster and mass casualty events should focus on an "all hazards" approach, defined as the ability to adapt and apply fundamental disaster management principles universally to any mass casualty incident, whether caused by people or nature. Organizational tools such as the Incident Command System and the Hospital Incident Command System help to effect a rapid and coordinated response to specific situations. The United States federal government, through the National Response Plan, has the responsibility to respond quickly and efficiently to catastrophic incidents and to ensure critical life-saving assistance. International medical surgical response teams are capable of providing medical, surgical, and intensive care services in austere environments anywhere in the world.

32 CFR 60.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... COMMAND ASSISTANCE TEAM (FACAT) § 60.3 Definitions. Unless otherwise noted, these terms and their.... FACAT. A multidisciplinary team composed of specially trained and experienced individuals who are on...

The Role of the Technical Specialist in Disaster Response and Recovery

NASA Astrophysics Data System (ADS)

Curtis, J. C.

2017-12-01

Technical Specialists provide scientific expertise for making operational decisions during natural hazards emergencies. Technical Specialists are important members of any Incident Management Team (IMT) as is described in in the National Incident Management System (NIMS) that has been designed to respond to emergencies. Safety for the responders and the threatened population is the foremost consideration in command decisions and objectives, and the Technical Specialist is on scene and in the command post to support and promote safety while aiding decisions for incident objectives. The Technical Specialist's expertise can also support plans, logistics, and even finance as well as operations. This presentation will provide actual examples of the value of on-scene Technical Specialists, using National Weather Service "Decision Support Meteorologists" and "Incident Meteorologists". These examples will demonstrate the critical role of scientists that are trained in advising and presenting life-critical analysis and forecasts during emergencies. A case will be made for local, state, and/or a national registry of trained and deployment-ready scientists that can support emergency response.

AFFTC commander Brig. Gen. Curtis Bedke experienced a Shuttle approach and landing in NASA's Shuttle Training Aircraft from STS-114 commander Eileen Collins

NASA Image and Video Library

2005-03-29

Brig. Gen. Curtis Bedke, commander of the Air Force Flight Test Center at Edwards Air Force Base, received some first-hand insight on how to fly a Space Shuttle approach and landing, courtesy of NASA astronaut and STS-114 mission commander Eileen Collins. The series of proficiency flights in NASA's modified Grumman Gulfstream-II Shuttle Training Aircraft were in preparation for the STS-114 mission with the shuttle Discovery. Although NASA's Kennedy Space Center in Florida is the primary landing site for Space Shuttle missions, flight crews also practice the shuttle's steep approach and landing at Edwards in case weather or other situations preclude a landing at the Florida site and force a diversion to Edwards AFB.

Flight test evaluation of a separate surface attitude command control system on a Beech 99 airplane

NASA Technical Reports Server (NTRS)

Gee, S. W.; Jenks, G. E.; Roskam, J.; Stone, R. L.

1976-01-01

A joint NASA/university/industry program was conducted to flight evaluate a potentially low cost separate surface implementation of attitude command in a Beech 99 airplane. Saturation of the separate surfaces was the primary cause of many problems during development. Six experienced professional pilots made simulated instrument flight evaluations in light-to-moderate turbulence. They were favorably impressed with the system, particularly with the elimination of control force transients that accompanied configuration changes. For ride quality, quantitative data showed that the attitude command control system resulted in all cases of airplane motion being removed from the uncomfortable ride region.

Survey of spatial disorientation in military pilots and navigators.

PubMed

Holmes, Sharon R; Bunting, Alex; Brown, David Lex; Hiatt, Keith L; Braithwaite, Malcolm G; Harrigan, Michael J

2003-09-01

The direction of future spatial disorientation (SD) research and training is shaped primarily by the outcome of formal investigation of aircraft accidents and incidents. However, another source of vital information is aircrews' experience of SD that does not result in reported incidents. A short postal SD survey was distributed to 5 Naval Air Squadrons, 22 Joint Helicopter Command Units, and 7 Royal Air Force stations in the United Kingdom. There were 752 questionnaires, including responses from 562 pilots and 149 navigators, that were returned. Analysis was conducted primarily on the pilot data. The most frequently experienced SD episodes were "the leans" (by 92% of respondents), loss of horizon due to atmospheric conditions (82%), misleading altitude cues (79%), sloping horizon (75%), and SD arising from distraction (66%). In general, the frequency of SD episodes and ratings of severity of the worst ever SD episode were positively related to flying experience (p < 0.05). Overall, pilots who had received in-flight SD training reported more episodes of SD than those who had not participated in this training (p < 0.05). Differences in types of SD experienced were found between aircraft categories, e.g., more episodes of SD during night vision goggle use were reported by rotary-wing pilots compared with fast-jet aviators (p < 0.05). This preliminary survey has shown that SD is still a significant hazard of military flying. Overall, this study shows that the postal questionnaire is a useful tool for assessing how SD training and experience may benefit the recognition of situations that may cause SD. However, it is difficult to access those situations where aircrew were truly disorientated.

Helpful Hints for School Emergency Management: The National Incident Management System (NIMS) and Schools. Frequently Asked Questions and FY 2006 NIMS Compliance Activities for Schools

ERIC Educational Resources Information Center

US Department of Education, 2006

2006-01-01

"Helpful Hints" offers a quick overview of school emergency preparedness topics that are frequently the subject of inquiries. The National Incident Management System (NIMS) is a comprehensive system that improves tribal and local emergency response operations through the use of the Incident Command System (ICS) and the application of standardized…

Smoking and Soldier Performance: A Literature Review.

DTIC Science & Technology

1986-06-01

Army Medical Research June 1986 • dud uevelopment Command 13. NUMBER OF PAGES Fort Detrick, Frederick, MD 21701-5012 223 " 14. MONITORING AGENCY NAME...the LIS Army Medical Research and Development Command.- This literature review resulted - from an unsolicited proposal submitted by Research Solutions... medical drugs .1.... % e) Varicocele incidence. ............................ 151,i’ f) Body size and weigh !5. 4’ f de .......................... g

Research of an emergency medical system for mass casualty incidents in Shanghai, China: a system dynamics model.

PubMed

Yu, Wenya; Lv, Yipeng; Hu, Chaoqun; Liu, Xu; Chen, Haiping; Xue, Chen; Zhang, Lulu

2018-01-01

Emergency medical system for mass casualty incidents (EMS-MCIs) is a global issue. However, China lacks such studies extremely, which cannot meet the requirement of rapid decision-support system. This study aims to realize modeling EMS-MCIs in Shanghai, to improve mass casualty incident (MCI) rescue efficiency in China, and to provide a possible method of making rapid rescue decisions during MCIs. This study established a system dynamics (SD) model of EMS-MCIs using the Vensim DSS program. Intervention scenarios were designed as adjusting scales of MCIs, allocation of ambulances, allocation of emergency medical staff, and efficiency of organization and command. Mortality increased with the increasing scale of MCIs, medical rescue capability of hospitals was relatively good, but the efficiency of organization and command was poor, and the prehospital time was too long. Mortality declined significantly when increasing ambulances and improving the efficiency of organization and command; triage and on-site first-aid time were shortened if increasing the availability of emergency medical staff. The effect was the most evident when 2,000 people were involved in MCIs; however, the influence was very small under the scale of 5,000 people. The keys to decrease the mortality of MCIs were shortening the prehospital time and improving the efficiency of organization and command. For small-scale MCIs, improving the utilization rate of health resources was important in decreasing the mortality. For large-scale MCIs, increasing the number of ambulances and emergency medical professionals was the core to decrease prehospital time and mortality. For super-large-scale MCIs, increasing health resources was the premise.

Fire Weather Products for Public and Emergency Use: Extending Professional Resources to the Public

NASA Astrophysics Data System (ADS)

Rogers, M. A.; Schranz, S.; Kriederman, L.

2012-12-01

Large wildfires require significant resources to combat, including dedicated meteorological support to provide accurate and timely forecasts to assist incident commanders in making decisions for logistical and tactical firefighting operations. Smaller fires often require the same capabilities for understanding fire and the fire weather environment, but access to needed resources and tools is often limited due to technical, training, or education limitations. Providing fire weather information and training to incident commanders for smaller wildfires should prove to enhance firefighting capabilities and improve safety for both firefighters and for the public as well. One of the premier tools used to support fire weather forecasting for the largest wildfires is the FX-Net product, a thin-client version of the Advanced Weather Interactive Processing System used by NWS incident meteorologists (IMETs) deployed to large wildfires. We present results from an ongoing project to extend the sophisticated products available from FX-Net to more accessible and mobile software platforms, such as Google Earth. The project involves input from IMETs and fire commanders to identify the key parameters used in fighting wildfires, and involves a large training component for fire responders to utilize simplified products to improve understanding of fire weather in the context of firefighting operations.

Psychological Trauma in the Workplace: Variation of Incident Severity among Industry Settings and between Recurring vs Isolated Incidents.

PubMed

DeFraia, G S

2015-07-01

Psychologically traumatic workplace events (known as critical incidents) occur within various work environments, with workgroups in certain industries vulnerable to multiple incidents. With the increasing prevalence of incidents in the USA, incident response is a growing practice area within occupational medicine, industrial psychology, occupational social work and other occupational health professions. To analyze a measure of incident severity based on level of disruption to the workplace and explore whether incident severity varied among different industry settings or between workgroups experiencing multiple vs single traumatic incidents. Administrative data mining was employed to examine practice data from a workplace trauma response unit in the USA. Bivariate analyses were conducted to test whether scores from an instrument measuring incident severity level varied among industry settings or between workgroups impacted by multiple vs isolated events. Incident severity level differed among various industry settings. Banks, retail stores and fast food restaurants accounted for the most severe incidents, while industrial and manufacturing sites reported less severe incidents. Workgroups experiencing multiple incidents reported more severe incidents than workgroups experiencing a single incident. Occupational health practitioners should be alert to industry differences in several areas: pre-incident resiliency training, the content of business recovery plans, assessing worker characteristics, strategies to assist continuous operations and assisting workgroups impacted by multiple or severe incidents.

Review of Criminal Investigations of Alleged Detainee Abuse

DTIC Science & Technology

2006-08-25

reporting requirements published in Anny Regulation (AR) 190-40, "Serious Incident Report," November 30, 1993.13 A serious incident is "[a]ny actual...investigated by commanders under the authority of this regulation . In its purpose statement, the regulation states that the policy is limited to...provisions of this regulation , when made applicable, and the provisions of the specific directive authorizing the 15 AR 190-40, Serious Incident Report

Space Shuttle Program (SSP) Orbiter Main Propulsion System (MPS) Gaseous Hydrogen (GH2) Flow Control Valve (FCV) Poppet Eddy Current (EC) Inspection Probability of Detection (POD) Study. Volume 1

NASA Technical Reports Server (NTRS)

Piascik, Robert S.; Prosser, William H.

2011-01-01

The Director of the NASA Engineering and Safety Center (NESC), requested an independent assessment of the anomalous gaseous hydrogen (GH2) flow incident on the Space Shuttle Program (SSP) Orbiter Vehicle (OV)-105 during the Space Transportation System (STS)-126 mission. The main propulsion system (MPS) engine #2 GH2 flow control valve (FCV) LV-57 transition from low towards high flow position without being commanded. Post-flight examination revealed that the FCV LV-57 poppet had experienced a fatigue failure that liberated a section of the poppet flange. The NESC assessment provided a peer review of the computational fluid dynamics (CFD), stress analysis, and impact testing. A probability of detection (POD) study was requested by the SSP Orbiter Project for the eddy current (EC) nondestructive evaluation (NDE) techniques that were developed to inspect the flight FCV poppets. This report contains the findings and recommendations from the NESC assessment.

Space Shuttle Program (SSP) Orbiter Main Propulsion System (MPS) Gaseous Hydrogen (GH2) Flow Control Valve (FCV) Poppet Eddy Current (EC) Inspection Probability of Detection (POD) Study. Volume 2; Appendices

NASA Technical Reports Server (NTRS)

Piascik, Robert S.; Prosser, William H.

2011-01-01

The Director of the NASA Engineering and Safety Center (NESC), requested an independent assessment of the anomalous gaseous hydrogen (GH2) flow incident on the Space Shuttle Program (SSP) Orbiter Vehicle (OV)-105 during the Space Transportation System (STS)-126 mission. The main propulsion system (MPS) engine #2 GH2 flow control valve (FCV) LV-57 transition from low towards high flow position without being commanded. Post-flight examination revealed that the FCV LV-57 poppet had experienced a fatigue failure that liberated a section of the poppet flange. The NESC assessment provided a peer review of the computational fluid dynamics (CFD), stress analysis, and impact testing. A probability of detection (POD) study was requested by the SSP Orbiter Project for the eddy current (EC) nondestructive evaluation (NDE) techniques that were developed to inspect the flight FCV poppets. This report contains the Appendices to the main report.

Disruptive Behavior Disorders

MedlinePlus

... Ribbon Commands Skip to main content Turn off Animations Turn on Animations Our Sponsors Log in | Register Menu Log in | ... greater chance of experiencing learning disabilities such as reading disorders and verbal impairment. But what distinguishes children ...

32 CFR 700.873 - Inspection incident to commissioning of ships.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Inspection incident to commissioning of ships. 700.873 Section 700.873 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS The Commanding Officer Special Circumstances...

IED Campaign in the U.S. Homeland: Are U.S. Military EOD Units Prepared to Respond

DTIC Science & Technology

2017-06-09

Bombing Incident Doctrine .........................................82 Terrorism Incident Law Enforcement Investigation Annex...to the Boston Marathon Bombing ..........................................93 Phase 1 Training and Operations Practice Analysis Raw Data Summary...Bureau of Alcohol Tobacco Firearms and Explosives BMC Bomb Management Center C2 Command and Control CBRNE Chemical, Biological, Radiological

Leadership and Management Education and Training (LMET) Course Requirements for Recruit Company Commanders and ’A’ School Instructors.

DTIC Science & Technology

1983-12-01

integration of TAEG findings with contractor findings. Critical incident interview techniques, as used by the contractor, were specifically prohibited in order...than the critical incident interview technique were to be explored for use in the identification of leadership competencies. These competencies and

46 CFR 4.05-35 - Incidents involving nuclear vessels.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 1 2013-10-01 2013-10-01 false Incidents involving nuclear vessels. 4.05-35 Section 4... involving nuclear vessels. The master of any nuclear vessel shall immediately inform the Commandant in the event of any accident or casualty to the nuclear vessel which may lead to an environmental hazard. The...

46 CFR 4.05-35 - Incidents involving nuclear vessels.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Incidents involving nuclear vessels. 4.05-35 Section 4... involving nuclear vessels. The master of any nuclear vessel shall immediately inform the Commandant in the event of any accident or casualty to the nuclear vessel which may lead to an environmental hazard. The...

46 CFR 4.05-35 - Incidents involving nuclear vessels.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 1 2011-10-01 2011-10-01 false Incidents involving nuclear vessels. 4.05-35 Section 4... involving nuclear vessels. The master of any nuclear vessel shall immediately inform the Commandant in the event of any accident or casualty to the nuclear vessel which may lead to an environmental hazard. The...

46 CFR 4.05-35 - Incidents involving nuclear vessels.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 1 2012-10-01 2012-10-01 false Incidents involving nuclear vessels. 4.05-35 Section 4... involving nuclear vessels. The master of any nuclear vessel shall immediately inform the Commandant in the event of any accident or casualty to the nuclear vessel which may lead to an environmental hazard. The...

46 CFR 4.05-35 - Incidents involving nuclear vessels.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 1 2014-10-01 2014-10-01 false Incidents involving nuclear vessels. 4.05-35 Section 4... involving nuclear vessels. The master of any nuclear vessel shall immediately inform the Commandant in the event of any accident or casualty to the nuclear vessel which may lead to an environmental hazard. The...

School Crisis Teams within an Incident Command System

ERIC Educational Resources Information Center

Nickerson, Amanda B.; Brock, Stephen E.; Reeves, Melissa A.

2006-01-01

Despite the increasing attention given to the need for schools to be prepared to respond in a variety of crisis situations, there is a lack of information about how to coordinate with multiple agencies following a crisis. This article describes the U. S. Department of Homeland Security's (2004) National Incident Management System and its Incident…

A 6-Month Assessment of Sleep During Naval Deployment: A Case Study of a Commanding Officer

DTIC Science & Technology

2015-05-01

Association AEROSPACE MEDICINE AND HUMAN PERFORMANCE Vol. 86, No. 5 May 2015 481 C A S E R E P O R T Sleep deprivation is a well-recognized problem in...Deployment: A Case Study of a Commanding Offi cer Nita Lewis Shattuck ; Panagiotis Matsangas BACKGROUND: Sleep deprivation is known to be a... sleep debt) rather than prophylactic in nature. Th e participant was chronically sleep - deprived , and when he experienced a foreshortened night sleep

Assessing the Utility of Work Team Theory in a Unified Command Environment at Catastrophic Incidents

DTIC Science & Technology

2005-03-01

between agencies that potentially affects command post (CP) interactions . All of the foregoing factors contribute to a turbulent management environment...requiring special strategy consideration with and IMT preparation. “Conflict refers to a process of social interaction involving a struggle over...from interactions . These schemas can be grouped as cultural norms perpetuated generationally from seasoned officers to raw recruits, and shared by

Introduction to Command, Control and Communications (C3) Through Comparative Case Analysis

DTIC Science & Technology

1990-03-01

enhancing the process of learning from experience. Case study allows the student to apply concepts , theories, and techniques to an actual incident within...part of the thesis describes selected principles and concepts of 33 related to cormruication management, interoperability, command structure and...The solutions to the cases require applying the principles and concepts presented in the first rart. The four cases are: (1) the Iran hostage rescue

Rapid Radiochemical Methods for Selected Radionuclides

EPA Pesticide Factsheets

The rapid methods documents are supplement guidance in a planned series designed to present radioanalytical laboratory personnel, Incident Commanders (and their designees), and other field response personnel.

Research of an emergency medical system for mass casualty incidents in Shanghai, China: a system dynamics model

PubMed Central

Liu, Xu; Chen, Haiping; Xue, Chen

2018-01-01

Objectives Emergency medical system for mass casualty incidents (EMS-MCIs) is a global issue. However, China lacks such studies extremely, which cannot meet the requirement of rapid decision-support system. This study aims to realize modeling EMS-MCIs in Shanghai, to improve mass casualty incident (MCI) rescue efficiency in China, and to provide a possible method of making rapid rescue decisions during MCIs. Methods This study established a system dynamics (SD) model of EMS-MCIs using the Vensim DSS program. Intervention scenarios were designed as adjusting scales of MCIs, allocation of ambulances, allocation of emergency medical staff, and efficiency of organization and command. Results Mortality increased with the increasing scale of MCIs, medical rescue capability of hospitals was relatively good, but the efficiency of organization and command was poor, and the prehospital time was too long. Mortality declined significantly when increasing ambulances and improving the efficiency of organization and command; triage and on-site first-aid time were shortened if increasing the availability of emergency medical staff. The effect was the most evident when 2,000 people were involved in MCIs; however, the influence was very small under the scale of 5,000 people. Conclusion The keys to decrease the mortality of MCIs were shortening the prehospital time and improving the efficiency of organization and command. For small-scale MCIs, improving the utilization rate of health resources was important in decreasing the mortality. For large-scale MCIs, increasing the number of ambulances and emergency medical professionals was the core to decrease prehospital time and mortality. For super-large-scale MCIs, increasing health resources was the premise. PMID:29440876

Workload differences across command levels and emergency response organizations during a major joint training exercise.

PubMed

Prytz, Erik G; Rybing, Jonas; Jonson, Carl-Oscar

2016-01-01

This study reports on an initial test using a validated workload measurement method, the NASA Task Load Index (TLX), as an indicator of joint emergency exercise effectiveness. Prior research on emergency exercises indicates that exercises must be challenging, ie, result in high workload, to be effective. However, this is often problematic with some participants being underloaded and some overloaded. The NASA TLX was used to test for differences in workload between commanders and subordinates and among three different emergency response organizations during a joint emergency exercise. Questionnaire-based evaluation with professional emergency responders. The study was performed in conjunction with a large-scale interorganizational joint emergency exercise in Sweden. A total of 20 participants from the rescue services, 12 from the emergency medical services, and 12 from the police participated in the study (N=44). Ten participants had a command-level role during the exercise and the remaining 34 were subordinates. The main outcome measures were the workload subscales of the NASA TLX: mental demands, physical demands, temporal demands, performance, effort, and frustration. The results showed that the organizations experienced different levels of workload, that the commanders experienced a higher workload than the subordinates, and that two out of three organizations fell below the twenty-fifth percentile of average workload scores compiled from 237 prior studies. The results support the notion that the NASA TLX could be a useful complementary tool to evaluate exercise designs and outcomes. This should be further explored and verified in additional studies.

The Effect of Computer-Based Simulation Training on Fire Ground Incident Commander Decision Making

ERIC Educational Resources Information Center

Hall, Kurt A.

2010-01-01

Since the establishment of the first volunteer fire brigades in the United States, firefighters have lost their lives in fire fighting operations at emergency incidents and live-fire training activities. While there are various reasons for these firefighter deaths and injuries, the United States Fire Administration (2002) reported that many of…

Marius and Trajan: Two Great Roman Strategists

DTIC Science & Technology

1984-04-01

soon respected as a good commander upon whom a soldier could count. His fairness of command is best demonstrated in an incident related by Plutarch ...to their discomfort and problems. (10:343) Plutarch also gave credit to Marius for altering the construction of the javelin. Marius replaced one of...Putnam’s Sons, 1927. 10. Plutarch (Translated by John Dryden, Revised by Arthur Hugh Clough). The Lives of the Noble Grecians and Romans. Chicago

Battalion Commanders Speak Out; An Anthology on the Philosophy of Command

DTIC Science & Technology

1977-05-20

the performance of other battalions in the divi incidents of black- marketing by soldiers of the dropped to almost zero. The participation by a...battalion and relative to slon. Of special note, the 2d Aviation Battalion soldier in black- marketing with a Korean prostitute, discipline...Mile High as immoral and uncontrolled. That required me to make some adjustments, but it did not cquse me to change my basic strategy of

Mortality Among Confirmed Lassa Fever Cases During the 2015-2016 Outbreak in Nigeria.

PubMed

Buba, Maryam Ibrahim; Dalhat, Mahmood Muazu; Nguku, Patrick Mboya; Waziri, Ndadilnasiya; Mohammad, Jibreel Omar; Bomoi, Idriss Mohammed; Onyiah, Amaka Pamela; Onwujei, Jude; Balogun, Muhammad Shakir; Bashorun, Adebobola Toluwalashe; Nsubuga, Peter; Nasidi, Abdulsalami

2018-02-01

To determine factors associated with mortality among confirmed Lassa fever cases. We reviewed line lists and clinical records of laboratory-confirmed cases of Lassa fever during the 2016 outbreak in Nigeria to determine factors associated with mortality. We activated an incident command system to coordinate response. We documented 47 cases, 28 of whom died (case fatality rate [CFR] = 59.6%; mean age 31.4 years; SD = ±18.4 years). The youngest and the oldest were the most likely to die, with 100% mortality in those aged 5 years or younger and those aged 55 years or older. Patients who commenced ribavirin were more likely to survive (odds ratio [OR] = 0.1; 95% confidence interval [CI] = 0.03, 0.50). Fatality rates went from 100% (wave 1) through 69% (wave 2) to 31% (wave 3; χ 2 for linear trend: P < .01). Patients admitted to a health care center before incident command system activation were more likely to die (OR = 4.4; 95% CI = 1.1, 17.6). The only pregnant patient in the study died postpartum. Effective, coordinated response reduces mortality from public health events. Attention to vulnerable groups during disasters is essential. Public Health Implications. Activating an incident command system improves the outcome of disasters in resource-constrained settings.

Malaria on a military peacekeeping operation: a case study with no cases.

PubMed

Houston, David J K; Tuck, Jeremy J H

2005-03-01

Malaria continues to be a disease of importance to travelers and the military is no exception. Individual protection measures based on advice, bite avoidance, chemoprophylaxis, and diagnosis are advocated for protection against the disease. However, the military has an additional strand to malaria protection--the chain of command. To describe the experience of a British military deployment where the Force Commander took a proactive approach to malaria protection. In 512 person-weeks of exposure in a theater with high rates of transmission of malaria, with an enduring threat of asymmetric military action and with a proactive approach by the chain of command to the implementation of malaria protection policy, no malaria cases developed. The chain of command can have a significant impact on compliance with malaria protection measures, which might reduce incidence of the disease in the deployed population.

Regional interoperability: making systems connect in complex disasters.

PubMed

Briggs, Susan Miller

2009-08-01

Effective use of the Incident Command System (ICS) is the key to regional interoperability. Many different organizations with different command structures and missions respond to a disaster. The ICS allows different kinds of agencies (fire, police, and medical) to work together effectively in response to a disaster. Functional requirements, not titles, determine the organizational hierarchy of the ICS structure. The ICS is a modular/adaptable system for all disasters regardless of etiology and for all organizations regardless of size.

A Uniform Approach to National Suicide Bomber Incident Response and Recovery

DTIC Science & Technology

2008-03-01

33 D. ELEMENTS OF MOTIVATION.................................................................35 E. THE TAMIL TIGER INFLUENCE...34 Ibid., 11. 35 Ibid., 8-12. 12 support of common objectives. Use of the Incident Command System (ICS) is an important element across multi... elements : • Initial strategic focus: to drive overt and covert United States forces from Muslim lands in the Near and Middle East. Covert American

AFRL Commander's Challenge 2015: stopping the active shooter

NASA Astrophysics Data System (ADS)

McIntire, John P.; Boston, Jonathan; Smith, Brandon; Swartz, Pete; Whitney-Rawls, Amy; Martinez Calderon, Julian; Magin, Jonathan

2017-05-01

In this work, we describe a rapid-innovation challenge to combat and deal with the problem of internal, insider physical threats (e.g., active shooters) and associated first-responder situation awareness on military installations. Our team's research and development effort described within focused on several key tech development areas: (1) indoor acoustical gunshot detection, (2) indoor spatial tracking of first responders, (3) bystander safety and protection, (4) two-way mass alerting capability, and (5) spatial information displays for command and control. The technological solutions were specifically designed to be innovative, low-cost, and (relatively) easy-to-implement, and to provide support across the spectrum of possible users including potential victims/bystanders, first responders, dispatch, and incident command.

7 CFR 4279.155 - Loan priorities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... natural resource value-added product (2 points). (iii) Occupations. The priority score for occupations... natural disaster or experiencing fundamental structural changes in its economic base (5 points). (iv... for the following: (A) Business that offers high value, specialized products and services that command...

7 CFR 4279.155 - Loan priorities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... natural resource value-added product (2 points). (iii) Occupations. The priority score for occupations... natural disaster or experiencing fundamental structural changes in its economic base (5 points). (iv... for the following: (A) Business that offers high value, specialized products and services that command...

7 CFR 4279.155 - Loan priorities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... natural resource value-added product (2 points). (iii) Occupations. The priority score for occupations... natural disaster or experiencing fundamental structural changes in its economic base (5 points). (iv... for the following: (A) Business that offers high value, specialized products and services that command...

7 CFR 4279.155 - Loan priorities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... natural resource value-added product (2 points). (iii) Occupations. The priority score for occupations... natural disaster or experiencing fundamental structural changes in its economic base (5 points). (iv... for the following: (A) Business that offers high value, specialized products and services that command...

Go Deeper, Go Deeper: Understanding submarine command and control during the completion of dived tracking operations.

PubMed

Roberts, Aaron P J; Stanton, Neville A; Fay, Daniel T

2018-05-01

This is a world's first-of-a-kind study providing empirical evidence for understanding submarine control room performance when completing higher and lower demand Dived Tracking (DT) scenarios. A submarine control room simulator was built, using a non-commercial version of Dangerous Waters as the simulation engine. The creation of networked workstations allowed a team of nine operators to perform tasks completed by submarine command teams during DT. The Event Analysis of Systemic Teamwork (EAST) method was used to model the social, task and information networks and describe command team performance. Ten teams were recruited for the study, affording statistical comparisons of how command team roles and level of demand affected performance. Results indicate that command teams can covertly DT a contact differently depending on demand (e.g. volume of contacts). In low demand it was possible to use periscope more often than in high demand, in a 'duck-and-run' fashion. Therefore, the type of information and frequency of particular task completion, was significantly different between the higher and lower demand conditions. This resulted in different operators in the command team experiencing greater demand depending on how the DT mission objective was completed. Potential bottlenecks in the command team were identified and implications are discussed alongside suggestions for future work. Copyright © 2018 Elsevier Ltd. All rights reserved.

Agility through Automated Negotiation for C2 Services

DTIC Science & Technology

2014-06-01

using this e-contract negotiation methodology in a C2 context in Brazil. We have modeled the operations of the Rio de Janeiro Command Center that will be...methodology in a C2 context in Brazil. We have modeled the operations of the Rio de Janeiro Command Center that will be in place for the World Cup (2014...through e-contracts. The scenario chosen to demonstrate this methodology is a security incident in Rio de Janeiro , host city of the next World Cup (2014

’Whiskey on the Rocks’ - The Submarine Incident off Karlskrona (’Whisky on the Rocks’ - Der U-Boot-Zwischefall vor Karlskrona),

DTIC Science & Technology

1982-04-19

kowledg tha hoediee e i sumrieoesgeufr umrednvgain sounded the arm to the "Oertogsbasstaben sic] in Karlskrona, whose chief of staff, Commander Karl...through: "Sweden--small--pfui--nothing, Soviet Union--great-- powerful ." Not quite diplomatic, but perhaps a measure of the master race mentality of...certain Soviet military people. Soviet Demonstration of Power When the alarm was sounded, all conceivable measures were taken by the Swedish commander𔃾n

Time-Of-Travel Tool Protects Drinking Water

EPA Pesticide Factsheets

The Lower Susquehanna Source Water Protection (SWP) Partnership utilizes the Incident Command Tool for Drinking Water Protection (ICWater) to support the Pennsylvania Department of Environmental Protection (PADEP) with real-time spill tracking information.

Personality Dynamics in a Military Training Command and Its Relationship to Maslow's Motivation Hierarch

ERIC Educational Resources Information Center

Trexler, Jerome T.; Schuh, Allen J.

1971-01-01

Questionnaire data pertaining to perceived need deficiencies were analyzed to test the concept of a hierarchy of need levels (Maslow's theory). Significant experimental control" differences were not found until deprivation was experienced by the experimental group. (Author)

Strategic operations planning - it's not just for wilderness! How the Strategic Operations Planner can help

Treesearch

Charles W. McHugh; Stu Hoyt; Brett Fay

2015-01-01

The Strategic Operational Planner (SOPL) wildland fire management position was created in the United States in 2009 to reflect updated terminology. SOPL merges the former Fire Use Manager positions (FUM1 and FUM2) and is now an established position within the Incident Command System. Traditionally, the FUM positions and the SOPL have been used on incidents managed for...

An Investigation of Operational Decision Making in Situ: Incident Command in the U.K. Fire and Rescue Service.

PubMed

Cohen-Hatton, Sabrina R; Butler, Philip C; Honey, Robert C

2015-08-01

The aim of this study was to better understand the nature of decision making at operational incidents in order to inform operational guidance and training. Normative models of decision making have been adopted in the guidance and training for emergency services. In these models, it is assumed that decision makers assess the current situation, formulate plans, and then execute the plans. However, our understanding of how decision making unfolds at operational incidents remains limited. Incident commanders, attending 33 incidents across six U.K. Fire and Rescue Services, were fitted with helmet-mounted cameras, and the resulting video footage was later independently coded and used to prompt participants to provide a running commentary concerning their decisions. The analysis revealed that assessment of the operational situation was most often followed by plan execution rather than plan formulation, and there was little evidence of prospection about the potential consequences of actions. This pattern of results was consistent across different types of incident, characterized by level of risk and time pressure, but was affected by the operational experience of the participants. Decision making did not follow the sequence of phases assumed by normative models and conveyed in current operational guidance but instead was influenced by both reflective and reflexive processes. These results have clear implications for understanding operational decision making as it occurs in situ and suggest a need for future guidance and training to acknowledge the role of reflexive processes. © 2015, Human Factors and Ergonomics Society.

Encounters with Racism and the International Student Experience

ERIC Educational Resources Information Center

Brown, Lorraine; Jones, Ian

2013-01-01

This article makes a contribution to the existing and extensive literature on the international student experience by reporting on the incidence of racism and religious incidents experienced by international students at a university in the south of England. Out of a survey of 153 international postgraduate students, 49 had experienced some form of…

Child maltreatment entrenched by poverty: how financial need is linked to poorer outcomes in family preservation.

PubMed

Escaravage, Jody Hearn

2014-01-01

This cross-sectional secondary data analysis examined the ecological factors influencing the outcomes of families receiving services from a local department of social services to address child maltreatment risk and incidence. The results indicated that families that experienced repeated maltreatment also experienced greater poverty and material need than families with more successful outcomes. This study highlights the responsibility of the child welfare system to address deep-seated poverty issues of families experiencing child maltreatment risk and incidence.

Workplace aggression, including bullying in nursing and midwifery: a descriptive survey (the SWAB study).

PubMed

Farrell, Gerald A; Shafiei, Touran

2012-11-01

Workplace aggression remains an important source of distress among nurses and midwives and has negative effects on staff health, patient care and organisations' reputation and fiscal health. To report on the nature and extent of workplace aggression, including bullying experienced by nurses and midwives in Victoria, Australia. A descriptive study design was chosen. The Nurses Board of Victoria posted 5000 surveys to the randomly selected registered nurses and midwives in Victoria, Australia, in 2010. The participants were asked about their experiences of violence (from clients) and bullying (from colleagues) within their most recent four working weeks. In addition, the study investigated staff actions following incidents, staff training and safety at work, and what staff believe contribute to incidents. Data analysis involved descriptive statistics, including frequencies and percentages. Chi square tests and P value were used to assess differences in categorical data. 1495 returned questionnaires were included in the study (30% response rate). Over half of the participants (52%) experienced some form of workplace aggression. Thirty-six percent experienced violence mostly from patients or their visitors/relatives and 32% experienced bullying mostly from colleagues or from their managers/supervisors. Significant differences were found between those who experienced aggression from patients and those who were bullied in respect to handling of incidents; factors thought to contribute to incidents; and organisations' handling of incidents. The study suggests that staff are less worried by patient initiated aggression compared to bullying from colleagues. For all types of aggression, respondents clearly wanted better/more realistic training, as well as enforcement of policies and support when incidents arise. Copyright © 2012 Elsevier Ltd. All rights reserved.

Policy Options to Address Crucial Communication Gaps in the Incident Command System

DTIC Science & Technology

2012-09-01

California Department of Forestry and Fire Protection COML Communications Unit Leader COMT Communication Technician EBRPD East Bay Regional Parks...Laguna Fire 1970 - One of California’s Worst Wildfires.” Available at http://www.cccarto.com/cal_wildfire/laguna/fire.html, Accessed August 10, 2012...NIMS - The Evolution of the National Incident Management System.” Fire Rescue Magazine, August 2011. 15 compatibility, and department emergency

33 CFR 160.113 - Prohibition of vessel operation and cargo transfers.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Commander or the Captain of the Port determines that the vessel's history of accidents, pollution incidents... requirements; (4) While underway, does not have at least one deck officer on the navigation bridge who is...

33 CFR 160.113 - Prohibition of vessel operation and cargo transfers.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Commander or the Captain of the Port determines that the vessel's history of accidents, pollution incidents... requirements; (4) While underway, does not have at least one deck officer on the navigation bridge who is...

33 CFR 160.113 - Prohibition of vessel operation and cargo transfers.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Commander or the Captain of the Port determines that the vessel's history of accidents, pollution incidents... requirements; (4) While underway, does not have at least one deck officer on the navigation bridge who is...

33 CFR 160.113 - Prohibition of vessel operation and cargo transfers.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Commander or the Captain of the Port determines that the vessel's history of accidents, pollution incidents... requirements; (4) While underway, does not have at least one deck officer on the navigation bridge who is...

Improving Situational Awareness for First Responders via Mobile Computing

NASA Technical Reports Server (NTRS)

Betts, Bradley J.; Mah, Robert W.; Papasin, Richard; Del Mundo, Rommel; McIntosh, Dawn M.; Jorgensen, Charles

2006-01-01

This project looks to improve first responder incident command, and an appropriately managed flow of situational awareness using mobile computing techniques. The prototype system combines wireless communication, real-time location determination, digital imaging, and three-dimensional graphics. Responder locations are tracked in an outdoor environment via GPS and uploaded to a central server via GPRS or an 802. II network. Responders can also wireless share digital images and text reports, both with other responders and with the incident commander. A pre-built three dimensional graphics model of the emergency scene is used to visualize responder and report locations. Responders have a choice of information end points, ranging from programmable cellular phones to tablet computers. The system also employs location-aware computing to make responders aware of particular hazards as they approach them. The prototype was developed in conjunction with the NASA Ames Disaster Assistance and Rescue Team and has undergone field testing during responder exercises at NASA Ames.

Using Earth Observations to Assess the Socioeconomic Impact of Human Decision Making during the Suppression of a Wildland Fire

NASA Astrophysics Data System (ADS)

Miller, V. V.; Kochanski, A.; Mandel, J.; Herr, V.; Schranz, S.

2016-12-01

This presentation will discuss the fire simulation system based on WRF-SFIRE and assimilation of satellite Active Fires detection to estimate the socio-economic impact of Earth observations and fire behavior modeling for the 2011 Las Conchas fire in New Mexico. Multiple scenarios will be developed with the WRF-SFIRE simulation based on value of information (VOI) provided by retired incident commanders, whose decision inputs will steer scenario development and simulation. The scenarios will differ according to the Earth observations available through NASA and then deemed useful to incident commanders. Each scenario will be evaluated in terms of its socio-economic impact as specified by NASA (2012) for its wildland fire program. This presentation is a proposed supplement to NASA grant NNX13AH59G Wildland Fire Behavior and Risk Forecasting, Sher Schranz, PI.

Perioperative incidents associated with internal maxillary distraction osteogenesis: a retrospective study of 20 patients.

PubMed

Kristian, Andersen; Erik, Nørholt Sven; Annelise, Küseler; John, Jensen; Klit, Pedersen Thomas

2012-12-01

This retrospective study aimed to assess the frequency and distribution of incidents encountered during the perioperative period of maxillary distraction with internal devices. The perioperative period was defined as the period between device placement and removal. Records of 20 patients treated during 2004-2011 with internal maxillary distraction osteogenesis were examined. Incidents were registered in terms of severity and need of intervention. Eighty percent of the patients experienced minor incidents, of which the most frequent were pain during activation and infections; 80% of these experienced ≥1 hard and soft tissue-related incidents, and 20% ≥1 device-related incidents. All incidents were solved with minimal or no intervention. Maxillary distraction using internal devices is a safe treatment with only minor incidents in the perioperative period. Preoperative planning and good cooperation are essential for preventing postoperative incidents. Prophylactic antibiotic treatment during the distraction period may be indicated. Copyright © 2012 Elsevier Inc. All rights reserved.

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

NSTec Environmental Restoration

Homeland Security Presidential Directive HSPD-5 requires all federal departments and agencies to adopt a National Incident Management System (NIMS)/Incident Command System (ICS) and use it in their individual domestic incident management and emergency prevention, preparedness, response, recovery, and mitigation programs and activities, as well as in support of those actions taken to assist state and local entities. This system provides a consistent nationwide template to enable federal, state, local, and tribal governments, private-sector, and nongovernmental organizations to work together effectively and efficiently to prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity, includingmore » acts of catastrophic terrorism. This document identifies the operational concepts of the Federal Radiological Monitoring and Assessment Center's (FRMAC) implementation of the NIMS/ICS response structure under the National Response Plan (NRP). The construct identified here defines the basic response template to be tailored to the incident-specific response requirements. FRMAC's mission to facilitate interagency environmental data management, monitoring, sampling, analysis, and assessment and link this information to the planning and decision staff clearly places the FRMAC in the Planning Section. FRMAC is not a mitigating resource for radiological contamination but is present to conduct radiological impact assessment for public dose avoidance. Field monitoring is a fact-finding mission to support this effort directly. Decisions based on the assessed data will drive public protection and operational requirements. This organizational structure under NIMS is focused by the mission responsibilities and interface requirements following the premise to provide emergency responders with a flexible yet standardized structure for incident response activities. The coordination responsibilities outlined in the NRP are based on the NIMS/ICS construct and Unified Command (UC) for management of a domestic incident. The NRP Nuclear/Radiological Incident Annex (NUC) further provides requirements and protocols for coordinating federal government capabilities to respond to nuclear/radiological Incidents of National Significance (INS) and other radiological incidents. When a FRMAC is established, it operates under the parameters of NIMS as defined in the NRP. FRMAC and its operations have been modified to reflect NIMS/ICS concepts and principles and to facilitate working in a Unified Command structure. FRMAC is established at or near the scene of the incident to coordinate radiological monitoring and assessment and is established in coordination with the U.S. Department of Homeland Security (DHS); the coordinating agency; other federal agencies; and state, local, and tribal authorities. However, regardless of the coordinating agency designation, U.S. Department of Energy (DOE) coordinates radiological monitoring and assessment activities for the initial phases of the offsite federal incident response through the Radiological Assistance Program (RAP) and FRMAC assets. Monitoring and assessment data are managed by FRMAC in an accountable, secure, and retrievable format. Monitoring data interpretations, including exposure rate contours, dose projections, and any requested radiological assessments are to be provided to the DHS; to the coordinating agency; and to state, local, and tribal government agencies.« less

Assessing hospital disaster preparedness: a comparison of an on-site survey, directly observed drill performance, and video analysis of teamwork.

PubMed

Kaji, Amy H; Langford, Vinette; Lewis, Roger J

2008-09-01

There is currently no validated method for assessing hospital disaster preparedness. We determine the degree of correlation between the results of 3 methods for assessing hospital disaster preparedness: administration of an on-site survey, drill observation using a structured evaluation tool, and video analysis of team performance in the hospital incident command center. This was a prospective, observational study conducted during a regional disaster drill, comparing the results from an on-site survey, a structured disaster drill evaluation tool, and a video analysis of teamwork, performed at 6 911-receiving hospitals in Los Angeles County, CA. The on-site survey was conducted separately from the drill and assessed hospital disaster plan structure, vendor agreements, modes of communication, medical and surgical supplies, involvement of law enforcement, mutual aid agreements with other facilities, drills and training, surge capacity, decontamination capability, and pharmaceutical stockpiles. The drill evaluation tool, developed by Johns Hopkins University under contract from the Agency for Healthcare Research and Quality, was used to assess various aspects of drill performance, such as the availability of the hospital disaster plan, the geographic configuration of the incident command center, whether drill participants were identifiable, whether the noise level interfered with effective communication, and how often key information (eg, number of available staffed floor, intensive care, and isolation beds; number of arriving victims; expected triage level of victims; number of potential discharges) was received by the incident command center. Teamwork behaviors in the incident command center were quantitatively assessed, using the MedTeams analysis of the video recordings obtained during the disaster drill. Spearman rank correlations of the results between pair-wise groupings of the 3 assessment methods were calculated. The 3 evaluation methods demonstrated qualitatively different results with respect to each hospital's level of disaster preparedness. The Spearman rank correlation coefficient between the results of the on-site survey and the video analysis of teamwork was -0.34; between the results of the on-site survey and the structured drill evaluation tool, 0.15; and between the results of the video analysis and the drill evaluation tool, 0.82. The disparate results obtained from the 3 methods suggest that each measures distinct aspects of disaster preparedness, and perhaps no single method adequately characterizes overall hospital preparedness.

SIG: a general-purpose signal processing program

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

Lager, D.; Azevedo, S.

1986-02-01

SIG is a general-purpose signal processing, analysis, and display program. Its main purpose is to perform manipulations on time- and frequency-domain signals. It also accommodates other representations for data such as transfer function polynomials. Signal processing operations include digital filtering, auto/cross spectral density, transfer function/impulse response, convolution, Fourier transform, and inverse Fourier transform. Graphical operations provide display of signals and spectra, including plotting, cursor zoom, families of curves, and multiple viewport plots. SIG provides two user interfaces with a menu mode for occasional users and a command mode for more experienced users. Capability exits for multiple commands per line, commandmore » files with arguments, commenting lines, defining commands, automatic execution for each item in a repeat sequence, etc. SIG is presently available for VAX(VMS), VAX (BERKELEY 4.2 UNIX), SUN (BERKELEY 4.2 UNIX), DEC-20 (TOPS-20), LSI-11/23 (TSX), and DEC PRO 350 (TSX). 4 refs., 2 figs.« less

Autonomous mobile platform for enhanced situational awareness in Mass Casualty Incidents.

PubMed

Yang, Dongyi; Schafer, James; Wang, Sili; Ganz, Aura

2014-01-01

To enhance the efficiency of the search and rescue process of a Mass Casualty Incident, we introduce a low cost autonomous mobile platform. The mobile platform motion is controlled by an Android Smartphone mounted on a robot. The pictures and video captured by the Smartphone camera can significantly enhance the situational awareness of the incident commander leading to a more efficient search and rescue process. Moreover, the active RFID readers mounted on the mobile platform can improve the localization accuracy of victims in the disaster site in areas where the paramedics are not present, reducing the triage and evacuation time.

32 CFR 536.13 - Chief, National Guard Bureau.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., National Guard Bureau (NGB), shall: (a) Ensure the designation of a point of contact for claims matters in... points of contact to the Commander USARCS. (c) Designate claims officers to investigate claims generated... area in which the claims incident occurred. ...

Decontamination Workshop for Emergency Responding Personnel How Clean is Clean Enough 12-14 September 2007

DTIC Science & Technology

2008-09-01

refers to a Medical Treatment Facility (MTF), can we assume that disrobing is sufficient? Is it possible to develop specific site clearance criteria ...o First responders , medical personnel, and the HAZMAT team o Incident Commanders o Public information officials o Hospitals and hospital networks ...clean personnel (both victims and first responders ) need to be when they are released from the incident site (or treatment facility for those that make

New York City’s First Responders: Enhancing Collaboration Between NYPD and FDNY

DTIC Science & Technology

2014-12-01

work together in programs designed to mitigate events before they occur. To accomplish this, the agencies need to develop ways for the precinct and...priority on addressing. The first chapter reviews the NYPD’s attempts to “think outside the box” in its collaborative efforts, which are designed ...the NYPD is designated as the single Incident Commander (IC) at any Chemical Biological Radiological Nuclear (CBRN) incident. In “New York City

The Benefits of Collaborative Processes for Establishing All Hazard Incident Management Teams in Urban Area Security Initiative Regions

DTIC Science & Technology

2013-09-01

incidents beyond wild land fires.15 This journal article also noted that national IMTs provided command functions at the World Trade Center on September...11, 2001, Hurricane Katrina in 2005 and search and recovery efforts following the Space Shuttle Columbia disaster.16 Because of the utility and...Management Team SWA Southwest Area SWCC Southwest Coordination Center UASI Urban Area Security Initiative UAWG Urban Area Working Group

Lessons Learned From Implementing an Incident Command System During a Local Multiagency Response to a Legionnaires' Disease Cluster in Sydney, NSW.

PubMed

Quinn, Emma; Johnstone, Travers; Najjar, Zeina; Cains, Toni; Tan, Geoff; Huhtinen, Essi; Nilsson, Sven; Burgess, Stuart; Dunn, Matthew; Gupta, Leena

2017-09-05

The incident command system (ICS) provides a common structure to control and coordinate an emergency response, regardless of scale or predicted impact. The lessons learned from the application of an ICS for large infectious disease outbreaks are documented. However, there is scant evidence on the application of an ICS to manage a local multiagency response to a disease cluster with environmental health risks. The Sydney Local Health District Public Health Unit (PHU) in New South Wales, Australia, was notified of 5 cases of Legionnaires' disease during 2 weeks in May 2016. This unusual incident triggered a multiagency investigation involving an ICS with staff from the PHU, 3 local councils, and the state health department to help prevent any further public health risk. The early and judicious use of ICS enabled a timely and effective response by supporting clear communication lines between the incident controller and field staff. The field team was key in preventing any ongoing public health risk through inspection, sampling, testing, and management of water systems identified to be at-risk for transmission of legionella. Good working relationships between partner agencies and trust in the technical proficiency of environmental health staff aided in the effective management of the response. (Disaster Med Public Health Preparedness. 2017;page 1 of 4).

Social determinants of lung cancer incidence in Canada: A 13-year prospective study.

PubMed

Mitra, Debjani; Shaw, Amanda; Tjepkema, Michael; Peters, Paul

2015-06-01

The risk of lung cancer has been shown to be inversely related to socioeconomic status (SES). Because the Canadian Cancer Registry does not contain socioeconomic data, the 1991 Canadian Census Cohort was used to study social determinants of lung cancer risk in the general Canadian population. This study examines incidence rates of lung cancer and histologic subtypes by educational attainment, income and occupation in a broadly representative sample of Canadians aged 25 or older. Data for the 1991 Canadian Census Cohort were analyzed. The cohort comprised 2,734,835 individuals, among whom 215,700 new cancer cases were diagnosed from 1991 through 2003. Age-standardized incidence rates were calculated by age, sex, and SES using the direct method. Rate ratios, rate differences, and excess incidence were also calculated. An inverse risk between lung cancer incidence and educational attainment, income and occupation emerged among men and women, and a stepped negative gradient in RRs was evident for all SES variables and age groups. If all cohort members had experienced the rate of those with a university degree, lung cancer incidence would have been 56% lower in men and 55% lower in women. If all cohort members had experienced the incidence rate of those in the highest income quintile, incidence would have been 33% lower in men and 25% lower in women. If all cohort members had experienced the rate of those in managerial occupations, incidence would have been 54% lower in men and 44% lower in women. A negative gradient in lung cancer risk was evident for all SES variables studied.

Women in the Superintendency: Barking up the Wrong Chain of Command?

ERIC Educational Resources Information Center

Wolverton, Mimi; Macdonald, R. Timothy

The U.S. may be experiencing a shortage of qualified applicants for the superintendency. Highly qualified candidates often do not want the job. Underrepresentation of women in the superintendency confounds the problem. This study was conducted to determine the most commonly exercised path to the superintendency in the Northwest. Career…

Preparing for a Crisis.

ERIC Educational Resources Information Center

Perea, Rosalie D.; Morrison, Shirley

1997-01-01

To handle unforeseen crises, Albuquerque Public Schools established a critical-incident response team with a simple, understandable chain of command. The group aims to ensure maximum safety and people' well-being, develop a districtwide crisis-response-management plan, coordinate necessary training, and collaborate with community agencies…

Gender violence: transgender experiences with violence and discrimination.

PubMed

Lombardi, E L; Wilchins, R A; Priesing, D; Malouf, D

2001-01-01

There is a pervasive pattern of discrimination and prejudice against transgendered people within society. Both economic discrimination and experiencing violence could be the result of a larger social climate that severely sanctions people for not conforming to society's norms concerning gender; as such, both would be strongly associated with each other. Questionnaires were distributed to people either through events or through volunteers, and made available upon the World Wide Web. A sample of 402 cases was collected over the span of 12 months (April 1996-April 1997). We found that over half the people within this sample experienced some form of harassment or violence within their lifetime, with a quarter experiencing a violent incident. Further investigation found that experiencing economic discrimination because one is transgendered had the strongest association with experiencing a transgender related violent incident. Economic discrimination was related to transgendered people's experience with violence. Therefore, both hate crimes legislation and employment protections are needed for transgendered individuals.

Application of Incident Command Structure to clinical trial management in the academic setting: principles and lessons learned.

