Human health risk assessment database, "the NHSRC toxicity value database": supporting the risk assessment process at US EPA's National Homeland Security Research Center.

PubMed

Moudgal, Chandrika J; Garrahan, Kevin; Brady-Roberts, Eletha; Gavrelis, Naida; Arbogast, Michelle; Dun, Sarah

2008-11-15

The toxicity value database of the United States Environmental Protection Agency's (EPA) National Homeland Security Research Center has been in development since 2004. The toxicity value database includes a compilation of agent property, toxicity, dose-response, and health effects data for 96 agents: 84 chemical and radiological agents and 12 biotoxins. The database is populated with multiple toxicity benchmark values and agent property information from secondary sources, with web links to the secondary sources, where available. A selected set of primary literature citations and associated dose-response data are also included. The toxicity value database offers a powerful means to quickly and efficiently gather pertinent toxicity and dose-response data for a number of agents that are of concern to the nation's security. This database, in conjunction with other tools, will play an important role in understanding human health risks, and will provide a means for risk assessors and managers to make quick and informed decisions on the potential health risks and determine appropriate responses (e.g., cleanup) to agent release. A final, stand alone MS ACESSS working version of the toxicity value database was completed in November, 2007.

The Assessment and Management of Suicide Risk: State of Workshop Education

ERIC Educational Resources Information Center

Pisani, Anthony R.; Cross, Wendi F.; Gould, Madelyn S.

2011-01-01

A systematic search of popular and scholarly databases identified workshops that addressed general clinical competence in the assessment or management of suicide risk, targeted mental health professionals, and had at least one peer-reviewed publication. We surveyed workshop developers and examined empirical articles associated with each workshop.…

A Systematic Review and Meta-Analysis on Self-Management for Improving Risk Factor Control in Stroke Patients.

PubMed

Sakakibara, Brodie M; Kim, Amy J; Eng, Janice J

2017-02-01

The aims of this review were to describe the self-management interventions used to improve risk factor control in stroke patients and quantitatively assess their effects on the following: 1) overall risk factor control from lifestyle behaviour (i.e. physical activity, diet and nutrition, stress management, smoking, alcohol, and medication adherence), and medical risk factors (i.e. blood pressure, cholesterol, blood glucose) and (2) individual risk factors. We systematically searched the PubMed, PsycINFO, CINAHL and Cochrane Database of Systematic Reviews databases to September 2015 to identify relevant randomized controlled trials investigating self-management to improve stroke risk factors. The self-management interventions were qualitatively described, and the data included in meta-analyses. Fourteen studies were included for review. The model estimating an effect averaged across all stroke risk factors was not significant, but became significant when four low-quality studies were removed (SMD = 0.10 [95 % CI = 0.02 to 0.17], I 2  = 0 %, p = 0.01). Subgroup analyses revealed a significant effect of self-management interventions on lifestyle behaviour risk factors (SMD = 0.15 [95 % CI = 0.04 to 0.25], I 2  = 0 %, p = 0.007) but not medical risk factors. Medication adherence was the only individual risk factor that self-management interventions significantly improved (SMD = 0.31 [95 % CI = 0.07 to 0.56], I 2  = 0 %, p = 0.01). Self-management interventions appear to be effective at improving overall risk factor control; however, more high-quality research is needed to corroborate this observation. Self-management has a greater effect on lifestyle behaviour risk factors than medical risk factors, with the largest effect at improving medication adherence.

Usefulness of Canadian Public Health Insurance Administrative Databases to Assess Breast and Ovarian Cancer Screening Imaging Technologies for BRCA1/2 Mutation Carriers.

PubMed

Larouche, Geneviève; Chiquette, Jocelyne; Plante, Marie; Pelletier, Sylvie; Simard, Jacques; Dorval, Michel

2016-11-01

In Canada, recommendations for clinical management of hereditary breast and ovarian cancer among individuals carrying a deleterious BRCA1 or BRCA2 mutation have been available since 2007. Eight years later, very little is known about the uptake of screening and risk-reduction measures in this population. Because Canada's public health care system falls under provincial jurisdictions, using provincial health care administrative databases appears a valuable option to assess management of BRCA1/2 mutation carriers. The objective was to explore the usefulness of public health insurance administrative databases in British Columbia, Ontario, and Quebec to assess management after BRCA1/2 genetic testing. Official public health insurance documents were considered potentially useful if they had specific procedure codes, and pertained to procedures performed in the public and private health care systems. All 3 administrative databases have specific procedures codes for mammography and breast ultrasounds. Only Quebec and Ontario have a specific procedure code for breast magnetic resonance imaging. It is impossible to assess, on an individual basis, the frequency of others screening exams, with the exception of CA-125 testing in British Columbia. Screenings done in private practice are excluded from the administrative databases unless covered by special agreements for reimbursement, such as all breast imaging exams in Ontario and mammograms in British Columbia and Quebec. There are no specific procedure codes for risk-reduction surgeries for breast and ovarian cancer. Population-based assessment of breast and ovarian cancer risk management strategies other than mammographic screening, using only administrative data, is currently challenging in the 3 Canadian provinces studied. Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Highway rock slope management program.