PubMed

Reynolds, Penny S; Michael, Mary J; Spiess, Bruce D

2017-02-09

Clinical trial success depends on appropriate management, but practical guidance to trial organisation and planning is lacking. The Incident Command System (ICS) is the 'gold standard' management system developed for managing diverse operations in major incident and public health arenas. It enables effective and flexible management through integration of personnel, procedures, resources, and communications within a common hierarchical organisational structure. Conventional ICS organisation consists of five function modules: Command, Planning, Operations, Logistics, and Finance/Administration. Large clinical trials will require a separate Regulatory Administrative arm, and an Information arm, consisting of dedicated data management and information technology staff. We applied ICS principles to organisation and management of the Prehospital Use of Plasma in Traumatic Haemorrhage (PUPTH) trial. This trial was a multidepartmental, multiagency, randomised clinical trial investigating prehospital administration of thawed plasma on mortality and coagulation response in severely injured trauma patients. We describe the ICS system as it would apply to large clinical trials in general, and the benefits, barriers, and lessons learned in utilising ICS principles to reorganise and coordinate the PUPTH trial. Without a formal trial management structure, early stages of the trial were characterised by inertia and organisational confusion. Implementing ICS improved organisation, coordination, and communication between multiple agencies and service groups, and greatly streamlined regulatory compliance administration. However, unfamiliarity of clinicians with ICS culture, conflicting resource allocation priorities, and communication bottlenecks were significant barriers. ICS is a flexible and powerful organisational tool for managing large complex clinical trials. However, for successful implementation the cultural, psychological, and social environment of trial participants must be accounted for, and personnel need to be educated in the basics of ICS. ClinicalTrials.gov, NCT02303964 . Registered on 28 November 2014.

VAGUE: a graphical user interface for the Velvet assembler.

PubMed

Powell, David R; Seemann, Torsten

2013-01-15

Velvet is a popular open-source de novo genome assembly software tool, which is run from the Unix command line. Most of the problems experienced by new users of Velvet revolve around constructing syntactically and semantically correct command lines, getting input files into acceptable formats and assessing the output. Here, we present Velvet Assembler Graphical User Environment (VAGUE), a multi-platform graphical front-end for Velvet. VAGUE aims to make sequence assembly accessible to a wider audience and to facilitate better usage amongst existing users of Velvet. VAGUE is implemented in JRuby and targets the Java Virtual Machine. It is available under an open-source GPLv2 licence from http://www.vicbioinformatics.com/. torsten.seemann@monash.edu.

BP Reg Experiment Operations

NASA Image and Video Library

2015-04-07

ISS043E091755 (04/07/2015) --- Expedition 43 Commander Terry Virts is seen here working inside of the Columbus laboratory on the Blood Pressure Regulation (BP Reg) experiment. Astronauts returning from long-duration space flights risk experiencing dizziness or fainting when they stand immediately after returning to Earth. This has an important health risk as it reduces the potential for astronauts to safely escape from an emergency situation. BP Reg will help researchers develop appropriate countermeasures so that astronauts returning from long-duration space flights will have very low risk of experiencing dizziness or fainting when they return to Earth.

BP Reg Experiment Operations

NASA Image and Video Library

2015-04-07

ISS043E091740 (04/07/2015) --- Expedition 43 Commander Terry Virts is seen here working inside of the Columbus laboratory on the Blood Pressure Regulation (BP Reg) experiment. Astronauts returning from long-duration space flights risk experiencing dizziness or fainting when they stand immediately after returning to Earth. This has an important health risk as it reduces the potential for astronauts to safely escape from an emergency situation. BP Reg will help researchers develop appropriate countermeasures so that astronauts returning from long-duration space flights will have very low risk of experiencing dizziness or fainting when they return to Earth.

Presentation to US-Canada Bilateral Technical Working ...

EPA Pesticide Factsheets

DHS and EPA have collaborated in the development of a draft charter for Technical Working Group (TWG) to serve as the basis of negotiations of bilateral agreements with other countries. The TWG would provide a mechanism for sharing both response and R&D expertise and experience in the event of a CBRN incident. The membership of each TWG was tailored to provide appropriate support to the incident commander for the particular situation. Some of the same expertise has been engaged in response to the

32 CFR 536.24 - Delegation of investigative responsibility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Delegation of investigative responsibility. 536.24 Section 536.24 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS... the appropriate commander to investigate claims incidents arising in the ACO's designated geographic...

32 CFR 536.24 - Delegation of investigative responsibility.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 3 2014-07-01 2014-07-01 false Delegation of investigative responsibility. 536.24 Section 536.24 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS... the appropriate commander to investigate claims incidents arising in the ACO's designated geographic...

32 CFR 536.24 - Delegation of investigative responsibility.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 3 2012-07-01 2009-07-01 true Delegation of investigative responsibility. 536.24 Section 536.24 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS... the appropriate commander to investigate claims incidents arising in the ACO's designated geographic...

32 CFR 536.24 - Delegation of investigative responsibility.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Delegation of investigative responsibility. 536.24 Section 536.24 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS... the appropriate commander to investigate claims incidents arising in the ACO's designated geographic...

32 CFR 536.24 - Delegation of investigative responsibility.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 3 2013-07-01 2013-07-01 false Delegation of investigative responsibility. 536.24 Section 536.24 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS... the appropriate commander to investigate claims incidents arising in the ACO's designated geographic...

The Incident Command System: a literature review.

PubMed

Jensen, Jessica; Thompson, Steven

2016-01-01

Given the foundational and the fundamental role that the Incident Command System (ICS) is intended to play in on-scene response efforts across the United States, it is important to determine what is known about the system and how this is known. Accordingly, this study addresses the following research question: 'How has research explored the ICS?'. To probe this question, a methodological review of the scant, but widening, pool of research literature directly related to the ICS was conducted. This paper reports on the findings of the analysis related to the focus, theoretical frameworks, population and sampling, methods, results, and conclusions of the existing research literature. While undertaken using different methodological approaches, the ICS research suggests that the system may be limited in its usefulness. In addition, the paper discusses the implications of the research for the state of knowledge of the system and for the direction of future research. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

Emergency Preparedness in the Workplace: The Flulapalooza Model for Mass Vaccination.

PubMed

Swift, Melanie D; Aliyu, Muktar H; Byrne, Daniel W; Qian, Keqin; McGown, Paula; Kinman, Patricia O; Hanson, Katherine Louise; Culpepper, Demoyne; Cooley, Tamara J; Yarbrough, Mary I

2017-09-01

To explore whether an emergency preparedness structure is a feasible, efficient, and sustainable way for health care organizations to manage mass vaccination events. We used the Hospital Incident Command System to conduct a 1-day annual mass influenza vaccination event at Vanderbilt University Medical Center over 5 successive years (2011-2015). Using continuous quality improvement principles, we assessed whether changes in layout, supply management, staffing, and documentation systems improved efficiency. A total of 66 591 influenza vaccines were administered at 5 annual Flulapalooza events; 13 318 vaccines per event on average. Changes to the physical layout, staffing mix, and documentation processes improved vaccination efficiency 74%, from approximately 38 to 67 vaccines per hour per vaccinator, while reducing overall staffing needs by 38%. An unexpected finding was the role of social media in facilitating active engagement. Health care organizations can use a closed point-of-dispensing model and Hospital Incident Command System to conduct mass vaccination events, and can adopt the "Flulapalooza method" as a best practice model to enhance efficiency.

Infectious episodes before and after a marathon race.

PubMed

Ekblom, B; Ekblom, O; Malm, C

2006-08-01

The aim of this study was to investigate the incidence of self-reported infectious episodes (IE) during 3 weeks before (pre-IE) and 3 weeks after (post-IE) a marathon race and relate these figures to training status, running time, socioeconomic and demographic factors. Two questionnaires, including questions about important factors for IE incidence, were given to a representative cohort of 1694 runners (17% of all finishers) in the Stockholm Marathon 2000. Pre-IE incidence in the cohort was 17% with no difference between women and men. Post-IE incidence in the whole cohort was 19% with no significant (P>0.05) difference between women and men. The post-IE incidence in runners without a pre-IE was 16% (P>0.05 to pre-IE incidence). In the group of runners with pre-IE, 33% experienced an IE after the race also (P<0.05 to Pre-IE incidence). A logistic regression analysis showed that younger age and pre race health status and, for men only, experienced nausea during and after the race were depended factors explaining post-IE incidence. Younger runners were more prone to experience IE both before and after the race. There was no relation between training volume 6 months before the race, finishing time and socioeconomic and demographic factors and pre-IE or post-IE. This study does not support the theory of increased infection rate after exhaustive long-distance running ("The Open Window Theory") in recreational runners, but suggests that the sometimes experienced increased rate of infections among athletes can be caused by strenuous exercise too soon after an infection.

Head injury screening and intimate partner violence: A brief report.

PubMed

Gagnon, Kerry L; DePrince, Anne P

2017-01-01

Although the importance of traumatic brain injury has gained public attention in recent years, relatively little attention has been paid to head injuries among women who have experienced intimate partner violence (IPV). The present study screened for lifetime exposure to mild traumatic brain injuries (mTBIs) among a sample of women who had experienced recent IPV (median days since target incident = 26). Participants included ethnically diverse women whose IPV experiences were reported to law enforcement. Women (n = 225) were asked about injuries to the head sustained during the target IPV incident as well as over the lifetime, and related symptoms. The vast majority of women (80%) reported a lifetime head injury. More than half (56%) screened positive for mTBI, defined as at least one instance in which they experienced a change in consciousness or a period of being dazed and confused as a result of a head injury. A minority of women (13%) reported injuries to the head during the target IPV incident. Most women who had experienced a lifetime head injury reported frequent and current cognitive difficulties. These findings highlight the importance of assessing head injuries and related symptoms among women who have experienced IPV, pointing to important implications for policy and practice.

2016 Earth System Grid Federation Annual Report

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

Williams, Dean N.

The Earth System Grid Federation (ESGF) experienced a major setback in June 2015, when it experienced a security incident that brought all systems to a halt for more than half a year. However, federation developers and management committee members turned the incident into an opportunity to dramatically upgrade the system security and functionality and to develop planning and policy documents to guide ESGF evolution and success. Moreover, despite the incident, ESGF developer working teams continue to make strong and significant progress on various enhancement projects that will help ensure ESGF can meet the needs of the climate community in themore » coming years.« less

The Impact of Social Media on the Nature of Conflict, and a Commander’s Strategy for Social Media

DTIC Science & Technology

2010-04-29

Twitter has experienced tremendous growth. In Russia, the social networking site, Vkontakte has more users than Facebook. Even in the...of social media tools to organize and spread the word about the protests in the region. They used YouTube, Vkontakte (a Russian Language social

Benefits, barriers, and limitations on the use of Hospital Incident Command System.

PubMed

Shooshtari, Shahin; Tofighi, Shahram; Abbasi, Shirin

2017-01-01

Hospital Incident Command System (HICS) has been established with the mission of prevention, response, and recovery in hazards. Regarding the key role of hospitals in medical management of events, the present study is aimed at investigating benefits, barriers, and limitations of applying HICS in hospital. Employing a review study, articles related to the aforementioned subject published from 1995 to 2016 were extracted from accredited websites and databases such as PubMed, Google Scholar, Elsevier, and SID by searching keywords such as HICS, benefits, barriers, and limitations. Then, those articles were summarized and reported. Using of HICS can cause creating preparedness in facing disasters, constructive management in strategies of controlling events, and disasters. Therefore, experiences indicate that there are some limitations in the system such as failure to assess the strength and severity of vulnerabilities of hospital, no observation of standards for disaster management in the design, constructing and equipping hospitals, and the absence of a model for evaluating the system. Accordingly, the conducted studies were investigated for probing the performance HICS. With regard to the role of health in disaster management, it requires advanced international methods in facing disasters. Using accurate models for assessing, the investigation of preparedness of hospitals in precrisis conditions based on components such as command, communications, security, safety, development of action plans, changes in staff's attitudes through effective operational training and exercises and creation of required maneuvers seems necessary.

Express railway disaster in Amagasaki: a review of urban disaster response capacity in Japan.

PubMed

Nagata, Takashi; Rosborough, Stephanie N; Rosborogh, Stephanie N; VanRooyen, Michael J; Kozawa, Shuichi; Ukai, Takashi; Nakayama, Shinichi

2006-01-01

On the morning of 25 April 2005, a Japan Railway express train derailed in an urban area of Amagasaki, Japan. The crash was Japan's worst rail disaster in 40 years. This study chronicles the rescue efforts and highlights the capacity of Japan's urban disaster response. Public reports were gathered from the media, Internet, government, fire department, and railway company. Four key informants, who were close to the disaster response, were interviewed to corroborate public data and highlight challenges facing the response. The crash left 107 passengers dead and 549 injured. First responders, most of whom were volunteers, were helpful in the rescue effort, and no lives were lost due to transport delays or faulty triage. Responders criticized an early decision to withdraw rescue efforts, a delay in heliport set-up, the inefficiency of the information and instruction center, and emphasized the need for training in confined space medicine. Communication and chain-of-command problems created confusion at the scene. The urban disaster response to the train crash in Amagasaki was rapid and effective. The Kobe Earthquake and other incidents sparked changes that improved disaster preparedness in Amagasaki. However, communication and cooperation among responders were hampered, as in previous disasters, by the lack of a structured command system. Application of an incident command system may improve disaster coordination in Japan.

Command Relationships of Active and National Guard Forces During Domestic Disaster Response in California

DTIC Science & Technology

2007-06-15

is replacing the term Military Assistance to Civil Authorities ( MACA ). Emergency Management. The provision of overall operational control or...both public and private, to organize field-level incident management operations. Military Assistance to Civil Authorities ( MACA ). The broad mission of

A Wireless Local Area Network Command and Control System for Explosive Ordnance Disposal Incident Response

DTIC Science & Technology

2001-09-01

43 4. GPS ......................................................................................................44 E. POWER SUPPLY HARDWARE...44 Figure 5.6 Earthmate GPS Receiver ........................................................................................45...and 5Watts at 25 Ft Effective Range Minimum range of wireless link is 5 miles. Positional awareness System requires GPS input to determine

NOAA Homeland Security Program Office

Science.gov Websites

Emergency Managment Institute IS 100.b - Introduction to Incident Command System IS 700.a - NIMS An Introduction IS 701.b - NIMS Multiagency Coordination System (MACS) Course IS 800.b - National Response Framework, An Introduction United States Coast Guard; Maritime Domain Awareness Privacy Act Statement

Apollo 16 Mission: Oxidizer Deservicing Tank Failure. No. 1; Anomaly Report

NASA Technical Reports Server (NTRS)

1972-01-01

An explosive failure of a ground support equipment decontamination unit tank occurred during the postflight deactivation of the oxidizer (nitrogen tetroxide) portion of the Apollo 16 command module reaction control system. A discussion of the significant aspects of the incident and conclusions are included.

Incidence of work injuries amongst Danish adolescents and their association with work environment factors.

PubMed

Rasmussen, Kurt; Hansen, Claus D; Nielsen, Kent J; Andersen, Johan H

2011-02-01

The objective was to examine the incidence of work accidents that required medical attention among Danish adolescents and to identify possible work environment factors associated with such accidents. We collected information in two questionnaire rounds (2004 and 2007) from a birth cohort comprising all adolescents born in 1989 (n = 3,687) living in Ringkjøbing County, Denmark. The questionnaire contained items on self-reported number of accidents and number of working hours in both rounds and on work environment factors in the second round. Approximately 5% of the adolescents who held a job, experienced a work injury at the age of 17. This equals an incidence of 65 accidents per million working hours. Most adolescents had decent working conditions, although nearly half reported that their work was heavy, monotonous or psychologically demanding. Heavy work, high psychological demands and low social support increased the risk of experiencing work injuries after adjustment for a number of factors. The incidence of work injuries among adolescents appears to be higher than the incidence among their older colleagues. Lack of social support from management significantly raised adolescents' risk of experiencing a work injury. This suggests that more direct supervision may be a good way of preventing accidents in this age group. Copyright © 2010 Wiley-Liss, Inc.

Returning home: forced conscription, reintegration, and mental health status of former abductees of the Lord's Resistance Army in northern Uganda

PubMed Central

Pham, Phuong N; Vinck, Patrick; Stover, Eric

2009-01-01

Background Since the late 1980s, the Lord's Resistance Army (LRA), a spiritualist rebel group in northern Uganda, has killed and mutilated thousands of civilians and abducted an estimated 52,000 to 75,000 people to serve as soldiers, porters, and sex slaves for its commanders. This study examines the types of violence to which former abductees have been exposed and the extent to which these acts have affected their psychological well-being. Methods This is a cross-sectional study of 2,875 individuals selected through a multi-stage stratified cluster sampling design conducted in 8 districts of northern Uganda. Multivariate logistic regressions were performed with symptoms for Post-traumatic Stress Disorder (PTSD) and depression as the main outcome measures. Results One-third of the respondents (33%) self-reported having experienced abduction (49% among the Acholi, the largest tribal group in northern Uganda). Over half (56%) of all the respondents and over two-thirds of those who experienced abduction met the criteria for symptoms of post-traumatic stress disorder (PTSD). Multivariate analysis shows that several factors increased the risk of former LRA abductees developing symptoms of PTSD. These factors included gender (females were more susceptible than males), being a member of the Acholi ethnic group, participating in or witnessing a cumulative number of traumatic events, and encountering difficulties re-integrating into communities after abduction. Factors associated with increased risk of meeting criteria for symptoms of depression included older age of males at the time of abduction, lower score on social relationship scale, high incidence of general traumatic event exposure, high incidence of forced acts of violence, and problems reintegrating into communities after abduction. Conclusion Abduction and forced conscription of civilians has affected the psychological well-being of a significant number of northern Ugandans. The sources of psychological trauma are multiple, ranging from witnessing to being forced to commit violent acts, and compounded by prolonged exposure to violence, often for months or years. Community-based mental health care services and reintegration programs are needed to facilitate the reintegration of former abductees back into their communities. PMID:19445689

Methods of instruction of the incident command system and related topics at US veterinary schools.

PubMed

Smith, Joe S; Kuldau, Gretchen A

2014-12-01

The Incident Command System (ICS) is an adaptable construct designed to streamline response efforts to a disaster or other incident. We aimed to examine the methods used to teach the ICS at US veterinary schools and to explore alternative and novel methods for instruction of this material. A total of 29 US accredited veterinary schools (as of February 2012) were surveyed, and 18 of the 29 schools responded. The ICS and related topics were taught by both classroom methods and online instruction by most of the surveyed schools. Several of the schools used readily available Federal Emergency Management Agency and US Department of Agriculture resources to aid in instruction. Most schools used one course to teach the ICS, and some schools also used unique methods such as field exercises, drills, side-by-side training with disaster response teams, elective courses, extracurricular clubs, and externships to reinforce the ICS and related topics. Some of the surveyed institutions also utilized fourth-year clinical rotations and field deployments during actual disasters as a component of their ICS and emergency response curriculum. The ICS is being taught at some form at a significant number of US veterinary schools. Additional research is needed to evaluate the efficacy of the teaching methods of the ICS in US veterinary schools.

Integrating an incident management system within a continuity of operations programme: case study of the Bank of Canada.

PubMed

Loop, Carole

2013-01-01

Carrying out critical business functions without interruption requires a resilient and robust business continuity framework. By embedding an industry-standard incident management system within its business continuity structure, the Bank of Canada strengthened its response plan by enabling timely response to incidents while maintaining a strong focus on business continuity. A total programme approach, integrating the two disciplines, provided for enhanced recovery capabilities. While the value of an effective and efficient response organisation is clear, as demonstrated by emergency events around the world, incident response structures based on normal operating hierarchy can experience unique challenges. The internationally-recognised Incident Command System (ICS) model addresses these issues and reflects the five primary incident management functions, each contributing to the overall strength and effectiveness of the response organisation. The paper focuses on the Bank of Canada's successful implementation of the ICS model as its incident management and continuity of operations programmes evolved to reflect current best practices.

Homeland security and the non-federal healthcare sector: evaluation of your incident command system (ICS).

PubMed

Blair, James D

2005-01-01

Healthcare and other private sector industries have lagged behind federal agencies in fulfilling their security readiness mission, according to the author. A comprehensive and timely resource is now available, he reports, to help healthcare officials in improving emergency response and preparedness.

32 CFR 750.2 - Investigations: In general.

Code of Federal Regulations, 2011 CFR

2011-07-01

... give rise to a claim against the United States shall include the following: This investigation has been... command where the incident giving rise to the claim is alleged to have happened is responsible for... result in a claim against or in favor of the United States shall be promptly and thoroughly investigated...

Radiofrequency/Microwave Radiation Biological Effects and Safety Standards: A Review

DTIC Science & Technology

1994-06-01

reported that a 50 year old woman had developed cataracts after intermittent exposure to a 2.45 GHz microwave oven. The incident power density levels were...include: Survelance, Communications, Command and Control, Intelligence, Signal Processing, Computer Sience and Technology, Electrom Technology, Photoracs and laiity Saences. S* I l I

DOD Civil Support During the 2007 and 2008 California Wildland Fires

DTIC Science & Technology

2009-11-13

removing DOD assets from the electric grid so that the electricity could be used elsewhere. We reviewed:  prior audits;  the Stafford Act...42, section 1856a. Understanding the distinction between a local incident invo lving local mil itary commanders and local civilian officia ls verses

The Incidence of Posttraumatic Stress Disorder After Floods: A Meta-Analysis.

PubMed

Chen, Long; Liu, Aizhong

2015-06-01

This study analyzes the incidence of posttraumatic stress disorder (PTSD) among flood victims, between different flood intensities, and between different time points after a flood. A search of several electronic literature databases was conducted to collect data on the incidence of PTSD after a flood. Loney criteria for research quality were used to evaluate the quality of selected search results. The combined incidence of PTSD was estimated using the Freeman-Tukey double arcsine transformation method. Subgroup analyses were conducted on different trauma intensities and different time points after a flood. Sensitivity analysis was performed to evaluate the impact of research quality. Fourteen articles were included in this meta-analysis, including a total of 40 600 flood victims; 3862 victims were diagnosed with PTSD. The combined incidence of PTSD was 15.74%. The subgroup analyses showed that the incidence of PTSD in victims who experienced severe and moderate flood intensity was higher than that in victims who experienced mild flood intensity. The incidence of PTSD was lower at 6 or more months after a flood (11.45%) than within 6 months (16.01%) of a flood. In conclusion, the incidence of PTSD among floods of different trauma intensities was statistically significant.

Pilot reports of disorientation across 14 years of flight.

NASA Technical Reports Server (NTRS)

Clark, B.

1971-01-01

The purpose of this study was to compare recent incidents involving disorientation in flight reported by 336 Air Force, Army, and Navy pilots with incidents reported by 137 pilots in 1956. The pilots reported their experiences using a check list and a written description of an experience with disorientation in the aircraft they were flying at the time. The latter included 40 incidents which occurred in support of operations in Vietnam. The reports of disorientation showed a striking similarity across types of aircraft flown over 14 years of flying, as well as with the incidents occurring in Vietnam. However, some variation in reports between aircraft types was noted. These reports of disorientation suggest that disorientation is currently experienced in a wide variety of flight operations and that it will continue to be experienced by aircraft pilots.

The Efficacy of Cognitive Shock

DTIC Science & Technology

2015-05-21

as the doctrinal forms of tempo, momentum, and simultaneity are described in self - referential terms of operating against an enemy. This exploration...will process events different then those physically experiencing them. The manner in which time and space are processed , interpreted, and utilized...command and control nodes, logistics, and other capabilities not in direct contact with friendly forces.” Time retains an inward, self -oriented focus

Tumbling and spaceflight: the Gemini VIII experience.

PubMed

Mohler, S R; Nicogossian, A E; McCormack, P D; Mohler, S R

1990-01-01

A malfunctioning orbital flight attitude thruster during the flight of Gemini VIII led to acceleration forces on astronauts Neil Armstrong (commander) and David Scott (pilot) that created the potential for derogation of oculo-vestibular and eye-hand coordination effects. The spacecraft attained an axial tumbling rotation of 50 rpm and would have exceeded this had not the commander accurately diagnosed the problem and taken immediate corrective action. By the time counter-measure controls were applied, both astronauts were experiencing vertigo and the physiological effects of the tumbling acceleration. Data from the recorders reveal that one astronaut experienced -Gy of 0.92 G-units, and the other +Gy of 0.92 for approximately 46 s. Both received a -Gz of 0.89 G-units from the waist up with a +Gz of 0.05 from the waist down. A substantial increase of time and/or an increase in rpm would ultimately have produced incapacitation of both astronauts. NASA corrected the Gemini thruster problem by changing the ignition system wiring. Future space-craft undertaking long-term missions could be equipped with unambiguous thruster fault displays and could have computer-controlled automatic cutoffs to control excessive thruster burns.

Force Protection for Fire Fighters: Warm Zone Operations at Paramilitary Style Active Shooter Incidents in a Multi-Hazard Environment as a Fire Service Core Competency

DTIC Science & Technology

2012-03-01

weapon. The paramilitary style assault by two students at Columbine High School in 1999 revealed serious shortcomings in the fire service “standby...1158 hours, four of those students were still lying on the lawn in front of the school cafeteria . Even though the scene was not secure, paramedics...Lance Kirklin, one of the severely injured students rescued from in front of the cafeteria , briefly stopped at the incident command post en route to

Incident Command Systems: Because Life Happens

ERIC Educational Resources Information Center

Isaac, Gayle; Moore, Brian

2011-01-01

Preparing for every possible contingency seems daunting, but with teamwork and some help from the government, it's almost do-able. There is a great system out there that will help business professionals and educators develop a strong, effective emergency preparedness plan. If they haven't done a good job of implementing a solid emergency response…

75 FR 37712 - Temporary Suspension of Certain Oil Spill Response Time Requirements To Support Deepwater Horizon...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

.... (Memorandum from Rear Admiral J.A. Watson, FOSC BP Deepwater Horizon Oil Spill, to National Incident Command... Temporary Suspension of Certain Oil Spill Response Time Requirements To Support Deepwater Horizon Oil Spill... Protection Agency (EPA) temporary interim rule will suspend oil spill response time requirements, and certain...

Emergency Preparedness in the Workplace: The Flulapalooza Model for Mass Vaccination

PubMed Central

Aliyu, Muktar H.; Byrne, Daniel W.; Qian, Keqin; McGown, Paula; Kinman, Patricia O.; Hanson, Katherine Louise; Culpepper, Demoyne; Cooley, Tamara J.; Yarbrough, Mary I.

2017-01-01

Objectives. To explore whether an emergency preparedness structure is a feasible, efficient, and sustainable way for health care organizations to manage mass vaccination events. Methods. We used the Hospital Incident Command System to conduct a 1-day annual mass influenza vaccination event at Vanderbilt University Medical Center over 5 successive years (2011–2015). Using continuous quality improvement principles, we assessed whether changes in layout, supply management, staffing, and documentation systems improved efficiency. Results. A total of 66 591 influenza vaccines were administered at 5 annual Flulapalooza events; 13 318 vaccines per event on average. Changes to the physical layout, staffing mix, and documentation processes improved vaccination efficiency 74%, from approximately 38 to 67 vaccines per hour per vaccinator, while reducing overall staffing needs by 38%. An unexpected finding was the role of social media in facilitating active engagement. Conclusions. Health care organizations can use a closed point-of-dispensing model and Hospital Incident Command System to conduct mass vaccination events, and can adopt the “Flulapalooza method” as a best practice model to enhance efficiency. PMID:28892449

Pilot study on identification of incidents in healthcare transitions and concordance between medical records and patient interview data

PubMed Central

van Melle, Marije A; Erkelens, Daphne C A; van Stel, Henk F; de Wit, Niek J; Zwart, Dorien L M

2016-01-01

Objective To investigate whether transitional incidents can be identified from the medical records of the general practitioners and the hospital and to assess the concordance of transitional incidents between medical records and patient interviews. Design A pilot study. Setting The study was conducted in 2 regions in the Netherlands: a rural and an urban region. Participants A purposeful sample of patients who experienced a transitional incident or are at high risk of experiencing transitional incidents. Main outcome measures Transitional incidents were identified from both the interviews with patients and medical records and concordance was assessed. We also classified the transitional incidents according to type, severity, estimated cause and preventability. Results We identified 28 transitional incidents within 78 transitions of which 3 could not be found in the medical records and another 5 could have been missed without the patient as information source. To summarise, 8 (29%) incidents could have been missed using solely medical records, and 7 (25%) using the patients’ information exclusively. Concordance in transitional incidents between patient interviews and medical records was 64% (18/28). The majority of the transitional incidents were unsafe situations; however, 43% (12/28) of the incidents reached the patient and 18% (5/28) caused temporary patient harm. Over half of the incidents were potentially preventable. Conclusions This pilot study suggests that the majority of transitional incidents can be identified from medical records of the general practitioner and hospital. With this information, we aim to develop a measurement tool for transitional incidents in the medical record of general practitioner and hospital. PMID:27543588

Incidence, trends and severity of primary postpartum haemorrhage in Australia: A population-based study using Victorian Perinatal Data Collection data for 764 244 births.

PubMed

Flood, Margaret; McDonald, Susan J; Pollock, Wendy; Cullinane, Fiona; Davey, Mary-Ann

2018-05-22

Increasing incidence and severity of postpartum haemorrhage, together with postpartum haemorrhage-associated morbidities, have been reported in many high-resource countries. In-depth analysis of such factors in Victorian births since 2002 was lacking. Our aim was to determine the incidence and trends for primary postpartum haemorrhage (World Health Organization and International Classification of Diseases 10th revision, Australian Modification definitions) for all confinements in Victoria, Australia, for the years 2003-2013 and the incidence and trends for severe postpartum haemorrhage (≥1500 mL) for 2009-2013. In this population-based cross-sectional study de-identified data from the Victorian Perinatal Data Collection were analysed for confinements (excluding terminations) from 2003 to 2013 (n = 764 244). Perinatal information for all births ≥20 weeks (or of at least 400 g birthweight if gestation was unknown) were prospectively collected. One in five women (21.8%) who gave birth between 2009 and 2013 experienced a primary postpartum haemorrhage and one in 71 women (1.4%) experienced a severe primary postpartum haemorrhage. The increasing trends in incidence of primary postpartum haemorrhage, severe primary postpartum haemorrhage, blood transfusion, admission to an intensive care or high dependency unit and peripartum hysterectomy were significant (P < 0.001). Women who had an unassisted vaginal birth had the lowest incidence of primary postpartum haemorrhage. The highest incidence was experienced by women who had an unplanned caesarean section birth. Women who had a forceps birth had the highest incidence of severe primary postpartum haemorrhage. The incidence of primary postpartum haemorrhage, severe primary postpartum haemorrhage and associated maternal morbidities have increased significantly over time in Victoria. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Forensic reconstruction of two military combat related shooting incidents using an anatomically correct synthetic skull with a surrogate skin/soft tissue layer.

PubMed

Mahoney, Peter; Carr, Debra; Harrison, Karl; McGuire, Ruth; Hepper, Alan; Flynn, Daniel; Delaney, Russ J; Gibb, Iain

2018-03-07

Six synthetic head models wearing ballistic protective helmets were used to recreate two military combat-related shooting incidents (three per incident, designated 'Incident 1' and 'Incident 2'). Data on the events including engagement distances, weapon and ammunition types was collated by the Defence Science and Technology Laboratory. The models were shot with 7.62 × 39 mm ammunition downloaded to mean impact velocities of 581 m/s (SD 3.5 m/s) and 418 m/s (SD 8 m/s), respectively, to simulate the engagement distances. The damage to the models was assessed using CT imaging and dissection by a forensic pathologist experienced in reviewing military gunshot wounds. The helmets were examined by an MoD engineer experienced in ballistic incident analysis. Damage to the helmets was consistent with that seen in real incidents. Fracture patterns and CT imaging on two of the models for Incident 1 (a frontal impact) were congruent with the actual incident being modelled. The results for Incident 2 (a temporoparietal impact) produced realistic simulations of tangential gunshot injury but were less representative of the scenario being modelled. Other aspects of the wounds produced also exhibited differences. Further work is ongoing to develop the models for greater ballistic injury fidelity.

Incidence of laminitis and survey of dietary and management practices in pleasure horses and ponies in south-eastern Australia.

PubMed

Potter, S J; Bamford, N J; Harris, P A; Bailey, S R

2017-10-01

The aims of this study were to (1) report the incidence of laminitis among a population of horses and ponies attending Pony Clubs in Victoria, Australia, and (2) describe the dietary and management practices of the sample population. Researchers visited 10 Pony Clubs over a 10-month period. Horse and pony owners completed a questionnaire to provide information on management relating to diet and exercise. Owners were also asked to report their animal's history of laminitis, if any. From a survey population of 233 horses and ponies, 15.0% of animals (35 individuals) were reported to have suffered from at least one episode of laminitis. Of the animals that had suffered from laminitis, more than half had experienced multiple episodes. The majority of previously laminitic horses and ponies (71.4%) had not experienced an episode of laminitis within the past 12 months; however, 14.2% had experienced an incident within the past month. The proportion of ponies affected by laminitis (31/142; 21.8%) was significantly higher (P < 0.001) than the proportion of horses affected by laminitis (4/91; 4.4%). The incidence of laminitis within the pony group sampled was 6.5 cases per 100 pony years, while the incidence in horses was 0.55 cases per 100 horse years. This study provided information on the incidence of laminitis in the general population of pleasure horses and ponies in south-eastern Australia. It also provided an overview of dietary and management practices. Given the high incidence of animals that had been affected by laminitis (and the associated welfare implications), this study highlights the importance of owner education regarding appropriate feeding and management strategies to reduce the risk of laminitis. © 2017 Australian Veterinary Association.

Childhood betrayal trauma and self-blame appraisals among survivors of intimate partner abuse.

PubMed

Babcock, Rebecca L; DePrince, Anne P

2012-01-01

Child abuse perpetrated by a close other, such as a parent, is linked to a wide range of detrimental effects, including an increased risk of self-blame. The current study evaluated whether experiences of childhood betrayal trauma were linked to self-blame following victimization in adulthood. A diverse sample of women (n = 230) from an urban city were recruited based on having experienced an incident of intimate partner abuse (IPA) reported to the local police. Women reported on their trauma histories and levels of self-blame for the target IPA incident. Results showed that a history of childhood betrayal trauma exposure predicted the degree of self-blame for the IPA incident. Women who experienced severe IPA during the target incident also indicated higher levels of self-blame. Findings from this study suggest that it may be important to target self-blame appraisals in interventions with adults exposed to abuse in childhood.

Does clinical incident seriousness and receipt of work-based support influence mood experienced by nurses at work? A behavioural diary study.

PubMed

Jones, Martyn C; Johnston, Derek W

2012-08-01

While the relationship between general perceptions of the work environment and negative mood is well detailed, little is known about the effect of specific clinical incident characteristics on the mood experienced at work by nurses. This study examines the effect of incident seriousness and receipt of work-based support in the worst event of a shift from managers and colleagues on the Negative and Positive Affect experienced by nurses at work. We approached the total cohort of medical and surgical nurses in 4 large district general hospitals in England, 17% volunteered. Some 171 nurses filled end of shift and standard entry (every 90 min) computerised behavioural diaries over three consecutive shifts. The diaries measured Incident Seriousness, Receipt of Managerial and Co-worker Support, Negative Affect and Positive Affect. Results were analysed using multilevel modelling (MLwiN 2.19). Following the worst clinical incident of a shift, nurses reported higher Negative Affect (β=1.28, [95%CI: 0.12, 2.45], z=2.17, p<.05) and lower Positive Affect (β=-2.39, [95%CI: -3.96, -0.82], z=2.99, p<.005) which persisted for the remainder of the shift. Most critically, Negative Affect was more elevated after serious incidents (β=0.07, [95%CI: 0.04, 0.10], z=3.5, p<.005). Nurses who reported Receipt of Managerial Support following an incident reported significantly lower levels of Positive Affect compared to those reporting no such contact (β=-5.30, [95%CI: -9.51, -1.09], z=2.47, p<.05). The interaction between Incident and the Receipt of Work-Based Support on NA was not significant (β=2.34 [95%CI: -0.82, 3.95], z=1.45, p>.05). Receipt of Colleague Support had no relationship with Negative Affect or Positive Affect. Free text reports mainly revealed the negative impact of managerial support, although there were instances of contact with managers which were sought following exposure to difficult clinical situations. Serious clinical incidents have enduring effects on Negative Affect and Positive Affect for the remainder of the shift. Nurse Positive Affect was significantly worse following the worst clinical incident of shift when managerial support was received. Further research is required to determine the positive and negative effects of managerial support on the mood experienced by nurses at work. Copyright © 2012 Elsevier Ltd. All rights reserved.

Abuse of family physicians by patients seeking controlled substances.

PubMed

Saveland, Christine; Hawker, Leisha; Miedema, Baukje; Macdougall, Peter

2014-02-01

To examine family physicians' career prevalence and monthly incidence of workplace abuse by controlled substance prescription seekers. A 4-page cross-sectional survey. A family medicine continuing medical education event in Halifax, NS. The survey was distributed to 316 family physicians attending the continuing medical education event. Career prevalence and monthly incidence of workplace abuse related to the act of prescribing controlled substances. Fifty-six percent (n = 178) of the 316 surveys were returned completed. Half the study participants were men (49%). Most study participants were in private practice and lived in Nova Scotia, and approximately half (51%) practised in urban settings. On average, the study participants had 20 years of practice experience. The career prevalence of abusive encounters related to controlled substance prescribing was divided into "minor," "major," and "severe" incidents. Overall, 95% of study participants reported having experienced at least 1 incident of minor abuse; 48% had experienced at least 1 incident of major abuse; and 17% had experienced at least 1 incident of severe abuse during their careers. Further, 30% reported having been abused in the past month; among those, the average number of abusive encounters was 3. Most (82%) of the abusers were male with a history of addiction (85%) and mental illness (39%). Opioids were the most frequently sought controlled substance. Abuse of family physicians by patients seeking controlled substances is substantial. Family physicians who prescribe controlled substances are at risk of being subjected to minor, major, or even severe abuse. Opioids were the most often sought controlled substance. A national discussion to deal with this issue is needed.

DSN human factors project

NASA Technical Reports Server (NTRS)

Chafin, R. L.; Martin, T. H.

1980-01-01

The project plan was to hold focus groups to identify the factors influencing the ease of use characteristics of software and to bond the problem. A questionnaire survey was conducted to evaluate those factors which were more appropriately measured with that method. The performance oriented factors were analyzed and relationships hypothesized. The hypotheses were put to test in the experimental phase of the project. In summary, the initial analysis indicates that there is an initial performance effect favoring computer controlled dialogue but the advantage fades fast as operators become experienced. The user documentation style is seen to have a significant effect on performance. The menu and prompt command formats are preferred by inexperienced operators. The short form mnemonic is least favored. There is no clear best command format but the short form mnemonic is clearly the worst.

Nonlethal weapons as force options for the Army

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

Alexander, J.B.

This paper suggests that future challenges to US national security will be very different from those previously experienced. In a number of foreseeable circumstances, conventional military force will be inappropriate. The National Command Authority, and other appropriate levels of command, need expanded options available to meet threats for which the application of massive lethal force is counterproductive or inadvisable. It is proposed that nonlethal concepts be developed that provide additional options for military leaders and politicians. Included in this initiative should be exploration of policy, strategy, doctrine, and training issues as well as the development of selected technologies and weapons.more » In addition, civilian law enforcement agencies have similar requirements for less-than-lethal systems. This may be an excellent example for a joint technology development venture.« less

Corporate crisis management managing a major crisis in a chemical facility.

PubMed

Marwitz, Steve; Maxson, Neil; Koch, Bill; Aukerman, Todd; Cassidy, Jim; Belonger, David

2008-11-15

Chemical sites should have well trained and organized emergency response plans to manage an incident within the plant or during transport. The implementation of an incident command system utilizing either internal resources or external response through mutual aid agreements is generally sufficient to address the direct impact of an event on the site. When the site resources become overwhelmed in addressing resulting issues such as press releases, medical advice/support, employees and family support, Agency notifications, etc, Corporate should be ready and able to respond. This paper, taken from an in-depth CCPS workshop led by the author, describes an outline for corporate assistance in the event of a major incident at a site or during transportation.

Westgate Shootings: An Emergency Department Approach to a Mass-casualty Incident.

PubMed

Wachira, Benjamin W; Abdalla, Ramadhani O; Wallis, Lee A

2014-10-01

At approximately 12:30 pm on Saturday September 21, 2013, armed assailants attacked the upscale Westgate shopping mall in the Westlands area of Nairobi, Kenya. Using the seven key Major Incident Medical Management and Support (MIMMS) principles, command, safety, communication, assessment, triage, treatment, and transport, the Aga Khan University Hospital, Nairobi (AKUH,N) emergency department (ED) successfully coordinated the reception and care of all the casualties brought to the hospital. This report describes the AKUH,N ED response to the first civilian mass-casualty shooting incident in Kenya, with the hope of informing the development and implementation of mass-casualty emergency preparedness plans by other EDs and hospitals in Kenya, appropriate for the local health care system.

Herpes Zoster and Recurrent Herpes Zoster

PubMed Central

Toyama, Nozomu; Daikoku, Tohru; Yajima, Misako

2017-01-01

Abstract Background. The incidence of recurrent herpes zoster (HZ) and the relationship between initial and recurrent HZ are not clear. Methods. The Miyazaki Dermatologist Society has surveyed ~5000 patients with HZ annually since 1997. A questionnaire regarding HZ and its recurrence was completed by the dermatologists. Results. A total of 34 877 patients with HZ were registered at 43 clinics between June 2009 and November 2015. Among 16 784 patients seen at 10 of the 43 clinics, 1076 patients (6.41%) experienced recurrence. Herpes zoster was more frequent in female than in male patients (5.27 vs 4.25 in 1000 person-years, P < .001), as was HZ recurrence (7.63% vs 4.73%, P < .001). Two and three recurrences were observed in 49 and 3 patients, respectively. Recurrence in the same dermatome was observed in 16.3% of patients, and more frequently this occurred in the left side (P = .027). The number of HZ-experienced persons increased with age, and one third of the population had experienced HZ by the age of 80. Conclusions. Recurrent HZ was observed in 6.41% of patients, with a higher incidence in women. Moreover, HZ experience reduced the HZ incidence to 31.7% of the incidence in the HZ-naive population. PMID:28480280

Managing multiple-casualty incidents: a rural medical preparedness training assessment.

PubMed

Glow, Steven D; Colucci, Vincent J; Allington, Douglas R; Noonan, Curtis W; Hall, Earl C

2013-08-01

The objectives of this study were to develop a novel training model for using mass-casualty incident (MCI) scenarios that trained hospital and prehospital staff together using Microsoft Visio, images from Google Earth and icons representing first responders, equipment resources, local hospital emergency department bed capacity, and trauma victims. The authors also tested participants' knowledge in the areas of communications, incident command systems (ICS), and triage. Participants attended Managing Multiple-Casualty Incidents (MCIs), a one-day training which offered pre- and post-tests, two one-hour functional exercises, and four distinct, one-hour didactic instructional periods. Two MCI functional exercises were conducted. The one-hour trainings focused on communications, National Incident Management Systems/Incident Command Systems (NIMS/ICS) and professional roles and responsibilities in NIMS and triage. The trainings were offered throughout communities in western Montana. First response resource inventories and general manpower statistics for fire, police, Emergency Medical Services (EMS), and emergency department hospital bed capacity were determined prior to MCI scenario construction. A test was given prior to and after the training activities. A total of 175 firefighters, EMS, law enforcement, hospital personnel or other first-responders completed the pre- and post-test. Firefighters produced higher baseline scores than all other disciplines during pre-test analysis. At the end of the training all disciplines demonstrated significantly higher scores on the post-test when compared with their respective baseline averages. Improvements in post-test scores were noted for participants from all disciplines and in all didactic areas: communications, NIMS/ICS, and triage. Mass-casualty incidents offer significant challenges for prehospital and emergency room workers. Fire, Police and EMS personnel must secure the scene, establish communications, define individuals' roles and responsibilities, allocate resources, triage patients, and assign transport priorities. After emergency department notification and in advance of arrival, emergency department personnel must assess available physical resources and availability and type of manpower, all while managing patients already under their care. Mass-casualty incident trainings should strengthen the key, individual elements essential to well-coordinated response such as communications, incident management system and triage. The practice scenarios should be matched to the specific resources of the community. The authors also believe that these trainings should be provided with all disciplines represented to eliminate training "silos," to allow for discussion of overlapping jurisdictional or organizational responsibilities, and to facilitate team building.

Infrared Sensor on Unmanned Aircraft Transmits Time-Critical Wildfire Data

NASA Technical Reports Server (NTRS)

Pestana, Mark

2010-01-01

Since 2006, NASA fs Dryden Flight Research Center (DFRC) and Ames Research Center have been perfecting and demonstrating a new capability for geolocation of wildfires and the real-time delivery of data to firefighters. Managed for the Western States Fire Mission, the Ames-developed Autonomous Modular Scanner (AMS), mounted beneath a wing of DFRC fs MQ-9 Ikhana remotely piloted aircraft, contains an infrared sensor capable of discriminating temperatures within 0.5 F (approx. = 0.3 C), up to 1,000 F (approx. = 540 C). The AMS operates like a digital camera with specialized filters to detect light energy at visible, infrared, and thermal wavelengths. By placing the AMS aboard unmanned aircraft, one can gather information and imaging for thousands of square miles, and provide critical information about the location, size, and terrain around fires to commanders in the field. In the hands of operational agencies, the benefits of this NASA research and development effort can support nationwide wildfire fighting efforts. The sensor also provides data for post-burn and vegetation regrowth analyses. The MQ-9 Unmanned Aircraft System (UAS), a version of the Predator-B, can operate over long distances, staying aloft for over 24 hours, and controlled via a satellite-linked command and control system. This same link is used to deliver the fire location data directly to fire incident commanders, in less than 10 minutes from the time of overflight. In the current method, similarly equipped short-duration manned aircraft, with limited endurance and range, must land, hand-carry, and process data, and then deliver information to the firefighters, sometimes taking several hours in the process. Meanwhile, many fires would have moved over great distances and changed direction. Speed is critical. The fire incident commanders must assess a very dynamic situation, and task resources such as people, ground equipment, and retardant-dropping aircraft, often in mountainous terrain obscured by dense smoke.

Prospective Vigilance: Assessing Complex Coordinated Attack Preparedness Programs

DTIC Science & Technology

2017-12-01

for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and...significant challenges with incident command, strategic communication, and information management ; limitations in both training and equipment; and... information management ; limitations in both training and equipment; and inadequate response protocols.9 During the Mumbai CCA, fire and emergency

32 CFR 536.111 - Investigation of claims arising under international agreements (for those claims arising in the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Investigation of claims arising under international agreements (for those claims arising in the United States). 536.111 Section 536.111 National... for the geographic area in which the incident occurred. The Commander USARCS, an ACO, and a CPO are...

Improving Emergency Management by Modeling Ant Colonies

DTIC Science & Technology

2015-03-01

LEFT BLANK vii TABLE OF CONTENTS I.  THE INCIDENT COMMAND SYSTEM AND AUTONOMOUS ACTORS ......1  A.  PROBLEM STATEMENT...managerial level tasking.12 The Oklahoma City bombing has generally been viewed as a success for the ICS model; however, there were numerous occurrences...developed. The youngest generation of ant 25 Bert Holldobler and Edward O. Wilson, The Ants

Building a Collaborative Governance System: A Comparative Case Analysis

DTIC Science & Technology

2015-06-01

additional resources. Bandwagon effects occur. As the process emerges and appears to be achieving success, more resources are attracted. Consensus...97 C. WHAT ARE THE ENABLERS AND BARRIERS TO EFFECTIVE COLLABORATION IN THIS CASE...seems as though the challenges are getting bigger as well as more frequent, across many disciplines.”1 Effective incident response requires command

32 CFR 536.111 - Investigation of claims arising under international agreements (for those claims arising in the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 3 2013-07-01 2013-07-01 false Investigation of claims arising under international agreements (for those claims arising in the United States). 536.111 Section 536.111 National... for the geographic area in which the incident occurred. The Commander USARCS, an ACO, and a CPO are...

32 CFR 536.111 - Investigation of claims arising under international agreements (for those claims arising in the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Investigation of claims arising under international agreements (for those claims arising in the United States). 536.111 Section 536.111 National... for the geographic area in which the incident occurred. The Commander USARCS, an ACO, and a CPO are...

BpWrapper: BioPerl-based sequence and tree utilities for rapid prototyping of bioinformatics pipelines.

PubMed

Hernández, Yözen; Bernstein, Rocky; Pagan, Pedro; Vargas, Levy; McCaig, William; Ramrattan, Girish; Akther, Saymon; Larracuente, Amanda; Di, Lia; Vieira, Filipe G; Qiu, Wei-Gang

2018-03-02

Automated bioinformatics workflows are more robust, easier to maintain, and results more reproducible when built with command-line utilities than with custom-coded scripts. Command-line utilities further benefit by relieving bioinformatics developers to learn the use of, or to interact directly with, biological software libraries. There is however a lack of command-line utilities that leverage popular Open Source biological software toolkits such as BioPerl ( http://bioperl.org ) to make many of the well-designed, robust, and routinely used biological classes available for a wider base of end users. Designed as standard utilities for UNIX-family operating systems, BpWrapper makes functionality of some of the most popular BioPerl modules readily accessible on the command line to novice as well as to experienced bioinformatics practitioners. The initial release of BpWrapper includes four utilities with concise command-line user interfaces, bioseq, bioaln, biotree, and biopop, specialized for manipulation of molecular sequences, sequence alignments, phylogenetic trees, and DNA polymorphisms, respectively. Over a hundred methods are currently available as command-line options and new methods are easily incorporated. Performance of BpWrapper utilities lags that of precompiled utilities while equivalent to that of other utilities based on BioPerl. BpWrapper has been tested on BioPerl Release 1.6, Perl versions 5.10.1 to 5.25.10, and operating systems including Apple macOS, Microsoft Windows, and GNU/Linux. Release code is available from the Comprehensive Perl Archive Network (CPAN) at https://metacpan.org/pod/Bio::BPWrapper . Source code is available on GitHub at https://github.com/bioperl/p5-bpwrapper . BpWrapper improves on existing sequence utilities by following the design principles of Unix text utilities such including a concise user interface, extensive command-line options, and standard input/output for serialized operations. Further, dozens of novel methods for manipulation of sequences, alignments, and phylogenetic trees, unavailable in existing utilities (e.g., EMBOSS, Newick Utilities, and FAST), are provided. Bioinformaticians should find BpWrapper useful for rapid prototyping of workflows on the command-line without creating custom scripts for comparative genomics and other bioinformatics applications.

Occupational carbon monoxide poisoning in Washington State, 2000-2005.

PubMed

Reeb-Whitaker, Carolyn K; Bonauto, David K; Whittaker, Stephen G; Adams, Darrin

2010-10-01

Washington State workers' compensation data can be used to guide prevention efforts focused on occupational carbon monoxide (CO) poisoning. Between 2000 and 2005, a total of 345 individual claims comprising 221 different exposure incidents were identified for the 6-year time period. The construction industry had 43 (20%) CO incidents, followed by wholesale trade with 32 (15%), and agriculture with 27 (12%) incidents. Fuel-powered forklifts caused 29% of all incidents, while autos/trucks/buses were responsible for 26%. The number of forklift incidents in fruit packing and cold storage companies declined significantly from 1994 through 2007 (Spearman's rho = 0.6659, p < 0.01). While this study used multiple medical records from workers' compensation claims to identify CO poisoning, a surveillance system that lacks extensive medical records may rely principally on carboxyhemoglobin (COHb) tests. This study demonstrated that 71% of the identified workers' compensation claims had associated COHb tests. The recurrence and timing of CO poisoning as well as control of the CO-generating source were determined. Approximately 8% of all work sites had recurring CO poisoning incidents. Two percent experienced a recurrent incident within 16 days of the initial incident, and 6% experienced a recurrent incident between 16 days and 3 years after the initial incident. Sixty-seven percent of claimants exposed to CO were not in direct control of the CO-generating source; this has implications for CO prevention and underscores the need for all employees to be trained on CO hazards.

Maintenance Training Simulators Design and Acquisition: Summary of Current Procedures.

DTIC Science & Technology

1979-11-01

of maintenance training and training equipment for new systems . This organization has a core of highly experienced ISD team personnel and has evolved...S LABORATORY AIR FORCE SYSTEMS COMMAND BROOKS AIR FORCE BAbE,TEXAS 78235 ." .~ 8. . NOTI(’F When U.S. Government drawings. specifications. ot otlher...Force personirel in performning 4 Instrutinal Systems Devlopmrent (ISO) analyses to define maintenance training equipment requirements. and byv

Tried And True Integrating Active And Reserve Components

DTIC Science & Technology

2016-02-16

management, and retirement to recruit and train higher quality members.4 During his tenure from 1973 - 1975, Secretary of Defense James Schesinger...from home station to work and train with experienced maintainers in the Reserve Component. Since there are no dorms or dining facilities, young...moves disrupt family life and spouse careers. Questions arise from how the assignment process works when a commander or senior leader is removed for

Zero-gravity open-type urine receptacle

NASA Technical Reports Server (NTRS)

Girala, A. S.

1972-01-01

The development of the zero-gravity open-type urine receptacle used in the Apollo command module is described. This type receptacle eliminates the need for a cuff-type urine collector or for the penis to circumferentially contact the receptacle in order to urinate. This device may be used in a gravity environment, varying from zero gravity to earth gravity, such as may be experienced in a space station or space base.

Momentum management strategy during Space Station buildup

NASA Technical Reports Server (NTRS)

Bishop, Lynda; Malchow, Harvey; Hattis, Philip

1988-01-01

The use of momentum storage devices to control effectors for Space Station attitude control throughout the buildup sequence is discussed. Particular attention is given to the problem of providing satisfactory management of momentum storage effectors throughout buildup while experiencing variable torque loading. Continuous and discrete control strategies are compared and the effects of alternative control moment gyro strategies on peak momentum storage requirements and on commanded maneuver characteristics are described.

Implications of a Resurgent Russian Federation for U.S. European Command

DTIC Science & Technology

2011-06-10

Slovakia, Hungary, Romania , and Moldova. It also has a substantial coastline along the Black Sea. A map of Ukraine is located in Appendix A. Seventy...and is currently experiencing its longest run of sovereign independence.95 Ukraine declared independence from the Russian Empire in 1918 following...after until 1991 from Moscow and St. Petersburg. Georgia gained independence briefly in 1918 following the Russian Revolution and established a

78 FR 57839 - Request for Information on Computer Security Incident Coordination (CSIC)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-20

... Institute of Standards and Technology (NIST), United States Department of Commerce. ACTION: Notice, extension of comment period. SUMMARY: NIST is extending the deadline for submitting comments relating to Computer Security Incident Coordination. NIST experienced technical difficulties with receiving email...

Public health incident management: Logistical and operational aspects of the 2009 initial outbreak of H1N1 influenza in Mexico.

PubMed

Cruz, Miguel A; Hawk, Nicole M; Poulet, Christopher; Rovira, Jose; Rouse, Edward N

2015-01-01

Hosting an international outbreak response team can pose a challenge to jurisdictions not familiar with incident management frameworks. Basic principles of team forming, organizing, and executing mission critical activities require simple and flexible communication that can be easily understood by the host country's public health leadership and international support agencies. Familiarity with incident command system principles before a public health emergency could save time and effort during the initial phases of the response and aid in operationalizing and sustaining complex field activities throughout the response. The 2009 initial outbreak of H1N1 in Mexico highlighted the importance of adequately organizing and managing limited resources and expertise using incident management principles. This case study describes logistical and operational aspects of the response and highlights challenges faced during this response that may be relevant to the organization of public health responses and incidents requiring international assistance and cooperation.

Public health incident management: logistical and operational aspects of the 2009 initial outbreak of H1N1 influenza in Mexico.

PubMed

Cruz, Miguel A; Hawk, Nicole M; Poulet, Christopher; Rovira, Jose; Rouse, Edward N

2015-01-01

Hosting an international outbreak response team can pose a challenge to jurisdictions not familiar with incident management frameworks. Basic principles of team forming, organizing, and executing mission critical activities require simple and flexible communication that can be easily understood by the host country's public health leadership and international support agencies. Familiarity with incident command system principles before a public health emergency could save time and effort during the initial phases of the response and aid in operationalizing and sustaining complex field activities throughout the response. The 2009 initial outbreak of H1N1 in Mexico highlighted the importance of adequately organizing and managing limited resources and expertise using incident management principles. This case study describes logistical and operational aspects of the response and highlights challenges faced during this response that may be relevant to the organization of public health responses and incidents requiring international assistance and cooperation.

Effects of Command and Control Vehicle (C2V) operational environment on soldier health and performance

NASA Technical Reports Server (NTRS)

Cowings, P. S.; Toscano, W. B.; DeRoshia, C.; Tauso, R.

2001-01-01

The purpose of this project was to use NASA technology to assist the US Army in the assessment of motion sickness incidences and effects on soldier performance and mood states within the Command and Control Vehicle (C2V). Specific objectives were (1) to determine if there was a significant difference between three internal configurations of the C2V and/or between seats within these vehicles; (2) to determine if there was a significant difference between the park, move, or short-halt field conditions; and (3) to validate a method of converging indicators developed by NASA to assess environmental impact of long duration spaceflight on crewmembers, using a large sample of subjects under ground-based operational conditions.

Standardized emergency management system and response to a smallpox emergency.

PubMed

Kim-Farley, Robert J; Celentano, John T; Gunter, Carol; Jones, Jessica W; Stone, Rogelio A; Aller, Raymond D; Mascola, Laurene; Grigsby, Sharon F; Fielding, Jonathan E

2003-01-01

The smallpox virus is a high-priority, Category-A agent that poses a global, terrorism security risk because it: (1) easily can be disseminated and transmitted from person to person; (2) results in high mortality rates and has the potential for a major public health impact; (3) might cause public panic and social disruption; and (4) requires special action for public health preparedness. In recognition of this risk, the Los Angeles County Department of Health Services (LAC-DHS) developed the Smallpox Preparedness, Response, and Recovery Plan for LAC to prepare for the possibility of an outbreak of smallpox. A unique feature of the LAC-DHS plan is its explicit use of the Standardized Emergency Management System (SEMS) framework for detailing the functions needed to respond to a smallpox emergency. The SEMS includes the Incident Command System (ICS) structure (management, operations, planning/intelligence, logistics, and finance/administration), the mutual-aid system, and the multi/interagency coordination required during a smallpox emergency. Management for incident command includes setting objectives and priorities, information (risk communications), safety, and liaison. Operations includes control and containment of a smallpox outbreak including ring vaccination, mass vaccination, adverse events monitoring and assessment, management of confirmed and suspected smallpox cases, contact tracing, active surveillance teams and enhanced hospital-based surveillance, and decontamination. Planning/intelligence functions include developing the incident action plan, epidemiological investigation and analysis of smallpox cases, and epidemiological assessment of the vaccination coverage status of populations at risk. Logistics functions include receiving, handling, inventorying, and distributing smallpox vaccine and vaccination clinic supplies; personnel; transportation; communications; and health care of personnel. Finally, finance/administration functions include monitoring costs related to the smallpox emergency, procurement, and administrative aspects that are not handled by other functional divisions of incident command systems. The plan was developed and is under frequent review by the LAC-DHS Smallpox Planning Working Group, and is reviewed periodically by the LAC Bioterrorism Advisory Committee, and draws upon the Smallpox Response Plan and Guidelines of the Centers for Disease Control and Prevention (CDC) and recommendations of the Advisory Committee on Immunization Practices (ACIP). The Smallpox Preparedness, Response, and Recovery Plan, with its SEMS framework and ICS structure, now is serving as a model for the development of LAC-DHS plans for responses to other terrorist or natural-outbreak responses.

Analysis of good practice of public health Emergency Operations Centers.

PubMed

Xu, Min; Li, Shi-Xue

2015-08-01

To study the public health Emergency Operations Centers (EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Command Center in Chinese National Health and Family Planning Commission. Literature review was conducted to explore the EOCs of selected countries. The study focused on EOC function, organizational structure, human resources and information management. The selected EOCs had the basic EOC functions of coordinating and commanding as well as the public health related functions such as monitoring the situation, risk assessment, and epidemiological briefings. The organizational structures of the EOCs were standardized, scalable and flexible. Incident Command System was the widely applied organizational structure with a strong preference. The EOCs were managed by a unit of emergency management during routine time and surge staff were engaged upon emergencies. The selected EOCs had clear information management framework including information collection, assessment and dissemination. The performance of National Health Emergency Response Command Center can be improved by learning from the good practice of the selected EOCs, including setting clear functions, standardizing the organizational structure, enhancing the human resource capacity and strengthening information management. Copyright © 2015 Hainan Medical College. Production and hosting by Elsevier B.V. All rights reserved.

STS-42 Commander Grabe works with MWPE at IML-1 Rack 8 aboard OV-103

NASA Technical Reports Server (NTRS)

1992-01-01

STS-42 Commander Ronald J. Grabe works with the Mental Workload and Performance Evaluation Experiment (MWPE) (portable laptop computer, keyboard cursor keys, a two-axis joystick, and a track ball) at Rack 8 in the International Microgravity Laboratory 1 (IML-1) module. The test was designed as a result of difficulty experienced by crewmembers working at a computer station on a previous Space Shuttle mission. The problem was due to the workstation's design being based on Earth-bound conditions with the operator in a typical one-G standing position. For STS-42, the workstation was redesigned to evaluate the effects of microgravity on the ability of crewmembers to interact with a computer workstation. Information gained from this experiment will be used to design workstations for future Spacelab missions and Space Station Freedom (SSF).

Ethnic variations in incidence of asthma episodes in England & Wales: national study of 502,482 patients in primary care.

PubMed

Netuveli, Gopalakrishnan; Hurwitz, Brian; Sheikh, Aziz

2005-10-21

Recent studies have demonstrated marked international variations in the prevalence of asthma, but less is known about ethnic variations in asthma epidemiology within individual countries and in particular the impact of migration on risk of developing asthma. Recent within country comparisons have however revealed that despite originating from areas of the world with a low risk for developing asthma, South Asian and Afro-Caribbean people in the UK are significantly (3x and 2x respectively) more likely to be admitted to hospital for asthma related problems than Whites. Using data from the Fourth National Study of Morbidity Statistics in General Practice, a one-percent broadly representative prospective cohort study of consultations in general practice, we investigated ethnic variations in incident asthma consultations (defined as new or first consultations), and compared consultation rates between those born inside and outside the UK (migrant status). Logistic regression models were used to examine the combined effects of ethnicity and migration on asthma incident consultations. Results showed significantly lower new/first asthma consultation rates for Whites than for each of the ethnic minority groups studied (mean age-adjusted consultation rates per 1000 patient-years: Whites 26.4 (95%CI 26.4, 26.4); South Asians 30.4 (95%CI 30.3, 30.5); Afro-Caribbeans 35.1 (95%CI 34.9, 35.3); and Others 27.8 (27.7, 28.0). Within each of these ethnic groups, those born outside of the UK showed consistently lower rates of incident asthma consultations. Modelling the combined effects of ethnic and migrant status revealed that UK-born South Asians and Afro-Caribbeans experienced comparable risks for incident GP consultations for asthma to UK-born Whites. Non-UK born Whites however experienced reduced risks (adjusted OR 0.82, 95%CI 0.69, 0.97) whilst non-UK born South Asians experienced increased risks (adjusted OR 1.33, 95%CI 1.04, 1.70) compared to UK-born Whites. These findings strongly suggest that ethnicity and migration have significant and independent effects on asthma incidence. The known poorer asthma outcomes in UK South Asians and Afro-Caribbeans may in part be explained by the offspring of migrants experiencing an increased risk of developing asthma when compared to UK-born Whites. This is the first study to find heterogeneity for incident asthma consultations in Whites by migrant status.

Censorship and the Teacher of English: A Questionnaire Survey of a Selected Sample of Secondary School Teachers of English.

ERIC Educational Resources Information Center

Ahrens, Nyla Herber

A study designed to provide a systematic description of the incidence of censorship and the censorship incidents reported by a selected group of teachers during a specified time period is presented. Objectives are: (1) to provide some measure of the frequency of censorship incidents experienced by a sample population of teachers of English, and…

Evaluation of the Virtual Squad Training System

DTIC Science & Technology

2010-01-01

ABSTRACT (Maximum 200 words): The Virtual Squad Training System ( VSTS ) is a network of nine individual immersive simulators with Helmet-Mounted...Displays (HMDs), and a command station for controlling computer generated entities. The VSTS includes both tethered and wearable simulators. The VSTS was...affected Soldiers’ ratings of the VSTS . Simulator sickness incidence was low compared to previous evaluations of antecedent systems using HMDs

A Theory of Electromagnetic Shielding with Applications to MIL-STD-285, IEEE-299, and EMP Simulation

DTIC Science & Technology

1985-02-01

in a building sized enclosure slot-like discontinuities may not all be small compar- ed to all wavelengths in the incident field, and slot resonan ...OFFICE OF RESEARCH/ NPP US AIR FORCE SPACE COMMAND ATTN STATE & LOCAL PROG SUPPORT O ATTN KKO 500 C STREET, SW ATTN KRQ WASHINGTON, DC 20472 ATTN XPOW

Department of Defense Utilization of the Incident Command System

DTIC Science & Technology

2008-01-01

the Los Angeles City Fire Department as an Assistant Chief with...response planning for fire, rescue and EMS for the 51 .. ; 1984 Los Angeles Summer Olympics. He was worked with the Park City, Utah Fire department in...Director of Operations of the Los Angeles Fire Department Historical Society. He is a member of many organizations and associations including the

Forest Fire Advanced System Technology (FFAST): A Conceptual Design for Detection and Mapping

Treesearch

J. David Nichols; John R. Warren

1987-01-01

The Forest Fire Advanced System Technology (FFAST) project is developing a data system to provide near-real-time forest fire information to fire management at the fire Incident Command Post (ICP). The completed conceptual design defined an integrated forest fire detection and mapping system that is based upon technology available in the 1990's. System component...

Counseling Adult Women Who Experienced Incest in Childhood or Adolescence.

ERIC Educational Resources Information Center

Courtois, Christine A.; Watts, Deborah L.

1982-01-01

Discusses the definition and incidence of incest, counseling needs of incest victims, and strategies for working with women who experienced incest in childhood or adolescence. Identifies techniques and resources for individual and group counseling. Suggests counselors expand their knowledge about incest in order to offer appropriate services.…

Descriptive epidemiology of veterinary events in flat racing Thoroughbreds in Great Britain (2000 to 2013).

PubMed

Rosanowski, S M; Chang, Y M; Stirk, A J; Verheyen, K L P

2017-05-01

To date, no large scale studies have reported race-day events requiring veterinary attention in British Thoroughbreds racing on the flat. Quantifying and describing common injuries and health conditions affecting racehorses will enable targeted risk factor analysis aimed at reducing their occurrence. To describe the type and incidence of race-day veterinary events experienced by Thoroughbred racehorses participating in flat racing in the UK. Retrospective cohort study (2000 to 2013). Veterinary events recorded by race-day veterinarians were retrieved and linked to race start data. Race-day veterinary events were described by type, location and anatomical structure(s) affected and whether the outcome was fatal or not. Incidence per 1000 starts was calculated, both overall and by year. Stratified incidence rates were calculated for selected event categories by specific course- and horse-level variables. There were 7993 events experienced by 6727 horses, with an incidence of 9.37 events per 1000 starts. Soft tissue injuries other than tendon and ligament injuries were the most commonly occurring veterinary events (24.1%), followed by gait observations (21.2%) and respiratory conditions (21.2%). In total, 13.8% of events were bone injuries. The incidence of fatality (n = 628) was 0.76 per 1000 starts. Most (485/628, 77.2%) fatal events were bone injuries, 64 were due to cardiac conditions and 54 due to tendon and ligament injuries. All-weather tracks had a higher incidence of veterinary events and fatalities than turf tracks. Firmer (turf) or faster (all-weather) going were associated with a higher incidence of all veterinary events. Events were based on presumptive, rather than definitive, veterinary diagnosis. The most common events experienced by racehorses on race-day were relatively minor and not career-ending. Although more severe bone, joint, tendon and ligament injuries were less common, they had a greater impact on whether the outcome of the event was fatal. © 2016 EVJ Ltd.

An Assessment of Drug Testing within the Construction Industry.

ERIC Educational Resources Information Center

Gerber, Jonathan K.; Yacoubian, George S., Jr.

2002-01-01

Investigates the efficacy of workplace drug-testing programs in reducing injury incident rates and workers' compensation experience-rating modification factors within the construction industry. Analyses indicate that companies with drug-testing programs experienced a 51 percent reduction in incident rates within two years of implementation.…

Commonalities in Russian Military Operations in Urban Environments

DTIC Science & Technology

2003-06-06

6th Army was the Russian 62nd Siberian Army commanded by Vasili I Chuikov. The 6th Siberian Army was demoralized and depleted after a year of warfare...Battle of Stalingrad pitted untrained Russian militia and civilians against a highly trained German Army. Predictably the Russians experienced...Pennsylvania: U.S. Army War College. Chuikov, Vasili I. 1964. The Battle for Stalingrad, Trans. by: Harold Silver, New York, New York: Holt, Rhinehart and

U. S. Navy Deepening of Pinole Shoal and Mare Island Strait Regulatory Permit Application by the Commander, Mare Island Shipyard, Solano County, California.

DTIC Science & Technology

1981-07-01

1858 and 1970 513 ships, ranging from landing craft and destroyers to battleships and Polaris submarines have been launched from the Shipyard...impacts would be experienced by local wildlife, both on the site and at adjacent areas. On the other hand open space habitat enhancement of the site...and project History. .. ............. ...... 20 Sumary .. .............. ................ 1,10 Terestrial Vegetation .. ............... ........ 33

Substance use by soldiers who abuse their spouses.

PubMed

Martin, Sandra L; Gibbs, Deborah A; Johnson, Ruby E; Sullivan, Kristen; Clinton-Sherrod, Monique; Walters, Jennifer L Hardison; Rentz, E Danielle

2010-11-01

Data on 7,424 soldier spouse abuse offenders were analyzed to determine the prevalence of substance use during abusive incidents, and to examine differences between substance-using and non-substance-using offenders. Results showed that 25% of all offenders used substances during abusive incidents, with males and non-Hispanic Whites being more likely to hav e used substances. Substance-using offenders were more likely to perpetrate physical spouse abuse and more severe spouse abuse. These findings underscore the importance of educating military personnel (including commanders) about links between substance use and domestic violence, and of coordinating preventive and therapeutic substance abuse and violence-related interventions.

Incidence of hospital-acquired pressure ulcers - a population-based cohort study.

PubMed

Gardiner, Joseph C; Reed, Philip L; Bonner, Joseph D; Haggerty, Diana K; Hale, Daniel G

2016-10-01

Our study sought to estimate the association between race, gender, comorbidity and body mass index (BMI) on the incidence of hospital-acquired pressure ulcer (PU) from a population-based retrospective cohort comprising 242 745 unique patient hospital discharges in two fiscal years from July 2009 to June 2010 from 15 general and tertiary care hospitals. Cases were patients with a single inpatient encounter that led to an incident PU. Controls were patients without a PU at any encounter during the two fiscal years with the earliest admission retained for analysis. Logistic regression models quantified the association of potential risk factors for PU incidence. Spline functions captured the non-linear effects of age and comorbidity. Overall 2·68% of patients experienced an incident PU during their inpatient stay. Unadjusted analyses revealed statistically significant associations by age, gender, race, comorbidity, BMI, admitted for a surgical procedure, source of admission and fiscal year, but differences by gender and race did not persist in adjusted analyses. Interactions between age, comorbidity and BMI contributed significantly to the likelihood of PU incidence. Patients who were older, with multiple comorbidities and admitted for a surgical diagnosis-related groups (DRG) were at greater risk of experiencing a PU during their stay. © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Limitations in learning: How treatment verifications fail and what to do about it?

PubMed

Richardson, Susan; Thomadsen, Bruce

The purposes of this study were: to provide dialog on why classic incident learning systems have been insufficient for patient safety improvements, discuss failures in treatment verification, and to provide context to the reasons and lessons that can be learned from these failures. Historically, incident learning in brachytherapy is performed via database mining which might include reading of event reports and incidents followed by incorporating verification procedures to prevent similar incidents. A description of both classic event reporting databases and current incident learning and reporting systems is given. Real examples of treatment failures based on firsthand knowledge are presented to evaluate the effectiveness of verification. These failures will be described and analyzed by outlining potential pitfalls and problems based on firsthand knowledge. Databases and incident learning systems can be limited in value and fail to provide enough detail for physicists seeking process improvement. Four examples of treatment verification failures experienced firsthand by experienced brachytherapy physicists are described. These include both underverification and oververification of various treatment processes. Database mining is an insufficient method to affect substantial improvements in the practice of brachytherapy. New incident learning systems are still immature and being tested. Instead, a new method of shared learning and implementation of changes must be created. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Predictors of the frequency and subjective experience of cycling near misses: Findings from the first two years of the UK Near Miss Project.

PubMed

Aldred, Rachel; Goodman, Anna

2018-01-01

Using 2014 and 2015 data from the UK Near Miss Project, this paper examines the stability of self-report incident rates for cycling near misses across these two years. It further examines the stability of the individual-level predictors of experiencing a near miss, including what influences the scariness of an incident. The paper uses three questions asked for only in 2015, which allow further exploration of factors shaping near miss rates and impacts of incidents. Firstly, a respondent's level of cycling experience; secondly, whether an incident was perceived as deliberate; and finally, whether the respondent themselves described the incident as a 'near miss' (as opposed to only a frightening and/or annoying non-injury incident). Using this data, we find a decline of almost a third in incident rates in 2015 compared to 2014, which we believe is likely to be largely an artefact due to differences in reporting rates. This suggests caution about interpreting small fluctuations in subjectively reported near miss rates. However, in both years near miss rates are many times more frequent than injury collisions. In both years of data collection our findings are very similar in terms of the patterning of incident types, and how frightening different incident categories are, which increases confidence in these findings. We find that new cyclists experience very high incident rates compared to other cyclists, and test a conceptual model explaining how perceived deliberateness, near-miss status, and scariness are connected. For example, incidents that are perceived to be deliberate are more likely to be experienced as very frightening, independent of their 'near miss' status. Copyright © 2017 Elsevier Ltd. All rights reserved.

King has no clothes: The role of the military in responding to a terrorist chemical/biological attack. Final report

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

Osterman, J.L.

1996-06-14

The United States has begun a program of counterproliferation in order to preempt the use of WMD by such elements, however, the ability to respond to the terrorist employment of biological/chemical weapons is absent. Given the structure, capability and technical expertise in the Federal Emergency Management Agency (FEMA) and the Federal Bureau of Investigation (FBI), the Department of Defense (DoD) will be tasked to conduct the response to such an incident. The geographical Commander in Chief (CINC) and the appointed Joint Task Force (JTF) commander will ultimately be assigned the response mission. Planning, training and coordination is required to developmore » a force capable of responding in a timely and coordinated manner.« less

Game-specific characteristics of sport-related concussions.

PubMed

Helmich, Ingo

2018-01-01

Concussions are common incidences in sports. However, game-specific characteristics such as tactics, field positions, etc. might positively/negatively contribute to the occurrence of mild traumatic brain injuries (mTBI) in various sports such as soccer, volleyball, handball, or basketball. Thus, the intention of this study was to analyze game-specific characteristics of concussive incidents in active players from the perspective of different sportive disciplines. Four sport-specific questionnaires for soccer, handball, volleyball and basketball were established using an online survey tool. A total of 3001 participants completed the questionnaires. 18% of the participants answered that they had experienced a concussion which significantly differed depending on the sport practiced (χ2(3)=56.868, P<0.001; soccer 25%, handball 24%, volleyball 13%, basketball 15%). Whereas handball and soccer players experienced most concussions on the amateur level, volleyball players experienced most on the professional level and basketball players during leisure play (χ2(9)=112.667, P<0.001). Soccer players experienced most concussions by a collision with another player, volleyball players instead experienced most concussions by hits from the ball (χ2(6)=211.260, P<0.001). In soccer, goalkeepers and defensive midfield players showed most concussive incidences (χ2(7)=19.638, P<0.01); in volleyball, the libero position and outside positions showed to be significantly affected from sport-related concussions (χ2(6)=13.617, P<0.05). The present results showed that factors critically contributing to the occurrence of concussions are sport-specific and particularly concern amateurs. This indicates that most concussions in ball games appear in situations, where medical care units are not necessarily present. Preventive measures should therefore especially address amateurs in ball sports.

Defense.gov - Special Report - Media Roundtable with the Commander-in-Chief

Science.gov Websites

incidents of post-traumatic stress disorder. Story Obama: Health Care Reform Won’t Impact VA, Tricare works with Congress to shore up gaps in Post-9/11 GI Bill benefits, President Barack Obama said he wants Secretary Eric Shinseki discuss Post-9/11 GI Bill benefits and health care reform with military journalists

Disaster management: using Internet-based technology.

PubMed

Dimitruk, Paul

2007-01-01

Disasters impose operational challenges and substantial financial burdens on hospitals. Internet-based disaster management technology can help. This technology should: Capture, analyze, and track relevant data. Be available 24/7. Guide decision makers in setting up an incident command center and monitor the completion of jobs by ICC role. Provide assistance in areas that hospitals are not used to dealing with, e.g., chemical or bio-terror agents.

Local Area Defense (LAD) Demonstration

DTIC Science & Technology

2004-09-01

Prozac ? Fentanyl? Institution, incident command, community drills - use of internet - digital photos of all victims to follow them through the system...and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503 1. AGENCY USE ONLY 2. REPORT DATE 3. REPORT TYPE AND DATES COVERED (Leave...detection and rapid response system for local area defense using the University of Maryland Baltimore (UMB) Campus as a testbed. Additional goals includes

Connecting Our Nation’s Crisis Information Management Systems

DTIC Science & Technology

2008-12-01

Voice Alert is a communications solution that uses a combination of database and GIS mapping technologies to deliver outbound notifications.85 EOC...needing to be accessed through an extension is necessary. With many businesses, hotels , and other locations requiring an extension to reach...built around five major management activities of an incident.130  Command  Operations  Planning  Logistics  Finance/administration. The new

DoD Needs a Comprehensive Approach to Address Workplace Violence

DTIC Science & Technology

2015-10-15

respond to an act of workplace violence, which could jeopardize their safety during a workplace violence threat or incident. Workplace Violence Prevention... Management Command (IMCOM) Prevention of Workplace Violence Program (U),” September 21, 2012. 18 OPORD 14-091, “U.S. Army Installation Management ... Safety and Health Administration’s definition of workplace violence25 and applies to military, civilian, and contractor personnel. 22 SECNAVINST

A comparison of command center activations versus disaster drills at three institutions from 2013 to 2015.

PubMed

Ebbeling, Laura G; Goralnick, Eric; Bivens, Matthew J; Femino, Meg; Berube, Claire G; Sears, Bryan; Sanchez, Leon D

2016-01-01

Disaster exercises often simulate rare, worst-case scenario events that range from mass casualty incidents to severe weather events. In actuality, situations such as information system downtimes and physical plant failures may affect hospital continuity of operations far more significantly. The objective of this study is to evaluate disaster drills at two academic and one community hospital to compare the frequency of planned drills versus real-world events that led to emergency management command center activation. Emergency management exercise and command center activation data from January 1, 2013 to October 1, 2015 were collected from a database. The activations and drills were categorized according to the nature of the event. Frequency of each type of event was compared to determine if the drills were representative of actual activations. From 2013 to 2015, there were a total of 136 command center activations and 126 drills at the three hospital sites. The most common reasons for command center activations included severe weather (25 percent, n = 34), maintenance failure (19.9 percent, n = 27), and planned mass gathering events (16.9 percent, n = 23). The most frequent drills were process tests (32.5 percent, n = 41), hazardous material-related events (22.2 percent, n = 28), and in-house fires (15.10 percent, n = 19). Further study of the reasons behind why hospitals activate emergency management plans may inform better preparedness drills. There is no clear methodology used among all hospitals to create drills and their descriptions are often vague. There is an opportunity to better design drills to address specific purposes and events.

Examining critical care nurses' critical incident stress after in hospital cardiopulmonary resuscitation (CPR).

PubMed

Laws, T

2001-05-01

The object of this study was to determine if critical care nurses' emotional responses to having performed cardiopulmonary resuscitation were indicative of critical incident stress. A descriptive approach was employed using a survey questionnaire of 31 critical care nurses, with supportive interview data from 18 of those participants. Analysis of the data generated from the questionnaire indicated that the respondents experienced thought intrusion and avoidance behaviour. A majority of those interviewed disclosed that they had experienced a wide range of emotional stressors and physical manifestations in response to having performed the procedure. The findings from both questionnaire and interview data were congruent with signs of critical incident stress, as described in the literature. This has been found to be detrimental to employees' mental health status and, for this reason, employers have a duty of care to minimise the risk of its occurrence and to manage problems as they arise.

Plane down in the city: Operation Crash and Surge.

PubMed

Kann, Duane F; Draper, Thomas W

2014-01-01

This article is about the experiences gained from the largest full-scale exercise ever conducted in the State of Florida, specifically regarding the Orlando International Airport (MCO) venues. The exercise was centred on an airplane crashing into a hotel just outside of MCO property. The scenario clarified details regarding Incident Command and the unique jurisdictional responsibilities associated with a large-scale mass casualty incident. There were additional challenges with airline operations, walking wounded, and information sharing that provided valuable experiences toward enhancing emergency operations. This article also outlines information gained by the MCO "go team" that traveled to San Francisco following the crash of Asiana flight 214. This real-life incident shone a light on many of the strengths and opportunities found throughout the MCO exercise and this article shows the interrelationship of both of these invaluable experiences.

Command Center Training Tool (C2T2)

NASA Technical Reports Server (NTRS)

Jones, Phillip; Drucker, Nich; Mathews, Reejo; Stanton, Laura; Merkle, Ed

2012-01-01

This abstract presents the training approach taken to create a management-centered, experiential learning solution for the Virginia Port Authority's Port Command Center. The resultant tool, called the Command Center Training Tool (C2T2), follows a holistic approach integrated across the training management cycle and within a single environment. The approach allows a single training manager to progress from training design through execution and AAR. The approach starts with modeling the training organization, identifying the organizational elements and their individual and collective performance requirements, including organizational-specific performance scoring ontologies. Next, the developer specifies conditions, the problems, and constructs that compose exercises and drive experiential learning. These conditions are defined by incidents, which denote a single, multi-media datum, and scenarios, which are stories told by incidents. To these layered, modular components, previously developed meta-data is attached, including associated performance requirements. The components are then stored in a searchable library An event developer can create a training event by searching the library based on metadata and then selecting and loading the resultant modular pieces. This loading process brings into the training event all the previously associated task and teamwork material as well as AAR preparation materials. The approach includes tools within an integrated management environment that places these materials at the fingertips of the event facilitator such that, in real time, the facilitator can track training audience performance and resultantly modify the training event. The approach also supports the concentrated knowledge management requirements for rapid preparation of an extensive AAR. This approach supports the integrated training cycle and allows a management-based perspective and advanced tools, through which a complex, thorough training event can be developed.

STS-55 crewmembers repair waste water tank under OV-102's middeck subfloor

NASA Technical Reports Server (NTRS)

1993-01-01

STS-55 Pilot Terence T. Henricks uses a spotlight and pen to point out a possible problem area on a waste water tank in the bilge area below Columbia's, Orbiter Vehicle (OV) 102's, middeck. Mission Specialist 1 (MS1) and Payload Commander (PLC) Jerry L. Ross records the activity with a video camcorder. The crewmembers are participating in an inflight maintenance (IFM) exercise to counter problems experienced with the waste water tank.

STS-55 crewmembers repair waste water tank on OV-102's middeck

NASA Technical Reports Server (NTRS)

1993-01-01

Three STS-55 crewmembers participate in an inflight maintenance (IFM) exercise to counter problems experienced with a waste water tank below Columbia's, Orbiter Vehicle (OV) 102's, middeck. Mission Specialist 3 (MS3) Bernard A. Harris, Jr, inside the airlock, holds middeck floor access panel MD54G and looks below at Pilot Terence T. Henricks who is in the bilge area. Commander Steven R. Nagel is lying on middeck floor at the left.

Antibodies to Squalene in US Navy Persian Gulf War Veterans with Chronic Multisymptom Illness

DTIC Science & Technology

2009-01-01

worked in small teams and experienced many unique environmental and geographical exposures. Active - duty Seabees who remained in the US Navy after the...2009) 3921–3926 described byGray et al. [3].Members of 14 regular active -dutyNavy Seabee commands at Port Hueneme, CA, and Gulfport, Mississippi...either of the two federally sponsored Gulf War veteran registries [13]. Exposure and symptom questions were based on the deployment activities of

Regionally Aligned Forces: The Critical Role of Military Engagement and Interdependence Between Conventional and Special Operations Forces

DTIC Science & Technology

2015-05-21

110 Ibid., 212. 111 Ibid., 43-45. 112 Peter L. Berger and Thomas Luckmann, The Social Construction of...time and resources. As noted by Army Colonel Alan Shumate, a former battalion commander in a unit similar to 2/1 ABCT, “I personally experienced how...136 Alan Shumate, “Employing US Army Special Forces to Defeat America’s Emerging Threats,” manuscript USAWC Civilian Research Project, US

Technical Issues in Evolving to Integrated Services Digital Network (ISDN)

DTIC Science & Technology

1991-06-01

channel through some Page 13 Technical Issues in Evolving to ISDN Final Report separate interface (such as the AT command set of the Hayes modems or the...errors experienced over standard modem provided connectivity. But, in this project connectivity has been established only over a single CO. Those...examined to some extent and are discussed below. Existing equipment was of two types: that which treats ISDN as just another leased line providing 56k or

The Future of the Brigade Combat Team: Air-Ground Integration and the Operating Environment

DTIC Science & Technology

2017-06-09

Attack Controllers (JTACs) at each level.15 There is no requirement for JTAC support at the company level or to non - maneuver battalions. However...experienced non -commissioned officer or officer. Theater Air Control System (TACS): It includes all of the command and control related capabilities...information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM

SIG. Signal Processing, Analysis, & Display

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

Hernandez, J.; Lager, D.; Azevedo, S.

1992-01-22

SIG is a general-purpose signal processing, analysis, and display program. Its main purpose is to perform manipulations on time and frequency-domain signals. However, it has been designed to ultimately accommodate other representations for data such as multiplexed signals and complex matrices. Two user interfaces are provided in SIG; a menu mode for the unfamiliar user and a command mode for more experienced users. In both modes errors are detected as early as possible and are indicated by friendly, meaningful messages. An on-line HELP package is also included. A variety of operations can be performed on time and frequency-domain signals includingmore » operations on the samples of a signal, operations on the entire signal, and operations on two or more signals. Signal processing operations that can be performed are digital filtering (median, Bessel, Butterworth, and Chebychev), ensemble average, resample, auto and cross spectral density, transfer function and impulse response, trend removal, convolution, Fourier transform and inverse window functions (Hamming, Kaiser-Bessel), simulation (ramp, sine, pulsetrain, random), and read/write signals. User definable signal processing algorithms are also featured. SIG has many options including multiple commands per line, command files with arguments, commenting lines, defining commands, and automatic execution for each item in a `repeat` sequence. Graphical operations on signals and spectra include: x-y plots of time signals; real, imaginary, magnitude, and phase plots of spectra; scaling of spectra for continuous or discrete domain; cursor zoom; families of curves; and multiple viewports.« less

SIG. Signal Processing, Analysis, & Display

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

Hernandez, J.; Lager, D.; Azevedo, S.

1992-01-22

SIG is a general-purpose signal processing, analysis, and display program. Its main purpose is to perform manipulations on time-and frequency-domain signals. However, it has been designed to ultimately accommodate other representations for data such as multiplexed signals and complex matrices. Two user interfaces are provided in SIG - a menu mode for the unfamiliar user and a command mode for more experienced users. In both modes errors are detected as early as possible and are indicated by friendly, meaningful messages. An on-line HELP package is also included. A variety of operations can be performed on time and frequency-domain signals includingmore » operations on the samples of a signal, operations on the entire signal, and operations on two or more signals. Signal processing operations that can be performed are digital filtering (median, Bessel, Butterworth, and Chebychev), ensemble average, resample, auto and cross spectral density, transfer function and impulse response, trend removal, convolution, Fourier transform and inverse window functions (Hamming, Kaiser-Bessel), simulation (ramp, sine, pulsetrain, random), and read/write signals. User definable signal processing algorithms are also featured. SIG has many options including multiple commands per line, command files with arguments, commenting lines, defining commands, and automatic execution for each item in a repeat sequence. Graphical operations on signals and spectra include: x-y plots of time signals; real, imaginary, magnitude, and phase plots of spectra; scaling of spectra for continuous or discrete domain; cursor zoom; families of curves; and multiple viewports.« less

Signal Processing, Analysis, & Display

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

Lager, Darrell; Azevado, Stephen

1986-06-01

SIG is a general-purpose signal processing, analysis, and display program. Its main purpose is to perform manipulations on time- and frequency-domain signals. However, it has been designed to ultimately accommodate other representations for data such as multiplexed signals and complex matrices. Two user interfaces are provided in SIG - a menu mode for the unfamiliar user and a command mode for more experienced users. In both modes errors are detected as early as possible and are indicated by friendly, meaningful messages. An on-line HELP package is also included. A variety of operations can be performed on time- and frequency-domain signalsmore » including operations on the samples of a signal, operations on the entire signal, and operations on two or more signals. Signal processing operations that can be performed are digital filtering (median, Bessel, Butterworth, and Chebychev), ensemble average, resample, auto and cross spectral density, transfer function and impulse response, trend removal, convolution, Fourier transform and inverse window functions (Hamming, Kaiser-Bessel), simulation (ramp, sine, pulsetrain, random), and read/write signals. User definable signal processing algorithms are also featured. SIG has many options including multiple commands per line, command files with arguments,commenting lines, defining commands, and automatic execution for each item in a repeat sequence. Graphical operations on signals and spectra include: x-y plots of time signals; real, imaginary, magnitude, and phase plots of spectra; scaling of spectra for continuous or discrete domain; cursor zoom; families of curves; and multiple viewports.« less

SIG. Signal Processing, Analysis, & Display

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

Hernandez, J.; Lager, D.; Azevedo, S.

1992-01-22

SIG is a general-purpose signal processing, analysis, and display program. Its main purpose is to perform manipulations on time- and frequency-domain signals. However, it has been designed to ultimately accommodate other representations for data such as multiplexed signals and complex matrices. Two user interfaces are provided in SIG - a menu mode for the unfamiliar user and a command mode for more experienced users. In both modes errors are detected as early as possible and are indicated by friendly, meaningful messages. An on-line HELP package is also included. A variety of operations can be performed on time- and frequency-domain signalsmore » including operations on the samples of a signal, operations on the entire signal, and operations on two or more signals. Signal processing operations that can be performed are digital filtering (median, Bessel, Butterworth, and Chebychev), ensemble average, resample, auto and cross spectral density, transfer function and impulse response, trend removal, convolution, Fourier transform and inverse window functions (Hamming, Kaiser-Bessel), simulation (ramp, sine, pulsetrain, random), and read/write signals. User definable signal processing algorithms are also featured. SIG has many options including multiple commands per line, command files with arguments,commenting lines, defining commands, and automatic execution for each item in a repeat sequence. Graphical operations on signals and spectra include: x-y plots of time signals; real, imaginary, magnitude, and phase plots of spectra; scaling of spectra for continuous or discrete domain; cursor zoom; families of curves; and multiple viewports.« less

Workplace harassment: double jeopardy for minority women.

PubMed

Berdahl, Jennifer L; Moore, Celia

2006-03-01

To date there have been no studies of how both sex and ethnicity might affect the incidence of both sexual and ethnic harassment at work. This article represents an effort to fill this gap. Data from employees at 5 organizations were used to test whether minority women are subject to double jeopardy at work, experiencing the most harassment because they are both women and members of a minority group. The results supported this prediction. Women experienced more sexual harassment than men, minorities experienced more ethnic harassment than Whites, and minority women experienced more harassment overall than majority men, minority men, and majority women.

The epidemiology of post-traumatic stress disorder in Norway: trauma characteristics and pre-existing psychiatric disorders.

PubMed

Lassemo, Eva; Sandanger, Inger; Nygård, Jan F; Sørgaard, Knut W

2017-01-01

The prevalence of PTSD differs by gender. Pre-existing psychiatric disorders and different traumas experienced by men and women may explain this. The aims of this study were to assess (1) incidence and prevalence of exposure to traumatic events and PTSD, (2) the effect of pre-existing psychiatric disorders prior to trauma on the risk for PTSD, and (3) the effect the characteristics of trauma have on the risk for PTSD. All stratified by gender. CIDI was used to obtain diagnoses at the interview stage and retrospectively for the general population N = 1634. The incidence for trauma was 466 and 641 per 100,000 PYs for women and men, respectively. The incidence of PTSD was 88 and 31 per 100,000 PYs. Twelve month and lifetime prevalence of PTSD was 1.7 and 4.3 %, respectively, for women, and 1.0 and 1.4 %, respectively, for men. Pre-existing psychiatric disorders were risk factors for PTSD, but only in women. Premeditated traumas were more harmful. Gender differences were observed regarding traumatic exposure and in the nature of traumas experienced and incidences of PTSD. Men experienced more traumas and less PTSD. Pre-existing psychiatric disorders were found to be risk factors for subsequent PTSD in women. However, while trauma happens to most, it only rarely leads to PTSD, and the most harmful traumas were premeditated ones. Primary prevention of PTSD is thus feasible, although secondary preventive efforts should be gender-specific.

Managing Chronic Conditions in College: Findings from Prompted Health Incidents Diaries

ERIC Educational Resources Information Center

Ravert, Russell D.; Russell, Luke T.; O'Guin, Monica B.

2017-01-01

Objective: This pilot study assessed an electronic health diary method designed to collect data about critical health incidents experienced by college students who have chronic health conditions. Participants: Nine university students with chronic medical conditions were recruited to complete a series of e-mail-based surveys, sent once every…

Failure to activate the in-hospital emergency team: causes and outcomes.

PubMed

Barbosa, Vera; Gomes, Ernestina; Vaz, Senio; Azevedo, Gustavo; Fernandes, Gonçalo; Ferreira, Amélia; Araujo, Rui

2016-01-01

To determine the incidence of afferent limb failure of the in-hospital Medical Emergency Team, characterizing it and comparing the mortality between the population experiencing afferent limb failure and the population not experiencing afferent limb failure. A total of 478 activations of the Medical Emergency Team of Hospital Pedro Hispano occurred from January 2013 to July 2015. A sample of 285 activations was obtained after excluding incomplete records and activations for patients with less than 6 hours of hospitalization. The sample was divided into two groups: the group experiencing afferent limb failure and the group not experiencing afferent limb failure of the Medical Emergency Team. Both populations were characterized and compared. Statistical significance was set at p ≤ 0.05. Afferent limb failure was observed in 22.1% of activations. The causal analysis revealed significant differences in Medical Emergency Team activation criteria (p = 0.003) in the group experiencing afferent limb failure, with higher rates of Medical Emergency Team activation for cardiac arrest and cardiovascular dysfunction. Regarding patient outcomes, the group experiencing afferent limb failure had higher immediate mortality rates and higher mortality rates at hospital discharge, with no significant differences. No significant differences were found for the other parameters. The incidence of cardiac arrest and the mortality rate were higher in patients experiencing failure of the afferent limb of the Medical Emergency Team. This study highlights the need for health units to invest in the training of all healthcare professionals regarding the Medical Emergency Team activation criteria and emergency medical response system operations.

Mental health impacts of racial discrimination in Australian culturally and linguistically diverse communities: a cross-sectional survey.

PubMed

Ferdinand, Angeline S; Paradies, Yin; Kelaher, Margaret

2015-04-18

Racial discrimination denies those from racial and ethnic minority backgrounds access to rights such as the ability to participate equally and freely in community and public life, equitable service provision and freedom from violence. Our study was designed to examine how people from racial and ethnic minority backgrounds in four Australian localities experience and respond to racial discrimination, as well as associated health impacts. Data were collected from 1,139 Australians regarding types of racial discrimination experienced, settings for these incidents, response mechanisms and psychological distress as measured by the Kessler 6 (K6) Psychological Distress Scale. Age, education, religion, gender, visibility and rurality were all significantly associated with differences in the frequency of experiencing racial discrimination. Experiencing racial discrimination was associated with worse mental health. Mental health impacts were not associated with the type of discriminatory experience, but experiencing racial discrimination in shops and in employment and government settings was associated with being above the threshold for high or very high psychological distress. One out of twelve response mechanisms was found to be associated with lower stress following a discriminatory incident. Study results indicate that poorer mental health was associated with the volume of discrimination experienced, rather than the type of experience. However, the impact of experiencing discrimination in some settings was shown to be particularly associated with high or very high psychological distress. Our findings suggest that interventions designed to prevent the occurrence of racism have more potential to increase mental health in racial and ethnic minority communities than interventions that work with individuals in response to experiencing racism.

Active Duty-U.S. Army Noise Induced Hearing Injury Quarterly Surveillance Q3 2011 thru Q4 2013

DTIC Science & Technology

2014-06-30

incident case rates for sensorineural hearing loss significant threshold shift, tinnitus , and Noise-Induced Hearing Loss. RECOMMENDATIONS: Commanders...2013 A-1 APPENDIX A REFERENCES Humes LE, Jollenbeck LM, Durch JS: Noise and military service: Implications for hearing loss and tinnitus . Washington...FUNCTION STUDIES TINN Tinnitus 38830 TINNITUS UNSPECIFIED TINN Tinnitus 38831 SUBJECTIVE TINNITUS TINN Tinnitus 38832 OBJECTIVE TINNITUS CPT Codes

Examination of the home destruction in Los Alamos associated with the Cerro Grande Fire - July 10, 2000

Treesearch

Jack D. Cohen

2000-01-01

I arrived at Los Alamos on May 14, 2000 to conduct an examination of the home destruction associated with the Cerro Grande Fire. My examination occurred between the afternoon of 5/14 and late afternoon on 5/16. I had contact with the southern command post incident management team, the Los Alamos Fire Department, and the Santa Fe National Forest.The...

Unity of Command for Homeland Security: Title 32, Title 10, or a Combination.

DTIC Science & Technology

2006-01-01

the absence of Los Angeles Police Department ( LAPD ) officers. Hundreds of arson and looting incidents begin. 2100 The California governor’s...time there were over 1,200 CANG soldiers deployed in support of the LOS ANGELES police department , 1,600 in support of the LOS ANGELES County... the streets, but most active component Army and Marine Corps personnel remained in staging areas preparing for

Hospital Administration and Nursing Leadership in Disasters: An Exploratory Study Using Concept Mapping.

PubMed

Veenema, Tener Goodwin; Deruggiero, Katherine; Losinski, Sarah; Barnett, Daniel

Strong leadership is critical in disaster situations when "patient surge" challenges a hospital's capacity to respond and normally acceptable patterns of care are disrupted. Activation of the emergency operations plan triggers an incident command system structure for leadership decision making. Yet, implementation of the emergency operations plan and incident command system protocols is ultimately subject to nursing and hospital leadership at the service- and unit level. The results of these service-/unit-based leadership decisions have the potential to directly impact staff and patient safety, quality of care, and ultimately, patient outcomes. Despite the critical nature of these events, nurse leaders and administrators receive little education regarding leadership and decision making during disaster events. The purpose of this study is to identify essential competencies of nursing and hospital administrators' leadership during disaster events. An integrative mixed-methods design combining qualitative and quantitative approaches to data collection and analysis was used. Five focus groups were conducted with nurse leaders and hospital administrators at a large urban hospital in the Northeastern United States in a collaborative group process to generate relevant leadership competencies. Concept Systems Incorporated was used to sort, prioritize, and analyze the data (http://conceptsystemsinc.com/). The results suggest that participants' institutional knowledge (of existing resources, communications, processes) and prior disaster experience increase leadership competence.

Operational Experience with Long Duration Wildfire Mapping: UAS Missions Over the Western United States

NASA Technical Reports Server (NTRS)

Hall, Philip; Cobleigh, Brent; Buoni, Greg; Howell, Kathleen

2008-01-01

The National Aeronautics and Space Administration, United States Forest Service, and National Interagency Fire Center have developed a partnership to develop and demonstrate technology to improve airborne wildfire imaging and data dissemination. In the summer of 2007, a multi-spectral infrared scanner was integrated into NASA's Ikhana Unmanned Aircraft System (UAS) (a General Atomics Predator-B) and launched on four long duration wildfire mapping demonstration missions covering eight western states. Extensive safety analysis, contingency planning, and mission coordination were key to securing an FAA certificate of authorization (COA) to operate in the national airspace. Infrared images were autonomously geo-rectified, transmitted to the ground station by satellite communications, and networked to fire incident commanders within 15 minutes of acquisition. Close coordination with air traffic control ensured a safe operation, and allowed real-time redirection around inclement weather and other minor changes to the flight plan. All objectives of the mission demonstrations were achieved. In late October, wind-driven wildfires erupted in five southern California counties. State and national emergency operations agencies requested Ikhana to help assess and manage the wildfires. Four additional missions were launched over a 5-day period, with near realtime images delivered to multiple emergency operations centers and fire incident commands managing 10 fires.

Frozen moments: flashback memories of critical incidents in emergency personnel.

PubMed

Kleim, Birgit; Bingisser, Martina-Barbara; Westphal, Maren; Bingisser, Roland

2015-07-01

Emergency Department personnel regularly face highly stressful situations or critical incidents (CIs) that may subsequently be recalled as unbidden intrusive memories. In their most extreme form, such memories are reexperienced as if they were happening again in the present, as flashbacks. This study examined (1) which CIs are associated with flashback memories; (2) candidate person and work-related features that predict flashback memories; and (3) the association between flashback memories and anxiety, depression, and emotional exhaustion. Emergency nurses (N = 91; 80.2% female) were recruited from two urban teaching hospitals and filled in self-report questionnaires. A majority (n = 59, 65%) experienced intrusive memories; almost half of the sample reported that their memories had flashback character. Those involved in resuscitations in the past week were at a fourfold risk for experiencing flashbacks. Having worked more consecutive days without taking time off was associated with a somewhat lower incidence of flashbacks. Moreover, older individuals who reported more work-related conflicts were at greater risk for experiencing flashback memories than their younger colleagues with heightened work conflict and flashback memory scores, respectively. Flashback memories were associated with heightened symptoms of anxiety, depression, and emotional exhaustion. The present findings have implications for evidence-based health promotion in emergency personnel and other individuals regularly exposed to CIs.

Difficult incidents and tutor interventions in problem-based learning tutorials.

PubMed

Kindler, Pawel; Grant, Christopher; Kulla, Steven; Poole, Gary; Godolphin, William

2009-09-01

Tutors report difficult incidents and distressing conflicts that adversely affect learning in their problem-based learning (PBL) groups. Faculty development (training) and peer support should help them to manage this. Yet our understanding of these problems and how to deal with them often seems inadequate to help tutors. The aim of this study was to categorise difficult incidents and the interventions that skilled tutors used in response, and to determine the effectiveness of those responses. Thirty experienced and highly rated tutors in our Year 1 and 2 medical curriculum took part in semi-structured interviews to: identify and describe difficult incidents; describe how they responded, and assess the success of each response. Recorded and transcribed data were analysed thematically to develop typologies of difficult incidents and interventions and compare reported success or failure. The 94 reported difficult incidents belonged to the broad categories 'individual student' or 'group dynamics'. Tutors described 142 interventions in response to these difficult incidents, categorised as: (i) tutor intervenes during tutorial; (ii) tutor gives feedback outside tutorial, or (iii) student or group intervenes. Incidents in the 'individual student' category were addressed relatively unsuccessfully (effective < 50% of the time) by response (i), but with moderate success by response (ii) and successfully (> 75% of the time) by response (iii). None of the interventions worked well when used in response to problems related to 'group dynamics'. Overall, 59% of the difficult incidents were dealt with successfully. Dysfunctional PBL groups can be highly challenging, even for experienced and skilled tutors. Within-tutorial feedback, the treatment that tutors are most frequently advised to apply, was often not effective. Our study suggests that the collective responsibility of the group, rather than of the tutor, to deal with these difficulties should be emphasised.

Developing a New National Strategy for U.S.-Russian Relations

DTIC Science & Technology

1993-02-24

National Startegy for U.S.-Russian Relations 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK...command economy to a free market economy. Judging by the problems being experienced integrating the old East German economy, viewed by many experts...as the most advanced of the Warsaw Pact countries, it’s becoming clear that moving to a market oriented economy is more costly, difficult, and

Tani during EVA 14

NASA Image and Video Library

2008-01-30

ISS016-E-026454 (30 Jan. 2008) --- Astronaut Daniel Tani, Expedition 16 flight engineer, participates in a session of extravehicular activity (EVA) as maintenance and construction continue on the International Space Station. During the 7-hour, 10-minute spacewalk, Tani and astronaut Peggy Whitson (out of frame), commander, replaced a motor, known as the Bearing Motor Roll Ring Module (BMRRM), at the base of one of the station's solar wings. The BMRRM is part of the Beta Gimbal Assembly, which experienced electrical failures Dec. 8.

Airborne Missions in the Mediterranean, 1942-1945

DTIC Science & Technology

1955-09-01

the po rt of Oran. How- by Lt. Gen . D wight D . Eisenhower thro ugh A llied ever, t he po rt, surrounded by clif s and bristling. Force Headquart...Some experienced officers calledForce, an American organization commanded by it "harebrained. " A ir Marshal William L . Welsh ,y _. Maj. Gen . Lloyd...that the troo p carriers be con-A ir Fo rce under Brig. Gen . James H. Dooli ttle . served fo r use in the race to Tunis after D -day. , D-day for the

Keyboarding Instruction at NABTE Institutions: Are We Teaching Techniques to Reduce CTD Incidence?

ERIC Educational Resources Information Center

Blaszczynski, Carol; Joyce, Marguerite Shane

1996-01-01

Responses from 157 of 193 business teachers who teach keyboarding indicated that 78.7% were aware of cumulative trauma disorder and 22% had experienced it. Only 13% of classrooms were equipped with wrist rests. About 53% teach techniques to reduce incidence, but 20% did not know whether they taught preventive measures. (SK)

The Continuing Incidence of Natural Decrease in American Counties

ERIC Educational Resources Information Center

Johnson, Kenneth M.

2011-01-01

In 2002, more American counties (985) experienced natural decrease than at any time in the nation's history. The incidence of natural decrease has diminished since then, but remains near record levels. It is most common in rural areas remote from metropolitan centers. Spatial concentrations exist in the Great Plains, Corn Belt, and East Texas,…

Psychosoma in Crisis: An Autoethnographic Study of Medically Unexplained Symptoms and Their Diverse Contexts

ERIC Educational Resources Information Center

Hills, John; Lees, John; Freshwater, Dawn; Cahill, Jane

2018-01-01

In this study, we examine autoethnographic data from three critical incidents as experienced by the first author demonstrating the importance of context in understanding medically unexplained symptoms, their incidence and underlying patterns. We make the case for ethnographies as a crucial research strand in discerning the finer aspects of the…

Pain after root canal treatment with different instruments: A systematic review and meta-analysis.

PubMed

Sun, Chengjun; Sun, Jicheng; Tan, Minmin; Hu, Bo; Gao, Xiang; Song, Jinlin

2018-03-07

The aims of this systematic review were to compare the incidence and intensity of postoperative pain after single-visit root canal treatment using manual, rotary and reciprocating instruments. An extensive literature search in PubMed, EMBASE, Cochrane Library, and Web of Science was performed to identify investigations that evaluated the effects of different instruments on post-endodontic pain. Meta-analyses and additional analyses, including subgroup and sensitivity analyses, were conducted. We included seventeen trials in this study. Pooled results showed that patients treated with rotary instruments experienced a significantly lower incidence of postoperative pain (RR, 0.32, P = 0.0005) and reduced pain intensity than did patients treated with manual instruments. In addition, patients treated with multiple rotary-file systems experienced a significantly lower incidence of postoperative pain than did those treated with reciprocating systems (RR, 0.73; P < 0.0001). The use of rotary instruments contributed to a lower incidence and intensity of postoperative pain than did the use of hand files in patients who received single-visit root canal treatment. In addition, the use of multiple rotary-file systems contributed to a lower incidence of postoperative pain than did the use of reciprocating systems. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Cumulative incidence of infertility in a New Zealand birth cohort to age 38 by sex and the relationship with family formation.

PubMed

van Roode, Thea; Dickson, Nigel Patrick; Righarts, Alida Antoinette; Gillett, Wayne Richard

2015-04-01

To estimate the cumulative incidence of infertility for men and women in a population-based sample. Longitudinal study of a birth cohort. Research unit. A population-based birth cohort of 1,037 men and women born in Dunedin, New Zealand, between 1972 and 1973. None. Cumulative incidence of infertility by age 32 and 38, distribution of causes and service use for infertility, live birth subsequent to infertility, and live birth by age 38. The cumulative incidence of infertility by age 38 ranged from 14.4% to 21.8% for men and from 15.2% to 26.0% for women depending on the infertility definition and data used. Infertility, defined as having tried to conceive for 12 months or more or having sought medical help to conceive, was experienced by 21.8% (95% confidence interval [CI], 17.7-26.2) of men and 26.0% (95% CI, 21.8-30.6) of women by age 38. For those who experienced infertility, 59.8% (95% CI, 48.3-70.4) of men and 71.8% (95% CI, 62.1-80.3) of women eventually had a live birth. Successful resolution of infertility and entry into parenthood by age 38 were much lower for those who first experienced infertility in their mid to late thirties compared with at a younger age. Comparison of reports from two assessments in this cohort study suggests infertility estimates from a single cross-sectional study may underestimate lifetime infertility. The lower rate of resolution and entry into parenthood for those first experiencing infertility in their mid to late thirties highlights the consequences of postponing parenthood and could result in involuntary childlessness and fewer children than desired. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

The Importance of Affective Containment during Unwelcome Educational Change: The Curious Incident of the Deer Hut Fire

ERIC Educational Resources Information Center

Dale, Di; James, Chris

2015-01-01

Educational change can call up a range of feelings that can pose a number of problems for those experiencing and/or organizing it. This article analyses the processes of educational change from a psychodynamic standpoint. In particular it explores affective containment, which enables feelings to be fully experienced and to be used productively. an…

Workplace physical violence, verbal violence, and mobbing experienced by nurses at a university hospital.

PubMed

Aksakal, Fatma Nur Baran; Karaşahin, Emine Füsun; Dikmen, Asiye Uğraş; Avci, Emine; Ozkan, Seçil

2015-01-01

The aim of this study was to determine the frequency of and risk factors for physical violence, verbal violence, and mobbing experienced by nurses in a university hospital. This was a cross-sectional study conducted at Gazi University Medical Faculty Hospital. A questionnaire form recommended by the WHO and the International Labor Organization was administered through face-to-face interviews to determine the violence experienced in the past 12 months by nurses. The prevalence of physical violence, verbal violence, and mobbing was 13.9%, 41.8%, and 17.1%, respectively. Working more than 40 h per week increased the risk of physical violence by 1.86 times. The majority of nurses who experienced verbal violence and mobbing were significantly more willing to change their work, their institution, and their profession if given the opportunity. Fewer than one-fourth of the victims indicated they reported any incident. We knew that the prevalence of physical violence, verbal violence, and mobbing were high among nurses and that incidents were underreported, and the study corroborated this information. What this study adds to the topic is that long working hours increased the prevalence of physical violence and was defined as an important contributory factor.

Using social media to communicate during crises: an analytic methodology

NASA Astrophysics Data System (ADS)

Greene, Marjorie

2011-06-01

The Emerging Media Integration Team at the Department of the Navy Office of Information (CHINFO) has recently put together a Navy Command Social Media Handbook designed to provide information needed to safely and effectively use social media. While not intended to be a comprehensive guide on command use of social media or to take the place of official policy, the Handbook provides a useful guide for navigating a dynamic communications environment. Social media are changing the way information is diffused and decisions are made, especially for Humanitarian Assistance missions when there is increased emphasis on Navy commands to share critical information with other Navy command sites, government, and official NGO (nongovernmental organization) sites like the American Red Cross. In order to effectively use social media to support such missions, the Handbook suggests creating a centralized location to funnel information. This suggests that as the community of interest (COI) grows during a crisis, it will be important to ensure that information is shared with appropriate organizations for different aspects of the mission such as evacuation procedures, hospital sites, location of seaports and airports, and other topics relevant to the mission. For example, in the first 14 days of the U.S. Southern Command's Haiti HA/DR (Humanitarian Assistance/Disaster Relief) mission, the COI grew to over 1,900 users. In addition, operational conditions vary considerably among incidents, and coordination between different groups is often set up in an ad hoc manner. What is needed is a methodology that will help to find appropriate people with whom to share information for particular aspects of a mission during a wide range of events related to the mission. CNA has developed such a methodology and we would like to test it in a small scale lab experiment.

Magic moment? Maternal marriage for children born out of wedlock.

PubMed

Gibson-Davis, Christina

2014-08-01

To test the existence of the "magic moment" for parental marriage immediately post-birth and to inform policies that preferentially encourage biological over step parent marriage, this study estimates the incidence and stability of maternal marriage for children born out of wedlock. Data came from the National Survey of Family Growth on 5,255 children born non maritally. By age 15, 29 % of children born non maritally experienced a biological-father marriage, and 36 % experienced a stepfather marriage. Stepfather marriages occurred much later in a child's life-one-half occurred after the child turned age 7-and had one-third higher odds of dissolution. Children born to black mothers had qualitatively different maternal marriage experiences than children born to white or Hispanic mothers, with less biological-parent marriage and higher incidences of divorce. Findings support the existence of the magic moment and demonstrate that biological marriages were more enduring than stepfather marriages. Yet relatively few children born out of wedlock experienced stable, biological-parent marriages as envisioned by marriage promotion programs.

AMOS Galaxy 15 Satellite Observations and Analysis

NASA Astrophysics Data System (ADS)

Hall, D.

2011-09-01

In early April 2010, the Galaxy 15 geosynchronous satellite experienced an on-orbit anomaly. Even though the satellite's transmitters and articulating solar panel were still functioning, ground controllers lost the ability to command and maneuver the satellite. With its orbital position no longer maintained, Galaxy 15 began to drift eastward. This forced several other satellites to make collision avoidance maneuvers during the following months. Soon after the initial anomaly, Galaxy 15's operators predicted that the satellite’s reaction wheels would eventually become saturated, causing a loss of both spacecraft attitude and proper sunward orientation of the solar panels. This "off-pointing" event finally occurred in late December, ultimately leading to a depletion of Galaxy 15's batteries. This near-death experience had a fortunate side effect, however, in that it forced the satellite’s command unit to reboot and once again be able to both receive and execute ground commands. The satellite operators have since recovered control of the satellite. AMOS conducted non-resolved photometric observations of Galaxy 15 before, during and after these events. Similar observations were conducted of Galaxy 12, the nearly-identical replacement satellite. This presentation presents and discusses these temporal brightness signatures in detail, comparing the changing patterns in the observations to the known sequence of events.

GNSS-based emergency management system

NASA Astrophysics Data System (ADS)

Wu, Yuhang; Chen, Xiuwan; Ma, Lei

2009-06-01

Public safety and public service is a particularly challenging task. The questions of how to use the limited resources efficiently, how to improve the Government's emergency rapid response and ability of risk resistance, and how to provide a more efficient emergency service for the public, have increasingly become the focus to strengthen urban management. Emergency Response Management System is a highly efficient and powerful command system dealing with natural and social disasters, by using all aspects of the force being gathered in a short period of time, sudden events can be handled efficiently, and further development of the incident can be controlled. In this paper, based on the analysis of development status of the emergency management system at home and abroad, and the key technologies of the emergency management system based on GNSS, research and development on emergency command system based on GNSS has been done. Meanwhile, test in Sichuan earthquake has also been carried out. Practice in Sichuan province earthquake relief work has proved that the emergency management command system based on GNSS can play the advantage function and exert the maximum potential, and can play the role of "lifeline" in the critical moment.

[The role of cooperation between the command and district medical service in prophylaxis of acute respiratory diseases].

PubMed

Kalmykov, A A; Nosarev, V G; Aminev, R M; Konovalov, P P

2014-11-01

The problem of increased incidence of respiratory diseases in troops is significant due to reorganization of military staff and redeployment of military units, which led to the deterioration of the terms of accommodation and living conditions of personnel. Significant contribution to the growth of this disease has brought an increase in the number of young recruits after the transition to a one-year compulsory military service, as well as reducing the number of doctors in the military echelon. In the Central Military District has developed a unified system of sanitary and anti-epidemic and preventive measures, an understanding commanders associations, military units and formations of the order and timing of their implementation, establish a uniform procedure for reporting on the sanitary and epidemiological situation in the garrisons as in operational duty, and on medical service. All this allows us time to carry out or correct preventive measures, to achieve a positive result of work on the health of military personnel. Due to the close interaction between the command and the medical service in the district after 2012 reduced the number of cases with respiratory diseases.

Physiotherapy students' experience, confidence and attitudes on the causes and management of violent and aggressive behaviour.

PubMed

Stubbs, Brendon; Rayment, Nick; Soundy, Andrew

2011-12-01

Healthcare professionals are at risk of experiencing violent and aggressive behaviour from patients. This is most notable in those with least experience, such as students, yet little reported research has considered the experiences of physiotherapy students. The aims of this study were to: (1) explore the incidence and nature of violent and aggressive behaviour experienced by physiotherapy students; and (2) consider the attitudes and confidence of the students in dealing with such behaviour. Retrospective survey. A university in the Midlands region of the UK. Sixty-four final year physiotherapy students. The Management of Aggression and Violence Attitude Scale and an additional survey. Over half (33/64, 52%) of the respondents had experienced at least one incident of violent and aggressive behaviour on a clinical placement. The overwhelming majority of victims (60/64, 94%) did not feel adequately confident to deal with such situations. However, no incidents were officially reported to the university. Both victims and non-victims agreed broadly with the internal model of the causes of aggression and violence, but significantly (P=0.02) more victims did not associate the violent and aggressive behaviour with the responsibility of the patient to control their feelings. Many physiotherapy students experience at least one incident of violent and aggressive behaviour whilst on a clinical placement. Training in the recognition and management of violent and aggressive behaviour would be a beneficial addition to the curricula of physiotherapy programmes. Further larger scale research is warranted. Copyright © 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Incidence of Mastitis in the Neonatal Period in a Traditional Breastfeeding Society: Results of a Cohort Study.

PubMed

Khanal, Vishnu; Scott, Jane A; Lee, Andy H; Binns, Colin W

2015-12-01

Mastitis is a painful problem experienced by breastfeeding women, especially in the first few weeks postpartum. There have been limited studies of the incidence of mastitis from traditionally breastfeeding societies in South Asia. This study investigated the incidence, determinants, and management of mastitis in the first month postpartum, as well as its association with breastfeeding outcomes at 4 and 6 months postpartum, in western Nepal. Subjects were a subsample of 338 mothers participating in a larger prospective cohort study conducted in 2014 in western Nepal. Mothers were interviewed during the first month postpartum and again at 4 and 6 months to obtain information on breastfeeding practices. The association of mastitis and determinant variables was investigated using multivariable logistic regression, and the association with breastfeeding duration was examined using Kaplan-Meier estimation. The incidence of mastitis was 8.0% (95% confidence interval, 5.1%, 10.8%) in the first month postpartum. Prelacteal feeding (adjusted odds ratio = 2.76; 95% confidence interval, 1.03, 7.40) and cesarean section (adjusted odds ratio = 3.52; 95% confidence interval, 1.09, 11.42) were associated with a higher likelihood of mastitis. Kaplan-Meier estimation showed no significant difference in the duration of exclusive breastfeeding among the mothers who experienced an episode of mastitis and those who did not. Roughly one in 10 (8.0%) women experienced mastitis in the first month postpartum, and there appeared to be little effect of mastitis on breastfeeding outcomes. Traditional breastfeeding practices should be encouraged, and the management of mastitis should be included as a part of lactation promotion.

STS-84 Commander Charles J. Precourt in white room

NASA Technical Reports Server (NTRS)

1997-01-01

KENNEDY SPACE CENTER, FLA. -- STS-84 Commander Charles J. Precourt prepares to enter the Space Shuttle Atlantis at Launch Pad 39A with help from white room closeout crew members. The fourth Shuttle mission of 1997 will be the sixth docking of the Space Shuttle with the Russian Space Station Mir. The commander is Charles J. Precourt. The pilot is Eileen Marie Collins. The five mission specialists are C. Michael Foale, Carlos I. Noriega, Edward Tsang Lu, Jean-Francois Clervoy of the European Space Agency and Elena V. Kondakova of the Russian Space Agency. The planned nine-day mission will include the exchange of Foale for U.S. astronaut and Mir 23 crew member Jerry M. Linenger, who has been on Mir since Jan. 15. Linenger transferred to Mir during the last docking mission, STS-81; he will return to Earth on Atlantis. Foale is slated to remain on Mir for about four months until he is replaced in September by STS-86 Mission Specialist Wendy B. Lawrence. During the five days Atlantis is scheduled to be docked with the Mir, the STS-84 crew and the Mir 23 crew, including two Russian cosmonauts, Commander Vasily Tsibliev and Flight Engineer Alexander Lazutkin, will participate in joint experiments. The STS-84 mission also will involve the transfer of more than 7,300 pounds of water, logistics and science equipment to and from the Mir. Atlantis is carrying a nearly 300-pound oxygen generator to replace one of two Mir units which have experienced malfunctions. The oxygen it generates is used for breathing by the Mir crew.

Operational Art and the Incident Command System: Public Health’s Bridge in Bioterrorism Preparedness and Response

DTIC Science & Technology

2003-03-22

e.g., tuberculosis screening or a maximal treadmill test ); and 3) tertiary prevention limits disability and rehabilitation where the disease or injury...major city/county laboratories to develop the capacity to conduct rapid and accurate diagnostic and reference testing for select biologic agents likely...system, but it has not been thoroughly tested and coordinated in the civilian sector. The association of mass casualty care with hospital

Validating a Method for Enhanced Communications and Situational Awareness at the Incident Command Level

DTIC Science & Technology

2006-03-01

operations, and other applications for the MITOC that are beneficial to national security. It will illustrate how the concept was validated by the...of the potential impact on funding, a concern was noted in discussion among members of the National Emergency Management Association (NEMA) in their...This concept of a “virtual” Homeland Security-focused National Laboratory was comprised of the combined resources of the public and private

Seeing Eye Drones: How The DOD Can Transform CBM And Disaster Response In The Homeland

DTIC Science & Technology

2016-12-01

thesis explores the possibility of integrating small unmanned aircraft systems (sUAS) with video capability and CBRN detection and identification sensors...small, unmanned aircraft systems (sUAS) with video capability and CBRN detection and identification sensors for use by National Guard civil support...CBRN) and hazardous material (HAZMAT) materials, as well as providing video to the incident commander. One of the primary benefits of providing

Causes and types of health effects during the use of crop protection chemicals: data from a survey of over 6,300 smallholder applicators in 24 different countries.

PubMed

Tomenson, John A; Matthews, Graham A

2009-08-01

The present investigation looks in detail at the causes and types of health incidents reported by 6,300 mainly smallholder agrochemical users in 24 countries during 2005 and 2006. The investigation is based on a questionnaire survey of knowledge, attitude and practice that concentrated on the sequence of events from purchasing the pesticide to disposal. Information was also collected about health problems experienced while using agrochemicals. The survey targeted mainly smallholder knapsack spray operators who were expected to be at a highest risk of exposure. In the 12 months prior to interview, 1.2% of users reported an agrochemical-related incident that required hospital treatment, 5.8% reported an incident requiring at least trained medical treatment but not hospitalisation and 19.8% reported only a minor sign or symptom. Users who had experienced an incident involving agricultural equipment were 3.38 (95% CI 2.29-4.99) times more likely to experience an agrochemical-related health incident, but confident users who felt that their use of personal protective equipment while spraying was best practice were 0.60 (95% CI 0.44-0.84) times less likely to experience such an incident. Over 80% of product-related incidents were caused by insecticides and the incidence rate per spraying time for incidents linked to insecticides was significantly higher than that for fungicides or herbicides. Headache/dizziness and nausea/vomiting, often smell related, were the most common symptoms reported by users who listed agrochemical products that had caused them health problems (52 and 38% of product mentions, respectively). In most countries, the incidence of serious health effects was low; however, there was a high incidence of minor signs and symptoms in a few countries, especially in Africa. A disproportionate number of incidents occurred during insecticide use relative to the time that they were sprayed. Failure to exercise caution as indicated by whether users had incidents involving agricultural equipment or livestock, and lack of confidence in their practices were the most important predictors of agrochemical-related incidents.

Prevalence and Incidence of Hypoglycaemia in 532,542 People with Type 2 Diabetes on Oral Therapies and Insulin: A Systematic Review and Meta-Analysis of Population Based Studies

PubMed Central

Edridge, Chloe L.; Dunkley, Alison J.; Bodicoat, Danielle H.; Rose, Tanith C.; Gray, Laura J.; Davies, Melanie J.; Khunti, Kamlesh

2015-01-01

Objective To collate and evaluate the current literature reporting the prevalence and incidence of hypoglycaemia in population based studies of type 2 diabetes. Research Design and Methods Medline, Embase and Cochrane were searched up to February 2014 to identify population based studies reporting the proportion of people with type 2 diabetes experiencing hypoglycaemia or rate of events experienced. Two reviewers independently screened studies for eligibility and extracted data for included studies. Random effects meta-analyses were carried out to calculate the prevalence and incidence of hypoglycaemia. Results 46 studies (n = 532,542) met the inclusion criteria. Prevalence of hypoglycaemia was 45% (95%CI 0.34,0.57) for mild/moderate and 6% (95%CI, 0.05,0.07) for severe. Incidence of hypoglycaemic episodes per person-year for mild/moderate and for severe was 19 (95%CI 0.00, 51.08) and 0.80 (95%CI 0.00,2.15), respectively. Hypoglycaemia was prevalent amongst those on insulin; for mild/moderate episodes the prevalence was 50% and incidence 23 events per person-year, and for severe episodes the prevalence was 21% and incidence 1 event per person-year. For treatment regimes that included a sulphonylurea, mild/moderate prevalence was 30% and incidence 2 events per person-year, and severe prevalence was 5% and incidence 0.01 events per person-year. A similar prevalence of 5% was found for treatment regimes that did not include sulphonylureas. Conclusions Current evidence shows hypoglycaemia is considerably prevalent amongst people with type 2 diabetes, particularly for those on insulin, yet still fairly common for other treatment regimens. This highlights the subsequent need for educational interventions and individualisation of therapies to reduce the risk of hypoglycaemia. PMID:26061690

Breast cancer in Asian Americans in California, 1988-2013: increasing incidence trends and recent data on breast cancer subtypes.

PubMed

Gomez, Scarlett Lin; Von Behren, Julie; McKinley, Meg; Clarke, Christina A; Shariff-Marco, Salma; Cheng, Iona; Reynolds, Peggy; Glaser, Sally L

2017-07-01

In contrast to other US racial/ethnic groups, Asian Americans (AA) have experienced steadily increasing breast cancer rates in recent decades. To better understand potential contributors to this increase, we examined incidence trends by age and stage among women from seven AA ethnic groups in California from 1988 to 2013, and incidence patterns by subtype and age at diagnosis for the years 2009 through 2013. Joinpoint regression was applied to California Cancer Registry data to calculate annual percentage change (APC) for incidence trends. Incidence rate ratios were used to compare rates for AA ethnic groups relative to non-Hispanic whites (NHW). All AA groups except Japanese experienced incidence increases, with the largest among Koreans in 1988-2006 (APC 4.7, 95% CI 3.8, 5.7) and Southeast Asians in 1988-2013 (APC 2.5, 95% CI 0.8, 4.2). Among women younger than age 50, large increases occurred for Vietnamese and other Southeast Asians; among women over age 50, increasing trends occurred in all AA ethnic groups. Rates increased for distant-stage disease among Filipinas (2.2% per year, 95% CI 0.4, 3.9). Compared to NHW, Filipinas and older Vietnamese had higher incidence rates of some HER2+ subtypes. Breast cancer incidence rates have risen rapidly among California AA, with the greatest increases in Koreans and Southeast Asians. Culturally tailored efforts to increase awareness of and attention to breast cancer risk factors are needed. Given the relatively higher rates of HER2-overexpressing subtypes in some AA ethnicities, research including these groups and their potentially unique exposures may help elucidate disease etiology.

Desert Rats 2010 Operations Tests: Insights from the Geology Crew Members

NASA Technical Reports Server (NTRS)

Bleacher, J. E.; Hurtado, J. M., Jr.; Young, K. E.; Rice, J.; Garry, W. B.; Eppler, D.

2011-01-01

Desert Research and Technology Studies (Desert RATS) is a multi-year series of tests of NASA hardware and operations deployed in the high desert of Arizona. Conducted annually since 1997, these activities exercise planetary surface hardware and operations in relatively harsh conditions where long-distance, multi-day roving is achievable. Such activities not only test vehicle subsystems, they also stress communications and operations systems and enable testing of science operations approaches that advance human and robotic surface exploration capabilities. Desert RATS 2010 tested two crewed rovers designed as first-generation prototypes of small pressurized vehicles, consistent with exploration architecture designs. Each rover provided the internal volume necessary for crewmembers to live and work for periods up to 14 days, as well as allowing for extravehicular activities (EVAs) through the use of rear-mounted suit ports. The 2010 test was designed to simulate geologic science traverses over a 14-day period through a volcanic field that is analogous to volcanic terrains observed throughout the Solar System. The test was conducted between 31 August and 13 September 2010. Two crewmembers lived in and operated each rover for a week with a "shift change" on day 7, resulting in a total of eight test subjects for the two-week period. Each crew consisted of an engineer/commander and an experienced field geologist. Three of the engineer/commanders were experienced astronauts with at least one Space Shuttle flight. The field geologists were drawn from the scientific community, based on funded and published field expertise.

A biological decontamination process for small, privately owned buildings.

PubMed

Krauter, Paula; Tucker, Mark

2011-09-01

An urban wide-area recovery and restoration effort following a large-scale biological release will require extensive resources and tax the capabilities of government authorities. Further, the number of private decontamination contractors available may not be sufficient to respond to the needs. These resource limitations could create the need for decontamination by the building owner/occupant. This article provides owners/occupants with a simple method to decontaminate a building or area following a wide-area release of Bacillus anthracis using liquid sporicidal decontamination materials, such as pH-amended bleach or activated peroxide; simple application devices; and high-efficiency particulate air-filtered vacuums. Owner/occupant decontamination would be recommended only after those charged with overseeing decontamination-the Unified Command/Incident Command-identify buildings and areas appropriate for owner/occupant decontamination based on modeling and environmental sampling and conduct health and safety training for cleanup workers.

Anticoagulation Therapy for Venous Thromboembolism in the Real World　- From the COMMAND VTE Registry.

PubMed

Yamashita, Yugo; Morimoto, Takeshi; Amano, Hidewo; Takase, Toru; Hiramori, Seiichi; Kim, Kitae; Konishi, Takashi; Akao, Masaharu; Kobayashi, Yohei; Inoue, Takeshi; Oi, Maki; Izumi, Toshiaki; Takahashi, Kotaro; Tada, Tomohisa; Chen, Po-Min; Murata, Koichiro; Tsuyuki, Yoshiaki; Sakai, Hiroshi; Saga, Syunsuke; Sasa, Tomoki; Sakamoto, Jiro; Yamada, Chinatsu; Kinoshita, Minako; Togi, Kiyonori; Ikeda, Tomoyuki; Ishii, Katsuhisa; Kaneda, Kazuhisa; Mabuchi, Hiroshi; Otani, Hideo; Takabayashi, Kensuke; Takahashi, Mamoru; Shiomi, Hiroki; Makiyama, Takeru; Ono, Koh; Kimura, Takeshi

2018-04-25

Venous thromboembolism (VTE) has a long-term risk of recurrence, which can be prevented by anticoagulation therapy.Methods and Results:The COMMAND VTE Registry is a multicenter registry enrolling 3,027 consecutive patients with acute symptomatic VTE between January 2010 and August 2014. The entire cohort was divided into the transient risk (n=855, 28%), unprovoked (n=1,477, 49%), and cancer groups (n=695, 23%). The rate of anticoagulation discontinuation was highest in the cancer group (transient risk: 37.3% vs. unprovoked: 21.4% vs. cancer: 43.5% at 1 year, P<0.001). The cumulative 5-year incidences of recurrent VTE, major bleeding and all-cause death were highest in the cancer group (recurrent VTE: 7.9% vs. 9.3% vs. 17.7%, P<0.001; major bleeding: 9.0% vs. 9.4% vs. 26.6%, P<0.001; and all-cause death: 17.4% vs. 15.3% vs. 73.1%, P<0.001). After discontinuation of anticoagulation therapy, the cumulative 3-year incidence of recurrent VTE was lowest in the transient risk group (transient risk: 6.1% vs. unprovoked: 15.3% vs. cancer: 13.2%, P=0.001). The cumulative 3-year incidence of recurrent VTE beyond 1 year was lower in patients on anticoagulation than in patients off anticoagulation at 1 year in the unprovoked group (on: 3.7% vs. off: 12.2%, P<0.001), but not in the transient risk and cancer groups (respectively, 1.6% vs. 2.5%, P=0.30; 5.6% vs. 8.6%, P=0.44). The duration of anticoagulation therapy varied widely in discordance with current guideline recommendations. Optimal duration of anticoagulation therapy should be defined according to the risk of recurrent VTE and bleeding as well as death.

Socializing the human factors analysis and classification system: incorporating social psychological phenomena into a human factors error classification system.

PubMed

Paletz, Susannah B F; Bearman, Christopher; Orasanu, Judith; Holbrook, Jon

2009-08-01

The presence of social psychological pressures on pilot decision making was assessed using qualitative analyses of critical incident interviews. Social psychological phenomena have long been known to influence attitudes and behavior but have not been highlighted in accident investigation models. Using a critical incident method, 28 pilots who flew in Alaska were interviewed. The participants were asked to describe a situation involving weather when they were pilot in command and found their skills challenged. They were asked to describe the incident in detail but were not explicitly asked to identify social pressures. Pressures were extracted from transcripts in a bottom-up manner and then clustered into themes. Of the 28 pilots, 16 described social psychological pressures on their decision making, specifically, informational social influence, the foot-in-the-door persuasion technique, normalization of deviance, and impression management and self-consistency motives. We believe accident and incident investigations can benefit from explicit inclusion of common social psychological pressures. We recommend specific ways of incorporating these pressures into theHuman Factors Analysis and Classification System.

[Mass casualty incidents : preparedness of German soccer arenas].

PubMed

Luiz, T; Preisegger, T; Madler, C

2013-04-01

Each weekend soccer arenas attract hundreds of thousands of spectators with the German Bundesliga being one of the most attractive sport series worldwide. In 2006 when the FIFA soccer World Cup™ took place in Germany, the precautions in the participating arenas against mass casualty incidents (MCI) reached a level formerly unknown in Germany. However, it is unknown how soccer arenas are prepared to deal with such incidents in everyday life. In 2011 all German major soccer league clubs were questioned about medical precautions in case of MCIs occurring in the stadium. The questionnaire included the following items: stadium capacity, the number of paramedic personnel, emergency physicians and ambulance vehicles, the command and communication structures, the availability of MCI plans, recent MCI drills and the frequency of MCI. Out of 39, 15 (38.4 %) participated, 50 % from the first league and 20.8 % from the second league. The mean stadium capacity was 41,800 spectators (minimum 10,600, maximum 80,700). Depending on the number of spectators and the individual risk score of the match the following resources were available within the stadiums (average, minimum, maximum,): emergency medical technicians 61-67 (15, 120), emergency physicians 2.3-2.5 (1, 5) and transport capacity 5.3-5.8 patients (1, 15). In 14 arenas (93.3 %) the medical personnel were trained in mass casualty care and had prepared MCI operation schedules. All stadiums had mission control centers equipped with a variety of wired and wireless communication tools, although only eight (52.3 %) arenas used a joint command structure and five (33.3 %) arenas reported MCIs (defined as a scenario involving more than 10 patients) within the past 10 years. In 40 % of the participants the last MCI-related exercise was conducted more than 36 months ago. Most of the participating arenas were adequately staffed to manage the first phase of MCIs but in contrast command structures and transport capacities often focused on individual emergencies. Although most of the participants stated that they planned the resources provision according to well established algorithms, the resources actually available at the arenas varied considerably. The frequency of MCIs in soccer arenas was surprisingly high in contrast to the frequency of MCI-related drills.

Nurses' intention to resign and avoidance of emergency department violence: A moderated mediation model.

PubMed

Li, Yu-Fang; Chao, Minston; Shih, Chih-Ting

2017-10-10

Studies that examined the negative impact of violence in emergency departments on nurses' leave and avoidance behavior are well-documented. However, few studies provided an integrated model of how and when violence influences their leave and avoidance behavior. The study adopted Affective Events Theory to propose and examine a model of violent events, negative emotions, and (leave and avoidance) behaviors on nurses in emergency departments and further analyzed whether the model is salient to nurses' occupational burnout, nursing experience, and nursing rank. The sample included 123 emergency department nurses at a teaching hospital in northern, Taiwan. All participants had experienced violent incidents within the preceding 6 months. Moderated mediation analysis suggested that nurses experienced one of two emotional processes following violent incidents: "violence-negative feelings toward work-intention to resign" or "violence-negative emotion and physical symptoms-avoidance tendencies." Moreover, nurses with high burnout levels expressed weaker intention to resign after violent incidents, while nurses with more experience and higher rank were less likely to avoid violence after violent incidents. Emergency nurses do not simply elect to escape but may engage in avoidance behavior. This study revealed that how violent incidents affect nurses' resignation or avoidance behaviors depends on how they feel. Occupational burnout and nurses' attributes affected their behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

Adverse health experiences, environmental attitudes, and pesticide usage behavior of farm operators.

PubMed

Lichtenberg, E; Zimmerman, R

1999-04-01

Water pollution from agricultural pesticides continues to be a public concern. Given that the use of such pesticides on the farm is largely governed by voluntary behavior, it is important to understand what drives farmer behavior. Health belief models in public health and social psychology argue that persons who have adverse health experiences are likely to undertake preventive behavior. An analogous hypothesis set was tested here: farmers who believe they have had adverse health experiences from pesticides are likely to have heightened concerns about pesticides and are more likely to take greater precautions in dealing with pesticides. This work is based on an original survey of a population of 2700 corn and soybean growers in Maryland, New York, and Pennsylvania using the U.S. Department of Agriculture data base. It was designed as a mail survey with telephone follow-up, and resulted in a 60 percent response rate. Farm operators report experiencing adverse health problems they believe are associated with pesticides that is equivalent to an incidence rate that is higher than the reported incidence of occupational pesticide poisonings, but similar to the reported incidence of all pesticide poisonings. Farmers who report experiencing such problems have more heightened concerns about water pollution from fertilizers and pesticides, and illness and injury from mixing, loading, and applying pesticides than farmers who have not experienced such problems. Farmers who report experiencing such problems also are more likely to report using alternative pest management practices than farmers who do not report having such problems. This implies that farmers who have had such experiences do care about the effects of application and do engage in alternative means of pest management, which at least involve the reduction in pesticide use.

A Randomized Trial of Cognitive Behaviour Therapy and Cognitive Therapy for Children with Posttraumatic Stress Disorder following Single-Incident Trauma

ERIC Educational Resources Information Center

Nixon, Reginald David Vandervord; Sterk, Jisca; Pearce, Amanda

2012-01-01

The present study compared the efficacy of trauma-focused cognitive behavior therapy (CBT) with trauma-focused cognitive therapy (without exposure; CT) for children and youth with posttraumatic stress disorder (PTSD). Children and youth who had experienced single-incident trauma (N = 33; 7-17 years old) were randomly assigned to receive 9 weeks of…

Early Diagnosis and Intervention Strategies for Post-Traumatic Heterotopic Ossification in Severely Injured Extremities

DTIC Science & Technology

2016-12-01

the study for the presence or absence of ectopic bone formation at the indicated time points post injury (Table 1.). 8 Table 1. Incidence of HO...1 Award Number: W81XWH-12-2-0119 TITLE: Early Diagnosis and Intervention Strategies for Post -Traumatic Heterotopic Ossification in Severely...2016 TYPE OF REPORT: Final PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION STATEMENT

Civil Support: DOD Needs to Clarify Its Roles and Responsibilities for Defense Support of Civil Authorities during Cyber Incidents

DTIC Science & Technology

2016-04-01

resources in response to requests for assistance from civil authorities for domestic emergencies (e.g., hurricanes and wildfires ), special events (e.g...in its DSCA mission, DOD supports civil authorities by providing them with resources for responses to disasters like Hurricane Sandy and wildfires ...since 2004. For example, DOD used the dual-status commander for the 2012 Colorado wildfire response. In its technical comments, DOD identified four

Decreasing Variance in Response Time to Singular Incidents of Piracy in the Horn of Africa Area of Operation

DTIC Science & Technology

2010-06-01

must be considered when forces are (notionally) allocated . The model in this thesis will attempt to show the amount of time each person in the 2...Command and Control organization will allocate to this mission. This thesis then intends to demonstrate that an organizational structure that...Indian Ocean. Focusing on this geographic area helps to frame the structure of the Department of Defense forces that monitor, assess, allocate

Developing Collaboration in Complex Events: A Model for Civil-Military Inter-Organizational Problem-Solving and Decision-Making

DTIC Science & Technology

2011-06-01

2009, p.2). Given the wide adoption of principles and structures associated with the Incident Command System (ICS) in emergency management , it was...relationships in disaster response but also the factors that might lead to a more effective response and management . The cases were analysed...team was guided by the following considerations: 1. Use of an extended timeline – The model was conceptualized within a risk management paradigm in

Amphibian conservation: clarifications to comments from Andreone

USGS Publications Warehouse

Muths, Erin L.; Fisher, Robert N.

2017-01-01

We appreciate the comments from Andreone (2016) regarding our proposed alternative strategy for addressing the amphibian crisis. Andreone recognizes the utility of an Incident Command System approach but doubts the feasibility of implementation at an international level. We stated in our original article, however, that ‘the feasibility of our suggestion is debatable, but our point is that radically different approaches are necessary to effectively manage the largest extinction event in modern history’ (Muths & Fisher, 2015). There are examples of where such top-down strategies are being applied; e.g. for the brown tree snake Boiga irregularis (Stanford & Rodda, 2007), and biosecurity planning for Micronesia and Hawaii (NAVFAC Pacific, 2016). Another example is presented by Andreone. In Madagascar a community-wide conservation plan has been developed complete with prioritization of specific actions (Andreone, 2016). As with any top-down strategy, challenges will surface, especially when making decisions that affect economics. We note this caveat in our article, and Andreone points out such issues in Madagascar, where there are mismatches in priorities between biodiversity conservation and civil needs. Our suggestion is that a new paradigm needs to be considered given the gravity of amphibian decline, and one option may be to take a global approach focusing on specific, major threats. Application of an Incident Command System would not necessitate competition with, or emasculation of, local conservation priorities or actions.

Barriers to surge capacity of an overcrowded emergency department for a serious foodborne disease outbreak.

PubMed

Lee, Wen-Huei; Ghee, Chew; Wu, Kuan-Han; Hung, Shih-Chiang

2010-10-01

The purpose of this study was to investigate barriers to surge capacity of an overcrowded emergency department (ED) for a foodborne disease outbreak (FBDO) and to identify solutions to the problems. The emergency response of an overcrowded ED to a serious FBDO with histamine fish poisoning was reviewed. The ED of a tertiary academic medical centre (study hospital) with 1600 acute beds in southern Taiwan. Among the 346 patients in the outbreak, 333 (96.2%) were transferred to the study hospital without prehospital management within about 2 h. The most common symptoms were dizziness (58.9%), nausea and vomiting (36.3%). 181 patients (54.4%) received intravenous fluid infusion and blood tests were ordered for 82 (24.6%). All patients were discharged except one who required admission. The prominent problems with surge capacity of the study hospital were shortage of spare space in the ED, lack of biological incident response plan, poor command system, inadequate knowledge and experience of medical personnel to manage the FBDO. Patients with FBDO could arrive at the hospital shortly after exposure without field triage and management. The incident command system and emergency operation plan of the study hospital did not address the clinical characteristics of the FBDO and the problem of ED overcrowding. Further planning and training of foodborne disease and surge capacity would be beneficial for hospital preparedness for an FBDO.

Glasgow marathons 1982-1987. A review of medical problems.

PubMed

Ridley, S A; Rogers, P N; Wright, I H

1990-02-01

The race statistics, whether conditions and incidence of medical problems for the six consecutive years of the Glasgow Marathon are reviewed. The results suggest that the popularity of marathon running is declining but that the competitors are becoming more experienced, seeking medical assistance earlier and, as a result, experiencing fewer and less serious problems at the finish. The effect of weather conditions on the runners' performance is discussed.

Mcqueuer

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

2016-09-12

Mcqueuer is a simple tool that allows anyone from researchers to experienced developers to create multi-node/multi-core jobs by simply creating a file with a list of commands. Users simply combine tasks, which would otherwise each be their own job on the cluster, into a single file that is given to Mcqueuer. Mcqueuer then does the heavy lifting required to process the tasks in parallel in a single multi-node job. In addition, Mcqueuer provides load-balancing, which frees the user from having to worry about complex memory and CPU considerations, and instead focus on the processing itself.

Crippen, pilot for STS-1, during a training session

NASA Image and Video Library

1978-03-22

S79-25014 (13 Dec. 1978) --- Astronaut Robert L. Crippen, pilot of the first space shuttle orbital flight test (STS-1), eases into a water immersion facility (WIF) during a training session in the Johnson Space Center?s training and test facility (Bldg. 260). The WIF affords one of two ways to simulate the feeling of weightlessness experienced during space extravehicular activity (EVA), the other being inside aircraft flying a parabolic curve. Crippen will be joined by astronaut John W. Young, commander for the STS-1 flight. Photo credit: NASA

Ice Crystal Icing Engine Testing in the NASA Glenn Research Center's Propulsion Systems Laboratory (PSL): Altitude Investigation

NASA Technical Reports Server (NTRS)

Oliver, Michael J.

2015-01-01

The National Aeronautics and Space Administration conducted a full scale ice crystal icing turbofan engine test in the NASA Glenn Research Centers Propulsion Systems Laboratory (PSL) Facility in February 2013. Honeywell Engines supplied the test article, an obsolete, unmodified Lycoming ALF502-R5 turbofan engine serial number LF01 that experienced an un-commanded loss of thrust event while operating at certain high altitude ice crystal icing conditions. These known conditions were duplicated in the PSL for this testing.

Tani during EVA 14

NASA Image and Video Library

2008-01-30

ISS016-E-026022 (30 Jan. 2008) --- The face of astronaut Daniel Tani, Expedition 16 flight engineer, is easily recognizable as he participates in a session of extravehicular activity (EVA) as maintenance and construction continue on the International Space Station. During the 7-hour, 10-minute spacewalk, Tani and astronaut Peggy Whitson (out of frame), commander, replaced a motor, known as the Bearing Motor Roll Ring Module (BMRRM), at the base of one of the station's solar wings. The BMRRM is part of the Beta Gimbal Assembly, which experienced electrical failures Dec. 8.

Incidence of Mastitis in the Neonatal Period in a Traditional Breastfeeding Society: Results of a Cohort Study

PubMed Central

Scott, Jane A.; Lee, Andy H.; Binns, Colin W.

2015-01-01

Abstract Background: Mastitis is a painful problem experienced by breastfeeding women, especially in the first few weeks postpartum. There have been limited studies of the incidence of mastitis from traditionally breastfeeding societies in South Asia. This study investigated the incidence, determinants, and management of mastitis in the first month postpartum, as well as its association with breastfeeding outcomes at 4 and 6 months postpartum, in western Nepal. Subjects and Methods: Subjects were a subsample of 338 mothers participating in a larger prospective cohort study conducted in 2014 in western Nepal. Mothers were interviewed during the first month postpartum and again at 4 and 6 months to obtain information on breastfeeding practices. The association of mastitis and determinant variables was investigated using multivariable logistic regression, and the association with breastfeeding duration was examined using Kaplan–Meier estimation. Results: The incidence of mastitis was 8.0% (95% confidence interval, 5.1%, 10.8%) in the first month postpartum. Prelacteal feeding (adjusted odds ratio = 2.76; 95% confidence interval, 1.03, 7.40) and cesarean section (adjusted odds ratio = 3.52; 95% confidence interval, 1.09, 11.42) were associated with a higher likelihood of mastitis. Kaplan–Meier estimation showed no significant difference in the duration of exclusive breastfeeding among the mothers who experienced an episode of mastitis and those who did not. Conclusions: Roughly one in 10 (8.0%) women experienced mastitis in the first month postpartum, and there appeared to be little effect of mastitis on breastfeeding outcomes. Traditional breastfeeding practices should be encouraged, and the management of mastitis should be included as a part of lactation promotion. PMID:26488802

Twenty-Five-Year (1986-2011) Trends in the Incidence and Death Rates of Stroke Complicating Acute Myocardial Infarction.

PubMed

Hariri, Essa; Tisminetzky, Mayra; Lessard, Darleen; Yarzebski, Jorge; Gore, Joel; Goldberg, Robert

2018-05-04

The occurrence of a stroke after an acute myocardial infarction is associated with increased morbidity and mortality rates. However, limited data are available, particularly from a population-based perspective, about recent trends in the incidence and mortality rates associated with stroke complicating an acute myocardial infarction. The purpose of this study was to examine 25-year trends (1986-2011) in the incidence and in-hospital mortality rates of initial episodes of stroke complicating acute myocardial infarction. The study population consisted of 11,436 adults hospitalized with acute myocardial infarction at all 11 medical centers in central Massachusetts on a biennial basis between 1986 and 2011. In this study cohort, 159 patients (1.4%) experienced an acute first-ever stroke during hospitalization for acute myocardial infarction. The proportion of patients with acute myocardial infarction who developed a stroke increased through the 1990s but decreased slightly thereafter. Compared with patients who did not experience a stroke, those who experienced a stroke were significantly older, were more likely to be female, had a previous acute myocardial infarction, had a significant burden of comorbidities, and were more likely to have died (32.1% vs 10.8%) during their index hospitalization. Patients who developed a first stroke in the most recent study years (2003-2011) were more likely to have died during hospitalization than those hospitalized during earlier study years. Although the incidence rates of acute stroke complicating acute myocardial infarction remained relatively stable during the years under study, the in-hospital mortality rates of those experiencing a stroke have not decreased. Copyright © 2018. Published by Elsevier Inc.

Non-dreamers.

PubMed

Pagel, J F

2003-05-01

Assess incidence and clarify whether diagnostic correlates exist for sleep laboratory patients reporting a lack of dream recall. To awaken, during polysomnographically defined sleep including rapid eye movement (REM) sleep, individuals reporting never having experienced a dream, and determine whether they report dreaming. Study # 1 - Incidence and polysomnographic correlates of sleep lab patients responding on questionnaire that they had never experienced dreaming. Study # 2 - Phone interviews with those individuals reporting non-dreaming on questionnaire to reassess incidence. Study # 3 - After reassessment, individuals (non-dreamers - # 16) are awakened during polysomnographic defined sleep (including REM sleep) and queried about dream recall. This group is compared statistically to a group (rare-dreamers - # 12) that reported dreaming as an extremely rare occurrence (mean dream recall latency - 13.5 years). Study # 1: Incidence of questionnaire reported non-dreaming in this sleep laboratory population is 6.5% (N=534) and is associated with the diagnosis of obstructive sleep apnea (specificity 95.6% for respiratory disturbance index >15). Study # 2 - Individuals who report after interview to have never experienced dreaming are more unusual (0.38% of this sleep laboratory population). Study # 3 - None of the non-dreamers (# 16) reported dream recall after waking in the sleep laboratory (36 awakenings in total for this group). This group does not differ, based on polysomnographic, clinical, or demographic variables, from the rare-dreaming group that occasionally reported dreams when awakened (3/12 patients, 3/32 awakenings) - a finding consistent with the reports of previous studies. The experience of dreaming may not be as ubiquitous as generally accepted. The group of non-dreamers evaluated in this study reports never having recalled a dream and reports no dreams when awakened during polysomnographicly defined sleep. These individuals might not experience dreaming.

The Association of Statin Therapy with the Risk of Recurrent Venous Thrombosis

PubMed Central

Smith, Nicholas L.; Harrington, Laura B.; Blondon, Marc; Wiggins, Kerri L.; Floyd, James S.; Sitlani, Colleen M.; McKnight, Barbara; Larson, Eric B.; Rosendaal, Frits R.; Heckbert, Susan R.; Psaty, Bruce M.

2016-01-01

Background Meta-analyses of randomized controlled trials suggest that treatment with HMG-CoA reductase inhibitors (statins) lowers the risk of incident venous thrombosis (VT), particularly among those without prevalent clinical cardiovascular disease (CVD). Whether this is true for the prevention of recurrent VT is debated. We used an observational inception cohort to estimate the association of current statin use with the risk of recurrent VT. Methods and Results The study setting was a large healthcare organization with detailed medical record and pharmacy information at cohort entry and throughout follow-up. We followed 2,798 subjects 18–89 years of age who experienced a validated incident VT between January 1, 2002 and December 31, 2010, for a first recurrent VT, validated by medical record review. During follow-up, 457 (16%) developed a first recurrent VT. In time-to-event models incorporating time-varying statin use and adjusting for potential confounders, current statin use was associated with a 26% lower risk of recurrent VT: HR=0.74; 95%CI: 0.59–0.94. Among cohort members free of CVD (n=2,134), current statin use was also associated with a lower risk (38%) of recurrent VT: HR=0.62; 95%CI: 0.45–0.85. We found similar results when restricting to new users of statins and in subgroups of different statin types and doses. Conclusions In a population-based cohort of subjects who had experienced an incident VT, statin use, compared with non-use, was associated with a clinically-relevant lower risk of recurrent VT. These findings suggest a potential secondary benefit of statins among patients who have experienced an incident VT. PMID:27061794

Case ascertainment of heat illness in the British Army: evidence of under-reporting from analysis of Medical and Command notifications, 2009-2013.

PubMed

Stacey, Michael J; Brett, S; Woods, D; Jackson, S; Ross, D

2016-12-01

Heat illness in the Armed Forces is considered preventable. The UK military relies upon dual Command and Medical reporting for case ascertainment, investigation of serious incidents and improvement of preventive practices and policy. This process could be vulnerable to under-reporting. To establish whether heat illness in the British Army has been under-reported, by reviewing concordance of reporting to the Army Incident Notification Cell (AINC) and the Army Health Unit (AHU) and to characterise the burden of heat illness reported by these means. Analysis of anonymised reporting databases held by the AHU and AINC, for the period 2009-2013. 565 unique cases of heat illness were identified. Annual concordance of reporting ranged from 9.6% to 16.5%. The overall rate was 13.3%. July was the month with the greatest number of heat illness reports (24.4% of total reporting) and the highest concordance rate (30%). Reports of heat illness from the UK (n=343) exceeded overseas notifications (n=221) and showed better concordance (17.1% vs 12.8%). The annual rate of reported heat illness varied widely, being greater in full-time than reservist personnel (87 vs 23 per100 000) and highest in full-time untrained personnel (223 per100 000). The risk of heat illness was global, year-round and showed dynamic local variation. Failure to dual-report casualties impaired case ascertainment of heat illness across Command and Medical chains. Current preventive guidance, as applied in training and on operations, should be critically evaluated to ensure that risk of heat illness is reduced as low as possible. Clear procedures for casualty notification and surveillance are required in support of this and should incorporate communication within and between the two reporting chains. 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/.

Case ascertainment of heat illness in the British Army: evidence of under-reporting from analysis of Medical and Command notifications, 2009–2013

PubMed Central

Stacey, Michael J; Brett, S; Woods, D; Jackson, S; Ross, D

2016-01-01

Background Heat illness in the Armed Forces is considered preventable. The UK military relies upon dual Command and Medical reporting for case ascertainment, investigation of serious incidents and improvement of preventive practices and policy. This process could be vulnerable to under-reporting. Objectives To establish whether heat illness in the British Army has been under-reported, by reviewing concordance of reporting to the Army Incident Notification Cell (AINC) and the Army Health Unit (AHU) and to characterise the burden of heat illness reported by these means. Methods Analysis of anonymised reporting databases held by the AHU and AINC, for the period 2009–2013. Results 565 unique cases of heat illness were identified. Annual concordance of reporting ranged from 9.6% to 16.5%. The overall rate was 13.3%. July was the month with the greatest number of heat illness reports (24.4% of total reporting) and the highest concordance rate (30%). Reports of heat illness from the UK (n=343) exceeded overseas notifications (n=221) and showed better concordance (17.1% vs 12.8%). The annual rate of reported heat illness varied widely, being greater in full-time than reservist personnel (87 vs 23 per100 000) and highest in full-time untrained personnel (223 per100 000). Conclusions The risk of heat illness was global, year-round and showed dynamic local variation. Failure to dual-report casualties impaired case ascertainment of heat illness across Command and Medical chains. Current preventive guidance, as applied in training and on operations, should be critically evaluated to ensure that risk of heat illness is reduced as low as possible. Clear procedures for casualty notification and surveillance are required in support of this and should incorporate communication within and between the two reporting chains. PMID:25717054

Workplace Violence and Harassment Against Emergency Medicine Residents

PubMed Central

Schnapp, Benjamin H.; Slovis, Benjamin H.; Shah, Anar D.; Fant, Abra L.; Gisondi, Michael A.; Shah, Kaushal H.; Lech, Christie A.

2016-01-01

Introduction Several studies have shown that workplace violence in the emergency department (ED) is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM) residents by patients and visitors and to identify perceived barriers to safety. Methods This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work. Results A majority of residents (66%, 78/119) reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119) experienced verbal harassment, 78% (93/119) had experienced verbal threats, and 52% (62/119) reported sexual harassment. Almost a quarter of residents felt safe “Occasionally,” “Seldom” or “Never” while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease. Conclusion Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts. PMID:27625721

Workplace Violence and Harassment Against Emergency Medicine Residents.

PubMed

Schnapp, Benjamin H; Slovis, Benjamin H; Shah, Anar D; Fant, Abra L; Gisondi, Michael A; Shah, Kaushal H; Lech, Christie A

2016-09-01

Several studies have shown that workplace violence in the emergency department (ED) is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM) residents by patients and visitors and to identify perceived barriers to safety. This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work. A majority of residents (66%, 78/119) reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119) experienced verbal harassment, 78% (93/119) had experienced verbal threats, and 52% (62/119) reported sexual harassment. Almost a quarter of residents felt safe "Occasionally," "Seldom" or "Never" while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease. Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts.

Antibody responses following incident anal and penile infection with human papillomavirus in teenage men who have sex with men.

PubMed

Zou, Huachun; Tabrizi, Sepehr N; Grulich, Andrew E; Hocking, Jane S; Garland, Suzanne M; Bradshaw, Catriona S; Cornall, Alyssa M; Fairley, Christopher K; Chen, Marcus Y

2016-08-01

Men who have sex with men (MSM) are at risk for human papillomavirus (HPV)-related anal cancer. Few data exist on antibody responses following incident anogenital infection with HPV in teenage MSM. A cohort of 200 MSM aged 16-20 years from Melbourne, Australia were assessed at baseline, 3, 6 and 12 months. At each visit anal and penile swabs were collected for HPV DNA and serum for HPV antibodies for genotypes 6, 11, 16 and 18 (Merck's Multiplex Assays using Luminex). The main outcome, seroconversion, was defined as the detection of HPV antibodies following a negative antibody result for the same HPV type at baseline. The seroincidence rates for HPV types 6, 11, 16 and 18 were: 19 (95% CI 12-26), 7 (3-12), 4 (1-8) and 6 (3-11) per 100 person-years, respectively. Men who experienced incident anal HPV infections from types 6/11 were significantly more likely to develop serum antibodies to the same HPV type(s) than those who experienced incident anal infections from types 16/18 [73 vs. 18%, odds ratio (OR) = 15, 95% CI: 2-118]. The median time between incident anal HPV infection and seroconversion for HPV 6, 11, 16 and 18 was: 91, 38, 161 and 182 days, respectively. Antibody responses against HPV types 6/11 were significantly more likely to occur following incident anal compared with incident penile infection with HPV types 6/11 (OR = 6, 95% CI: 2-21). The likelihood of antibody responses following anogenital HPV infections depends on the HPV type and site of infection. © 2016 UICC.

Incidence and lifetime costs of injuries in the United States

PubMed Central

Corso, P; Finkelstein, E; Miller, T; Fiebelkorn, I; Zaloshnja, E

2006-01-01

Background Standardized methodologies for assessing economic burden of injury at the national or international level do not exist. Objective To measure national incidence, medical costs, and productivity losses of medically treated injuries using the most recent data available in the United States, as a case study for similarly developed countries undertaking economic burden analyses. Method The authors combined several data sets to estimate the incidence of fatal and non‐fatal injuries in 2000. They computed unit medical and productivity costs and multiplied these costs by corresponding incidence estimates to yield total lifetime costs of injuries occurring in 2000. Main outcome measures Incidence, medical costs, productivity losses, and total costs for injuries stratified by age group, sex, and mechanism. Results More than 50 million Americans experienced a medically treated injury in 2000, resulting in lifetime costs of $406 billion; $80 billion for medical treatment and $326 billion for lost productivity. Males had a 20% higher rate of injury than females. Injuries resulting from falls or being struck by/against an object accounted for more than 44% of injuries. The rate of medically treated injuries declined by 15% from 1985 to 2000 in the US. For those aged 0–44, the incidence rate of injuries declined by more than 20%; while persons aged 75 and older experienced a 20% increase. Conclusions These national burden estimates provide unequivocal evidence of the large health and financial burden of injuries. This study can serve as a template for other countries or be used in intercountry comparisons. PMID:16887941

Factors influencing nurse supervisor competence: a critical incident analysis study.

PubMed

Arvidsson, Barbro; Fridlund, Bengt

2005-05-01

The aim of the study was to identify factors related to critical incidents that influence the competence of nurse supervisors. Nurse supervisors require considerable competence in order to help supervisees to reflect on their clinical work and to interpret the needs of the patient. A qualitative approach involving the critical incident technique was used. Critical incidents were collected by means of self-reports from 25 nurse supervisors. Two main areas emerged: a professional and a personal stance. The professional stance described the nurse supervisors' awareness of the importance of creating a secure learning environment and facilitating reflection. The supervisors structured the material and created awareness of fundamental nursing values. The second main area, personal stance, described the nurse supervisors' behaviour when they gave the participating nurses the opportunity to work through the experiences gained in the daily provision of nursing care. Although they experienced lack of self-assurance during the supervision session, they also expressed security regarding their own performance as nurse supervisors. Nurse supervisors need to include more nursing theory and focus on the nursing process as well as being aware of their own shortcomings and resources. One way for the supervisor to scrutinize his/her actions is to discuss and examine them with a more experienced nurse supervisor colleague.

Analysis of incidence of bulla formation after tattoo treatment using the combination of the picosecond Alexandrite laser and fractionated CO2 ablation.

PubMed

Au, Sonoa; Liolios, Ana M; Goldman, Mitchel P

2015-02-01

The picosecond Alexandrite laser has shown increased efficacy in tattoo removal in comparison to Q-switched lasers. However, bulla formation is a well-known and expected side effect of this novel treatment and causes patient discomfort. To analyze the incidence of bulla formation after tattoo treatment using the combination of the picosecond Alexandrite laser and fractionated CO2 ablation. This is a retrospective chart review to determine the incidence of bulla formation after laser tattoo removal in 95 patients who were treated with either with the picosecond Alexandrite laser alone or in combination with fractional CO2 ablation. Twenty-six patients (32%) treated with the picosecond laser alone experienced blistering, whereas none of the patients treated with the combination of the picosecond laser and fractionated CO2 ablation experienced blistering. The difference in incidence of bulla formation between the 2 groups was found to be statistically significant (p < .05). This study shows a significant decrease in bulla formation associated with tattoo treatment when fractionated CO2 ablation is added to the picosecond Alexandrite laser, which is consistent with observations from a previous case series. This is important because decreasing extensive blistering likely results in increased patient satisfaction and willingness to return for future treatments.

Incidence of Injury Among Male Brazilian Jiujitsu Fighters at the World Jiu-Jitsu No-Gi Championship 2009

PubMed Central

Kreiswirth, Ethan M.; Myer, Gregory D.; Rauh, Mitchell J.

2014-01-01

Context: Brazilian jiujitsu is a modern combat martial art that uses joint locks to submit an opponent and achieve victory. This form of martial art is a relatively young but rapidly growing combat sport worldwide. Objective: To determine the cumulative injury incidence and risk of injury by belt rank and body region at an international-level Brazilian jiujitsu tournament. Design: Descriptive epidemiology study. Setting: World Jiu-Jitsu No-Gi Championship 2009 in Long Beach, California. Patients or Other Participants: We monitored 951 athletes (age range, 18–50 years) enrolled to compete in the World Jiu-Jitsu No-Gi Championship 2009. Intervention(s): Fighters were categorized by belt level for group comparisons (belt experience). Incidence rates per 1000 athlete-exposures (AEs) and incidence rate ratios were compared by belt rank. Main Outcome Measure(s): Incidence rates and incidence rate ratios. Results: During the tournament, 1606 AEs and 62 total injuries were reported. Of these injuries, 40 affected the joints, for an overall incidence rate of 24.9 per 1000 AEs. The joint incidence rate by belt rank was 21.5 per 1000 AEs for blue, 21.3 per 1000 AEs for purple, 25.2 per 1000 AEs for brown, and 35.1 per 1000 AEs for black. We found no differences for incidence rate ratios of joint injury among individual belt groups (P > .05). More experienced (brown belt and black belt) competitors had a higher injury risk than the less experienced (blue belt and purple belt) competitors; however, the difference was not significant (incidence rate ratio = 1.65, 95% confidence interval = 0.9, 2.9; P = .06). The incidence of joint injury was highest at the knee (7.5 per 1000 AEs) and elbow (7.5 per 1000 AEs). Conclusions: The data from this international Brazilian jiujitsu tournament indicated that the risk of joint injury was similar among belt ranks or experience during this Brazilian jiujitsu competition. The knee and elbow were the joints most susceptible to injury. Future investigation of injury mechanism is warranted to develop strategies to reduce potential risk factors attributed to injury. PMID:24377959

Incidence of injury among male Brazilian jiujitsu fighters at the World Jiu-Jitsu No-Gi Championship 2009.

PubMed

Kreiswirth, Ethan M; Myer, Gregory D; Rauh, Mitchell J

2014-01-01

Brazilian jiujitsu is a modern combat martial art that uses joint locks to submit an opponent and achieve victory. This form of martial art is a relatively young but rapidly growing combat sport worldwide. To determine the cumulative injury incidence and risk of injury by belt rank and body region at an international-level Brazilian jiujitsu tournament. Descriptive epidemiology study. World Jiu-Jitsu No-Gi Championship 2009 in Long Beach, California. We monitored 951 athletes (age range, 18-50 years) enrolled to compete in the World Jiu-Jitsu No-Gi Championship 2009. Fighters were categorized by belt level for group comparisons (belt experience). Incidence rates per 1000 athlete-exposures (AEs) and incidence rate ratios were compared by belt rank. Incidence rates and incidence rate ratios. During the tournament, 1606 AEs and 62 total injuries were reported. Of these injuries, 40 affected the joints, for an overall incidence rate of 24.9 per 1000 AEs. The joint incidence rate by belt rank was 21.5 per 1000 AEs for blue, 21.3 per 1000 AEs for purple, 25.2 per 1000 AEs for brown, and 35.1 per 1000 AEs for black. We found no differences for incidence rate ratios of joint injury among individual belt groups (P > .05). More experienced (brown belt and black belt) competitors had a higher injury risk than the less experienced (blue belt and purple belt) competitors; however, the difference was not significant (incidence rate ratio = 1.65, 95% confidence interval = 0.9, 2.9; P = .06). The incidence of joint injury was highest at the knee (7.5 per 1000 AEs) and elbow (7.5 per 1000 AEs). The data from this international Brazilian jiujitsu tournament indicated that the risk of joint injury was similar among belt ranks or experience during this Brazilian jiujitsu competition. The knee and elbow were the joints most susceptible to injury. Future investigation of injury mechanism is warranted to develop strategies to reduce potential risk factors attributed to injury.

Under-reporting of violent incidents against nursing staff.

PubMed

Ferns, Terry

This article examines factors that contribute to nurses failing to report incidents of violence and aggression in the clinical area and it develops the information published in a previous article (Ferns and Chojnacka 2005). Broader social factors are considered, including gender, violence experienced by women, the status of the nursing profession and bureaucratic structures that contribute to under-reporting. The life experiences of individual nursing staff play a significant role in how they react to violence in the clinical area. Strategies to minimise violence against nurses should consider the social, political and personal issues that limit the reporting of violent incidents. Only by reporting such incidents can the extent of violence towards nurses be determined and minimised.

Prospective Investigation of Injury Rates and Injury Risk Factors Among Federal Bureau of Investigation New Agent Trainees, Quantico, Virginia, 2009-2010

DTIC Science & Technology

2010-08-01

assistance of the United States Army Public Health Command (USAPHC) in injury prevention efforts at the FBI New Agent Training Program at the FBI...personnel to apply their experience in injury prevention programs in military training to assist in injury prevention efforts in the FBI New Agent... prevention recommendations USAPHC had made Army-wide. USAPHC personnel proposed a methodology to evaluate injury incidence and injury risk factors

Identification of Human Factors in Unmanned Aviation Via Pilot Incident Reports

NASA Technical Reports Server (NTRS)

Hobbs, Alan; Cardoza, Colleen; Null, Cynthia

2015-01-01

There is a need for incident data relevant to the operation of civilian unmanned aircraft systems (UAS) in the National Air Space (NAS). Currently, very limited incident and accident data are available from military sources, and the tightly-restricted civilian UAS industry has produced very few incident reports that could shed light on design issues relevant to human factors. An exploratory study is being conducted to examine the feasibility of collecting voluntary critical incident reports from UAS pilots, and using the information to identify areas where human factors guidelines will be of assistance. Experienced UAS pilots are participating in small focus groups in which they are prompted to describe critical incidents that either reveal a system flaw, or highlight a case where the human operator contributed to system resilience or mission success. The de-identified incidents are being analyzed to identify contributing factors, with a focus on design issues that either hindered or assisted the pilot in dealing with the incident. Preliminary findings will be described.

Abuse and neglect experienced by aging chinese in Canada.

PubMed

Lai, Daniel W L

2011-10-01

The traditional values of Chinese culture promote care and respect toward older adults. While it appears to be ironic to discuss issues of abuse and neglect in the Chinese culture, research findings in Chinese societies do indicate the occurrences of such problems. However, little research on the abuse and neglect of older Chinese in Western societies has been available. This study aims to examine the incidence of abuse and neglect and the associated correlates based on data collected from a random sample of 2,272 aging Chinese 55 years and older in seven Canadian cities. The findings show that 4.5% of the participants reported experiencing at least one incident of maltreatment or neglect within the past year. The most common forms of neglect and abuse experienced by the aging Chinese include being scolded, yelled at, treated impolitely all the time, and ridiculed. Close family members such as spouses and sons are those that most commonly maltreat older Chinese. Those who were more likely to report at least one incident of maltreatment or neglect were older adults living with others; they tended to have no education, more access barriers, more chronic illnesses, less favorable mental health, and a higher level of identification with Chinese cultural values. The findings implied that the face value of respect and care received by older people in Chinese culture should not be taken for granted. Culturally appropriate precautionary steps are needed for prevention and early problem identification.

Fall prevalence, time trend and its related risk factors among elderly people in China.

PubMed

Wu, Hong; Ouyang, Peng

2017-11-01

To study the fall prevalence, time trends and related risk factors among elderly people in the Chinese mainland from 2011 to 2013. Our data were from China Health and Retirement Longitudinal Study in 2011 and 2013. The population sample included people aged 60 years and over. Whether the person had experienced fall accident in the last two years was used to measure fall incidence. The time trend and age groups were investigated through the chi-square test. The related risk factors were examined based on the binary logistic regression model. In 2011, 19.64% (95% CI, 18.66%, 20.67%) of elderly people experienced fall incidents and in 2013, 19.28% (95% CI, 18.46%, 20.13%) of elderly people experienced fall incidents. However, no significant difference was seen in the fall prevalence between 2011 and 2013. The fall prevalence among elderly people aged 66-70 declined significantly while that among people aged over 80 showed an increasing time trend. The fall prevalence was affected significantly by factors including age (66-70), gender, marital status, self-rated health, quantity of chronic diseases, quantity of disability items, activities of daily living and physical functioning. It is revealed the fall prevalence showed no increment from 2011 to 2013 but at a high level. More efforts should be made to reduce the fall prevalence, and special attention should be paid to the elderly people aged over 80 and older. Copyright © 2017 Elsevier B.V. All rights reserved.

Management of Contaminated Autologous Grafts in Plastic Surgery

PubMed Central

Centeno, Robert F; Desai, Ankit R; Watson, Marla E

2008-01-01

Background: Contamination of autologous grafts unfortunately occurs in plastic surgery, but the literature provides no guidance for management of such incidents. Methods: American Society of Aesthetic Plastic Surgery members were asked to complete an online survey that asked about the number and causes of graft contaminations experienced, how surgeons dealt with the problem, the clinical outcomes, and patient disclosure. Results: Nineteen hundred surgeons were asked to participate in the survey, and 223 responded. Of these, 70% had experienced at least 1 graft contamination incident, with 26% experiencing 4 or more. The most frequently reported reason for graft contamination was a graft falling on the floor (reported by 75%). Nearly two thirds of the contaminated grafts related to craniofacial procedures. Ninety-four percent of grafts were managed with decontamination and completion of the operation. The most common method of decontamination was washing with povidone-iodine, but this practice is contrary to recommendations in the literature. Only 3 surgeons (1.9%) said a clinical infection developed following decontaminated graft use. Patients were not informed in 60% of graft contamination incidents. The survey results and review of the literature led to development of algorithms for the management of inadvertent graft contamination and patient disclosure. Conclusions: Although autologous grafts do become contaminated in plastic surgery, the overwhelming majority can be safely decontaminated and produce minimal or no clinical sequelae. The algorithms presented are intended to serve as guides for prevention of contamination events or for their management should they occur. PMID:18496583

Human Factors of Remotely Piloted Aircraft Systems: Lessons from Incident Reports

NASA Technical Reports Server (NTRS)

Hobbs, Alan; Null, Cynthia

2016-01-01

An exploratory study is being conducted to examine the feasibility of collecting voluntary critical incident reports from RPAS pilots. Twenty-three experienced RPAS pilots volunteered to participate in focus groups in which they described critical incidents from their own experience. Participants were asked to recall (1) incidents that revealed a system flaw, or (2) highlighted a case where the human operator contributed to system resilience or mission success. Participants were asked to only report incidents that could be included in a public document. A total of 90 incidents were reported. Human factor issues included the impact of reduced sensory cues, traffic separation in the absence of an out-the-window view, control latencies, vigilance during monotonous and ultra-long endurance flights, control station design considerations, transfer of control between control stations, the management of lost link procedures, and decision-making during emergencies.

Ramp-related incidents involving wheeled mobility device users during transit bus boarding/alighting.

PubMed

Frost, Karen L; Bertocci, Gina; Smalley, Craig

2015-05-01

To estimate the prevalence of wheeled mobility device (WhMD) ramp-related incidents while boarding/alighting a public transit bus and to determine whether the frequency of incidents is less when the ramp slope meets the proposed Americans with Disabilities Act (ADA) maximum allowable limit of ≤9.5°. Observational study. Community public transportation. WhMD users (N=414) accessing a public transit bus equipped with an instrumented ramp. Not applicable. Prevalence of boarding/alighting incidents involving WhMD users and associated ramp slopes; factors affecting incidents. A total of 4.6% (n=35) of WhMD users experienced an incident while boarding/alighting a transit bus. Significantly more incidents occurred during boarding (6.3%, n=26) than during alighting (2.2%, n=9) (P<.01), and when the ramp was deployed to street level (mean slope=11.4°) compared with sidewalk level (mean slope=4.2°) (P=.01). The odds ratio for experiencing an incident when the ramp slope exceeded the proposed ADA maximum allowable ramp slope was 5.4 (95% confidence interval, 2.4-12.2; P<.01). The odds ratio for assistance being rendered to board/alight when the ramp slope exceeded the proposed ADA maximum allowable ramp slope was 5.1 (95% confidence interval, 2.9-9.0; P<.01). The findings of this study support the proposed ADA maximum allowable ramp slope of 9.5°. Ramp slopes >9.5° and ramps deployed to street level are associated with a higher frequency of incidents and provision of assistance. Transit agencies should increase awareness among bus operators of the effect kneeling and deployment location (street/sidewalk) have on the ramp slope. In addition, ramp components and the built environment may contribute to incidents. When prescribing WhMDs, skills training must include ascending/descending ramps at slopes encountered during boarding/alighting to ensure safe and independent access to public transit buses. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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

Ha, Kyoo-Man, E-mail: ha1999@hotmail.com

In Korea, there is a pervasive feeling of invincibility to the point that people and organizations do not believe that disasters can strike them. This has impact on the level of preparedness for disasters. This study aims to delve into how Korea has to change its governmental policies/practices with some private partners' efforts to mitigate disaster risks. A case study was utilized as the major methodology by comparing exclusive management with inclusive management. These two approaches have been comparatively analyzed via four variables, namely the central government, the local governments, the incident commander, and other stakeholders. The major finding ismore » that Korea's practices and policies have to evolve from the current exclusive management into future-oriented inclusive management. Moreover, the importance of communication, cooperation, collaboration, and multi-discipline coordination is discussed. Additionally, the problem of reductionism and equal participation among all stakeholders, as well as the resistance from vested interests, are recognized and elaborated for Korea and the international community. - Highlights: • Only a few stakeholders in Korea believe that disaster can happen to anyone. This study aims to delve into how Korea has to change its current practices to mitigate disaster risks. • To compare exclusive management with inclusive management, we have examined four comparative variables, namely the central government's policy, local government's strategy, the incident commander's post, and other stakeholders' efforts. • The major finding is that Korea's practices and policies have to evolve from the current exclusive management into future-oriented inclusive management.« less

Prehospital care in Hong Kong.

PubMed

Lo, C B; Lai, K K; Mak, K P

2000-09-01

A quick and efficient prehospital emergency response depends on immediate ambulance dispatch, patient assessment, triage, and transport to hospital. During 1999, the Ambulance Command of the Hong Kong Fire Services Department responded to 484,923 calls, which corresponds to 1329 calls each day. Cooperation between the Fire Services Department and the Hospital Authority exists at the levels of professional training of emergency medical personnel, quality assurance, and a coordinated disaster response. In response to the incident at the Hong Kong International Airport in the summer of 1999, when an aircraft overturned during landing, the pre-set quota system was implemented to send patients to designated accident and emergency departments. Furthermore, the 'first crew at the scene' model has been adopted, whereby the command is established and triage process started by the first ambulance crew members to reach the scene. The development of emergency protocols should be accompanied by good field-to-hospital and interhospital communication, the upgrading of decision-making skills, a good monitoring and auditing structure, and commitment to training and skills maintenance.

Magellan attitude control mission operations

NASA Technical Reports Server (NTRS)

Dukes, Eileen M.

1993-01-01

From the Martin Marietta Astronautics Group base in Denver, Colorado, spacecraft engineers have been operating the Magellan spacecraft for the past three and one half years, along with the Jet Propulsion Laboratory, for NASA. The spacecraft team in Denver is responsible for the health of the vehicle, from command generation to evaluation of engineering telemetry. Operation of the spacecraft's Attitude and Articulation Control Subsystem (AACS) has specifically posed several in-flight challenges. This system must provide accurate pointing of the spacecraft throughout each 3.2 hour orbit which typically consists of 5 - 9 discrete maneuvers. Preparation of bi-weekly command sequences, monitoring execution, and trending of subsystem performance is of paramount importance, but in-flight anomalies have also demanded the attention of AACS engineers. Anomalies are often very interesting and challenging aspects of a project, and the Magellan mission was no exception. From the first unsuccessful attempts to perform a starscan, to spacecraft safing events, much has been experienced to add to the `lessons learned' from this mission. Many of Magellan's in-flight experiences, anomalies, and their resolutions are highlighted in this paper.

Rhetorical skills as a component of midwifery care.

PubMed

Domajnko, Barbara; Drglin, Zalka; Pahor, Majda

2011-04-01

this article argues that rhetorical skills are an important quality factor of midwifery care. In particular, it aims to identify and discuss the relevance of three classical means of persuasion: ethos, pathos and logos. secondary analysis, rhetorical analysis of semi-structured interviews. Slovenia. Interviews were carried out predominantly in 2006. Data refer to childbirths in 2005 and 2006. four women with recent experience of childbirth. analysis identified the presence of all three means of persuasion in the interaction between midwives and women. Focusing on midwives, the quality of their awareness and command of rhetorical skills remains questionable. In particular, women experienced lack of a rational account of the situation and decisions made by health-care professionals involved in maternity care. acknowledging professional ethics, awareness and good command of all three means of persuasion [but above all, argumentative persuasion (logos)] is an integral component of midwifery care. It can contribute to collaborative relations between midwives and women, and thus promote women-centred midwifery care. knowledge of the three classical rhetorical means of persuasion should be integrated into professional midwifery curricula. Copyright © 2009 Elsevier Ltd. All rights reserved.

Magellan attitude control mission operations

NASA Astrophysics Data System (ADS)

Dukes, Eileen M.

From the Martin Marietta Astronautics Group base in Denver, Colorado, spacecraft engineers have been operating the Magellan spacecraft for the past three and one half years, along with the Jet Propulsion Laboratory, for NASA. The spacecraft team in Denver is responsible for the health of the vehicle, from command generation to evaluation of engineering telemetry. Operation of the spacecraft's Attitude and Articulation Control Subsystem (AACS) has specifically posed several in-flight challenges. This system must provide accurate pointing of the spacecraft throughout each 3.2 hour orbit which typically consists of 5 - 9 discrete maneuvers. Preparation of bi-weekly command sequences, monitoring execution, and trending of subsystem performance is of paramount importance, but in-flight anomalies have also demanded the attention of AACS engineers. Anomalies are often very interesting and challenging aspects of a project, and the Magellan mission was no exception. From the first unsuccessful attempts to perform a starscan, to spacecraft safing events, much has been experienced to add to the `lessons learned' from this mission. Many of Magellan's in-flight experiences, anomalies, and their resolutions are highlighted in this paper.

The association of statin therapy with the risk of recurrent venous thrombosis.

PubMed

Smith, N L; Harrington, L B; Blondon, M; Wiggins, K L; Floyd, J S; Sitlani, C M; McKnight, B; Larson, E B; Rosendaal, F R; Heckbert, S R; Psaty, B M

2016-07-01

Essentials A lowered risk of recurrent venous thrombosis (VT) with statin treatment is controversial. Among observational inception cohort of 2,798 adults with incident VT, 457 had recurrent VT. Time-to-event models with time-varying statin use and adjustment for potential confounders was used for analysis. Compared to nonuse, current statin use was associated with 26% lower risk of recurrent VT. Click to hear Prof. Büller's perspective on Anticoagulant Therapy in the Treatment of Venous Thromboembolism Background Meta-analyses of randomized controlled trials suggest that treatment with hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) lowers the risk of incident venous thrombosis (VT), particularly among those without prevalent clinical cardiovascular disease (CVD). Whether this is true for the prevention of recurrent VT is debated. We used an observational inception cohort to estimate the association of current statin use with the risk of recurrent VT. Methods and Results The study setting was a large healthcare organization with detailed medical record and pharmacy information at cohort entry and throughout follow-up. We followed 2798 subjects 18-89 years of age who experienced a validated incident VT between January 1, 2002, and December 31, 2010, for a first recurrent VT, validated by medical record review. During follow-up, 457 (16%) developed a first recurrent VT. In time-to-event models incorporating time-varying statin use and adjusting for potential confounders, current statin use was associated with a 26% lower risk of recurrent VT: hazard ratio 0.74, 95% confidence interval 0.59-0.94. Among cohort members free of CVD (n = 2134), current statin use was also associated with a lower risk (38%) of recurrent VT: hazard ratio 0.62, 95% confidence interval 0.45-0.85. We found similar results when restricting to new users of statins and in subgroups of different statin types and doses. Conclusions In a population-based cohort of subjects who had experienced an incident VT, statin use, compared with nonuse, was associated with a clinically relevant lower risk of recurrent VT. These findings suggest a potential secondary benefit of statins among patients who have experienced an incident VT. © 2016 International Society on Thrombosis and Haemostasis.

Crew/Automation Interaction in Space Transportation Systems: Lessons Learned from the Glass Cockpit

NASA Technical Reports Server (NTRS)

Rudisill, Marianne

2000-01-01

The progressive integration of automation technologies in commercial transport aircraft flight decks - the 'glass cockpit' - has had a major, and generally positive, impact on flight crew operations. Flight deck automation has provided significant benefits, such as economic efficiency, increased precision and safety, and enhanced functionality within the crew interface. These enhancements, however, may have been accrued at a price, such as complexity added to crew/automation interaction that has been implicated in a number of aircraft incidents and accidents. This report briefly describes 'glass cockpit' evolution. Some relevant aircraft accidents and incidents are described, followed by a more detailed description of human/automation issues and problems (e.g., crew error, monitoring, modes, command authority, crew coordination, workload, and training). This paper concludes with example principles and guidelines for considering 'glass cockpit' human/automation integration within space transportation systems.

The psychic costs of empathic engagement: personal and demographic predictors of genetic counselor compassion fatigue.

PubMed

Udipi, Sharanya; Veach, Patricia McCarthy; Kao, Juihsien; LeRoy, Bonnie S

2008-10-01

Empathic connection with one's patients is essential to genetic counselor clinical practice. However, repeatedly engaging with distressed patients may cause compassion fatigue, a phenomenon characterized as feeling overwhelmed by experiencing patients' suffering. In order to extend findings of an initial qualitative study, we surveyed 222 genetic counselors about their compassion fatigue and factors that predict its occurrence. Multiple regression analysis identified seven significant predictors accounting for 53.7% of the variance in compassion fatigue. Respondents at higher risk of compassion fatigue were more likely to report being burned out, using self-criticism and giving up to manage stress, experiencing a greater variety of distressing clinical events, having larger patient caseloads, relying on religion as a coping strategy, having no children, and seeking support to manage stress. Respondents also provided critical incidents regarding their compassion fatigue and themes in these incidents are described. Practice and research recommendations are provided.

The incidence of technological stress among baccalaureate nurse educators using technology during course preparation and delivery.

PubMed

Burke, Mary S

2009-01-01

The concept of technology-related stress was first introduced in the 1980s when computers became more prevalent in the business and academic world. Nurse educators have been impacted by the rapid changes in technology in recent years. A review of the literature revealed no research studies that have been conducted to investigate the incidence of technological stress among nurse educators. The purpose of this descriptive-correlational study was to describe the technological stressors that Louisiana baccalaureate nurse educators experienced while teaching nursing theory courses. A researcher-developed questionnaire, the nurse educator technostress scale (NETS) was administered to a census sample of 311 baccalaureate nurse educators in Louisiana. Findings revealed that Louisiana baccalaureate nurse educators are experiencing technological stress. The variable, perceived administrative support for use of technology in the classroom, was a significant predictor in a regression model predicting Louisiana baccalaureate nurse educators' technological stress (F=14.157, p<.001).

Spontaneous pushing to prevent postpartum urinary incontinence: a randomized, controlled trial

PubMed Central

Miller, Janis M.; Guo, Ying; Ashton-Miller, James A.; DeLancey, John O. L.; Sampselle, Carolyn M.

2014-01-01

Introduction and hypothesis The risk for urinary incontinence can be 2.6-fold greater in women after pregnancy and childbirth compared with their never-pregnant counterparts, with the incidence increasing with parity. We tested the hypothesis that the incidence of de novo postpartum urinary incontinence in primiparous women is reduced with the use of spontaneous pushing alone or in combination with perineal massage compared with women who experienced traditional directed pushing for second-stage management. Methods This was a prospective clinical trial enrolling and randomizing 249 women into a four-group design: (1) routine care with coached or directed pushing, (2) spontaneous self-directed pushing, (3) prenatal perineal massage initiated in the third trimester, and (4) the combination of spontaneous pushing plus perineal massage. Self-report of incontinence was assessed using analysis of variance (ANOVA) and covariance (ANCOVA) models in 145 remaining women at 12 months postpartum using the Leakage Index, which is sensitive to minor leakage. Results No statistical difference in the incidence of de novo postpartum incontinence was found based on method of pushing (spontaneous/directed) (P value=0.57) or in combination with prenatal perineal massage (P value=0.57). Fidelity to pushing treatment of type was assessed and between-groups crossover detected. Conclusions Spontaneous pushing did not reduce the incidence of postpartum incontinence experienced by women 1 year after their first birth due to high cross-over between randomization groups. PMID:22829349

Spontaneous pushing to prevent postpartum urinary incontinence: a randomized, controlled trial.

PubMed

Low, Lisa Kane; Miller, Janis M; Guo, Ying; Ashton-Miller, James A; DeLancey, John O L; Sampselle, Carolyn M

2013-03-01

The risk for urinary incontinence can be 2.6-fold greater in women after pregnancy and childbirth compared with their never-pregnant counterparts, with the incidence increasing with parity. We tested the hypothesis that the incidence of de novo postpartum urinary incontinence in primiparous women is reduced with the use of spontaneous pushing alone or in combination with perineal massage compared with women who experienced traditional directed pushing for second-stage management. This was a prospective clinical trial enrolling and randomizing 249 women into a four-group design: (1) routine care with coached or directed pushing, (2) spontaneous self-directed pushing, (3) prenatal perineal massage initiated in the third trimester, and (4) the combination of spontaneous pushing plus perineal massage. Self-report of incontinence was assessed using analysis of variance (ANOVA) and covariance (ANCOVA) models in 145 remaining women at 12 months postpartum using the Leakage Index, which is sensitive to minor leakage. No statistical difference in the incidence of de novo postpartum incontinence was found based on method of pushing (spontaneous/directed) (P value = 0.57) or in combination with prenatal perineal massage (P value = 0.57). Fidelity to pushing treatment of type was assessed and between-groups crossover detected. Spontaneous pushing did not reduce the incidence of postpartum incontinence experienced by women 1 year after their first birth due to high cross-over between randomization groups.

Human fatigue and the crash of the airship Italia.

PubMed

Bendrick, Gregg A; Beckett, Scott A; Klerman, Elizabeth B

2016-01-01

The airship Italia , commanded by General Umberto Nobile, crashed during its return flight from the North Pole in 1928. The cause of the accident was never satisfactorily explained. We present evidence that the crash may have been fatigue-related. Nobile's memoirs indicate that at the time of the crash he had been awake for at least 72 h. Sleep deprivation impairs multiple aspects of cognitive functioning necessary for exploration missions. Just prior to the crash, Nobile made three command errors, all of which are of types associated with inadequate sleep. First, he ordered a release of lift gas when he should have restarted engines (an example of incorrect data synthesis, with deterioration of divergent thinking); second, he inappropriately ordered the ship above the cloud layer (a deficiency in the assessment of relative risks); and third, he remained above the cloud layer for a prolonged period of time (examples of attention to secondary problems, and calculation problems). We argue that as a result of these three errors, which would not be expected from such an experienced commander, there was no longer enough static lift to maintain level flight when the ship went below the cloud layer. Applying Circadian Performance Simulation Software to the sleep-wake patterns described by Nobile in his memoirs, we found that the predicted performance for someone awake as long as he had been is extremely low. This supports the historical evidence that human fatigue contributed to the crash of the Italia .

Human fatigue and the crash of the airship Italia

PubMed Central

Bendrick, Gregg A.; Beckett, Scott A.; Klerman, Elizabeth B.

2016-01-01

The airship Italia, commanded by General Umberto Nobile, crashed during its return flight from the North Pole in 1928. The cause of the accident was never satisfactorily explained. We present evidence that the crash may have been fatigue-related. Nobile’s memoirs indicate that at the time of the crash he had been awake for at least 72 h. Sleep deprivation impairs multiple aspects of cognitive functioning necessary for exploration missions. Just prior to the crash, Nobile made three command errors, all of which are of types associated with inadequate sleep. First, he ordered a release of lift gas when he should have restarted engines (an example of incorrect data synthesis, with deterioration of divergent thinking); second, he inappropriately ordered the ship above the cloud layer (a deficiency in the assessment of relative risks); and third, he remained above the cloud layer for a prolonged period of time (examples of attention to secondary problems, and calculation problems). We argue that as a result of these three errors, which would not be expected from such an experienced commander, there was no longer enough static lift to maintain level flight when the ship went below the cloud layer. Applying Circadian Performance Simulation Software to the sleep–wake patterns described by Nobile in his memoirs, we found that the predicted performance for someone awake as long as he had been is extremely low. This supports the historical evidence that human fatigue contributed to the crash of the Italia. PMID:28490834

KC-135A Winglet Flight Flutter Program

NASA Technical Reports Server (NTRS)

Kehoe, M. W.

1982-01-01

The evaluation techniques, results and conclusions for the flight flutter testing conducted on a KC-135A airplane configured with and without winglets are discussed. Test results are presented for the critical symmetric and antisymmetric modes for a fuel distribution that consisted of 10,000 pounds in each wing main tank and empty reserve tanks. The results indicated that a lightly damped oscillation was experienced for a winglet configuration of a 0 deg cant and -4 deg incidence. The effects of cant and incidence angle variation on the critical modes are also discussed. Lightly damped oscillations were not encountered for any other winglet cant and incidence angles tested.

Mass-casualty Response to the Kiss Nightclub in Santa Maria, Brazil.

PubMed

Dal Ponte, Silvana T; Dornelles, Carlos F D; Arquilla, Bonnie; Bloem, Christina; Roblin, Patricia

2015-02-01

On January 27, 2013, a fire at the Kiss Nightclub in Santa Maria, Brazil led to a mass-casualty incident affecting hundreds of college students. A total of 234 people died on scene, 145 were hospitalized, and another 623 people received treatment throughout the first week following the incident.1 Eight of the hospitalized people later died.1 The Military Police were the first on scene, followed by the state fire department, and then the municipal Mobile Prehospital Assistance (SAMU) ambulances. The number of victims was not communicated clearly to the various units arriving on scene, leading to insufficient rescue personnel and equipment. Incident command was established on scene, but the rescuers and police were still unable to control the chaos of multiple bystanders attempting to assist in the rescue efforts. The Municipal Sports Center (CDM) was designated as the location for dead bodies, where victim identification and communication with families occurred, as well as forensic evaluation, which determined the primary cause of death to be asphyxia. A command center was established at the Hospital de Caridade Astrogildo de Azevedo (HCAA) in Santa Maria to direct where patients should be admitted, recruit staff, and procure additional supplies, as needed. The victims suffered primarily from smoke inhalation and many required endotracheal intubation and mechanical ventilation. There was a shortage of ventilators; therefore, some had to be borrowed from local hospitals, neighboring cities, and distant areas in the state. A total of 54 patients1 were transferred to hospitals in the capital city of Porto Alegre (Brazil). The main issues with the response to the fire were scene control and communication. Areas for improvement were identified, namely the establishment of a disaster-response plan, as well as regularly scheduled training in disaster preparedness/response. These activities are the first steps to improving mass-casualty responses.

Influence of torque control motors and the operator's proficiency on ProTaper failures.

PubMed

Yared, Ghassan; Bou Dagher, Fadia; Kulkarni, Kiran

2003-08-01

The purpose of this study was to evaluate the influence of 2 electric torque control motors and operator experience with a specific nickel-titanium rotary instrumentation technique on the incidence of deformation and separation of instruments. ProTaper (PT) nickel-titanium rotary instruments were used at 300 rpm. In the first part of the study, electric high torque control (group 1) and low torque control (group 2) motors were compared. In the second part of the study, 3 operators with varying experience (groups 3, 4, and 5) were also compared. Twenty sets of PT instruments and 100 canals of extracted human molars were used in each group. Each set of PT instruments was used in up to 5 canals and sterilized before each case. For irrigation, 2.5% NaOCl was used. The number of deformed and separated instruments among the groups (within each part of the study) was statistically analyzed for significance with pair-wise comparisons by using the Fisher exact test (alpha =.05). In part 1, instrument deformation and separation did not occur in groups 1 and 2. In part 2, 25 and 12 instruments were deformed and separated, respectively, with the least experienced operator. Instrument deformation and separation did not occur with the most experienced operator. The Fisher exact test revealed a significant difference between groups 3 and 4 with respect to instrument deformation (P =.0296). In addition, the Fisher exact test revealed that the incidence of instrument deformation was statistically different between groups 3 and 5 (P <.0001) and groups 4 and 5 (P =.0018). The incidence of instrument separation was significantly higher in group 5 than in groups 3 and 4 (P =.001). Preclinical training in the use of the PT technique at 300 rpm is crucial to prevent instrument separation and reduce the incidence of instrument deformation. The use of an electric high torque control motor is safe with the experienced operator.

Patients with prior vertebral or hip fractures treated with teriparatide in the Direct Assessment of Nonvertebral Fractures in Community Experience (DANCE) observational study.

PubMed

Beall, D P; Feldman, R G; Gordon, M L; Gruber, B L; Lane, J M; Valenzuela, G; Yim, D; Alam, J; Krege, J H; Krohn, K

2016-03-01

In patients in the Direct Assessment of Nonvertebral Fractures in Community Experience (DANCE) observational study with and without a prior vertebral or hip fracture, the incidence of nonvertebral fractures was lower with >6 months of teriparatide treatment than during the first 6 months. Clinical evidence on the effect of teriparatide in patients with prior fracture is limited. In the DANCE observational study, the incidence of nonvertebral fragility fractures (NVFX) decreased significantly in patients receiving teriparatide for >6 months (6-24 months) versus >0 to ≤6 months (reference period). We performed a post hoc analysis to assess the effect of teriparatide 20 μg/day in patients who entered DANCE with prior vertebral or hip fractures. The incidence of patients experiencing a NVFX for four 6-month intervals during and after treatment was compared with the reference period. Overall, 4085 patients received ≥1 dose of teriparatide. Of 3720 with sufficient data for efficacy analysis, 692 had prior vertebral fracture, including 179 with previous kyphoplasty/vertebroplasty; 290 had prior hip fracture. These patients were older, and those with prior vertebral fractures had more comorbid conditions at baseline than those without prior vertebral fractures. The incidence of patients experiencing NVFX declined over time in all patient groups. The fracture incidence rate declined 49 and 46%, respectively, in patients with and without prior vertebral fracture and was 63 and 46% lower in patients with previous kyphoplasty/vertebroplasty and without prior vertebral fracture. NVFX declined 43 and 48% in patients with and without prior hip fracture. The reduced incidence over time was consistent in the subgroups (all interaction p values >0.05). Patients with prior fracture were more likely to experience serious adverse events. The incidence of NVFX decreased over time in patients receiving teriparatide in DANCE regardless of prior fracture status.

Application of a plume model for decision makers' situation awareness during an outdoor airborne HAZMAT release.

PubMed

Meris, Ronald G; Barbera, Joseph A

2014-01-01

In a large-scale outdoor, airborne, hazardous materials (HAZMAT) incident, such as ruptured chlorine rail cars during a train derailment, the local Incident Commanders and HAZMAT emergency responders must obtain accurate information quickly to assess the situation and act promptly and appropriately. HAZMAT responders must have a clear understanding of key information and how to integrate it into timely and effective decisions for action planning. This study examined the use of HAZMAT plume modeling as a decision support tool during incident action planning in this type of extreme HAZMAT incident. The concept of situation awareness as presented by Endsley's dynamic situation awareness model contains three levels: perception, comprehension, and projection. It was used to examine the actions of incident managers related to adequate data acquisition, current situational understanding, and accurate situation projection. Scientists and engineers have created software to simulate and predict HAZMAT plume behavior, the projected hazard impact areas, and the associated health effects. Incorporating the use of HAZMAT plume projection modeling into an incident action plan may be a complex process. The present analysis used a mixed qualitative and quantitative methodological approach and examined the use and limitations of a "HAZMAT Plume Modeling Cycle" process that can be integrated into the incident action planning cycle. HAZMAT response experts were interviewed using a computer-based simulation. One of the research conclusions indicated the "HAZMAT Plume Modeling Cycle" is a critical function so that an individual/team can be tasked with continually updating the hazard plume model with evolving data, promoting more accurate situation awareness.

Ikhana UAS Overview

NASA Technical Reports Server (NTRS)

Rivas, Mauricio

2017-01-01

Ikhana demonstrates capabilities of UAS to overfly and collect sensor data on widespread fires throughout Western US and also demonstrate long-endurance mission capabilities (20-hours+). Ikhana images multiple fires (greater than 4 fires per mission), to showcase extendable mission configuration and ability to either linger over key fires or station over disparate regional fires. Ikhana also demonstrates new UAV-compatible, autonomous sensor for improved thermal characterization of fires. Also it provides automated, on-board, terrain and geo-rectified sensor imagery over the horizon SATCOM links to national fire personnel and Incident commanders.

Incidence of admission to the Physical Training and Rehabilitation Programs in Initial Entry Training during fiscal year 2011.

PubMed

Devlin, Jevettra D; Knapik, Joseph J; Solomon, Zack; Hauret, Keith G; Morris, Krystal; Carter, Robert; McGill, Ryan; Paoli, Latondra

2014-05-01

The Physical Training and Rehabilitation Program (PTRP) is a recovery and reintegration program for recruits in Initial Entry Training (IET) who are unable to continue training because of serious injury. This investigation examined PTRP admission incidence among recruits in IET at Forts Jackson, Leonard Wood, Benning, and Sill during Fiscal Year 2011 (FY11). PTRP admission data were collected from a spreadsheet completed monthly by PTRP commanders. Total number of recruits was obtained from each post's Directorate of Programs, Training, and Management. In FY11, 368 men and 268 women were admitted into PTRPs at all installations. For Forts Jackson, Leonard Wood, Benning, and Sill, male admission incidences (cases/1,000 recruits) were 2.6, 3.0, 6.2, and 5.4, respectively; female admission incidences for Forts Jackson, Leonard Wood, and Sill, were 11.1, 10.1, and 22.6, respectively. Most injuries sent to PTRP were bone stress injuries (65%) or fractures (21%). 76% of recruits were returned to duty. Differences in admission incidence between posts appear primarily related to different local policies regarding convalescent leave and admission criteria. PTRP admission rates are lower than in the past, presumably related to policy changes and injury-reduction efforts. A cost-benefit analysis would assist in determining the value of the PTRP. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Increasing Incidence of Listeriosis in France and Other European Countries

PubMed Central

Hedberg, Craig; Le Monnier, Alban; de Valk, Henriette

2008-01-01

From 1999 through 2005, the incidence of listeriosis in France declined from 4.5 to 3.5 cases/million persons. In 2006, it increased to 4.7 cases/million persons. Extensive epidemiologic investigations of clusters in France have ruled out the occurrence of large foodborne disease outbreaks. In addition, no increase has occurred in pregnancy-associated cases or among persons <60 years of age who have no underlying disease. Increases have occurred mainly among persons >60 years of age and appear to be most pronounced for persons >70 years of age. In 8 other European countries, the incidence of listeriosis has increased, or remained relatively high, since 2000. As in France, these increases cannot be attributed to foodborne outbreaks, and no increase has been observed in pregnancy-associated cases. European countries appear to be experiencing an increased incidence of listeriosis among persons >60 years of age. The cause of this selective increased incidence is unknown. PMID:18439354

Men's sexual interest in children: one-year incidence and correlates in a population-based sample of Finnish male twins.

PubMed

Santtila, Pekka; Antfolk, Jan; Räfså, Anna; Hartwig, Maria; Sariola, Heikki; Sandnabba, N Kenneth; Mokros, Andreas

2015-01-01

In a study of 1,310 Finnish adult male twins we found that sexual interest in children aged 12 or younger was reported by 0.2% of the sample. Sexual interest in children aged 15 or younger was reported by 3.3%. Participants reporting sexual interest in children aged 15 or younger were younger, reported stronger sexual desire, and had experienced more childhood sexual and nonsexual abuse. The present study is the first to give a population-based estimate of the incidence of sexual interest in children among adult men. The 12-month incidence of sexual interest in children below the age of 16 years is roughly comparable to the one-year incidence of major depression or the lifetime prevalence of transvestitic fetishism.

Gender and age differences in prevalence and incidence of child sexual abuse in Croatia

PubMed Central

Ajduković, Marina; Sušac, Nika; Rajter, Miroslav

2013-01-01

Aim To examine age and gender differences in the prevalence and incidence of child sexual abuse, the level of acquaintance of the child and the perpetrator, and correlations between experiencing family violence and sexual abuse on a nationally representative sample of 11, 13, and 16 years old children. Method A probabilistic stratified cluster sample included 2.62% of the overall population of children aged 11 (n = 1223), 13 (n = 1188), and 16 (n = 1233) from 40 primary and 29 secondary schools. A modified version of ISPCAN Child Abuse Screening Tool – Children's Version was used. Five items referred to child sexual abuse (CSA) for all age groups. Results In Croatia, 10.8% of children experienced some form of sexual abuse (4.8% to 16.5%, depending on the age group) during childhood and 7.7% of children experienced it during the previous year (3.7% to 11.1%, depending on the age group). Gender comparison showed no difference in the prevalence of contact sexual abuse, whereas more girls than boys experienced non-contact sexual abuse. Correlations between sexual abuse and physical and psychological abuse in the family were small, but significant. Conclusion Comparisons with international studies show that Croatia is a country with a low prevalence of CSA. The fact that the majority of perpetrators of sexual abuse are male and female peers indicates the urgent need to address risks of sexual victimization in the health education of children. PMID:24170726

Gender and age differences in prevalence and incidence of child sexual abuse in Croatia.

PubMed

Ajdukovic, Marina; Susac, Nika; Rajter, Miroslav

2013-10-28

To examine age and gender differences in the prevalence and incidence of child sexual abuse, the level of acquaintance of the child and the perpetrator, and correlations between experiencing family violence and sexual abuse on a nationally representative sample of 11, 13, and 16 years old children. A probabilistic stratified cluster sample included 2.62% of the overall population of children aged 11 (n=1223), 13 (n=1188), and 16 (n=1233) from 40 primary and 29 secondary schools. A modified version of ISPCAN Child Abuse Screening Tool - Children's Version was used. Five items referred to child sexual abuse (CSA) for all age groups. In Croatia, 10.8% of children experienced some form of sexual abuse (4.8% to 16.5%, depending on the age group) during childhood and 7.7% of children experienced it during the previous year (3.7% to 11.1%, depending on the age group). Gender comparison showed no difference in the prevalence of contact sexual abuse, whereas more girls than boys experienced non-contact sexual abuse. Correlations between sexual abuse and physical and psychological abuse in the family were small, but significant. Comparisons with international studies show that Croatia is a country with a low prevalence of CSA. The fact that the majority of perpetrators of sexual abuse are male and female peers indicates the urgent need to address risks of sexual victimization in the health education of children.

Cancer Incidence in Five Continents: Inclusion criteria, highlights from Volume X and the global status of cancer registration.

PubMed

Bray, F; Ferlay, J; Laversanne, M; Brewster, D H; Gombe Mbalawa, C; Kohler, B; Piñeros, M; Steliarova-Foucher, E; Swaminathan, R; Antoni, S; Soerjomataram, I; Forman, D

2015-11-01

Cancer Incidence in Five Continents (CI5), a longstanding collaboration between the International Agency for Research on Cancer and the International Association of Cancer Registries, serves as a unique source of cancer incidence data from high-quality population-based cancer registries around the world. The recent publication of Volume X comprises cancer incidence data from 290 registries covering 424 populations in 68 countries for the registration period 2003-2007. In this article, we assess the status of population-based cancer registries worldwide, describe the techniques used in CI5 to evaluate their quality and highlight the notable variation in the incidence rates of selected cancers contained within Volume X of CI5. We also discuss the Global Initiative for Cancer Registry Development as an international partnership that aims to reduce the disparities in availability of cancer incidence data for cancer control action, particularly in economically transitioning countries, already experiencing a rapid rise in the number of cancer patients annually. © 2015 UICC.

Observations on Hearing Levels of Preschool Cleft-Palate Children

ERIC Educational Resources Information Center

Harrison, Robert J.; Philips, Betty Jane

1971-01-01

Pure-tone audiometry performed monthly on nine preschool cleft palate children showed the incidence of hearing loss ranging from 25 to 71 percent from month to month, with all children experiencing a significant hearing loss at some time. (Author/KW)

James Webb Space Telescope XML Database: From the Beginning to Today

NASA Technical Reports Server (NTRS)

Gal-Edd, Jonathan; Fatig, Curtis C.

2005-01-01

The James Webb Space Telescope (JWST) Project has been defining, developing, and exercising the use of a common eXtensible Markup Language (XML) for the command and telemetry (C&T) database structure. JWST is the first large NASA space mission to use XML for databases. The JWST project started developing the concepts for the C&T database in 2002. The database will need to last at least 20 years since it will be used beginning with flight software development, continuing through Observatory integration and test (I&T) and through operations. Also, a database tool kit has been provided to the 18 various flight software development laboratories located in the United States, Europe, and Canada that allows the local users to create their own databases. Recently the JWST Project has been working with the Jet Propulsion Laboratory (JPL) and Object Management Group (OMG) XML Telemetry and Command Exchange (XTCE) personnel to provide all the information needed by JWST and JPL for exchanging database information using a XML standard structure. The lack of standardization requires custom ingest scripts for each ground system segment, increasing the cost of the total system. Providing a non-proprietary standard of the telemetry and command database definition formation will allow dissimilar systems to communicate without the need for expensive mission specific database tools and testing of the systems after the database translation. The various ground system components that would benefit from a standardized database are the telemetry and command systems, archives, simulators, and trending tools. JWST has exchanged the XML database with the Eclipse, EPOCH, ASIST ground systems, Portable spacecraft simulator (PSS), a front-end system, and Integrated Trending and Plotting System (ITPS) successfully. This paper will discuss how JWST decided to use XML, the barriers to a new concept, experiences utilizing the XML structure, exchanging databases with other users, and issues that have been experienced in creating databases for the C&T system.

Emergency operations program is an excellent platform to deal with in-hospital operation disaster.

PubMed

Rogers, Frederick B; McCune, William; Jammula, Shreya; Gross, Brian W; Bradburn, Eric H; Riley, Deborah K; Manning, Jeffrey

2017-01-01

Described herein is the utilization of the hospital's Emergency Operations Plan and incident command structure to mitigate damage caused by the sudden loss of the heating, ventilation, and air conditioning system within the entire operating room suite. The ability to ameliorate a devastating situation that occurred during working hours at a busy Level II trauma center can be ascribed to the dedication of the leadership and clinical teams working seamlessly together. Their concerted efforts were augmented by adherence to an established protocol that had been thoroughly substantiated and practiced during numerous training simulations. This resulted in successful and timely resolution of an internal crisis that crippled the surgical capabilities of the sole trauma center in the county. After thorough investigation and identification of the issues that contributed to the malfunction, redundancies were built into the system to ensure that a similar incident did not occur again.

The Thai anesthesia incident monitoring study (Thai AIMS): an analysis of perioperative myocardial ischemia/infarction.

PubMed

Ngamprasertwong, Pornswan; Kositanurit, Inthiporn; Yokanit, Preechayuth; Wattanavinit, Rhuthai; Atichat, Sunida; Lapisatepun, Worawut

2008-11-01

To analyze the clinical course, outcome, contributing factors and factors minimizing the incidents of perioperative myocardial ischemia or infarction (PMI) from Thai AIMS study. The present study was a prospective multicenter study. Data was collected from 51 hospitals in Thailand during a six-month period. The participating anesthesia provider completed the standardized incident report form of the Thai AIMS as soon as they found the PMI incident. Each incident was reviewed by three peer reviewers for clinical courses, contributing factors, outcome and minimizing factors of PMI. From the Thai AIMS incident report, the authors found 25 suspected PMI cases which was 0.9% of the 2,669 incidents reported in the present study. Most of the PMI occurred in elective cases (84%) and orthopedic procedures (56%). The majority of PMI was reported from the patients undergoing general anesthesia (72%). Suspected PMI occurred mostly during operations (56%). New ST-T segment change was detected in 92% of these patients. The most common immediate outcome of PMI was major physiological change (88%). The most common management effect of PMI was unplanned ICU admission (64%); the others were prolonged ventilatory support (12%) and prolonged hospital stay (16%). Four patients (16%) died after the suspected PMI. Most of the events occurred spontaneously and were unpreventable (80%). Patient factors (100%), anesthesia factors (72%), surgical factors (32%) and system factors (8%) were all judged as a precipitating factor for PMI. Human factors were the most common contributing factors which included poor preoperative evaluation, inexperience and improper decision. The three most common factors minimizing the adverse incidents included prior experienced, high awareness and experienced assistance. The recommended corrective strategies were guideline practice, quality assurance activity, improvement of supervision and additional training. Perioperative myocardial ischemia/infarction was infrequent but may be lethal. Patient factors were the most common precipitating cause. The morbidity and mortality could be reduced by high quality preoperative evaluation and preparation, early detection and appropriate treatment. Guideline practice, quality assurance activity, improvement of supervision and additional training were suggested corrective strategies.

Impacts of Job Stress and Cognitive Failure on Patient Safety Incidents among Hospital Nurses.

PubMed

Park, Young-Mi; Kim, Souk Young

2013-12-01

This study aimed to identify the impacts of job stress and cognitive failure on patient safety incidents among hospital nurses in Korea. The study included 279 nurses who worked for at least 6 months in five general hospitals in Korea. Data were collected with self-administered questionnaires designed to measure job stress, cognitive failure, and patient safety incidents. This study showed that 27.9% of the participants had experienced patient safety incidents in the past 6 months. Factors affecting incidents were found to be shift work [odds ratio (OR) = 6.85], cognitive failure (OR = 2.92), lacking job autonomy (OR = 0.97), and job instability (OR = 1.02). Patient safety incidents were affected by shift work, cognitive failure, and job stress. Many countermeasures to reduce the incidents caused by shift work, and plans to reduce job stress to reduce the workers' cognitive failure are required. In addition, there is a necessity to reduce job instability and clearly define the scope and authority for duties that are directly related to the patient's safety.

Impacts of Job Stress and Cognitive Failure on Patient Safety Incidents among Hospital Nurses

PubMed Central

Park, Young-Mi; Kim, Souk Young

2013-01-01

Background This study aimed to identify the impacts of job stress and cognitive failure on patient safety incidents among hospital nurses in Korea. Methods The study included 279 nurses who worked for at least 6 months in five general hospitals in Korea. Data were collected with self-administered questionnaires designed to measure job stress, cognitive failure, and patient safety incidents. Results This study showed that 27.9% of the participants had experienced patient safety incidents in the past 6 months. Factors affecting incidents were found to be shift work [odds ratio (OR) = 6.85], cognitive failure (OR = 2.92), lacking job autonomy (OR = 0.97), and job instability (OR = 1.02). Conclusion Patient safety incidents were affected by shift work, cognitive failure, and job stress. Many countermeasures to reduce the incidents caused by shift work, and plans to reduce job stress to reduce the workers' cognitive failure are required. In addition, there is a necessity to reduce job instability and clearly define the scope and authority for duties that are directly related to the patient's safety. PMID:24422177

Real-time physiological monitoring with distributed networks of sensors and object-oriented programming techniques

NASA Astrophysics Data System (ADS)

Wiesmann, William P.; Pranger, L. Alex; Bogucki, Mary S.

1998-05-01

Remote monitoring of physiologic data from individual high- risk workers distributed over time and space is a considerable challenge. This is often due to an inadequate capability to accurately integrate large amounts of data into usable information in real time. In this report, we have used the vertical and horizontal organization of the 'fireground' as a framework to design a distributed network of sensors. In this system, sensor output is linked through a hierarchical object oriented programing process to accurately interpret physiological data, incorporate these data into a synchronous model and relay processed data, trends and predictions to members of the fire incident command structure. There are several unique aspects to this approach. The first includes a process to account for variability in vital parameter values for each individual's normal physiologic response by including an adaptive network in each data process. This information is used by the model in an iterative process to baseline a 'normal' physiologic response to a given stress for each individual and to detect deviations that indicate dysfunction or a significant insult. The second unique capability of the system orders the information for each user including the subject, local company officers, medical personnel and the incident commanders. Information can be retrieved and used for training exercises and after action analysis. Finally this system can easily be adapted to existing communication and processing links along with incorporating the best parts of current models through the use of object oriented programming techniques. These modern software techniques are well suited to handling multiple data processes independently over time in a distributed network.

Defining the problem, main objective, and strategies of medical management in mass-casualty incidents caused by terrorist events.

PubMed

Ashkenazi, Itamar; Kessel, Boris; Olsha, Oded; Khashan, Tawfik; Oren, Meir; Haspel, Jacob; Alfici, Ricardo

2008-01-01

Based on the experience of managing > 20 such events during the last decade, the authors' understanding of a mass-casualty incident is that it is an event in which there may be many victims, but only a few that actually suffer from life-threatening injuries. To make an impact on survival, one must identify those who are severely wounded as quickly as possible and offer those patients optimal care. Experienced trauma physicians are the most important resource available to achieve this objective, and they should be allocated to the treatment of seriously injured victims instead of more traditional management roles such as triage and incident manager.

Systolic blood pressure, arterial rigidity, and risk of stroke. The Framingham study.

PubMed

Kannel, W B; Wolf, P A; McGee, D L; Dawber, T R; McNamara, P; Castelli, W P

1981-03-27

Based on prospective data from the Framingham study relating systolic pressure, diastolic pressure, age, and pulse-wave configuration to future stroke incidence, it would appear that isolated systolic hypertension predisposes to stroke independent of arterial rigidity. The prevalence of isolated systolic hypertension increased with age and with the degree of blunting of the dicrotic notch in the pulse wave. Subjects with isolated systolic hypertension experienced two to four times as many strokes as did normotensive persons. While diastolic pressure is related to stroke incidence, in the subject with systolic hypertension, the diastolic component adds little to risk assessment and in men, in this subgroup, appears unrelated to stroke incidence.

Daily reports of witnessing and experiencing peer harassment in middle school.

PubMed

Nishina, Adrienne; Juvonen, Jaana

2005-01-01

Two studies examined daily incidents of peer harassment in urban middle schools. Sixth-grade students (M age = 11 years) described their daily personal experiences and witnessed accounts of peer harassment, and rated their negative feelings across a 2-week period. In Study 1 (n = 95), within-subject analyses across 4 days revealed that both personally experienced and witnessed harassment were associated with increases in daily anxiety, whereas witnessing harassment buffered students against increases in humiliation on days when they personally experienced harassment. Evidence for witnessing as a buffer against increases in humiliation and anger was also found in Study 2 (n = 97) that included 5 daily reports. Witnessing harassment also protected students against increases in negative self-perceptions.

Sexual harassment during clinical clerkships in Dutch medical schools.

PubMed

Rademakers, Jany J D J M; van den Muijsenbergh, Maria E T C; Slappendel, Geerte; Lagro-Janssen, Antoine L M; Borleffs, Jan C C

2008-05-01

Sexual harassment of medical students has been the focus of many international studies. Prevalence rates from 18% to over 60% have been reported. However, a Dutch study at Nijmegen Medical School found the prevalence rate to be lower (13.3% in the total group; 20% among female students only). We aimed to identify whether Nijmegen constitutes a positive sample of Dutch medical schools or whether incidents of sexual harassment are less prevalent in the Netherlands than elsewhere, and to establish if and how these experiences impact the professional lives of students. Students received a semi-structured questionnaire containing questions about their experiences of sexual harassment during clerkships. The questions referred to students' reactions to any incidents, the possible consequences for their wellbeing or professional functioning and the way cases of sexual harassment were handled. The prevalence of sexual harassment was significantly higher in Utrecht than in Nijmegen. In both studies rates were relatively low compared with international data. Nevertheless, 1 in 3-5 Dutch female medical students had experienced unwelcome sexual attention from patients, colleagues or supervisors. Three of 10 students who had experienced such an incident stated that it had a negative impact on their functioning afterwards. Prevalence rates of sexual harassment in medical schools in the Netherlands are low compared with international rates. However, the number of women students who experience sexual harassment is still 1 in 3-5. The occurrence of and ways to deal with these incidents should be important topics in the training of medical students and supervisors.

Hope Modified the Association between Distress and Incidence of Self-Perceived Medical Errors among Practicing Physicians: Prospective Cohort Study

PubMed Central

Hayashino, Yasuaki; Utsugi-Ozaki, Makiko; Feldman, Mitchell D.; Fukuhara, Shunichi

2012-01-01

The presence of hope has been found to influence an individual's ability to cope with stressful situations. The objective of this study is to evaluate the relationship between medical errors, hope and burnout among practicing physicians using validated metrics. Prospective cohort study was conducted among hospital based physicians practicing in Japan (N = 836). Measures included the validated Burnout Scale, self-assessment of medical errors and Herth Hope Index (HHI). The main outcome measure was the frequency of self-perceived medical errors, and Poisson regression analysis was used to evaluate the association between hope and medical error. A total of 361 errors were reported in 836 physician-years. We observed a significant association between hope and self-report of medical errors. Compared with the lowest tertile category of HHI, incidence rate ratios (IRRs) of self-perceived medical errors of physicians in the highest category were 0.44 (95%CI, 0.34 to 0.58) and 0.54 (95%CI, 0.42 to 0.70) respectively, for the 2nd and 3rd tertile. In stratified analysis by hope score, among physicians with a low hope score, those who experienced higher burnout reported higher incidence of errors; physicians with high hope scores did not report high incidences of errors, even if they experienced high burnout. Self-perceived medical errors showed a strong association with physicians' hope, and hope modified the association between physicians' burnout and self-perceived medical errors. PMID:22530055

Self-reported Hypoglycaemia in Patients treated with Insulin: A Large Slovenian Retrospectively-prospective Study

PubMed Central

Pongrac Barlovič, Draženka; Zavratnik, Andrej; Skvarča, Aleš; Janša, Karmen; Vukelič, Bojana; Tomažič, Marjeta; Ravnik Oblak, Maja

2017-01-01

Abstract Introduction Hypoglycaemia is the major barrier for glycaemic target achievement in patients treated with insulin. The aim of the present study was to investigate real-world incidence and predictors of hypoglycaemia in insulin-treated patients. Methods More than 300 consecutive patients with type 1 or type 2 diabetes treated with insulin were enrolled during regular out-patient visits from 36 diabetes practices throughout the whole country. They completed a comprehensive questionnaire on hypoglycaemia knowledge, awareness, and incidence in the last month and last six months. In addition, in the prospective part, patients recorded incidence of hypoglycaemic events using a special diary prospectively on a daily basis, through 4 weeks. Results At least one hypoglycaemic event was self-reported in 84.1%, and 56.4% of patients with type 1 and type 2 diabetes, respectively, during the prospective period of 4 weeks. 43.4% and 26.2% of patients with type 1 and type 2 diabetes, respectively, experienced a nocturnal hypoglycaemic event. In the same time-period, severe hypoglycaemia was experienced by 15.9% and 7.1% of patients with type 1 and type 2 diabetes, respectively. Lower glycated haemoglobin was not a significant predictor of hypoglycaemia. Conclusions Rates of self-reported hypoglycaemia in patients treated with insulin in the largest and most comprehensive study in Slovenia so far are higher than reported from randomised control trials, but comparable to data from observational studies. Hypoglycaemia incidence was high even with high glycated haemoglobin values. PMID:29062399

Reduction in high-frequency hearing loss following technical modifications to microvascular decompression for hemifacial spasm.

PubMed

Thirumala, Parthasarathy; Frederickson, Andrew M; Balzer, Jeffrey; Crammond, Donald; Habeych, Miguel E; Chang, Yue-Fang; Sekula, Raymond F

2015-10-01

Microvascular decompression is a safe and effective procedure to treat hemifacial spasm, but the operation poses some risk to the patient's hearing. While severe sensorineural hearing loss across all frequencies occurs at a low rate in experienced hands, a recent study suggests that as many as one-half of patients who undergo this procedure may experience ipsilateral high-frequency hearing loss (HFHL), and as many as one-quarter may experience contralateral HFHL. While it has been suggested that drill-related noise may account for this finding, this study was designed to examine the effect of a number of techniques designed to protect the vestibulocochlear nerve from operative manipulation on the incidence of HFHL. Pure-tone audiometry was performed both preoperatively and postoperatively on 67 patients who underwent microvascular decompression for hemifacial spasm during the study period. A change of greater than 10 dB at either 4 kHz or 8 kHz was considered to be HFHL. Additionally, the authors analyzed intraoperative brainstem auditory evoked potentials from this patient cohort. The incidence of ipsilateral HFHL in this cohort was 7.4%, while the incidence of contralateral HFHL was 4.5%. One patient (1.5%; also included in the HFHL group) experienced an ipsilateral nonserviceable hearing loss. The reduced incidence of HFHL in this study suggests that technical modifications including performing the procedure without the use of fixed retraction may greatly reduce, but not eliminate, the occurrence of HFHL following microvascular decompression for hemifacial spasm.

Incidence of opportunistic illness before and after initiation of highly active antiretroviral therapy in children.

PubMed

Nesheim, Steven R; Hardnett, Felicia; Wheeling, John T; Siberry, George K; Paul, Mary E; Emmanuel, Patricia; Bohannon, Beverly; Dominguez, Kenneth

2013-10-01

Little is known about immune reconstitution inflammatory syndrome in children in the United States. LEGACY is a longitudinal cohort study of HIV-infected participants 0-24 years at enrollment during 2005 to 2007 from 22 US clinics. For this analysis, we included participants with complete medical record abstraction from birth or time of HIV diagnosis through 2006. Opportunistic illness (OI) included AIDS-defining conditions and selected HIV-related diagnoses. We calculated the incidence (#/100 patient-years) of OI diagnosed in the months pre- and postinitiation of the first highly active antiretroviral therapy (HAART) regimen which was followed by ≥1 log reduction in HIV viral load. We defined OI as immune reconstitution inflammatory syndrome if an OI incidence increased after HAART initiation. "Responders" were defined as experiencing ≥1 log decline in viral load within 6 months after HAART initiation. Among 575 patients with complete chart abstraction, 524 received HAART. Of these 524 patients, 343 were responders, 181 were nonresponders and 86 experienced OI. Responders accounted for 98 of 124 (79%) of OI. Pre-HAART and post-HAART OI incidences were 43.7 and 24.4 (P = 0.003), respectively, among responders and 15.9 and 9.1 (P = 0.2), respectively, among nonresponders. Overall, OI incidences among responders and nonresponders were 33.8 and 12.3, respectively (P = 0.002). Responders were more likely than nonresponders to experience herpes simplex and herpes zoster before HAART initiation (all, P < 0.002). The lack of immune reconstitution inflammatory syndrome in participants initiating HAART may be due to low overall OI rates. The unexpectedly higher OI prevalence comprised mainly of herpes simplex and zoster, before HAART initiation among responders, may have motivated them to better adhere to HAART.

The influence of anaesthetists' experience on workload, performance and visual attention during simulated critical incidents.

PubMed

Schulz, Christian M; Schneider, Erich; Kohlbecher, Stefan; Hapfelmeier, Alexander; Heuser, Fabian; Wagner, Klaus J; Kochs, Eberhard F; Schneider, Gerhard

2014-10-01

Development of accurate Situation Awareness (SA) depends on experience and may be impaired during excessive workload. In order to gain adequate SA for decision making and performance, anaesthetists need to distribute visual attention effectively. Therefore, we hypothesized that in more experienced anaesthetists performance is better and increase of physiological workload is less during critical incidents. Additionally, we investigated the relation between physiological workload indicators and distribution of visual attention. In fifteen anaesthetists, the increase of pupil size and heart rate was assessed in course of a simulated critical incident. Simulator log files were used for performance assessment. An eye-tracking device (EyeSeeCam) provided data about the anaesthetists' distribution of visual attention. Performance was assessed as time until definitive treatment. T tests and multivariate generalized linear models (MANOVA) were used for retrospective statistical analysis. Mean pupil diameter increase was 8.1% (SD ± 4.3) in the less experienced and 15.8% (±10.4) in the more experienced subjects (p = 0.191). Mean heart rate increase was 10.2% (±6.7) and 10.5% (±8.3, p = 0.956), respectively. Performance did not depend on experience. Pupil diameter and heart rate increases were associated with a shift of visual attention from monitoring towards manual tasks (not significant). For the first time, the following four variables were assessed simultaneously: physiological workload indicators, performance, experience, and distribution of visual attention between "monitoring" and "manual" tasks. However, we were unable to detect significant interactions between these variables. This experimental model could prove valuable in the investigation of gaining and maintaining SA in the operation theatre.

A gender-based incidence study of workplace violence in psychiatric and forensic settings.

PubMed

Hatch-Maillette, Mary A; Scalora, Mario J; Bader, Shannon M; Bornstein, Brian H

2007-01-01

Limited data exist analyzing the role of gender in workplace violence in health care settings. This study examined whether different types of threatening incidents with patients (physical, verbal, sexual, or posturing) were salient to male versus female staff across psychiatric settings (inpatient forensic, inpatient acute/chronic psychiatric, and outpatient psychiatric). Results indicated that although women disproportionately experienced sexualized threats, they were not more likely to report such incidents as salient and threatening. The study also assessed the extent to which situational variables contributed to staff's feelings of threat. Results showed that rapport with the patient, quality of relationships with coworkers, and presence of coworkers in the area were not significantly related to how threatened staff felt in a recent threatening incident. Findings are discussed within the context of staff training and organizational benefits.

A survey assessment of the level of preparedness for domestic terrorism and mass casualty incidents among Eastern Association for the Surgery of Trauma members.

PubMed

Ciraulo, David L; Frykberg, Eric R; Feliciano, David V; Knuth, Thomas E; Richart, Charles M; Westmoreland, Christy D; Williams, Kathryn A

2004-05-01

The goal of this survey was to establish a benchmark for trauma surgeons' level of operational understanding of the command structure for a pre-hospital incident, a mass casualty incident (MCI), and weapons of mass destruction (WMD). The survey was distributed before the World Trade Center destruction on September 11, 2001. The survey was developed by the authors and reviewed by a statistician for clarity and performance. The survey was sent to the membership of the 2000 Eastern Association for the Surgery of Trauma spring mailing, with two subsequent mailings and a final sampling at the Eastern Association for the Surgery of Trauma 2001 meeting. Of 723 surveys mailed, 243 were returned and statistically analyzed (significance indicated by p < 0.05). No statistical difference existed between level of designation of a trauma center (state or American College of Surgeons) and a facility's level of pre-paredness for MCIs or WMD. Physicians in communities with chemical plants, railways, and waterway traffic were statistically more likely to work at facilities with internal disaster plans addressing chemical and biological threats. Across all variables, physicians with military training were significantly better prepared for response to catastrophic events. With the exception of cyanide (50%), less than 30% of the membership was prepared to manage exposure to a nerve agent, less than 50% was prepared to manage illness from intentional biological exposure, and only 73% understood and were prepared to manage blast injury. Mobile medical response teams were present in 46% of the respondents' facilities, but only 30% of those teams deployed a trauma surgeon. Approximately 70% of the membership had been involved in an MCI, although only 60% understood the command structure for a prehospital incident. Only 33% of the membership had training regarding hazardous materials. Of interest, 76% and 65%, respectively, felt that education about MCIs and WMD should be included in residency training. A facility's level of pre-paredness for MCIs or WMD was not related to level of designation as a trauma center, but may be positively influenced by local physicians with prior military background. Benchmark information from this survey will provide the architecture for the development and implementation of further training in these areas for trauma surgeons.

KSC-97PC807

NASA Image and Video Library

1997-05-15

STS-84 Commander Charles J. Precourt prepares to enter the Space Shuttle Atlantis at Launch Pad 39A with help from white room closeout crew members. The fourth Shuttle mission of 1997 will be the sixth docking of the Space Shuttle with the Russian Space Station Mir. The commander is Charles J. Precourt. The pilot is Eileen Marie Collins. The five mission specialists are C. Michael Foale, Carlos I. Noriega, Edward Tsang Lu, Jean-Francois Clervoy of the European Space Agency and Elena V. Kondakova of the Russian Space Agency. The planned nine-day mission will include the exchange of Foale for U.S. astronaut and Mir 23 crew member Jerry M. Linenger, who has been on Mir since Jan. 15. Linenger transferred to Mir during the last docking mission, STS-81; he will return to Earth on Atlantis. Foale is slated to remain on Mir for about four months until he is replaced in September by STS-86 Mission Specialist Wendy B. Lawrence. During the five days Atlantis is scheduled to be docked with the Mir, the STS-84 crew and the Mir 23 crew, including two Russian cosmonauts, Commander Vasily Tsibliev and Flight Engineer Alexander Lazutkin, will participate in joint experiments. The STS-84 mission also will involve the transfer of more than 7,300 pounds of water, logistics and science equipment to and from the Mir. Atlantis is carrying a nearly 300-pound oxygen generator to replace one of two Mir units which have experienced malfunctions. The oxygen it generates is used for breathing by the Mir crew

Establishments licensed to serve alcohol and their contribution to police-recorded crime in Australia: further opportunities for harm reduction.

PubMed

Rowe, Shelley C; Wiggers, John H; Wolfenden, Luke; Francis, J Lynn

2010-11-01

Although strategies exist to minimize alcohol-related harms associated with establishments licensed to serve alcohol, such establishments are associated with a disproportionate level of harm. To date, understanding the association between such establishments and alcohol-related harms, and hence the opportunities for reducing harm, has been limited by inadequate information regarding incidents of alcohol-related crime. To address this deficiency, this study was undertaken to describe the association between such establishments and incidents of crime using enhanced police-recorded, alcohol-related crime intelligence. A descriptive analysis was undertaken of intoxicated people who had last consumed alcohol in establishments licensed to serve alcohol (841 bars, 551 licensed social clubs, 11 nightclubs, and 18 other locations) preceding their involvement in police-recorded incidents of violence, disorder, or motor vehicle crashes. The study area encompassed 21 nonmetropolitan police commands in the state of New South Wales, Australia. Among intoxicated persons involved in incidents of violence, disorder, or motor vehicle crashes, the risk of being recorded as having last consumed alcohol in a bar or nightclub before the incident was at least twice that of licensed social clubs and other establishments. Approximately 20% of establishments accounted for 80% of intoxicated persons involved in such incidents, and 6% of establishments were in the top 20% of establishments for all three offense types. The disproportionate burden of alcohol-related crime associated with establishments licensed to serve alcohol may be reduced if harm-reduction strategies address the specific risks posed by bars and nightclubs, and individual high-risk establishments.

The Comparative Efficacy of Lifestyle Intervention and Metformin by Educational Attainment in the Diabetes Prevention Program

PubMed Central

O’Brien, Matthew J.; Whitaker, Robert C.; Yu, Daohai; Ackermann, Ronald T.

2015-01-01

Objective Educational attainment is inversely associated with type 2 diabetes risk, but it is unknown whether education impacts individuals’ diabetes prevention efforts. We examined the comparative efficacy of intensive lifestyle intervention and metformin by educational attainment among participants in the Diabetes Prevention Program (DPP), an ongoing U.S. multi-site trial beginning in 1996. Methods We studied 2,910 DPP participants randomized to receive lifestyle intervention, metformin, or placebo. Stratifying by educational attainment, diabetes incidence and relative risk reductions by treatment assignment were estimated using Cox proportional hazards regression. Results 47% of participants had completed college and 53% had not. Compared to placebo, lifestyle participants who had completed college demonstrated a 68% reduction in diabetes incidence (95% CI=56, 77), whereas those with less education experienced a 47% risk reduction (95% CI=29, 61). For metformin participants, college graduates experienced a 49% relative risk reduction (95% CI=33, 62), compared to 23% (95% CI=1, 41) among those with lower educational attainment. There was a statistically significant education-by-treatment interaction with incident diabetes (p=0.03). Conclusions Intensive lifestyle intervention and metformin have greater efficacy among highly educated individuals. Future efforts to deliver these treatments and study their dissemination may be more effective if tailored to individuals’ educational background. PMID:26024851

Change and Stability in the Characteristics of Homicide Victims, Offenders and Incidents During Rapid Social Change

PubMed Central

Pridemore, William Alex

2008-01-01

The Russian homicide rate doubled during the 1990s and is now among the highest in the world. During this same period, Russian citizens experienced swift, widespread, and meaningful political, economic, and social change. It is likely that this profound transition altered structural conditions, cultural norms, and interpersonal relations in a way that led to changes in the nature of interpersonal violence. Taking advantage of a unique set of homicide narratives drawn from court and police records in the Udmurt Republic, this study examined stability and change in the distribution of Russian homicide victim, offender, and incident characteristics before and after the fall of the Soviet Union. Odds ratios obtained from logistic regression showed no change in victim characteristics, but substantial changes in several offender and incident characteristics. We discuss the potential mechanisms through which the structural and cultural shifts are resulting in these changes and conclude that the ongoing transition is largely responsible for the changing nature of homicide in Russia. In doing so, we introduce the new term “criminological transition” and suggest that Russia (and perhaps other nations) may have experienced a change in its crime profile in much the same way as we discuss a “demographic transition” in terms of fertility and mortality profiles. PMID:19122789

The comparative efficacy of lifestyle intervention and metformin by educational attainment in the Diabetes Prevention Program.

PubMed

O'Brien, Matthew J; Whitaker, Robert C; Yu, Daohai; Ackermann, Ronald T

2015-08-01

Educational attainment is inversely associated with type 2 diabetes risk, but it is unknown whether education impacts individuals' diabetes prevention efforts. We examined the comparative efficacy of intensive lifestyle intervention and metformin by educational attainment among participants in the Diabetes Prevention Program (DPP), an ongoing U.S. multi-site trial beginning in 1996. We studied 2,910 DPP participants randomized to receive lifestyle intervention, metformin, or placebo. Stratifying by educational attainment, diabetes incidence and relative risk reductions by treatment assignment were estimated using Cox proportional hazards regression. 47% of participants had completed college and 53% had not. Compared to placebo, lifestyle participants who had completed college demonstrated a 68% reduction in diabetes incidence (95% CI=56, 77), whereas those with less education experienced a 47% risk reduction (95% CI=29, 61). For metformin participants, college graduates experienced a 49% relative risk reduction (95% CI=33, 62), compared to 23% (95% CI=1, 41) among those with lower educational attainment. There was a statistically significant education-by-treatment interaction with incident diabetes (p=0.03). Intensive lifestyle intervention and metformin have greater efficacy among highly educated individuals. Future efforts to deliver these treatments and study their dissemination may be more effective if tailored to individuals' educational background. Copyright © 2015 Elsevier Inc. All rights reserved.

78 FR 58965 - Airworthiness Directives; Bombardier, Inc. Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-25

... November 26, 2012. Zodiac Services has issued the following service bulletins. Zodiac Services Service... electrical status indications on the push button annunciators and the engine instrument and crew alerting system. Certain of those reported incidents resulted in the airplane experiencing a momentary loss of...

Poor visibility : a common cause of wrong-way driving.

DOT National Transportation Integrated Search

1975-01-01

On-site investigations were made of interchanges in Virginia, some of which had been the site of wrong-way entries and some of which had not, and of intersections that had experienced wrong-way incidents. From the observations made on-site it has bee...

Transfusion service disaster planning.

PubMed

Bundy, K L; Foss, M L; Stubbs, J R

2008-01-01

The Mayo Clinic, in Rochester, Minnesota, recently set forth a directive to develop a Mayo Emergency Incident Command System (MEICS) plan to respond to major disasters. The MEICS plan that was developed interfaces with national response plans to ensure effective communication and coordination between our institution and local, state, and federal agencies to establish a common language and communication structure. The MEICS plan addresses multiple aspects of dealing with resource needs during a crisis, including the need for blood and transfusion medicine services. The MEICS plan was developed to supplement our current local emergency preparedness procedures and provide a mechanism for responding to the escalating severity of an emergency to deal with situations of a magnitude that is outside the normal experience. A plan was developed to interface the existing Transfusion Medicine disaster plan standard operating procedures (SOP) with the institutional and Department of Laboratory Medicine (DLMP) MEICS plans. The first step in developing this interface was defining MEICS. Other major steps were defining the chain of command, developing a method for visually indicating who is "in charge," planning communication, defining the actions to be taken, assessing resource needs, developing flowcharts and updating SOPs, and developing a blood rationing team to deal with anticipated blood shortages. Several key features of the interface and updated disaster plan that were developed are calling trees for response personnel, plans for relocating leadership to alternative command centers, and action sheets to assist with resource assessment. The action sheets also provide documentation of key actions by response personnel.

Effort to recover SOHO spacecraft continue as investigation board focuses on most likely causes

NASA Astrophysics Data System (ADS)

1998-07-01

Meanwhile, the ESA/NASA investigation board concentrates its inquiry on three errors that appear to have led to the interruption of communications with SOHO on June 25. Officials remain hopeful that, based on ESA's successful recovery of the Olympus spacecraft after four weeks under similar conditions in 1991, recovery of SOHO may be possible. The SOHO Mission Interruption Joint ESA/NASA Investigation Board has determined that the first two errors were contained in preprogrammed command sequences executed on ground system computers, while the last error was a decision to send a command to the spacecraft in response to unexpected telemetry readings. The spacecraft is controlled by the Flight Operations Team, based at NASA's Goddard Space Flight Center, Greenbelt, MD. The first error was in a preprogrammed command sequence that lacked a command to enable an on-board software function designed to activate a gyro needed for control in Emergency Sun Reacquisition (ESR) mode. ESR mode is entered by the spacecraft in the event of anomalies. The second error, which was in a different preprogrammed command sequence, resulted in incorrect readings from one of the spacecraft's three gyroscopes, which in turn triggered an ESR. At the current stage of the investigation, the board believes that the two anomalous command sequences, in combination with a decision to send a command to SOHO to turn off a gyro in response to unexpected telemetry values, caused the spacecraft to enter a series of ESRs, and ultimately led to the loss of control. The efforts of the investigation board are now directed at identifying the circumstances that led to the errors, and at developing a recovery plan should efforts to regain contact with the spacecraft succeed. ESA and NASA engineers believe the spacecraft is currently spinning with its solar panels nearly edge-on towards the Sun, and thus not generating any power. Since the spacecraft is spinning around a fixed axis, as the spacecraft progresses in its orbit around the Sun, the orientation of the panels with respect to the Sun should gradually change. The orbit of the spacecraft and the seasonal change in the spacecraft-Sun alignment should result in the increased solar illumination of the spacecraft solar arrays over the next few months. The engineers predict that in late September 1998, illumination of the solar arrays and, consequently, power supplied to the spacecraft, should approach a maximum. The probability of successfully establishing contact reaches a maximum at this point. After this time, illumination of the solar arrays gradually diminishes as the spacecraft-Sun alignment continues to change. In an attempt to recover SOHO as soon as possible, the Flight Operations Team is uplinking commands to the spacecraft via NASA's Deep Space Network, managed by NASA's Jet Propulsion Laboratory, Pasadena, CA, approximately 12 hours per day with no success to date. A recovery plan is under development by ESA and NASA to provide for orderly restart of the spacecraft and to mitigate risks involved. The recovery of the Olympus spacecraft by ESA in 1991 under similar conditions leads to optimism that the SOHO spacecraft may be recoverable once contact is re-established. In May 1991, ESA's Olympus telecommunications satellite experienced a similar major anomaly which resulted in the loss of attitude, leading to intermittent power availability. As a consequence, there was inadequate communication, and the batteries and fuel froze. From analysis of the data available prior to the loss, there was confidence that the power situation would improve over the coming months. A recovery plan was prepared, supported by laboratory tests, to assess the characteristics of thawing batteries and propellants. Telecommand access of Olympus was regained four weeks later, and batteries and propellant tanks were thawed out progressively over the next four weeks. The attitude was then fully recovered and the payload switched back on three months after the incident. Equipment damage was sustained as a result of the low temperatures, but nothing significant enough to prevent the successful resumption of the mission. The experience of Olympus is being applied, where possible, to SOHO and increases the hope of also recovering this mission. Estimating the probability of recovery is made difficult by a number of unknown spacecraft conditions. Like Olympus, the hydrazine fuel and batteries may be frozen. Thermal stress may have damaged some of the scientific instruments as well. If the rate of spin is excessive, there may have been structural damage. SOHO engineers can reliably predict the spacecraft's orbit through November 1998. After that time, the long-term orbital behavior becomes dependent on the initial velocity conditions of the spacecraft at the time of the telemetry loss. These are not known precisely, due to spacecraft thruster activity that continued after loss of telemetry, so orbital prediction becomes very difficult.

Performance in noise: Impact of reduced speech intelligibility on Sailor performance in a Navy command and control environment.

PubMed

Keller, M David; Ziriax, John M; Barns, William; Sheffield, Benjamin; Brungart, Douglas; Thomas, Tony; Jaeger, Bobby; Yankaskas, Kurt

2017-06-01

Noise, hearing loss, and electronic signal distortion, which are common problems in military environments, can impair speech intelligibility and thereby jeopardize mission success. The current study investigated the impact that impaired communication has on operational performance in a command and control environment by parametrically degrading speech intelligibility in a simulated shipborne Combat Information Center. Experienced U.S. Navy personnel served as the study participants and were required to monitor information from multiple sources and respond appropriately to communications initiated by investigators playing the roles of other personnel involved in a realistic Naval scenario. In each block of the scenario, an adaptive intelligibility modification system employing automatic gain control was used to adjust the signal-to-noise ratio to achieve one of four speech intelligibility levels on a Modified Rhyme Test: No Loss, 80%, 60%, or 40%. Objective and subjective measures of operational performance suggested that performance systematically degraded with decreasing speech intelligibility, with the largest drop occurring between 80% and 60%. These results confirm the importance of noise reduction, good communication design, and effective hearing conservation programs to maximize the operational effectiveness of military personnel. Published by Elsevier B.V.

Factors Influencing Manual Performance in Cold Water Diving

DTIC Science & Technology

2008-04-01

montrent que « l’engourdissement » n’avait pas d’incidence sur la dextérité à une profondeur de 40 m (p > 0,05). Dans l’eau à 25 ºC, les gants en ...sensibilité tactile et la dextérité proprement dite. Le rendement ( en anglais performance ou p) a été évalué à des profondeurs de 0,4 m et de 40 m, avec...communication et d’affichage fait en sorte que l’aptitude des plongeurs à utiliser des systèmes de commande complexes constitue un facteur important de la

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

Barr, Jonathan L.; Taira, Randal Y.; Orr, Heather M.

The purpose of this document is to describe the operating concepts, capabilities, and benefits of RAMS including descriptions of how the system implementations can improve emergency response, damage assessment, task prioritization, and situation awareness. This CONOPS provides general information on operational processes and procedures required to utilize RAMS, and expected performance benefits of the system. The primary audiences for this document are the end users of RAMS (including flight operators and incident commanders) and the RAMS management team. Other audiences include interested offices within the Department of Homeland Security (DHS), and officials from other state and local jurisdictions who wantmore » to implement similar systems.« less

The concentration principle applied to spaceborne solar arrays. AGORA mission: Studies synthesis

NASA Astrophysics Data System (ADS)

Laget, R.

1986-01-01

Studies that led to selection of the distributed 25 kW SARA LOUVRE concept for the solar cell generator to be flown on the AGORA asteroid mission, and the major characteristics of such a spaceborne solar array are summarized. In the SARA LOUVRE concept, a parabolic cross section reflector concentrates incident light over the rear face of the identical, preceding reflector dish. The whole set of reflectors is pivotally commanded, thus compensating the effects of depointing. Geometric concentration factor is 10. End of life power level at 2.5 AU is 4.5 kW.

Incident surveillance in New Jersey career and technical education programs, 1999 to 2008: attributes, severity, and reported use of personal protective equipment.

PubMed

Shendell, Derek G; Jhaveri, Mehul; Nowakowski, Alexandra C H; Wozniak, Maryann E; Campbell, Jennifer K; Marshall, Elizabeth G; Kelly, Sarah W

2010-09-01

Through school-sponsored career and technical education programs in New Jersey, students work part-time during or after school in paid and unpaid structured learning experiences regulated by the New Jersey Department of Education. Schools submit information on "reportable incidents," injury or illness resulting in physician treatment. Incidents including reported use of personal protective equipment (PPE) were assessed; 1,600 incident reports (1999 to 2008) were received. Attributes such as type and severity, body parts affected, and PPE use for incidents occurring at school among students grades 9 to 12 or labeled as "adults" during school hours (n = 285) were analyzed. Older teens incurred more injuries. PPE use was consistently low across age and gender. Students most frequently experienced knife injuries involving fingers and hands. Results identified potential injury determinants and training and intervention topics such as PPE, and support development of an enhanced reporting form. Copyright 2010, SLACK Incorporated.

Comparative Evaluation of 4-Inch and 6-Inch Diameter Specimens for Testing Large Stone Asphalt Mixes

DOT National Transportation Integrated Search

1990-01-01

Increased incidence of premature rutting of heavy duty asphalt pavements has : been experienced in recent years. There is a general agreement among most : asphalt paving technologists that the use of large size stone in the binder and : base courses ...

Where Boards Cross the Line.

ERIC Educational Resources Information Center

Bryant, Miles T.; Grady, Marilyn L.

1990-01-01

Analyzes interviews with 81 Nebraska superintendents who had experienced "critical incidents" in their dealings with school board members. Of the 5 main categories, the most frequently cited were the following: (1) problems with relatives and friends (23 percent); (2) personal agendas (21 percent); and (3) disputes over hiring and firing…

Cops, cameras, and enclosures : a synthesis of the effectiveness of methods to provide enhanced security for bus operators

DOT National Transportation Integrated Search

2001-05-31

The safety of operators and passengers is a primary concern of transit systems and has become an increasingly important issue to transit bus operators themselves. Many transit agencies have experienced incidents of assaults against their bus operator...

A Report on Gender and Gender-Related Issues in the Accounting Professoriate.

ERIC Educational Resources Information Center

Lanier, Patricia A.; Tanner, John R.

1999-01-01

Responses from 188 of 500 female accounting faculty surveyed showed that only 34.3% had senior rank. Almost half earned $50,000-80,000. More than half experienced gender discrimination. They tended not to report incidents of racial or gender discrimination. (SK)

Characteristics of bias-based harassment incidents reported by a national sample of U.S. adolescents.

PubMed

Jones, Lisa M; Mitchell, Kimberly J; Turner, Heather A; Ybarra, Michele L

2018-06-01

Using a national sample of youth from the U.S., this paper examines incidents of bias-based harassment by peers that include language about victims' perceived sexual orientation, race/ethnicity, religion, weight or height, or intelligence. Telephone interviews were conducted with youth who were 10-20 years old (n = 791). One in six youth (17%) reported at least one experience with bias-based harassment in the past year. Bias language was a part of over half (52%) of all harassment incidents experienced by youth. Perpetrators of bias-based harassment were similar demographically to perpetrators of non-biased harassment. However, bias-based incidents were more likely to involve multiple perpetrators, longer timeframes and multiple harassment episodes. Even controlling for these related characteristics, the use of bias language in incidents of peer harassment resulted in significantly greater odds that youth felt sad as a result of the victimization, skipped school, avoided school activities, and lost friends, compared to non-biased harassment incidents. Copyright © 2018 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Risk factors for hazardous events in olfactory-impaired patients.

PubMed

Pence, Taylor S; Reiter, Evan R; DiNardo, Laurence J; Costanzo, Richard M

2014-10-01

Normal olfaction provides essential cues to allow early detection and avoidance of potentially hazardous situations. Thus, patients with impaired olfaction may be at increased risk of experiencing certain hazardous events such as cooking or house fires, delayed detection of gas leaks, and exposure to or ingestion of toxic substances. To identify risk factors and potential trends over time in olfactory-related hazardous events in patients with impaired olfactory function. Retrospective cohort study of 1047 patients presenting to a university smell and taste clinic between 1983 and 2013. A total of 704 patients had both clinical olfactory testing and a hazard interview and were studied. On the basis of olfactory function testing results, patients were categorized as normosmic (n = 161), mildly hyposmic (n = 99), moderately hyposmic (n = 93), severely hyposmic (n = 142), and anosmic (n = 209). Patient evaluation including interview, examination, and olfactory testing. Incidence of specific olfaction-related hazardous events (ie, burning pots and/or pans, starting a fire while cooking, inability to detect gas leaks, inability to detect smoke, and ingestion of toxic substances or spoiled foods) by degree of olfactory impairment. The incidence of having experienced any hazardous event progressively increased with degree of impairment: normosmic (18.0%), mildly hyposmic (22.2%), moderately hyposmic (31.2%), severely hyposmic (32.4%), and anosmic (39.2%). Over 3 decades there was no significant change in the overall incidence of hazardous events. Analysis of demographic data (age, sex, race, smoking status, and etiology) revealed significant differences in the incidence of hazardous events based on age (among 397 patients <65 years, 148 [37.3%] with hazardous event, vs 31 of 146 patients ≥65 years [21.3%]; P < .001), sex (among 278 women, 106 [38.1%] with hazardous event, vs 73 of 265 men [27.6%]; P = .009), and race (among 98 African Americans, 41 [41.8%] with hazardous event, vs 134 of 434 whites [30.9%]; P = .04). Increased level of olfactory impairment portends an increased risk of experiencing a hazardous event. Risk is further impacted by individuals' age, sex, and race. These results may assist health care practitioners in counseling patients on the risks associated with olfactory impairment.

A Study of Workplace Violence Experienced by Doctors and Associated Risk Factors in a Tertiary Care Hospital of South Delhi, India

PubMed Central

Kumar, Mukesh; Das, Timiresh; Pardeshi, Geeta; Kishore, Jugal; Padmanandan, Arun

2016-01-01

Introduction The increasing incidences of violence against doctors in their workplaces are an important reason for stress among these healthcare workers. Many incidences of workplace violence against doctors have been reported in the past and are also being continuously reported from different parts of the country as well as the world. Aim To determine the prevalence of workplace violence among doctors and to study the associated risk factors in a tertiary care hospital of Delhi, India. Material and Methods A cross-sectional study was conducted using a self-administered semi-structured questionnaire. The contents were: data related to the workplace, incidences at work, violence prevention policy of the institution, reporting of incidences and follow-up, education and training for violence management. A total of 151 doctors participated in the study. Results Total participants in the study were 151. The mean age of study participants was 26.73±4.24 years. Almost half (47.02%; 44.56% of males and 50.84% of females) of the doctors reported having an experience of violence during work hours in past 12 months. Among the cases, 39.4% were reported from Department of Obstetrics and Gynaecology while Surgery, Medicine and other departments reported 29.6%, 26.8% and 4.2% respectively. Patients or their relatives were perpetrators in most of the cases. Maximum (87.3%) of the reported cases were of verbal violence while 8.6% of the cases were of physical violence. Younger doctors with less work experience were more prone to physical violence. Regarding the time of violence, 35.1% of such cases occurred during afternoon while 30.1% of them took place at night. Conclusion A large number of doctors had experienced violence in past 12 months in a tertiary care hospital of South Delhi, India. Verbal violence came out to be most common form of violence experienced by the doctors. Afternoon or night hours were the timings when majority of such cases were reported. PMID:28050406

[Relationship between the incidence of chronic pain and academic pressure in high school students].

PubMed

Zhao, Qinghua; Zhang, Yongxing; Deng, Guoying; Jiang, Wenbin; Zhang, Linna; Di, Liqing; Su, Yangyang; Du, Xiaoyu; Wu, Xinyuan; Che, Qianzi; Chen, Keyu

2014-12-30

To explore the incidence of four types of chronic pain, i.e. headache, abdominal pain, neck & shoulder pain (NSP) and low back pain (LBP) and examine the relationship between the incidence of chronic pain and academic pressure in high school students. A total of 3 000 high school students were randomly surveyed with a questionnaire on related issues. And the results were analyzed with a multivariate Logistic regression model. Among them, 2 849 completed the questionnaire. And the overall incident rates of headache, abdominal pain, NSP, and LBP were 30.3%, 20.9%, 32.8% and 41.1% respectively. The students generally experienced a heavy burden of learning, a high level of stress and sleep deprivation closely related to four types of chronic pain. As a common condition in Chinese adolescents, chronic pain is closely correlated with academic pressure.

Operation of emergency operating centers during mass casualty incidents in taiwan: a disaster management perspective.

PubMed

Wen, Jet-Chau; Tsai, Chia-Chou; Chen, Mei-Hsuan; Chang, Wei-Ta

2014-10-01

On April 27, 2011, a train derailed and crashed in Taiwan, causing a mass casualty incident (MCI) that was similar to a previous event and with similar consequences. In both disasters, the emergency operating centers (EOCs) could not effectively integrate associated agencies to deal with the incident. The coordination and utilization of resources were inefficient, which caused difficulty in command structure operation and casualty evacuation. This study was designed to create a survey questionnaire with problem items using disaster management phases mandated by Taiwan's Emergency Medical Care Law (EMCL), use statistical methods (t test) to analyze the results and issues the EOCs encountered during the operation, and propose solutions for those problems. Findings showed that EOCs lacked authority to intervene or coordinate with associated agencies. Also, placing emphasis on the recovery phase should improve future prevention and response mechanisms. To improve the response to MCIs, the EMCL needs to be amended to give EOCs the lead during disasters; use feedback from the recovery phase to improve future disaster management and operation coordination; and establish an information-sharing platform across agencies to address all aspects of relief work.(Disaster Med Public Health Preparedness. 2014;0:1-6).

Are emergency care nurses prepared for chemical, biological, radiological, nuclear or explosive incidents?

PubMed

Mitchell, Christina J; Kernohan, W George; Higginson, Ray

2012-07-01

Two main areas exist within emergency care where chemical, biological, radiological, nuclear and explosive preparedness can be focused: departmental preparedness and staff preparedness. This study focused upon the latter. To identify areas where nurses require training in order to improve preparedness for a CBRNe incident. A competency questionnaire was developed from the literature and completed by 50 nursing staff across three Emergency Departments within one NHS Trust in Northern Ireland. Descriptive analysis was used for the quantitative data along with content analysis for the qualitative questions. Six key areas were identified for training; waste management (including clinical waste, contaminated clothing, contaminated water and the management of the contaminated deceased), Triage, Chain of command, PODs, awareness of the range of Personal Protective Equipment and its appropriate use and the decontamination of people and equipment. There is a need for a standardised 'blueprint' of role-specific competency criteria for a CBRNe incident for all emergency healthcare staff. The assessment tool used in this study can help to assess levels of preparedness amongst nursing staff and, if adapted accordingly, help gauge preparedness of other key healthcare professionals. Copyright © 2011 Elsevier Ltd. All rights reserved.

Homeland security: sharing and managing critical incident information

NASA Astrophysics Data System (ADS)

Ashley, W. R., III

2003-09-01

Effective critical incident response for homeland security requires access to real-time information from many organizations. Command and control, as well as basic situational awareness, are all dependant on quickly communicating a dynamically changing picture to a variety of decision makers. For the most part, critical information management is not unfamiliar or new to the public safety community. However, new challenges present themselves when that information needs to be seamlessly shared across multiple organizations at the local, state and federal level in real-time. The homeland security problem does not lend itself to the traditional military joint forces planning model where activities shift from a deliberate planning process to a crisis action planning process. Rather, the homeland security problem is more similar to a traditional public safety model where the current activity state moves from complete inactivity or low-level attention to immediate crisis action planning. More often than not the escalation occurs with no warning or baseline information. This paper addresses the challenges of sharing critical incident information and the impacts new technologies will have on this problem. The value of current and proposed approaches will be critiqued for operational value and areas will be identified for further development.

Abortion Incidence and Service Availability In the United States, 2014

PubMed Central

Jones, Rachel K.; Jerman, Jenna

2017-01-01

CONTEXT National and state-level information about abortion incidence can help inform policies and programs intended to reduce levels of unintended pregnancy. METHODS In 2015–2016, all U.S. facilities known or expected to have provided abortion services in 2013 or 2014 were surveyed. Data on the number of abortions were combined with population data to estimate national and state-level abortion rates. The number of abortion-providing facilities and changes since a similar 2011 survey were also assessed. The number and type of new abortion restrictions were examined in the states that had experienced the largest proportionate changes in clinics providing abortion services. RESULTS In 2014, an estimated 926,200 abortions were performed in the United States, 12% fewer than in 2011; the 2014 abortion rate was 14.6 abortions per 1,000 women aged 15–44, representing a 14% decline over this period. The number of clinics providing abortions declined 6% between 2011 and 2014, and declines were steepest in the Midwest (22%) and the South (13%). Early medication abortions accounted for 31% of nonhospital abortions, up from 24% in 2011. Most states that experienced the largest proportionate declines in the number of clinics providing abortions had enacted one or more new restrictions during the study period, but reductions were not always associated with declines in abortion incidence. CONCLUSIONS The relationship between abortion access, as measured by the number of clinics, and abortion rates is not straightforward. Further research is needed to understand the decline in abortion incidence. PMID:28094905

Long-term impact of earthquake stress on fasting glucose control and diabetes prevalence among Chinese adults of Tangshan.

PubMed

An, Cuixia; Zhang, Yun; Yu, Lulu; Li, Na; Song, Mei; Wang, Lan; Zhao, Xiaochuan; Gao, Yuanyuan; Wang, Xueyi

2014-01-01

To investigate the long-term influence of stresses from the 1976 Tangshan earthquake on blood glucose control and the incidence of diabetes mellitus in Chinese people of Tangshan. 1,551 adults ≥ 37 years of age were recruited for this investigation in Tangshan city of China, where one of the deadliest earthquakes occurred in 1796. All subjects finished a questionnaire. 1,030 of them who experienced that earthquake were selected into the exposure group, while 521 were gathered as the control group who have not exposed to any earthquake. The numbers of subjects who were first identified with diabetes or had normal FBG but with diabetic history were added for the calculation of diabetes prevalence. Statistic-analysis was applied on the baseline data, and incidences of IFG as well as diabetes among all groups. Statistic comparisons indicate there is no significant difference on average fasting glucose levels between the control group and the exposure group. However, the prevalence of IFG and diabetes among the exposure group displays significant variance with the control group. The prevalence of diabetes among exposure groups is significantly higher than the control group. Women are more likely to have diabetes after experiencing earthquake stresses compared to men. The earthquake stress was linked to higher diabetes incidence as an independent factor. The earthquake stress has long-term impacts on diabetes incidence as an independent risk factor. Emerging and long-term managements regarding the care of IFG and diabetes in populations exposed to earthquake stress should be concerned.

[An investigative report concerning safety and management in the magnetic resonance environment: there are more accidents than expected].

PubMed

Doi, Tsukasa; Yamatani, Yuya; Ueyama, Tsuyoshi; Nishiki, Shigeo; Ogura, Akio; Kawamitsu, Hideaki; Tsuchihashi, Toshio; Okuaki, Tomoyuki; Matsuda, Tsuyoshi; Kumashiro, Masayuki

2011-01-01

Using a questionnaire, we surveyed 2,500 facilities in Japan to clarify medical accidents concerning the magnetic resonance device and its environment. Data derived from 1,319 valid responses (52.8%), allowed us to analyze the situation of (or the reason for) the occurrence of the accidents and their environmental factors. Five hundred and nine facilities (39% of all facilities) had the experience of magnetically induced displacement of the large ferromagnetic material. Intravenous (I.V.) drip stands were involved the largest number of them: 31% (228 cases). Oxygen bottles had the second largest number of incidents: 20%. There were also many incidents involving various materials brought in by non-medical staff (e.g. stepladder for construction). About 20% of the accidents occurred outside of working hours. Patients in 12% of the facilities (154 facilities) experienced burns. In 39 of the cases, burns were received to the inside of the thighs. In 38 of the cases, patients received burns from an electrical cable touching the skin. There were also frequent incidents of burning regarding the boa. We received reports of burns and pain from the halo vest even though it's required to be worn for MR safety. Regarding incidents of contraindications, 280 patients with pacemakers were brought into the magnetic resonance (MR) inspection room. Twelve percent of the facilities experienced natural quench. Lack of training for the staff who introduce and operate high magnetic field devices are considered involving frequently occurring accidents of attractions and burns at hospitals with over 500 beds caused by carrying in materials.

Cyberbullying Behaviors among Female College Students: Witnessing, Perpetration, and Victimization

ERIC Educational Resources Information Center

Selkie, Ellen M.; Kota, Rajitha; Moreno, Megan

2016-01-01

Problem: Cyberbullying is common among adolescents, and emerging studies also describe this phenomenon in college students. Less is known about specific cyberbullying behaviors and roles in cyberbullying incidents experienced by college females. Methods: 249 female students from 4 colleges completed online surveys assessing involvement in 11…

Affective Response of Nonretarded and Retarded Children to the Emotions of a Protagonist.

ERIC Educational Resources Information Center

Wilson, Barbara J.; And Others

1986-01-01

Compares the affective reactions of nonretarded second- and third-grade children to those of mildly retarded children to a videotape in which a protagonist's initial behavior (good, bad) was factorially varied with the emotion he experienced in the concluding incident (happy, sad). (HOD)

The status of Bombus occidentalis and B. moderatus in Alaska with special focus on Nosema bombi incidence

USDA-ARS?s Scientific Manuscript database

Technical Abstract: Four North American bumble bee species in the subgenus Bombus sensu stricto, including Bombus occidentalis (Hymenoptera: Apidae), are experiencing dramatic declines in population abundance, range and genetic diversity. The prevailing hypothesis concerning their decline is the ‘s...

Dissociative Reactions to Incest.

ERIC Educational Resources Information Center

Hall, J. Mark

In contrast to Freud's later and revised view of the etiology of hysterical, or dissociative, symptoms, it is now known that real, and not fantasized, sexual experiences in childhood are experienced in disociative symptomatology. It is useful to understand that incest involves both traumatic events, that is, incidents of sexual violation per se,…

Sex Roles in Reading.

ERIC Educational Resources Information Center

Gunderson, Doris V.

Sex roles in two disparate areas, reading and literature, are treated separately in this paper. Sex-related factors listed which may attribute to the high incidence of boys experiencing reading difficulty were: (1) predominance of female teachers in the primary grades, (2) boys' lack of interest in basal readers, (3) adults considering reading a…

Ethical Conflicts Experienced by Iranian EFL Teachers in the Classroom Context

ERIC Educational Resources Information Center

Alimorad, Zahra

2014-01-01

Recently, EFL teachers' ethical conflicts in the situated classroom context have got paramount importance. This paper presents findings from an empirical study of ethical conflicts Iranian EFL teachers encounter while engaged in classroom assessment. Critical incidents generated by 49 practicing teachers revealed that a majority of reported…

Re/Learning Student Teaching Supervision: A Co/Autoethnographic Self-Study

ERIC Educational Resources Information Center

Butler, Brandon M.; Diacopoulos, Mark M.

2016-01-01

This article documents the critical friendship of an experienced teacher educator and a doctoral student through our joint exploration of student teaching supervision. By adopting a co/autoethnographic approach, we learned from biographical and contemporaneous critical incidents that informed short- and long-term practices. In particular, we…

Experiences of Differential Treatment among College Students of Color.

ERIC Educational Resources Information Center

Suarez-Balcazar, Yolanda; Orellana-Damacela, Lucia; Portillo, Nelson; Rowan, Jean M.; Andrews-Guillen, Chelsea

2003-01-01

Studied perceptions of differential treatment of students of color through surveys completed by Caucasian (n=500) and non-Caucasian (n=495) college students. Findings show African Americans experienced more incidents of differential treatment in peer-faculty situations and females rated higher both the degree of offensiveness and degree of…

Peer Coaching as a Technique To Foster Professional Development in Clinical Ambulatory Settings.

ERIC Educational Resources Information Center

Sekerka, Leslie E.; Chao, Jason

2003-01-01

Thematic analysis of critical incidents interviews with 13 physician coaches yielded two orientations to coaching: reflection/teaching coaches focused on others and described positive encounters experienced in coaching; personal learning and change coaches identified more personal benefits from the experience. (Contains 31 references.) (SK)

Scandinavian Universities Respond to Complaints of Sexual Harassment.

ERIC Educational Resources Information Center

Bollag, Burton

1997-01-01

Across Scandinavia, higher education institutions are acknowledging incidents of sexual harassment and developing policy and procedures to address them. The issue emerged after a University of Stockholm survey found 12% of all female employees on campus, including many graduate students, had experienced some harassment on the job. Initiatives…

The Shock and Vibration Bulletin: Proceedings on the Symposium on ShocK and Vibration (52nd) Held in New Orleans, Louisiana on 26-28 October 1981. Part 2. Invited Papers, Space Shuttle Loads and Dynamics, Space Shuttle Data Systems, Shock Testing, Shock Analysis Space Shuttle Thermal Protection Systems

DTIC Science & Technology

1982-05-01

discovered during posttest inspection. The unit had experienced 2 As- designed damper, 0.92-1-.14 grams 8 tests for a total of 330 seconds of opera- 3...a Modeling DAMPED STRUCTURE DESIGN USING FINITE ELEMENT ANALYSIS M. F. Klunmner and M. L. Drake, University of Dayti-n Resatch Institute, Dayton, OH...IN DYNAMICS T. E. Simkins, U.S. Army Armament Research and Development Command, Watervliet, NY Stucturd Dynamics A PROCEDURE FOR DESIGNING OVERDAMPED

Astronaut Mark Linenger measures height of Astronaut Mark Lee during DSO

NASA Image and Video Library

1994-09-15

STS064-05-020 (9-20 Sept. 1994) --- Astronaut Mark C. Lee gets his height measured by astronaut Jerry M. Linenger as part of a daily in-flight routine supporting a medical Detailed Supplementary Objective (DSO). Astronaut Richard N. Richards, STS-64 mission commander, looks on in the background. This study was designed to collect information about back pain and height changes experienced by astronauts during flight. Crew members participating in this DSO are required to record height measurements and long back-pain symptoms daily. As an ongoing program, this DSO will gather data from 30 astronauts who spend more than eight consecutive days in space. Photo credit: NASA or National Aeronautics and Space Administration

DSMC Simulations of Apollo Capsule Aerodynamics for Hypersonic Rarefied Conditions

NASA Technical Reports Server (NTRS)

Moss, James N.; Glass, Christopher E.; Greene, Francis A.

2006-01-01

Direct simulation Monte Carlo DSMC simulations are performed for the Apollo capsule in the hypersonic low density transitional flow regime. The focus is on ow conditions similar to that experienced by the Apollo Command Module during the high altitude portion of its reentry Results for aerodynamic forces and moments are presented that demonstrate their sensitivity to rarefaction that is for free molecular to continuum conditions. Also aerodynamic data are presented that shows their sensitivity to a range of reentry velocity encompasing conditions that include reentry from low Earth orbit lunar return and Mars return velocities to km/s. The rarefied results are anchored in the continuum regime with data from Navier Stokes simulations

Child murder committed by severely mentally III mothers: an examination of mothers found not guilty by reason of insanity. 2005 Honorable Mention/Richard Rosner Award for the best paper by a fellow in forensic psychiatry or forensic psychology.

PubMed

Friedman, Susan Hatters; Hrouda, Debra R; Holden, Carol E; Noffsinger, Stephen G; Resnick, Phillip J

2005-11-01

Forensic hospital records of 39 severely mentally ill mothers adjudicated Not Guilty by Reason of Insanity for filicide (child murder by parents) were analyzed to describe characteristics preceding this tragedy and to suggest prevention strategies. Almost three-quarters of the mothers (72%) had previous mental health treatment. Over two thirds (69%) of the mothers were experiencing auditory hallucinations, most frequently command hallucinations, and half (49%) were depressed at the time of the offense. Over one third (38%) of the filicides occurred during pregnancy or the postpartum period, and many had a history of postpartum psychosis. Almost three-quarters (72%) of the mothers had experienced considerable developmental stressors, such as death of their own mother or incest. Maternal motives for filicide were predominantly "altruistic" (meaning murder out of love) or "acutely psychotic" (occurring in the throes of psychosis, without rational motive). Psychiatrists should perform careful risk assessments for filicide in mothers with mental illnesses.

Relationship Between Cognitive Perceptual Abilities and Accident and Penalty Histories Among Elderly Korean Drivers

PubMed Central

2016-01-01

Objective To investigate the relationship between cognitive perceptual abilities of elderly drivers based on the Cognitive Perceptual Assessment for Driving (CPAD) test and their accident and penalty histories. Methods A total of 168 elderly drivers (aged ≥65 years) participated in the study. Participant data included CPAD scores and incidents of traffic accidents and penalties, attained from the Korea Road Traffic Authority and Korea National Police Agency, respectively. Results Drivers' mean age was 70.25±4.1 years and the mean CPAD score was 52.75±4.72. Elderly drivers' age was negatively related to the CPAD score (p<0.001). The accident history group had marginally lower CPAD scores, as compared to the non-accident group (p=0.051). However, incidence rates for traffic fines did not differ significantly between the two groups. Additionally, the group that passed the CPAD test had experienced fewer traffic accidents (3.6%), as compared to the group that failed (10.6%). The older age group (12.0%) had also experienced more traffic accidents, as compared to the younger group (2.4%). Conclusion Overall, elderly drivers who experienced driving accidents had lower CPAD scores than those who did not, without statistical significance. Thus, driving-related cognitive abilities of elderly drivers with insufficient cognitive ability need to be further evaluated to prevent traffic accidents. PMID:28119840

G-Induced Visual Symptoms in a Military Helicopter Pilot.

PubMed

McMahon, Terry W; Newman, David G

2016-11-01

Military helicopters are increasingly agile and capable of producing significant G forces experienced in the longitudinal (z) axis of the body in a head-to-foot direction (+Gz). Dehydration and fatigue can adversely affect a pilot's +Gz tolerance, leading to +Gz-induced symptomatology occurring at lower +Gz levels than expected. The potential for adverse consequences of +Gz exposure to affect flight safety in military helicopter operations needs to be recognized. This case report describes a helicopter pilot who experienced +Gz-induced visual impairment during low-level flight. The incident occurred during a tropical training exercise, with an ambient temperature of around 35°C (95°F). As a result of the operational tempo and the environmental conditions, aircrew were generally fatigued and dehydrated. During a low-level steep turn, a Blackhawk pilot experienced significant visual deterioration. The +Gz level was estimated at +2.5 Gz. After completing the turn, the pilot's vision returned to normal, and the flight concluded without further incident. This case highlights the potential dangers of +Gz exposure in tactical helicopters. Although the +Gz level was moderate, the pilot's +Gz tolerance was reduced by the combined effects of dehydration and fatigue. The dangers of such +Gz-induced visual impairment during low-level flight are clear. More awareness of +Gz physiology and +Gz tolerance-reducing factors in helicopter operations is needed. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Sexual harassment of critical care nurses: a costly workplace issue.

PubMed

Kaye, J; Donald, C G; Merker, S

1994-11-01

Sexual harassment in the workplace is a prevalent form of impermissible sex discrimination in employment. The high profile of this issue in the media, together with laws prohibiting sexual harassment, have not prevented this problem for working nurses. To describe and determine the extent of sexual harassment incidents experienced by nurses working in critical care areas, and to determine attitudes about, and presence of policies regarding, sexual harassment in hospitals. For this descriptive study the federal government's definition of sexual harassment and a list of sexually harassing behaviors was mailed with a survey to 188 critical care nurses. Findings indicated that 46% of the respondents had been harassed. Offensive sexual remarks (56%), unwanted physical contact (53%), unwanted nonverbal attention (27%), requests for dates (16%), and sexual propositions (9%) were types of sexual harassment experienced. Sexual assault was experienced by one woman. Harassers were physicians (82%), coworkers (20%), or immediate supervisors (7%). A majority of the incidents (69%) were not reported. Most nurses (80%) had not received training, nor were there policies and procedures to follow in most cases for reporting harassment. These results suggest that many critical care nurses are harassed and that relatively few hospitals have sexual harassment policies known to employees. They also indicate that sexual harassment training, policies, and procedures are needed to provide a safe, healthy work environment for critical care nurses.

Developing a Decision Support System for Flood Response: NIMS/ICS Fundamentals

NASA Astrophysics Data System (ADS)

Gutenson, J. L.; Zhang, X.; Ernest, A. N. S.; Oubeidillah, A.; Zhu, L.

2015-12-01

Effective response to regional disasters such as floods requires a multipronged, non-linear approach to reduce loss of life, property and harm to the environment. These coordinated response actions are typically undertaken by multiple jurisdictions, levels of government, functional agencies and other responsible entities. A successful response is highly dependent on the effectiveness and efficiency of each coordinated response action undertaken across a broad spectrum of organizations and activities. In order to provide a unified framework for those responding to incidents or planned events, FEMA provides a common and flexible approach for managing incidents, regardless of cause, size, location or complexity, referred to as the National Incident Management System (NIMS). Integral to NIMS is the Incident Command System (ICS), which establishes a common, pre-defined organizational structure to ensure coordination and management of procedures, resources and communications, for efficient incident management. While being both efficient and rigorous, NIMS, and ICS to a lesser extent, is an inherently complex framework that requires significant amount of training for planners, responders and managers to master, especially considering the wide array of incident types that Local Emergency Planning Committees (LEPCs) must be prepared to respond to. The existing Water-Wizard Decision Support System (DSS), developed to support water distribution system recovery operations for Decontamination (Decon), Operational Optimization (WDS), and Economic Consequence Assessment (Econ), is being evolved to integrate incident response functions. Water-Wizard runs on both mobile and desktop devices, and is being extended to utilize smartphone and mobile device specific data streams (e.g GPS location) to augment its fact-base in real-time for situational-aware DSS recommendations. In addition, the structured NIMS and ICS frameworks for incident management and response are being incorporated into the Water-Wizard knowledgebase, with a mid-term goal of integrating flood-specific emergency response domain knowledge to provide a real-time flood responder decision support.

Violence Towards Family Caregivers by Their Relative with Schizophrenia in Japan.

PubMed

Kageyama, Masako; Solomon, Phyllis; Yokoyama, Keiko; Nakamura, Yukako; Kobayashi, Sayaka; Fujii, Chiyo

2018-06-01

There have been several violence-related deaths in Japan due to family violence by persons with severe mental illness against their caregivers. However, it is not often acknowledged that these violent acts are mainly directed at family members. This study aimed to clarify what acts of violence family caregivers experienced from their relative with schizophrenia, and how frequently these violent incidents occurred in their lifetime. We also examined caregivers' thoughts of death about themselves and their relatives, as well as their consultation efforts and escape from the violence perpetrated by their relative. Of the 277 caregivers, 87.7% had experienced psychological violence and 75.8% had experienced physical violence perpetrated by their relative. Of 210 caregivers who had experienced physical violence, 26.7% had thought of murder-suicide and 31.0% had wished for their relative's death. Family violence by persons with schizophrenia is not rare but a common occurrence in Japan and may have fatal consequences.

Income related inequality and influencing factors: a study for the incidence of catastrophic health expenditure in rural China.

PubMed

Gu, Hai; Kou, Yun; Yan, Zhiwen; Ding, Yilei; Shieh, Jusheng; Sun, Jun; Cui, Nan; Wang, Qianjing; You, Hua

2017-09-20

Catastrophic health expenditure (CHE) puts a heavy disease burden on patients' families, aggravating income-related inequality. In an attempt to reduce the financial risks of rural families incurring CHE, China began the New Rural Cooperative Medical System (NCMS) on a trial basis in 2003 and has raised the reimbursement rates continuously since then. Based on statistical data about rural families in sample area of Jiangsu province, this study measures the incidence of CHE, analyzes socioeconomic inequality related to CHE, and explores the influences of the NCMS on the incidence of CHE. Statistical data were acquired from two surveys about rural health care, one conducted in 2009 and one conducted in 2010. In 2009, 1424 rural families were analyzed; in 2010, 1796 rural families were analyzed. An index of CHE is created to enable the evaluation of the associated financial risks. The concentration index and concentration curve are used to measure the income-related inequality involved in CHE. Multiple logistic regression is utilized to explore the factors that influence the incidence of CHE. The incidence of CHE decreased from 13.62% in 2009 to 7.74% in 2010. The concentration index of CHE was changed from -0.298 (2009) to -0.323 (2010). Compared with rural families in which all members were covered by the NCMS, rural families in which some members were not covered by the NCMS had a lower incidence of CHE: The odds ratio is 0.65 with a 95% confidence interval of 0.43 to 1.00. For rural families in which all members were covered by the NCMS, the increase in reimbursement rates is correlated to the decline in the incidence of CHE if other influencing factors were controlled: The odds ratio is 0.48 with a 95% confidence interval of 0.36 to 0.64. Between 2009 and 2010, the incidence rate of CHE in the sampled area decreased sharply, CHE was more concentrated among least wealthy and inequality increased during study period. As of 2010, the poorest rural families still had high risk of experiencing CHE. For rural families in which all members are covered by the NCMS, the rise in reimbursement rates reduces the probability of experiencing CHE.

The effect of race on the CYP3A-mediated metabolism of vincristine in pediatric patients with acute lymphoblastic leukemia.

PubMed

Sims, Rosalyn P

2016-02-01

The purpose of this preliminary study was to compare racial background and CYP3A distribution in pediatric acute lymphoblastic leukemia patients as it relates to vincristine-related neurotoxicity. Patients with B-precursor acute lymphoblastic leukemia treated at Children's Hospital of Michigan were eligible to participate in this study. Determination of the CYP3A variant for each patient was done using Qiagen DNA Blood Mini Kit and polymerase chain reaction amplification. Patients were monitored during their leukemia treatment course for vincristine-related neurotoxicity. Fifty-four patients were enrolled. Twenty-nine Caucasian patients (81%) and 13 African-American patients (77%) experienced neurotoxicity. CYP3A genotyping was done for 52 patients. Two African-American and two Caucasian patients were homozygous A/A for the CYP3A5*3 polymorphism. Three of these patients (75%) experienced grade 2 neuropathy. Two Caucasian patients and one African-American patient were heterozygous A/G. Two of these patients (66.7%) experienced grade 2 or 3 neuropathy. Thirty-five patients (67.3%) were homozygous for the mutant inactive G/G allele for CYP3A5*3, eight African-American and 27 Caucasian patients. Of these, six of the African-American patients (75%) and 22 of the Caucasian patients (81.5%) experienced neuropathy. The CYP3A5*3 genotype causes very low expression of the CYP3A5 protein and hence decreased vincristine metabolism. In this study, patients who expressed CYP3A5*3 had an increased incidence of vincristine-related neurotoxicity. Overall, a greater percentage of Caucasian patients had documented incidences of neurotoxicity. A larger sample size and more detailed gene analysis are needed for future studies. © The Author(s) 2014.

Risk factors of workplace violence at hospitals in Japan.

PubMed

Fujita, Shigeru; Ito, Shinya; Seto, Kanako; Kitazawa, Takefumi; Matsumoto, Kunichika; Hasegawa, Tomonori

2012-02-01

Patients and their relatives exposed to mental stress caused by hospitalization or illness might use violence against healthcare staff and interfere with quality healthcare. The aim of this study was to investigate incidences of workplace violence and the attributes of healthcare staff who are at high risk. A questionnaire-based, anonymous, and self-administered cross-sectional survey. Healthcare staff (n = 11,095) of 19 hospitals in Japan. Incidence rates and adjusted odd ratios of workplace violence were calculated to examine the effect of attributes of healthcare staff to workplace violence by using logistic regression analysis. The response rate for survey completion was 79.1% (8711/11,095). Among the respondents, 36.4% experienced workplace violence by patients or their relatives in the past year; 15.9% experienced physical aggression, 29.8% experienced verbal abuse, and 9.9% experienced sexual harassment. Adjusted odds ratios of physical aggression were significantly high in psychiatric wards, critical care centers/intensive care units (ICU)/cardiac care units (CCU), long-term care wards, for nurses, nursing aides/care workers, and for longer working hours. Adjusted odds ratios of verbal abuse were significantly high in psychiatric wards, long-term care wards, outpatient departments, dialysis departments, and for longer years of work experience, and for longer working hours. Adjusted odds ratios of sexual harassment were significantly high in dialysis departments, for nurses, nursing aides/care workers, technicians, therapists and females. The general ward and direct interaction with patients were common risk factors for each type of workplace violence. The mechanisms and the countermeasures for each type of workplace violence at those high-risk areas should be investigated. Copyright © 2011 Society of Hospital Medicine.

Workplace violence and drug use in women workers in a Peruvian Barrio.

PubMed

Musayón Oblitas, F Y; Caufield, C

2007-12-01

This exploratory and descriptive study explored the relationship between workplace violence and drug use in women. It also explored the perception of women workers on the relationship between workplace violence and drug use. The World Health Organization and the United Nations recognize violence against women and have adopted a definition of it. The Centres for Disease Control and Prevention reports that violence in the workplace has increased 300% over the last decade. Alcohol misuse, occupation and gender are associated with aggression in the workplace. Estimations of the incidence of non-fatal injuries sustained because of workplace violence and evaluations of the associated risk factors have rarely been documented. 125 women workers between the ages of 18 and 60 years were surveyed in four suburbs of Zapallal, Lima. Of the 125 women, 28.8% experienced violence in the workplace. Of the 36 women who had experienced violence in the workplace, 16 agreed to participate in interviews to explore their perceptions. The data were saturated with the 16 interviews. Of the 125 workers surveyed 17.6% experienced verbal violence, 9.6%% experienced physical violence, and 1.6% were sexually harassed in their workplace. Women who were verbally abused demonstrated eight times greater risk of drug use than those who did not experience this type of violence in their workplace. This paper contributes to an understanding of the relationships among drug abuse, gender and the incidence of violence in the workplace; it documents the perception women have of these relationships; and it supports the development of programmes and strategies related to the prevention of workplace violence and drug consumption by women workers.

Reshaping US Navy Pacific response in mitigating disaster risk in South Pacific Island nations: adopting community-based disaster cycle management.

PubMed

Reaves, Erik J; Termini, Michael; Burkle, Frederick M

2014-02-01

The US Department of Defense continues to deploy military assets for disaster relief and humanitarian actions around the world. These missions, carried out through geographically located Combatant Commands, represent an evolving role the US military is taking in health diplomacy, designed to enhance disaster preparedness and response capability. Oceania is a unique case, with most island nations experiencing "acute-on-chronic" environmental stresses defined by acute disaster events on top of the consequences of climate change. In all Pacific Island nation-states and territories, the symptoms of this process are seen in both short- and long-term health concerns and a deteriorating public health infrastructure. These factors tend to build on each other. To date, the US military's response to Oceania primarily has been to provide short-term humanitarian projects as part of Pacific Command humanitarian civic assistance missions, such as the annual Pacific Partnership, without necessarily improving local capacity or leaving behind relevant risk-reduction strategies. This report describes the assessment and implications on public health of large-scale humanitarian missions conducted by the US Navy in Oceania. Future opportunities will require the Department of Defense and its Combatant Commands to show meaningful strategies to implement ongoing, long-term, humanitarian activities that will build sustainable, host nation health system capacity and partnerships. This report recommends a community-centric approach that would better assist island nations in reducing disaster risk throughout the traditional disaster management cycle and defines a potential and crucial role of Department of Defense's assets and resources to be a more meaningful partner in disaster risk reduction and community capacity building.

Mixed martial arts: injury patterns and issues for the ringside physician.

PubMed

Seidenberg, Peter H

2011-01-01

Mixed martial arts (MMA) is a fast-growing combat sport. There are limited studies investigating MMA's injury incidence. However, from the data available, closed head injuries and lacerations commonly are experienced by competitors. Sanctioned events require the presence of ringside physicians, who should be well versed in handling these types of injuries. Additionally, sports-medicine providers should have an appropriately equipped medical bag, and before providing coverage, they need to coordinate with emergency medical personnel in order to more efficiently deliver care if urgent situations arise. More research is needed on injury incidence and prevention in MAA.

Peer bullying in a pre-registration student nursing population.

PubMed

Cooper, Brenda; Curzio, Joan

2012-11-01

Peer bullying is a major problem in schools and workplaces including the National Health Service. Although there are a few published studies exploring the incidence of peer bullying among university students, none is specific to pre-registration nursing students. Nursing programmes are delivered across two campuses of the university however students registered at individual campuses do not mix which makes the experiences of each campus individual. The aim of this study was to explore the incidence and manifestation of peer bullying amongst pre-registration nursing students in the university setting. The study describes the reported incidence of the three types of peer bullying behaviour: physical, verbal and non-verbal bullying. Participants in their final year of adult nurse education were asked to explore their perceptions of peer bullying, the frequency of witnessed or experienced behaviour and the location of where this behaviour occurred on the university campuses via a quantitative questionnaire. In total 190 students were surveyed with 156 (82%) responding. Participants reported peer bullying is experienced by student nurses on university premises and that academic members of staff are sometimes present when this behaviour is demonstrated. Reported levels of bullying decreased during their 2nd and 3rd years of the course compared to the foundation year. This decrease may have been in response to the university's strong anti-bullying stance. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Influence of Oral Dydrogesterone and Vaginal Progesterone on Threatened Abortion: A Systematic Review and Meta-Analysis

PubMed Central

Lee, Hee Joong; Park, Tae Chul; Kim, Jae Hoon; Norwitz, Errol

2017-01-01

Objective To conduct systematic analyses to evaluate the efficacy of progesterone therapy for the prevention of miscarriages in pregnant women experiencing threatened abortion. Methods In November 2016, we performed a systematic literature search and identified 51 articles in PubMed, Embase, and Cochrane databases. We identified nine randomized trials that included 913 pregnant women (including 322 treated with oral dydrogesterone, 213 treated with vaginal progesterone, and 378 control subjects) who met the selection criteria. Results The incidence of miscarriage was significantly lower in the total progesterone group than in the control group (13.0% versus 21.7%; odds ratio, 0.53; 95% confidence interval (CI), 0.36 to 0.78; P = 0.001; I2, 0%). Moreover, the incidence of miscarriage was significantly lower in the oral dydrogesterone group than in the control group (11.7% versus 22.6%; odds ratio, 0.43; 95% CI, 0.26 to 0.71; P = 0.001; I2, 0%) and was lower in the vaginal progesterone group than in the control group, although this difference was nonsignificant (15.4% versus 20.3%; odds ratio, 0.72; 95% CI, 0.39 to 1.34; P = 0.30; I2, 0%). However, the incidence of miscarriage was not different between the oral dydrogesterone and vaginal progesterone groups. Conclusion Progesterone therapy, especially oral dydrogesterone, can effectively prevent miscarriage in pregnant women experiencing threatened abortion. PMID:29392134

Advanced consequence management program: challenges and recent real-world implementations

NASA Astrophysics Data System (ADS)

Graser, Tom; Barber, K. S.; Williams, Bob; Saghir, Feras; Henry, Kurt A.

2002-08-01

The Enhanced Consequence Management, Planning and Support System (ENCOMPASS) was developed under DARPA's Advanced Consequence Management program to assist decision-makers operating in crisis situations such as terrorist attacks using conventional and unconventional weapons and natural disasters. ENCOMPASS provides the tools for first responders, incident commanders, and officials at all levels to share vital information and consequently, plan and execute a coordinated response to incidents of varying complexity and size. ENCOMPASS offers custom configuration of components with capabilities ranging from map-based situation assessment, situation-based response checklists, casualty tracking, and epidemiological surveillance. Developing and deploying such a comprehensive system posed significant challenges for DARPA program management, due to an inherently complex domain, a broad spectrum of customer sites and skill sets, an often inhospitable runtime environment, demanding development-to-deployment transition requirements, and a technically diverse and geographically distributed development team. This paper introduces ENCOMPASS and explores these challenges, followed by an outline of selected ENCOMPASS deployments, demonstrating how ENCOMPASS can enhance consequence management in a variety real world contexts.

Concussions during the 1997 Canadian Football League season.

PubMed

Delaney, J S; Lacroix, V J; Leclerc, S; Johnston, K M

2000-01-01

To examine the incidence and characteristics of concussions for one season in the Canadian Football League (CFL). Retrospective survey. 289 players reporting to CFL training camp. Of these, 154 players had played in the CFL during the 1997 season. Based on self-reported symptoms, calculations were made to determine the number of concussions experienced during the previous season, the duration of symptoms, the time for return to play after concussion, and any associated risk factors for concussions. Of all the athletes who played during the 1997 season, 44.8% experienced symptoms of a concussion. Only 18.8% of these concussed players recognized they had suffered a concussion. 69.6% of all concussed players experienced more than one episode. Symptoms lasted at least 1 day in 25.8% of cases. The odds of experiencing a concussion increased 13% with each game played. A past history of a loss of consciousness while playing football and a recognized concussion while playing football were both associated with increased odds of experiencing a concussion during the 1997 season. Many players experienced a concussion during the 1997 CFL season, but the majority of these players may not have recognized that fact. Players need to be better informed about the symptoms and effects of concussions.

On a Clear Day, You Can See ICS: The Dying Art of Incident Command and the Normal Accident of NIMS - A Policy Analysis

DTIC Science & Technology

2013-03-01

response in an effort to determine “What can be done better next time?” and “How do we prevent this from happening again?” One basic expectation that...effort to determine “What can be done better next time?” and “How do we prevent this from happening again?” One basic expectation that citizens have of...to determine “What can be done better next time?” and “How do we prevent this from happening again?” After the tragic events of September, 11, 2001

Special investigation report: Commercial space launch incident, launch procedure anomaly orbital sciences corporation PEGASUS/SCD-1, 80 nautical miles east of Cape Canaveral, Florida, February 9, 1993

NASA Astrophysics Data System (ADS)

This report explains the procedural anomaly that occurred during the launch sequence of an Orbital Sciences Corporation Pegasus expendable launch vehicle, which was subsequently deployed successfully from an NB-52B airplane, on 9 Feb. 1993. The safety issues discussed in the report include command, control and communications responsibility, launch crew fatigue, launch interphone procedures, efficiency of launch constraints, and the lack of common launch documents. Safety recommendations concerning these issues were made to the Department of Transportation, the National Aeronautics and Space Administration, and the Orbital Sciences Corporation.

Special Investigation Report: Commercial Space Launch Incident, Launch Procedure Anomaly Orbital Sciences Corporation PEGASUS/SCD-1, 80 Nautical Miles East of Cape Canaveral, Florida, February 9, 1993

NASA Technical Reports Server (NTRS)

1993-01-01

This report explains the procedural anomaly that occurred during the launch sequence of an Orbital Sciences Corporation Pegasus expendable launch vehicle, which was subsequently deployed successfully from an NB-52B airplane, on 9 Feb. 1993. The safety issues discussed in the report include command, control and communications responsibility, launch crew fatigue, launch interphone procedures, efficiency of launch constraints, and the lack of common launch documents. Safety recommendations concerning these issues were made to the Department of Transportation, the National Aeronautics and Space Administration, and the Orbital Sciences Corporation.

Sustainable Model for Public Health Emergency Operations Centers for Global Settings.

PubMed

Balajee, S Arunmozhi; Pasi, Omer G; Etoundi, Alain Georges M; Rzeszotarski, Peter; Do, Trang T; Hennessee, Ian; Merali, Sharifa; Alroy, Karen A; Phu, Tran Dac; Mounts, Anthony W

2017-10-01

Capacity to receive, verify, analyze, assess, and investigate public health events is essential for epidemic intelligence. Public health Emergency Operations Centers (PHEOCs) can be epidemic intelligence hubs by 1) having the capacity to receive, analyze, and visualize multiple data streams, including surveillance and 2) maintaining a trained workforce that can analyze and interpret data from real-time emerging events. Such PHEOCs could be physically located within a ministry of health epidemiology, surveillance, or equivalent department rather than exist as a stand-alone space and serve as operational hubs during nonoutbreak times but in emergencies can scale up according to the traditional Incident Command System structure.

Results of a Longitudinal Study of Airsickness Incidence during Naval Flight Officer Training,

DTIC Science & Technology

1984-11-01

Dt .0 Cie 0 A .0oW b V ~0 4-)4) S ) 4-)4)O L 0 4) 4.) H. Z 4)4.(4-)0 0.. V ) S .~ 4.0.04) 0. 0) .0 0 0) B-0 W I.. 0 AU )( s I 󈧓 ~044.0.’-4 IM 04.) L.14 4...Naval Aerospace Medical Research Laboratory Pensacola, Florida 32508 U.S.A. - S SUMMARV’ This paper outlines the results of a longitudinal study of...cooperation of the training . . command who allowed a large segment of the NFO study population to be exposed on a ..... .... .... .. s .7- 30-2 one-time

Subtle Symptoms Associated with Self-Reported Mild Head Injury.

ERIC Educational Resources Information Center

Segalowitz, Sidney J.; Lawson, Sheila

1995-01-01

A survey of 1,345 high school students and 2,321 university students found that 30-37% reported having experienced a head injury, with 12-15% reporting loss of consciousness. Significant relationships were found between mild head injury incidence and gender; sleep difficulties; social difficulties; handedness pattern; and diagnoses of attention…

Relations between Parents and Children in a Rural Family

ERIC Educational Resources Information Center

Reprintseva, G. I.

2009-01-01

This article discusses how the conditions in Russia are changing the characteristics of rural families, reducing the prevalence of traditional culture, changing the behavior of rural youth, and increasing familial conflict and the incidence of divorce. The deterioration of the social and economic situation that is being experienced today by many…

An Investigation of School Violence through Turkish Children's Drawings

ERIC Educational Resources Information Center

Yurtal, Filiz; Artut, Kazim

2010-01-01

This study investigates Turkish children's perception of violence in school as represented through drawings and narratives. In all, 66 students (12 to 13 years old) from the middle socioeconomic class participated. To elicit children's perception of violence, they were asked to draw a picture of a violent incident they had heard, experienced, or…

Team-Based Simulations: Learning Ethical Conduct in Teacher Trainee Programs

ERIC Educational Resources Information Center

Shapira-Lishchinsky, Orly

2013-01-01

This study aimed to identify the learning aspects of team-based simulations (TBS) through the analysis of ethical incidents experienced by 50 teacher trainees. A four-dimensional model emerged: learning to make decisions in a "supportive-forgiving" environment; learning to develop standards of care; learning to reduce misconduct; and learning to…

76 FR 22298 - Airworthiness Directives; Cessna Aircraft Company (Cessna) Model 172 Airplanes Modified by...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-21

... AD requires installing a full authority digital engine control (FADEC) backup battery, replacing the... battery every 12 calendar months. This AD was prompted by an incident where an airplane experienced an in... battery, replacing the supplement pilot's operating handbook and FAA approved airplane flight manual, and...

Forest thinning and subsequent bark beetle-caused mortality in Northeastern California

Treesearch

Joel M. Egan; William R. Jacobi; Jose F. Negron; Sheri L. Smith; Daniel R. Cluck

2010-01-01

The Warner Mountains of northeastern California on the Modoc National Forest experienced a high incidence of tree mortality (2001-2007) that was associated with drought and bark beetle (Coleoptera: Curculionidae, Scolytinae) attack. Various silvicultural thinning treatments were implemented prior to this period of tree mortality to reduce stand density and increase...

Early Campus Response to Disruptive Behavior

ERIC Educational Resources Information Center

Stump, Linda J.; Zdziarski, Eugene L.

2008-01-01

As major events define generations and tragedies define and refine protocol response to significant incidents, a sense of comfort and confidence is attained as the authors train individually and organizationally to respond to extreme events, and yet those who have experienced them know that no plan goes as it should. There are, however, steps or…

A Qualitative Investigation of Graduate-Student Changes Associated with Multicultural Counseling Courses

ERIC Educational Resources Information Center

Sammons, Cynthia C.; Speight, Suzette L.

2008-01-01

The critical incidents technique was used to gather information from graduate students about the changes they experienced connected to their participation in multicultural counseling courses. Trainees were also asked what course elements were linked to their personal changes. Racial and ethnic differences in response frequencies were analyzed. A…

Antecedents of Medical Workplace Violence in South China

ERIC Educational Resources Information Center

Cai, Wenzhi; Deng, Ling; Liu, Meng; Yu, Min

2011-01-01

It has been noted that workplace violence most frequently occurs in hospitals. The purpose of this study was to explore antecedents of workplace violence in south China. The authors conducted face-to-face, in-depth, semistructured interviews with 30 hospital staff who had experienced at least one incident of workplace violence from patients during…

Effectiveness of a Multiple Family Group Intervention for Juvenile First Offenders in Reducing Parent Stress

ERIC Educational Resources Information Center

Caldwell, Christopher Les; Horne, Arthur M.; Davidson, Bernard; Quinn, William H.

2007-01-01

Parenting practices are major influences on incidents of juvenile delinquency. Stress experienced by parents of children with behavioral problems is a leading contributor to parenting practices. We investigated the extent to which parental stress was reduced by participation in an established multiple group family intervention, the Family…

Alcohol, Consent, Sex: Reducing College Students' Risky Behaviors Utilizing an Integrated Orientation Model

ERIC Educational Resources Information Center

Smith, Diane Dani

2013-01-01

College students are at high risk of experiencing serious problems related to physical and social health issues that include binge drinking, sexual assault, and contracting a sexually transmitted disease. Despite research reporting that many of these incidents co-occur on campuses, university prevention programs have failed to present the…

Recovery from Large-Scale Crises: Guidelines for Crisis Teams and Administrators

ERIC Educational Resources Information Center

Communique, 2018

2018-01-01

The United States has recently experienced numerous large-scale crises that resulted in high death tolls and extensive property damage. Critical incidents such as suicide contagion, natural disasters, or mass casualty events have the potential to cause traumatic reactions and significantly affect children's sense of safety and security. School…

Postpolio Survivors: Needs for and Access to Social and Health Care Services.

ERIC Educational Resources Information Center

Foster, Larry W.; And Others

1993-01-01

Needs assessment survey of 268 polio survivors explored incidence of postpolio syndrome and perceived need for and access to social and health care services. Large proportion of respondents reported experiencing postpolio syndrome. Most perceived that they had no access to knowledgeable physicians or social and health care services, and most were…

Definition of Alaskan Aviation Training Requirements. Final Report.

ERIC Educational Resources Information Center

Mitchell, M. K.; And Others

Because of high accident rates and the unique conditions faced in Arctic flying, a project was conducted to develop a training program for airline pilots flying over Alaska. Data were gathered, through the critical incident method in conjunction with traditional job-analysis procedures, about how experienced Alaskan pilots learned to cope with the…

Percentage prevalence of patient and visitor violence against staff in high-risk UK medical wards.

PubMed

Lepping, Peter; Lanka, Srinivas Vn; Turner, Jim; Stanaway, Stephen Ers; Krishna, Murali

2013-12-01

Patient and visitor violence adversely affects staff and organisations; however, there are few UK data about patient and visitor violence on medical wards. Therefore, we conducted a cross-sectional study using a validated tool (Survey of Violence Experienced by Staff) in six medical wards in three North Wales district general hospitals to assess the prevalence of violence against healthcare staff. A total of 158 staff responded (12 men, 144 women, two not stated). We found that, within the previous 4 weeks, 83% of staff had experienced verbal aggression, 50% had been threatened and 63% had been physically assaulted. Of those assaulted, 56% sustained an injury, with three requiring medical assessment or treatment. Length of experience in the workplace correlated negatively with verbal abuse, but not with threats or assaults. Direct patient contact positively correlated with more overall incidents. There was no correlation between training in aggression management and the experience of incidents. Healthcare support workers and nurses reported a higher prevalence of patient and visitor violence compared with other groups of health worker.

Could masked conceptual primes increase recollection? The subtleties of measuring recollection and familiarity in recognition memory

PubMed Central

Taylor, Jason R.; Henson, Richard N.

2012-01-01

We begin with a theoretical overview of the concepts of recollection and familiarity, focusing, in the spirit of this special issue, on the important contributions made by Andrew Mayes. In particular, we discuss the issue of when the generation of semantically-related information in response to a retrieval cue might be experienced as recollection rather than familiarity. We then report a series of experiments in which two different types of masked prime, presented immediately prior to the test cue in a recognition memory paradigm, produced opposite effects on Remember vs. Know judgments. More specifically, primes that were conceptually related to the test item increased the incidence of Remember judgments, though only when intermixed with repetition primes (which increased the incidence of Know judgments instead, as in prior studies). One possible explanation—that the fluency of retrieval of item–context associations can be experienced as recollection, even when the source of that fluency is unknown—is counter to conventional views of recollection and familiarity, though it was anticipated by Andrew in his writings nearly two decades ago. PMID:22898644

Dilemmas experienced by government veterinarians when responding professionally to farm animal welfare incidents in Ireland.

PubMed

Devitt, C; Kelly, P; Blake, M; Hanlon, A; More, S J

2014-01-01

This paper identifies the dilemmas experienced by government veterinarians during their investigations of farm animal welfare incidents that involve herd owner social, health, and/or psychological difficulties. The paper builds on exploratory qualitative research into the impact of these difficulties on farm animal welfare. The study used a qualitative research approach. Focus groups were conducted. In Ireland, an Early Warning System (EWS), which brings together relevant agencies, is in place to identify and prevent farm animal welfare problems before they become critical. This study is concerned with the experiences of government veterinarians who respond to farm animal welfare incidents. Specific focus is on incidents that involve herd owner social/psychological/health-related difficulties. In total, n=18 government veterinarians (representing 15 per cent of the population sample), all with a keen interest in farm animal welfare, participated. These were selected on the basis of their interest, experience, and involvement in farm animal welfare. One government veterinarian declined to participate. Four focus groups were conducted with government veterinarians. These took place in the south (S), south-west (SW), midlands (M), and north-west region of Ireland (NW). All 16 District Veterinary Offices (DVOs) were represented in the focus groups. The results reveal three professional dilemmas that exist for government veterinarians: (1) defining professional parameters; (2) determining the appropriate response; (3) involvement versus detachment. Participants reported not wanting any additional training. Instead, it was agreed that a formal bridge to social service providers who have the professional capability to respond appropriately and with confidence, was required. Clearly defined guidelines are required for government veterinarians in their encounters with farm animal welfare incidents where there is a complex human component. A coordinated multiagency approach that is flexible enough to meet the needs of individual farm animal welfare cases is required.

Dilemmas experienced by government veterinarians when responding professionally to farm animal welfare incidents in Ireland

PubMed Central

Devitt, C.; Kelly, P.; Blake, M.; Hanlon, A.; More, S. J.

2014-01-01

Objectives This paper identifies the dilemmas experienced by government veterinarians during their investigations of farm animal welfare incidents that involve herd owner social, health, and/or psychological difficulties. The paper builds on exploratory qualitative research into the impact of these difficulties on farm animal welfare. Design The study used a qualitative research approach. Focus groups were conducted. Setting In Ireland, an Early Warning System (EWS), which brings together relevant agencies, is in place to identify and prevent farm animal welfare problems before they become critical. This study is concerned with the experiences of government veterinarians who respond to farm animal welfare incidents. Specific focus is on incidents that involve herd owner social/psychological/health-related difficulties. Participants In total, n=18 government veterinarians (representing 15 per cent of the population sample), all with a keen interest in farm animal welfare, participated. These were selected on the basis of their interest, experience, and involvement in farm animal welfare. One government veterinarian declined to participate. Four focus groups were conducted with government veterinarians. These took place in the south (S), south-west (SW), midlands (M), and north-west region of Ireland (NW). All 16 District Veterinary Offices (DVOs) were represented in the focus groups. Results The results reveal three professional dilemmas that exist for government veterinarians: (1) defining professional parameters; (2) determining the appropriate response; (3) involvement versus detachment. Participants reported not wanting any additional training. Instead, it was agreed that a formal bridge to social service providers who have the professional capability to respond appropriately and with confidence, was required. Conclusions Clearly defined guidelines are required for government veterinarians in their encounters with farm animal welfare incidents where there is a complex human component. A coordinated multiagency approach that is flexible enough to meet the needs of individual farm animal welfare cases is required. PMID:26392869

[Analysis on the incidence and relevant risk factors of campus violence among college students].

PubMed

Wang, Pei-Xi; Wang, Mian-Zhen; Lan, Ya-Jia; Pang, Qing-Juan; Wang, Zhi-Ming; Shao, Li-Ye; Lu, Bo

2005-12-01

To study the incidence and risk factors of campus violence and to provide evidence for preventing campus violence among college students. 5300 college students in two universities in a province of China were selected to participate in the study and were interviewed with questionnaires. Logistic regression was used for data analysis. (1) In total, 3910 useable questionnaires were gathered to show a response rate of 73.77%. 17.98% of the college students reported they had ever experienced campus violence in the last one year. 29.60% of the male students experienced campus violence so as 7.27% of the female students. The incidence of violence among male students was significantly higher than those of female students (chi2 = 329.89, P = 0.000). (2) Among male students who were victims of campus violence, the incidence rates of threat or blackmail, emotional abuse, physical assault, verbal sexual harassment, sexual assault were 18.03%, 13.97%, 10.77%, 0.85%, 0.48% respectively. Among female students who were victims of campus violence, the incidence rates were 3.64%, 5.84%, 1.38%, 1.33%, 1.13% respectively. The main source of the violence was from their schoolmates. (3) 10.40% of the male students reported they were perpetrators of campus violence in the last year, while 1.47% of the female students reported so. Schoolmates were the main subjects of their aggressive behaviors. (4) Among the college students who were victims of campus violence, logistic regression analysis revealed that smoking, drinking alcohol, frequently getting computer online were important risk factors. The OR values were 1.48, 2.96, 1.66 respectively. Among college students who were perpetrators of campus violence, the OR values were 2.92, 1.88, 2.09 respectively. Campus violence among college students was serious, suggesting that intervention measures should be taken.

Rapid Increase in Scrub Typhus Incidence in Mainland China, 2006-2014.

PubMed

Wu, Yi-Cheng; Qian, Quan; Magalhaes, Ricardo J Soares; Han, Zhi-Hai; Haque, Ubydul; Weppelmann, Thomas A; Hu, Wen-Biao; Liu, Yun-Xi; Sun, Yan-Song; Zhang, Wen-Yi; Li, Shen-Long

2016-03-01

Scrub typhus is a vector-borne disease, which has recently reemerged in China. In this study, we describe the distribution and incidence of scrub typhus cases in China from 2006 to 2014 and quantify differences in scrub typhus cases with respect to sex, age, and occupation. The results of our study indicate that the annual incidence of scrub typhus has increased during the study period. The number of cases peaked in 2014, which was 12.8 times greater than the number of cases reported in 2006. Most (77.97%) of the cases were reported in five provinces (Guangdong, Yunnan, Anhui, Fujian, and Shandong). Our study also demonstrates that the incidence rate of scrub typhus was significantly higher in females compared to males (P < 0.001) and was highest in the 60-69 year age group, and that farmers had a higher incidence rate than nonfarmers (P < 0.001). Different seasonal trends were identified in the number of reported cases between the northern and southern provinces of China. These findings not only demonstrate that China has experienced a large increase in scrub typhus incidence, but also document an expansion in the geographic distribution throughout the country. © The American Society of Tropical Medicine and Hygiene.

The influence of ATC message length and timing on pilot communication

NASA Technical Reports Server (NTRS)

Morrow, Daniel; Rodvold, Michelle

1993-01-01

Pilot-controller communication is critical to safe and efficient flight. It is often a challenging component of piloting, which is reflected in the number of incidents and accidents involving miscommunication. Our previous field study identified communication problems that disrupt routine communication between pilots and controllers. The present part-task simulation study followed up the field results with a more controlled investigation of communication problems. Pilots flew a simulation in which they were frequently vectored by Air Traffic Control (ATC), requiring intensive communication with the controller. While flying, pilots also performed a secondary visual monitoring task. We examined the influence of message length (one message with four commands vs. two messages with two commands each) and noncommunication workload on communication accuracy and length. Longer ATC messages appeared to overload pilot working memory, resulting in more incorrect or partial readbacks, as well as more requests to repeat the message. The timing between the two short messages also influenced communication. The second message interfered with memory for or response to the first short message when it was delivered too soon after the first message. Performing the secondary monitoring task did not influence communication. Instead, communication reduced monitoring accuracy.

SSRL Emergency Response Shore Tool

NASA Technical Reports Server (NTRS)

Mah, Robert W.; Papasin, Richard; McIntosh, Dawn M.; Denham, Douglas; Jorgensen, Charles; Betts, Bradley J.; Del Mundo, Rommel

2006-01-01

The SSRL Emergency Response Shore Tool (wherein SSRL signifies Smart Systems Research Laboratory ) is a computer program within a system of communication and mobile-computing software and hardware being developed to increase the situational awareness of first responders at building collapses. This program is intended for use mainly in planning and constructing shores to stabilize partially collapsed structures. The program consists of client and server components, runs in the Windows operating system on commercial off-the-shelf portable computers, and can utilize such additional hardware as digital cameras and Global Positioning System devices. A first responder can enter directly, into a portable computer running this program, the dimensions of a required shore. The shore dimensions, plus an optional digital photograph of the shore site, can then be uploaded via a wireless network to a server. Once on the server, the shore report is time-stamped and made available on similarly equipped portable computers carried by other first responders, including shore wood cutters and an incident commander. The staff in a command center can use the shore reports and photographs to monitor progress and to consult with structural engineers to assess whether a building is in imminent danger of further collapse.

Rating the Relevance of QUORUM-Selected ASRS Incident Narratives to a "Controlled Flight into Terrain" Accident

NASA Technical Reports Server (NTRS)

McGreevy, Michael W.; Statler, Irving C.

1998-01-01

An exploratory study was conducted to identify commercial aviation incidents that are relevant to a "controlled flight into terrain" (CFIT) accident using a NASA-developed text processing method. The QUORUM method was used to rate 67820 incident narratives, virtually all of the narratives in the Aviation Safety Reporting System (ASRS) database, according to their relevance to two official reports on the crash of American Airlines Flight 965 near Cali, Colombia in December 1995. For comparison with QUORUM's ratings, three experienced ASRS analysts read the reports of the crash and independently rated the relevance of the 100 narratives that were most highly rated by QUORUM, as well as 100 narratives randomly selected from the database. Eighty-four of 100 QUORUM-selected narratives were rated as relevant to the Cali accident by one or more of the analysts. The relevant incidents involved a variety of factors, including, over-reliance on automation, confusion and changes during descent/approach, terrain avoidance, and operations in foreign airspace. In addition, the QUORUM collection of incidents was found to be significantly more relevant than the random collection.

Project ARGO: Gas phase formation in simulated microgravity

NASA Technical Reports Server (NTRS)

Powell, Michael R.; Waligora, James M.; Norfleet, William T.; Kumar, K. Vasantha

1993-01-01

The ARGO study investigated the reduced incidence of joint pain decompression sickness (DCS) encountered in microgravity as compared with an expected incidence of joint pain DCS experienced by test subjects in Earth-based laboratories (unit gravity) with similar protocols. Individuals who are decompressed from saturated conditions usually acquire joint pain DCS in the lower extremities. Our hypothesis is that the incidence of joint pain DCS can be limited by a significant reduction in the tissue gas micronuclei formed by stress-assisted nucleation. Reductions in dynamic and kinetic stresses in vivo are linked to hypokinetic and adynamic conditions of individuals in zero g. We employed the Doppler ultrasound bubble detection technique in simulated microgravity studies to determine quantitatively the degree of gas phase formation in the upper and lower extremities of test subjects during decompression. We found no evidence of right-to-left shunting through pulmonary vasculature. The volume of gas bubble following decompression was examined and compared with the number following saline contrast injection. From this, we predict a reduced incidence of DCS on orbit, although the incidence of predicted mild DCS still remains larger than that encountered on orbit.

Interagency Evaluation of the Section 1206 Global Train and Equip Program

DTIC Science & Technology

2009-08-31

Capabilities, Joint Staff, U.S. Africa Command, U.S. Central Command, U.S Joint Forces Command, U.S. Pacific Command, U.S. Southern Command, U.S. Special...Intensity Conflict & Interdependent Capabilities; Commanders of U.S. Africa Command, U.S. Central Command, U.S. Joint Forces Command, U.S. Pacific... Central Command, commented that coordinating the Section 1206 project proposal with the partner nation prior to submission would inflate the

Are calving interval, abortions, incidence of stillbirths and pre-weaning losses in Nguni cows associated with linear type traits?

PubMed

Zindove, T J; Chimonyo, M

2015-09-01

The association of six linear type traits with calving interval, abortions, incidence of stillbirths and pre-weaning losses in Nguni cows in semi-arid and sub-humid communal areas was investigated. It was hypothesised that the odds of a cow having caving interval greater than 1 year, aborting, experiencing stillbirths or losing a calf from calving to weaning decreased with increase in body depth, rump height, flank circumference, chest circumference, navel height and body length. Navel height was measured as the distance from the ground to the lowest point of the cow's belly bottom (navel). Data were collected from a total of 200 Nguni cows from two sites experiencing sub-humid and semi-arid environments (100 each) between May and June 2013. Cows in sub-humid regions were 2.57 times more likely to have a calving interval of 1 year than cows in semi-arid areas. As body depth increased, the number of calves lost by a cow before weaning decreased linearly (p < 0.05) in all parities except parity 4. Cows in semi-arid regions were 2.13 times more likely to lose a calf from calving to weaning. For each unit increase in body depth, the odds of a cow aborting decreased by 1.12 and the odds of a cow having stillbirth decreased by 1.15. Rump height, flank circumference, chest circumference, navel height and body length were not associated with calving interval, abortions, incidence of stillbirths and pre-weaning losses. It was, therefore, concluded that body depth influences calving interval, incidence of stillbirths and abortions in Nguni cows. Copyright © 2015 Elsevier B.V. All rights reserved.

Incidence and predictors of mental health disorder diagnoses among people who inject drugs in a Canadian setting.

PubMed

Reddon, Hudson; Pettes, Tyler; Wood, Evan; Nosova, Ekaterina; Milloy, Michael-John; Kerr, Thomas; Hayashi, Kanna

2018-04-01

Limited attention has been given to the predictors of mental health diagnoses among people who inject drugs (PWID) in community settings. Therefore, we sought to longitudinally examine the prevalence, incidence and predictors of mental disorder diagnosis among a community-recruited cohort of PWID. Data were derived from two prospective cohort studies of PWID (VIDUS and ACCESS) in Vancouver, Canada between December 2005 and May 2015. We used multivariable extended Cox regression to identify factors independently associated with self-reported mental disorder diagnosis during follow-up among those without a history of such diagnoses at baseline. Among the 923 participants who did not report a mental disorder at baseline, 206 (22.3%) reported a first diagnosis of a mental disorder during follow-up for an incidence density of 4.29 [95% confidence interval (CI) 3.72-4.91] per 100 person-years. In the multivariable analysis, female sex [adjusted hazards ratio (AHR) = 1.74, 95% CI 1.29-2.33], experiencing non-fatal overdose (AHR = 2.33, 95% CI 1.38-3.94), accessing any drug or alcohol treatment (AHR = 1.68, 95% CI 1.24-2.27), accessing any community health or social services (AHR = 1.53, 95% CI 1.02-2.28) and experiencing violence (AHR = 1.60, 95% CI 1.12-2.29) were independently associated with a mental disorder diagnosis at follow-up. We observed a high prevalence and incidence of mental disorders among our community-recruited sample of PWID. The validity and implication of these diagnoses for key substance use and public health outcomes are an urgent priority. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Incidence and predictors of herpes zoster among antiretroviral therapy-naïve patients initiating HIV treatment in Johannesburg, South Africa

PubMed Central

Maskew, Mhairi; Ajayi, Toyin; Berhanu, Rebecca; Majuba, Pappie; Sanne, Ian; Fox, Matthew P.

2014-01-01

Summary Objectives To describe the characteristics of HIV-infected patients experiencing herpes zoster after antiretroviral therapy (ART) initiation and to describe the incidence and predictors of a herpes zoster diagnosis. Methods Adult patients initiating ART from April 2004 to September 2011 at the Themba Lethu Clinic in Johannesburg, South Africa were included. Patients were followed from ART initiation until the date of first herpes zoster diagnosis, or death, transfer, loss to follow-up, or dataset closure. Herpes zoster is described using incidence rates (IR) and predictors of herpes zoster are presented as subdistribution hazard ratios (sHR) and 95% confidence intervals (95% CI). Results Fifteen thousand and twenty-five patients were included; 62% were female, the median age was 36.6 years, and the median baseline CD4 count was 98 cells/mm3. Three hundred and forty patients (2.3%) experienced herpes zoster in a median of 26.1 weeks after ART initiation. Most (71.5%) occurred within 1 year of initiation, for a 1-year IR of 18.1/1000 person-years. In an adjusted model, patients with low CD4 counts (<50 vs. ≥200 cells/mm3; sHR: 1.71, 95% CI: 1.21–2.47) and with a prior episode of herpes zoster (sHR: 1.53, 95% CI: 0.97–2.28) were at increased risk of incident herpes zoster. Conclusions While only 2% of patients were diagnosed with herpes zoster in this cohort, patients with low CD4 counts and those with prior episodes of herpes zoster were at higher risk for a herpes zoster diagnosis. PMID:24680820

Risk Factors of Hypersensitivity to Carboplatin in Patients with Gynecologic Malignancies

PubMed Central

Tai, Yu-Hsiao; Tai, Yi-Jou; Hsu, Heng-Cheng; Lee, Shu-Ping; Chen, Yun-Yuan; Chiang, Ying-Cheng; Chen, Yu-Li; Chen, Chi-An; Cheng, Wen-Fang

2017-01-01

We evaluated the prevalence of and risk factors for hypersensitivity reactions related to carboplatin, which is commonly used to treat gynecological malignancies. All women with pathologically documented ovarian, fallopian tube, or primary peritoneal cancer treated with carboplatin alone or a carboplatin-based combination chemotherapy regimen at a single hospital between January 2006 and December 2013 were retrospectively recruited. We analyzed the incidence, characteristics, risk factors, management, and outcomes of carboplatin-related hypersensitivity reactions among these patients. Among 735 eligible women, 75 (10.2%) experienced a total of 215 carboplatin-related hypersensitivity reaction events. The annual incidence of carboplatin-related hypersensitivity reactions gradually increased from 0.88% in 2006 to 5.42% in 2013. The incidence of carboplatin-related hypersensitivity was higher in patients with advanced stage disease (P < 0.001, Kruskal-Wallis test), serous and mixed histological types (P = 0.003, Kruskal-Wallis test), malignant ascites (P = 0.009, chi-square test), and history of other drug allergy (P < 0.001, chi-square test). Compared to women without hypersensitivity reactions, women who experienced hypersensitivity reactions had a significantly greater median cycle number (12 vs. 6, P < 0.001, independent sample t-test) and dose (6,816 vs. 3,844 mg, P < 0.001, independent sample t-test). The cumulative incidence of carboplatin-related hypersensitivity reactions dramatically increased with >8 cycles or dose >3,500 mg. Therefore, disease severity, histological type, malignant ascites, past drug allergies, and cumulative carboplatin dose are risk factors for carboplatin-related hypersensitivity reactions. Such reactions could potentially be reduced or prevented by slowing the infusion rate and using a desensitization protocol involving anti-allergy medications. PMID:29163180

Incidence and risk factors of workplace violence against nurses in a Chinese top-level teaching hospital: A cross-sectional study.

PubMed

Chen, Xiaoming; Lv, Ming; Wang, Min; Wang, Xiufeng; Liu, Junyan; Zheng, Nan; Liu, Chunlan

2018-04-01

To investigate the incidence of workplace violence involving nurses and to identify related risk factors in a high-quality Chinese teaching hospital. A cross-sectional study design was used. The final sample comprised responses from 1831 registered nurses collected with a whole-hospital survey from June 1 to June 15, 2016. The demographic characteristics of the nurses who had experienced any form of violence were collected, and logistic regression analysis was applied to evaluate the risk factors for nurses related to workplace violence. Out of the total number of nurses surveyed, 904 (49.4%) nurses reported having experienced any type of violence in the past year. The frequencies of exposure to physical and non-physical violence were 6.3% (116) and 49.0% (897), respectively. All the incidence rates of violence were lower than those of other studies based on regional hospitals in China and were at the same level found in developed countries and districts. Binary logistic regression analysis revealed that nurses at levels 2 to 4 and female nurses in clinical departments were the most vulnerable to non-physical violence. For physical violence, the two independent risk factors were working in an emergency department and having 6-10 years of work experience. Workplace violence directly threatens nurses from high-quality Chinese teaching hospitals. However, the incidence of WPV against nurses in this teaching hospital was better than that in regional hospitals. This study also provides reference material to identify areas where nurses encounter relatively high levels of workplace violence in high-quality Chinese teaching hospitals. Copyright © 2018 Elsevier Inc. All rights reserved.

Risk Factors of Hypersensitivity to Carboplatin in Patients with Gynecologic Malignancies.

PubMed

Tai, Yu-Hsiao; Tai, Yi-Jou; Hsu, Heng-Cheng; Lee, Shu-Ping; Chen, Yun-Yuan; Chiang, Ying-Cheng; Chen, Yu-Li; Chen, Chi-An; Cheng, Wen-Fang

2017-01-01

We evaluated the prevalence of and risk factors for hypersensitivity reactions related to carboplatin, which is commonly used to treat gynecological malignancies. All women with pathologically documented ovarian, fallopian tube, or primary peritoneal cancer treated with carboplatin alone or a carboplatin-based combination chemotherapy regimen at a single hospital between January 2006 and December 2013 were retrospectively recruited. We analyzed the incidence, characteristics, risk factors, management, and outcomes of carboplatin-related hypersensitivity reactions among these patients. Among 735 eligible women, 75 (10.2%) experienced a total of 215 carboplatin-related hypersensitivity reaction events. The annual incidence of carboplatin-related hypersensitivity reactions gradually increased from 0.88% in 2006 to 5.42% in 2013. The incidence of carboplatin-related hypersensitivity was higher in patients with advanced stage disease ( P < 0.001, Kruskal-Wallis test), serous and mixed histological types ( P = 0.003, Kruskal-Wallis test), malignant ascites ( P = 0.009, chi-square test), and history of other drug allergy ( P < 0.001, chi-square test). Compared to women without hypersensitivity reactions, women who experienced hypersensitivity reactions had a significantly greater median cycle number (12 vs. 6, P < 0.001, independent sample t -test) and dose (6,816 vs. 3,844 mg, P < 0.001, independent sample t -test). The cumulative incidence of carboplatin-related hypersensitivity reactions dramatically increased with >8 cycles or dose >3,500 mg. Therefore, disease severity, histological type, malignant ascites, past drug allergies, and cumulative carboplatin dose are risk factors for carboplatin-related hypersensitivity reactions. Such reactions could potentially be reduced or prevented by slowing the infusion rate and using a desensitization protocol involving anti-allergy medications.

Expert system for UNIX system reliability and availability enhancement

NASA Astrophysics Data System (ADS)

Xu, Catherine Q.

1993-02-01

Highly reliable and available systems are critical to the airline industry. However, most off-the-shelf computer operating systems and hardware do not have built-in fault tolerant mechanisms, the UNIX workstation is one example. In this research effort, we have developed a rule-based Expert System (ES) to monitor, command, and control a UNIX workstation system with hot-standby redundancy. The ES on each workstation acts as an on-line system administrator to diagnose, report, correct, and prevent certain types of hardware and software failures. If a primary station is approaching failure, the ES coordinates the switch-over to a hot-standby secondary workstation. The goal is to discover and solve certain fatal problems early enough to prevent complete system failure from occurring and therefore to enhance system reliability and availability. Test results show that the ES can diagnose all targeted faulty scenarios and take desired actions in a consistent manner regardless of the sequence of the faults. The ES can perform designated system administration tasks about ten times faster than an experienced human operator. Compared with a single workstation system, our hot-standby redundancy system downtime is predicted to be reduced by more than 50 percent by using the ES to command and control the system.

Expert System for UNIX System Reliability and Availability Enhancement

NASA Technical Reports Server (NTRS)

Xu, Catherine Q.

1993-01-01

Highly reliable and available systems are critical to the airline industry. However, most off-the-shelf computer operating systems and hardware do not have built-in fault tolerant mechanisms, the UNIX workstation is one example. In this research effort, we have developed a rule-based Expert System (ES) to monitor, command, and control a UNIX workstation system with hot-standby redundancy. The ES on each workstation acts as an on-line system administrator to diagnose, report, correct, and prevent certain types of hardware and software failures. If a primary station is approaching failure, the ES coordinates the switch-over to a hot-standby secondary workstation. The goal is to discover and solve certain fatal problems early enough to prevent complete system failure from occurring and therefore to enhance system reliability and availability. Test results show that the ES can diagnose all targeted faulty scenarios and take desired actions in a consistent manner regardless of the sequence of the faults. The ES can perform designated system administration tasks about ten times faster than an experienced human operator. Compared with a single workstation system, our hot-standby redundancy system downtime is predicted to be reduced by more than 50 percent by using the ES to command and control the system.

Piloted simulation tests of propulsion control as backup to loss of primary flight controls for a mid-size jet transport

NASA Technical Reports Server (NTRS)

Bull, John; Mah, Robert; Davis, Gloria; Conley, Joe; Hardy, Gordon; Gibson, Jim; Blake, Matthew; Bryant, Don; Williams, Diane

1995-01-01

Failures of aircraft primary flight-control systems to aircraft during flight have led to catastrophic accidents with subsequent loss of lives (e.g. , DC-1O crash, B-747 crash, C-5 crash, B-52 crash, and others). Dryden Flight Research Center (DFRC) investigated the use of engine thrust for emergency flight control of several airplanes, including the B-720, Lear 24, F-15, C-402, and B-747. A series of three piloted simulation tests have been conducted at Ames Research Center to investigate propulsion control for safely landing a medium size jet transport which has experienced a total primary flight-control failure. The first series of tests was completed in July 1992 and defined the best interface for the pilot commands to drive the engines. The second series of tests was completed in August 1994 and investigated propulsion controlled aircraft (PCA) display requirements and various command modes. The third series of tests was completed in May 1995 and investigated PCA full-flight envelope capabilities. This report describes the concept of a PCA, discusses pilot controls, displays, and procedures; and presents the results of piloted simulation evaluations of the concept by a cross-section of air transport pilots.

Robonaut 2 and Watson: Cognitive Dexterity for Future Exploration

NASA Technical Reports Server (NTRS)

Badger, Julia M.; Strawser, Philip; Farrell, Logan; Goza, S. Michael; Claunch, Charles A.; Chancey, Raphael; Potapinski, Russell

2018-01-01

Future exploration missions will dictate a level of autonomy never before experienced in human spaceflight. Mission plans involving the uncrewed phases of complex human spacecraft in deep space will require a coordinated autonomous capability to be able to maintain the spacecraft when ground control is not available. One promising direction involves embedding intelligence into the system design both through the employment of state-of-the-art system engineering principles as well as through the creation of a cognitive network between a smart spacecraft or habitat and embodiments of cognitive agents. The work described here details efforts to integrate IBM's Watson and other cognitive computing services into NASA Johnson Space Center (JSC)'s Robonaut 2 (R2) anthropomorphic robot. This paper also discusses future directions this work will take. A cognitive spacecraft management system that is able to seamlessly collect data from subsystems, determine corrective actions, and provide commands to enable those actions is the end goal. These commands could be to embedded spacecraft systems or to a set of robotic assets that are tied into the cognitive system. An exciting collaboration with Woodside provides a promising Earth-bound testing analog, as controlling and maintaining not normally manned off-shore platforms have similar constraints to the space missions described.

The Inaccuracy of Patient Recall for COPD Exacerbation Rate Estimation and Its Implications: Results from Central Adjudication.

PubMed

Frei, Anja; Siebeling, Lara; Wolters, Callista; Held, Leonhard; Muggensturm, Patrick; Strassmann, Alexandra; Zoller, Marco; Ter Riet, Gerben; Puhan, Milo A

2016-10-01

COPD exacerbation incidence rates are often ascertained retrospectively through patient recall and self-reports. We compared exacerbation ascertainment through patient self-reports and single-physician chart review to central adjudication by a committee and explored determinants and consequences of misclassification. Self-reported exacerbations (event-based definition) in 409 primary care patients with COPD participating in the International Collaborative Effort on Chronic Obstructive Lung Disease: Exacerbation Risk Index Cohorts (ICE COLD ERIC) cohort were ascertained every 6 months over 3 years. Exacerbations were adjudicated by single experienced physicians and an adjudication committee who had information from patient charts. We assessed the accuracy (sensitivities and specificities) of self-reports and single-physician chart review against a central adjudication committee (AC) (reference standard). We used multinomial logistic regression and bootstrap stability analyses to explore determinants of misclassifications. The AC identified 648 exacerbations, corresponding to an incidence rate of 0.60 ± 0.83 exacerbations/patient-year and a cumulative incidence proportion of 58.9%. Patients self-reported 841 exacerbations (incidence rate, 0.75 ± 1.01; incidence proportion, 59.7%). The sensitivity and specificity of self-reports were 84% and 76%, respectively, those of single-physician chart review were between 89% and 96% and 87% and 99%, respectively. The multinomial regression model and bootstrap selection showed that having experienced more exacerbations was the only factor consistently associated with underreporting and overreporting of exacerbations (underreporters: relative risk ratio [RRR], 2.16; 95% CI, 1.76-2.65 and overreporters: RRR, 1.67; 95% CI, 1.39-2.00). Patient 6-month recall of exacerbation events are inaccurate. This may lead to inaccurate estimates of incidence measures and underestimation of treatment effects. The use of multiple data sources combined with event adjudication could substantially reduce sample size requirements and possibly cost of studies. www.ClinicalTrials.gov, NCT00706602. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

High Prevalence of Nontraumatic Shoulder Pain in a Regional Sample of Female High School Volleyball Athletes

PubMed Central

Frisch, Kayt E.; Clark, Jacob; Hanson, Chad; Fagerness, Chris; Conway, Adam; Hoogendoorn, Lindsay

2017-01-01

Background: Shoulder pain is becoming increasingly problematic in young players as volleyball gains popularity. Associations between repetitive motion and pain and overuse injury have been observed in other overhand sports (most notably baseball). Studies of adult athletes suggest that there is a shoulder pain and overuse problem present in volleyball players, but minimal research has been done to establish rates and causes in juvenile participants. Purpose: To establish rates of shoulder pain, regardless of whether it resulted in a loss of playing time, in female high school volleyball players. A secondary goal was to determine whether high repetition volumes correlated with an increased likelihood of experiencing pain. Study Design: Descriptive epidemiology study. Methods: A self-report survey focusing on the prevalence of pain not associated with a traumatic event in female high school youth volleyball players was developed. Survey questions were formulated by certified athletic trainers, experienced volleyball coaches, and biomechanics experts. Surveys were received from 175 healthy, active high school volleyball players in Iowa, South Dakota, and Minnesota. Results: Forty percent (70/175) of active high school volleyball players remembered experiencing shoulder pain not related to traumatic injury, but only 33% (23/70) reported taking time off to recover from the pain. Based on these self-reported data, activities associated with significantly increased risk of nontraumatic shoulder pain included number of years playing competitive volleyball (P = .01) and lifting weights out of season (P = .001). Players who reported multiple risk factors were more likely to experience nontraumatic shoulder pain. Conclusion: When using time off for recovery as the primary injury criterion, we found that the incidence of shoulder pain is more than twice as high as the incidence of injury reported by previous studies. Findings also indicated that the incidence of shoulder pain may be correlated with volume of previous volleyball experience. PMID:28680897

Additional Cost Because of Pneumonia in Nursing Home Residents: Results From the Incidence of Pneumonia and Related Consequences in Nursing Home Resident Study.

PubMed

Costa, Nadège; Hoogendijk, Emiel O; Mounié, Michael; Bourrel, Robert; Rolland, Yves; Vellas, Bruno; Molinier, Laurent; Cesari, Matteo

2017-05-01

Pneumonia is a frequent condition in older people. Our aim was to examine the total healthcare cost related to pneumonia in nursing home (NH) residents over a 1-year follow-up period. This was a prospective, longitudinal, observational, and multicenter study that was a part of the Incidence of Pneumonia and related Consequences in Nursing Home Resident study. Thirteen NHs located in Languedoc Roussillon and Midi-Pyrénées regions in France were included. Resident in NH, older than 60 years and had a group iso-resource score ranging from 2 to 5. Pneumonia events were characterized according to the Observatoire du Risque Infectieux en Geriatrie criteria. Direct medical and nonmedical costs were assessed from the French health insurance perspective. Healthcare resources was retrospectively gathered from the French Social Health Insurance database and valued using the tariffs reimbursed by the French health insurance. Sociodemographic variables, clinical factors, vaccinations, cognition, depression, functional status, frailty index, as well as group iso-resource score were also recorded. Among the 800 patients initially included in the Incidence of Pneumonia and Related Consequences in Nursing Home Resident study, 345 which were listed in the database of the French Social Health Insurance were included in this economic study. Among them, 64 (18%) experienced at least 1 episode of pneumonia during the 1-year follow-up period. Mean annual total additional cost for a patient who experienced at least 1 episode of pneumonia during the 1 year follow-up period is 2813€. On average, total annual costs increased by 60% to 93% when a patient experienced at least 1 episode of pneumonia. NH-acquired pneumonia has a great impact on total cost of care for NH residents. Our results suggest the potential economic savings that could be achieved if pneumonia could be prevented in NHs. Copyright © 2017. Published by Elsevier Inc.

Predictive validity and correlates of self-assessed resilience among U.S. Army soldiers.

PubMed

Campbell-Sills, Laura; Kessler, Ronald C; Ursano, Robert J; Sun, Xiaoying; Taylor, Charles T; Heeringa, Steven G; Nock, Matthew K; Sampson, Nancy A; Jain, Sonia; Stein, Murray B

2018-02-01

Self-assessment of resilience could prove valuable to military and other organizations whose personnel confront foreseen stressors. We evaluated the validity of self-assessed resilience among U.S. Army soldiers, including whether predeployment perceived resilience predicted postdeployment emotional disorder. Resilience was assessed via self-administered questionnaire among new soldiers reporting for basic training (N = 35,807) and experienced soldiers preparing to deploy to Afghanistan (N = 8,558). Concurrent validity of self-assessed resilience was evaluated among recruits by estimating its association with past-month emotional disorder. Predictive validity was examined among 3,526 experienced soldiers with no lifetime emotional disorder predeployment. Predictive models estimated associations of predeployment resilience with incidence of emotional disorder through 9 months postdeployment and with marked improvement in coping at 3 months postdeployment. Weights-adjusted regression models incorporated stringent controls for risk factors. Soldiers characterized themselves as very resilient on average [M = 14.34, SD = 4.20 (recruits); M = 14.75, SD = 4.31 (experienced soldiers); theoretical range = 0-20]. Demographic characteristics exhibited only modest associations with resilience, while severity of childhood maltreatment was negatively associated with resilience in both samples. Among recruits, resilience was inversely associated with past-month emotional disorder [adjusted odds ratio (AOR) = 0.65, 95% CI = 0.62-0.68, P < .0005 (per standard score increase)]. Among deployed soldiers, greater predeployment resilience was associated with decreased incidence of emotional disorder (AOR = 0.91; 95% CI = 0.84-0.98; P = .016) and increased odds of improved coping (AOR = 1.36; 95% CI = 1.24-1.49; P < .0005) postdeployment. Findings supported validity of self-assessed resilience among soldiers, although its predictive effect on incidence of emotional disorder was modest. In conjunction with assessment of known risk factors, measurement of resilience could help predict adaptation to foreseen stressors like deployment. © 2017 Wiley Periodicals, Inc.

High Prevalence of Nontraumatic Shoulder Pain in a Regional Sample of Female High School Volleyball Athletes.

PubMed

Frisch, Kayt E; Clark, Jacob; Hanson, Chad; Fagerness, Chris; Conway, Adam; Hoogendoorn, Lindsay

2017-06-01

Shoulder pain is becoming increasingly problematic in young players as volleyball gains popularity. Associations between repetitive motion and pain and overuse injury have been observed in other overhand sports (most notably baseball). Studies of adult athletes suggest that there is a shoulder pain and overuse problem present in volleyball players, but minimal research has been done to establish rates and causes in juvenile participants. To establish rates of shoulder pain, regardless of whether it resulted in a loss of playing time, in female high school volleyball players. A secondary goal was to determine whether high repetition volumes correlated with an increased likelihood of experiencing pain. Descriptive epidemiology study. A self-report survey focusing on the prevalence of pain not associated with a traumatic event in female high school youth volleyball players was developed. Survey questions were formulated by certified athletic trainers, experienced volleyball coaches, and biomechanics experts. Surveys were received from 175 healthy, active high school volleyball players in Iowa, South Dakota, and Minnesota. Forty percent (70/175) of active high school volleyball players remembered experiencing shoulder pain not related to traumatic injury, but only 33% (23/70) reported taking time off to recover from the pain. Based on these self-reported data, activities associated with significantly increased risk of nontraumatic shoulder pain included number of years playing competitive volleyball ( P = .01) and lifting weights out of season ( P = .001). Players who reported multiple risk factors were more likely to experience nontraumatic shoulder pain. When using time off for recovery as the primary injury criterion, we found that the incidence of shoulder pain is more than twice as high as the incidence of injury reported by previous studies. Findings also indicated that the incidence of shoulder pain may be correlated with volume of previous volleyball experience.

Additional exposure of the Irish adult population to dioxins and PCBs from the diet as a consequence of the 2008 Irish dioxin food contamination incident.

PubMed

Tlustos, C; Anderson, W; Flynn, A; Pratt, I

2014-01-01

In 2008, the discovery of elevated levels of dioxins and PCBs in a porcine fat sample taken as part of the national residues monitoring programme led to the detection of a major feed contamination incidence in the Republic of Ireland. To estimate additional exposure to dioxins and PCBs due to the contamination incident, all data associated with the contamination incident were collected and reviewed. An exposure model was devised that took into account the proportion of contaminated product reaching the final consumer during the contamination incident window and which utilised all additional information that became available after the incident occurred. Exposure estimates derived for both dioxins and PCBs showed that the body burden of the general population remained largely unaffected by the contamination incident and only approximately 10% were exposed to elevated levels of dioxins and PCBs. Whilst this proportion of the population experienced quite a significant additional load to the existing body burden, the estimated exposure values do not suggest that these would be associated with adverse health effects, based on current knowledge. The exposure period was also limited in time to approximately 3 months, following the recall of contaminated meat immediately on detection of the contamination.

5. Command center doors at command center entry, building 501, ...

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

5. Command center doors at command center entry, building 501, looking north - Offutt Air Force Base, Strategic Air Command Headquarters & Command Center, Command Center, 901 SAC Boulevard, Bellevue, Sarpy County, NE

Network, system, and status software enhancements for the autonomously managed electrical power system breadboard. Volume 3: Commands specification

NASA Technical Reports Server (NTRS)

Mckee, James W.

1990-01-01

This volume (3 of 4) contains the specification for the command language for the AMPS system. The volume contains a requirements specification for the operating system and commands and a design specification for the operating system and command. The operating system and commands sits on top of the protocol. The commands are an extension of the present set of AMPS commands in that the commands are more compact, allow multiple sub-commands to be bundled into one command, and have provisions for identifying the sender and the intended receiver. The commands make no change to the actual software that implement the commands.

Joint Chiefs of Staff > Media > Photos

Science.gov Websites

U.S. Army Gen. Curtis M. Scaparrotti, left, Commander of U.S. European Command and Supreme Allied , Commander of U.S. European Command and Supreme Allied Commander, Europe; speaks after receiving the . U.S. Army Gen. Curtis M. Scaparrotti, Commander of U.S. European Command and Supreme Allied Commander

Risk of Injuries in Paralympic Track and Field Differs by Impairment and Event Discipline: A Prospective Cohort Study at the London 2012 Paralympic Games.

PubMed

Blauwet, Cheri A; Cushman, Daniel; Emery, Carolyn; Willick, Stuart E; Webborn, Nick; Derman, Wayne; Schwellnus, Martin; Stomphorst, Jaap; Van de Vliet, Peter

2016-06-01

The incidence rates (IRs) and factors associated with injuries in the sport of Paralympic athletics (track and field) have not been comprehensively and prospectively studied. To determine injury IRs, characteristics of injuries, and associated factors in the sport of athletics at the London 2012 Paralympic Games. Cohort study; Level of evidence, 2. A total of 977 athletes competing in the sport of athletics were followed over a total 10-day competition period of the Paralympic Games. Daily injury data were obtained via 2 databases: (1) a custom-built, web-based injury and illness surveillance system (WEB-IISS), maintained by team medical personnel; and (2) the organizing committee database, maintained by medical providers in the medical stations operated by the London Organising Committee of the Olympic and Paralympic Games. Athlete impairment and event discipline were obtained via the International Paralympic Committee athlete database. IRs (injuries per 1000 athlete-days) by impairment, event discipline, sex, and age were examined. The overall IR was 22.1 injuries per 1000 athlete-days (95% CI, 19.5-24.7). In track disciplines, ambulant athletes with cerebral palsy experienced a lower incidence of injuries (IR, 10.2; 95% CI, 4.2-16.2) when compared with ambulant athletes from other impairment categories. Athletes in seated throwing experienced a higher incidence of injuries (IR, 23.7; 95% CI, 17.5-30.0) when compared with athletes in wheelchair racing (IR, 10.6; 95% CI, 5.5-15.6). In both track and field disciplines, the majority of injuries did not result in time loss from competition or training. Ambulant athletes experienced the greatest proportion of injuries to the thigh (16.4% of all injuries; IR, 4.0), observed predominantly in track athletes. Wheelchair or seated athletes experienced the greatest proportion of injuries to the shoulder/clavicle (19.3% of all injuries; IR, 3.4), observed predominantly in field athletes. This is the first prospective cohort study examining injury IRs and associated factors in the sport of athletics at the Paralympic Games. Injury patterns were specific to the event discipline and athlete impairment. The majority of injuries occurred to the thigh (ambulant athletes) or shoulder/clavicle (wheelchair or seated athletes) and did not result in time loss. © 2016 The Author(s).

Incidence of double ovulation during the early postpartum period in lactating dairy cows.

PubMed

Kusaka, Hiromi; Miura, Hiroshi; Kikuchi, Motohiro; Sakaguchi, Minoru

2017-03-15

In lactating cattle, the incidence of twin calving has many negative impacts on production and reproduction in dairy farming. In almost all cases, natural twinning in dairy cattle is the result of double ovulation. It has been suggested that the milk production level of cows influences the number of ovulatory follicles. The objective of the present study was to investigate the incidence of double ovulations during the early postpartum period in relation to the productive and reproductive performance of dairy cows. The ovaries of 43 Holstein cows (26 primiparous and 17 multiparous) were ultrasonographically scanned throughout the three postpartum ovulation sequences. The incidence of double ovulation in the unilateral ovaries was 66.7%, with a higher incidence in the right ovary than in the left, whereas that in bilateral ovaries was 33.3%. When double ovulations were counted dividing into each side ovary in which ovulations occurred, the total frequency of ovulations deviated from a 1:1 ratio (60.3% in the right side and 39.7% in the left side, P < 0.05). In multiparous cows, double ovulation occurred more frequently than in primiparous cows (58.8% vs. 11.5% per cow and 30.0% vs. 3.8% per ovulation, respectively P < 0.01). The double ovulators experienced more anovulatory repeated waves of follicles before their first ovulations than the single ovulators, which resulted in an extension of the period from parturition to third ovulation (81.5 days vs. 64.2 days, P < 0.05). In the multiparous cows, the double ovulators exhibited higher peak milk yield (P < 0.01) with lower milk lactose concentration (P < 0.05), indicating the prevalence of a more severe negative energy balance during the postpartum 3-month compared to the multiparous single ovulators. Our results showed that, regardless of their parity, double ovulation had no impact on the reproductive performance of the cows. Two multiparous cows that experienced double ovulation during the early postpartum period subsequently conceived twin fetuses. It can be speculated that the incidence of double ovulations during the early postpartum period partly contributes to the increased incidence of undesirable twin births in multiparous dairy cows. Copyright © 2016. Published by Elsevier Inc.

Roots of increased health care inequality in New York.

PubMed

Wallace, D

1990-01-01

During the 1970s, New York city experienced an epidemic of housing destruction by contagious fire and building abandonment. This epidemic was triggered by reductions in municipal services, especially fire control, in the poor areas of high population density and aging housing. The rapid loss of low rent housing led to a wave of forced internal migration of the poor within the city and overcrowding of areas adjacent to the burned out ones. The spread of overcrowding spread the high fire incidence. The massive upheaval resulted in destruction of social networks and in degraded living conditions. Public health, as measured by many indices such as disease incidence, substance abuse incidence, infant mortality, and incidence of homicide, deteriorated. This deterioration caused increased demand for hospital health care, especially emergency service. The data on average stay length in the poorest areas in comparison with wealthier areas hints that the overloading of the voluntary hospitals in the poorest areas has caused care rationing and greater inequality in access to care.

Managing chronic conditions in college: Findings from prompted health incidents diaries.

PubMed

Ravert, Russell D; Russell, Luke T; O'Guin, Monica B

2017-04-01

This pilot study assessed an electronic health diary method designed to collect data about critical health incidents experienced by college students who have chronic health conditions. Nine university students with chronic medical conditions were recruited to complete a series of e-mail-based surveys, sent once every 3 days across the fall 2014 semester. In each survey, participants described a health-related incident that occurred within the past day and cited resources that helped or could have helped in that situation. They completed follow-up interviews and ranked the importance of cited resources. The diary completion rate was 78.3% (141/180). Most frequently affected management areas were activities (61.3%), monitoring (34.9%), and problem-solving (34.3%). Resources considered helpful included situational knowledge, campus health professionals, peer support, and relaxation opportunities. Prompted health incidents diary method achieved a high completion rate and provided data that could be useful for college health researchers and practitioners.

“I’ll Never Drink Like That Again”: Characteristics of Alcohol-Related Incidents and Predictors of Motivation to Change in College Students*

PubMed Central

BARNETT, NANCY P.; GOLDSTEIN, ABBY L.; MURPHY, JAMES G.; COLBY, SUZANNE M.; MONTI, PETER M.

2011-01-01

Objective Alcohol use and its associated behaviors are among the most common reasons for medical treatment and disciplinary infractions among college students. The purpose of this study was to describe the characteristics of students who had recent serious alcohol-related incidents and to identify predictors of motivation to change alcohol use and heavy drinking in particular, with specific attention to gender. Method Students (N = 227; 52% female) who had been mandated to attend a session of alcohol education following alcohol-related medical treatment and/or a disciplinary infraction were assessed on their alcohol use, alcohol problems, characteristics of their alcohol-related incident, reactions to the incident, attributions about the incident, and motivation to change drinking and heavy drinking. Path and regression analyses were used to identify the individual and incident-related characteristics that were related to motivation to change. Results Perceived aversiveness of the incident was directly and positively related to motivation to change drinking and heavy drinking. Alcohol consumption in the month before the incident and past-year alcohol problems were negatively related to motivation to change heavy drinking, and women were more motivated to change heavy drinking than men. The more students consumed in the incident, the more likely they were to feel responsible for it, and the more responsible they felt about the incident, the greater its aversiveness. Conclusions Individual and incident-related characteristics are both directly and indirectly associated with motivation to change following an alcohol-related incident, and therefore have implications for interventions with college drinkers who have experienced an alcohol-related incident. PMID:16847545

Metabolic Abnormalities and Clinical Lipodystrophy in Children With Human Immunodeficiency Virus Infection: A Report From a Tertiary Care Center in India.

PubMed

Kumar, Prasanna; Suri, Deepti; Vignesh, Pandiarajan; Verma Attri, Savita; Kumar Bhalla, Anil; Singh, Surjit

2017-12-01

A cross-sectional study from a tertiary care center in India was undertaken to assess and compare the prevalence of blood glucose and lipid profile aberrations in children who received first-line antiretroviral therapy (ART; n = 63) and in children who were naïve to ART (n = 46). Impaired fasting blood glucose values were found in 7 children in ART-experienced group but none in ART-naïve group (P = 0.02). Low concentrations of high-density lipoprotein cholesterol were more prevalent in the ART-naïve group compared with ART-experienced group (54.3% vs. 22.2%; P = 0.001). Hypertriglyceridemia was noted in a significant proportion of both ART-naïve (43.5%) and ART-experienced children (39.7%). Incidence of clinical lipodystrophy was 47.7%, and there was no significant association noted between lipid profile abnormalities and lipodystrophy.

Preliminary Study on Acoustic Detection of Faults Experienced by a High-Bypass Turbofan Engine

NASA Technical Reports Server (NTRS)

Boyle, Devin K.

2014-01-01

The vehicle integrated propulsion research (VIPR) effort conducted by NASA and several partners provided an unparalleled opportunity to test a relatively low TRL concept regarding the use of far field acoustics to identify faults occurring in a high bypass turbofan engine. Though VIPR Phase II ground based aircraft installed engine testing wherein a multitude of research sensors and methods were evaluated, an array of acoustic microphones was used to determine the viability of such an array to detect failures occurring in a commercially representative high bypass turbofan engine. The failures introduced during VIPR testing included commanding the engine's low pressure compressor (LPC) exit and high pressure compressor (HPC) 14th stage bleed values abruptly to their failsafe positions during steady state

The unacknowledged incidence of laparoscopic stapler malfunction.

PubMed

Kwazneski, Douglas; Six, Cheryl; Stahlfeld, Kurt

2013-01-01

Laparoscopic instruments are being used with increasing frequency. Our surgeons recently experienced several independent adverse events involving the laparoscopic linear stapler. Although the Food and Drug Administration maintains a Manufacturer and User Facility Device Experience (MAUDE) database to track such voluntary reports, many events are not reported and the true incidence of adverse events is unknown. We attempted to determine how frequently minimally invasive surgeons have experienced technical problems with a laparoscopic stapler. Following IRB approval, we electronically distributed an anonymous 10-question survey to the 124 minimally invasive program directors listed in the Fellowship Council database. The questions focused on personal or peer experience with laparoscopic stapler malfunction, frequency and type of malfunction, device manufacturer, whether the operation was altered, and root cause analysis of the event. Forty-four of the 124 program directors (35%) completed the survey. The majority reported personal or peer experience (86%) with a linear stapler not releasing (66%) or not firing (73%) after application, with 27% of the respondents noting that this occurred three or more times. The malfunction was not related to type of load, straight (23%) or reticulating (32%) model, or manufacturer (Ethicon 30%, Covidien 36%). One quarter of the respondents noted that the malfunction caused them to significantly alter their operative procedure, and 30% reported that they received no helpful feedback from the manufacturer despite contacting it. Most minimally invasive surgeons have experienced laparoscopic linear stapler malfunction and 25% have had to significantly alter the planned operative procedure due to the malfunction.

Sexual violence associated with poor mental health in women attending Australian general practices.

PubMed

Tarzia, Laura; Maxwell, Sarah; Valpied, Jodie; Novy, Kitty; Quake, Rebecca; Hegarty, Kelsey

2017-10-01

Sexual violence (SV) against adult women is prevalent and associated with a range of mental health issues. General practitioners could potentially have a role in responding, however, there is little information to help guide them. Data around prevalence of all forms of adult SV (not just rape) is inconsistent, particularly in clinical samples, and the links between other forms of SV and mental health issues are not well supported. This study aimed to address these gaps in the knowledge base. A descriptive, cross-sectional study was conducted in Australian general practice clinics. Two hundred and thirty adult women completed an anonymous iPad survey while waiting to see the doctor. More than half the sample had experienced at least one incident of adult SV. Most commonly, women reported public harassment or flashing, unwanted groping and being coerced into sex. Women who had experienced adult SV were more likely to experience anxiety than women who had not, even after controlling for other factors. Women who had experienced adult SV were more likely to feel down, depressed or hopeless than women who had not; however, this association disappeared after controlling for childhood sexual abuse. The findings support the association between SV and poor mental health, even when 'lesser' incidents have occurred. Implications for public health: General practitioners should consider an experience of SV as a possible factor in otherwise unexplained anxiety and depressive symptoms in female patients. © 2017 The Authors.

32 CFR 700.1053 - Commander of a task force.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Commander of a task force. 700.1053 Section 700... Command Detail to Duty § 700.1053 Commander of a task force. (a) A geographic fleet commander, and any other naval commander, may detail in command of a task force, or other task command, any eligible...

Incidence of herpes zoster and seroprevalence of varicella-zoster virus in young adults of South Korea.

PubMed

Kang, Cheol-In; Choi, Chang-Min; Park, Tae-Sung; Lee, Dong-Jun; Oh, Myoung-don; Choe, Kang-Won

2008-05-01

This study was performed to determine the incidence of herpes zoster and seroprevalence of varicella-zoster virus (VZV) in young adults of South Korea, where VZV seroprevalence remains relatively high. In South Korea, military service is compulsory for all healthy young men and hence those in military service might provide a reflection of the general population. The computerized database of the Armed Forces Medical Command was examined to identify the number of reported herpes zoster cases. In order to evaluate VZV seroprevalence, serum samples were obtained from randomly selected subjects among those who had been admitted to the Armed Forces Capital Hospital. A total of 705 cases of herpes zoster were reported between June 2004 and May 2005. The annual incidence rate of herpes zoster was 141 (95% CI 131.0-151.8) per 100000 population. A total of 192 subjects were enrolled for the analysis of VZV seroprevalence. All subjects were male and their median age was 21 (range 19-24) years. The overall anti-VZV IgG seropositivity prevalence was 92.7% (178/192, 95% CI 88.0-95.7%). We have described a population-based study of the epidemiology of VZV infections in the military personnel of South Korea.

Enabling science support for better decision-making when responding to chemical spills

USGS Publications Warehouse

Weidhass, Jennifer L.; Dietrich, Andrea M.; DeYonker, Nathan J.; Dupont, R. Ryan; Foreman, William T.; Gallagher, Daniel; Gallagher, Jennifer E. G.; Whelton, Andrew J.; Alexander, William

2016-01-01

Chemical spills and accidents contaminate the environment and disrupt societies and economies around the globe. In the United States there were approximately 172,000 chemical spills that affected US waterbodies from 2004 to 2014. More than 8000 of these spills involved non–petroleum-related chemicals. Traditional emergency responses or incident command structures (ICSs) that respond to chemical spills require coordinated efforts by predominantly government personnel from multiple disciplines, including disaster management, public health, and environmental protection. However, the requirements of emergency response teams for science support might not be met within the traditional ICS. We describe the US ICS as an example of emergency-response approaches to chemical spills and provide examples in which external scientific support from research personnel benefitted the ICS emergency response, focusing primarily on nonpetroleum chemical spills. We then propose immediate, near-term, and long-term activities to support the response to chemical spills, focusing on nonpetroleum chemical spills. Further, we call for science support for spill prevention and near-term spill-incident response and identify longer-term research needs. The development of a formal mechanism for external science support of ICS from governmental and nongovernmental scientists would benefit rapid responders, advance incident- and crisis-response science, and aid society in coping with and recovering from chemical spills.

Long-term health experience of jet engine manufacturing workers: VIII. glioblastoma incidence in relation to workplace experiences with parts and processes.

PubMed

Marsh, Gary M; Youk, Ada O; Buchanich, Jeanine M; Downing, Sarah; Kennedy, Kathleen J; Esmen, Nurtan A; Hancock, Roger P; Lacey, Steven E; Pierce, Jennifer S; Fleissner, Mary Lou

2013-06-01

To determine whether glioblastoma (GB) incidence rates among jet engine manufacturing workers were associated with workplace experiences with specific parts produced and processes performed. Subjects were 210,784 workers employed between 1952 and 2001. We conducted nested case-control and cohort incidence studies with focus on 277 GB cases. We estimated time experienced with 16 part families, 4 process categories, and 32 concurrent part-process combinations with 20 or more GB cases. In both the cohort and case-control studies, none of the part families, process categories, or both considered was associated with increased GB risk. If not due to chance alone, the not statistically significantly elevated GB rates in the North Haven plant may reflect external occupational factors or nonoccupational factors unmeasured in the current evaluation.

Daily Reports of Witnessing and Experiencing Peer Harassment in Middle School

ERIC Educational Resources Information Center

Nishina, Adrienne; Juvonen, Jaana

2005-01-01

Two studies examined daily incidents of peer harassment in urban middle schools. Sixth-grade students (M age=11 years) described their daily personal experiences and witnessed accounts of peer harassment, and rated their negative feelings across a 2-week period. In Study 1 (n=95), within-subject analyses across 4 days revealed that both personally…

The Evaluation Consultant's Life Cycle: Theory, Practice, and Implications for Learning

ERIC Educational Resources Information Center

Barrington, Gail V.

2006-01-01

The purpose of the study reported in this chapter was to determine if senior evaluation consultants experienced stages of growth in their practice similar to the small business development stages described by Bruce and Scott, to identify the stimuli that led to those changes, to determine what the consultants learned from these incidents, and to…

Exploring the Factors Influencing Gifted Adolescents' Resistance to Report Experiences of Cyberbullying Behavior: Toward an Improved Understanding

ERIC Educational Resources Information Center

Connolly, Justin Patrick

2018-01-01

Academically gifted adolescents frequently experience cyberbullying behavior. Successful intervention and prevention of such bullying is, to a large degree, dependent on such incidents being reported to an adult caregiver. However, research shows that adolescents who have experienced cyberbullying tend not to inform parents or teachers. Despite…

Prevalence of Isolated Sleep Paralysis in Black Subjects

PubMed Central

Bell, Carl C.; Shakoor, Bambade; Thompson, Belinda; Dew, Donald; Hughley, Eugene; Mays, Raymond; Shorter-Gooden, Kumea

1984-01-01

Sleep paralysis is a state of consciousness experienced while waking from sleep or falling asleep. It is characterized by an experience of being unable to move for several seconds or minutes. This study represents the first survey to measure the incidence of this disorder in a black population of healthy subjects and psychiatric patients. PMID:6737506

Academic Interventions for Children with Dyslexia Who Have Phonological Core Deficits. ERIC Digest E539.

ERIC Educational Resources Information Center

Frost, Julie A.; Emery, Michael J.

This digest presents basic information for those providing educational services to children with dyslexia who have phonological core deficits. First it provides a brief overview, noting the incidence of dyslexia and the large number of these children with phonological deficits which result in far less academic progress than experienced by other…

Improving Coping Self-Efficacy among Distressed Students after Exposure to University Mass Violence: A Pilot Online Intervention

ERIC Educational Resources Information Center

Liu, Sabrina R.; Kia-Keating, Maryam

2018-01-01

Given the rise of incidents of mass violence affecting college campuses, interventions for students are gravely needed, especially ones with broader accessibility and reach. This pilot study examined two online narrative writing interventions for undergraduates experiencing distress a year after exposure to a mass murder at their university.…