DOT National Transportation Integrated Search

2001-06-30

Development of a comprehensive geotechnical database for risk management of highway rock slope problems is described. Computer software selected to program the client/server application in windows environment, components and structure of the geote...

40 CFR 1400.13 - Read-only database.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Read-only database. 1400.13 Section 1400.13 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY AND DEPARTMENT OF JUSTICE ACCIDENTAL RELEASE PREVENTION REQUIREMENTS; RISK MANAGEMENT PROGRAMS UNDER THE CLEAN AIR ACT SECTION 112(r)(7...

Disaster management and the critical thinking skills of local emergency managers: correlations with age, gender, education, and years in occupation.

PubMed

Peerbolte, Stacy L; Collins, Matthew Lloyd

2013-01-01

Emergency managers must be able to think critically in order to identify and anticipate situations, solve problems, make judgements and decisions effectively and efficiently, and assume and manage risk. Heretofore, a critical thinking skills assessment of local emergency managers had yet to be conducted that tested for correlations among age, gender, education, and years in occupation. An exploratory descriptive research design, using the Watson-Glaser Critical Thinking Appraisal-Short Form (WGCTA-S), was employed to determine the extent to which a sample of 54 local emergency managers demonstrated the critical thinking skills associated with the ability to assume and manage risk as compared to the critical thinking scores of a group of 4,790 peer-level managers drawn from an archival WGCTA-S database. This exploratory design suggests that the local emergency managers, surveyed in this study, had lower WGCTA-S critical thinking scores than their equivalents in the archival database with the exception of those in the high education and high experience group. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

Toward an open-access global database for mapping, control, and surveillance of neglected tropical diseases.

PubMed

Hürlimann, Eveline; Schur, Nadine; Boutsika, Konstantina; Stensgaard, Anna-Sofie; Laserna de Himpsl, Maiti; Ziegelbauer, Kathrin; Laizer, Nassor; Camenzind, Lukas; Di Pasquale, Aurelio; Ekpo, Uwem F; Simoonga, Christopher; Mushinge, Gabriel; Saarnak, Christopher F L; Utzinger, Jürg; Kristensen, Thomas K; Vounatsou, Penelope

2011-12-01

After many years of general neglect, interest has grown and efforts came under way for the mapping, control, surveillance, and eventual elimination of neglected tropical diseases (NTDs). Disease risk estimates are a key feature to target control interventions, and serve as a benchmark for monitoring and evaluation. What is currently missing is a georeferenced global database for NTDs providing open-access to the available survey data that is constantly updated and can be utilized by researchers and disease control managers to support other relevant stakeholders. We describe the steps taken toward the development of such a database that can be employed for spatial disease risk modeling and control of NTDs. With an emphasis on schistosomiasis in Africa, we systematically searched the literature (peer-reviewed journals and 'grey literature'), contacted Ministries of Health and research institutions in schistosomiasis-endemic countries for location-specific prevalence data and survey details (e.g., study population, year of survey and diagnostic techniques). The data were extracted, georeferenced, and stored in a MySQL database with a web interface allowing free database access and data management. At the beginning of 2011, our database contained more than 12,000 georeferenced schistosomiasis survey locations from 35 African countries available under http://www.gntd.org. Currently, the database is expanded to a global repository, including a host of other NTDs, e.g. soil-transmitted helminthiasis and leishmaniasis. An open-access, spatially explicit NTD database offers unique opportunities for disease risk modeling, targeting control interventions, disease monitoring, and surveillance. Moreover, it allows for detailed geostatistical analyses of disease distribution in space and time. With an initial focus on schistosomiasis in Africa, we demonstrate the proof-of-concept that the establishment and running of a global NTD database is feasible and should be expanded without delay.

Managing Large Scale Project Analysis Teams through a Web Accessible Database

NASA Technical Reports Server (NTRS)

O'Neil, Daniel A.

2008-01-01

Large scale space programs analyze thousands of requirements while mitigating safety, performance, schedule, and cost risks. These efforts involve a variety of roles with interdependent use cases and goals. For example, study managers and facilitators identify ground-rules and assumptions for a collection of studies required for a program or project milestone. Task leaders derive product requirements from the ground rules and assumptions and describe activities to produce needed analytical products. Disciplined specialists produce the specified products and load results into a file management system. Organizational and project managers provide the personnel and funds to conduct the tasks. Each role has responsibilities to establish information linkages and provide status reports to management. Projects conduct design and analysis cycles to refine designs to meet the requirements and implement risk mitigation plans. At the program level, integrated design and analysis cycles studies are conducted to eliminate every 'to-be-determined' and develop plans to mitigate every risk. At the agency level, strategic studies analyze different approaches to exploration architectures and campaigns. This paper describes a web-accessible database developed by NASA to coordinate and manage tasks at three organizational levels. Other topics in this paper cover integration technologies and techniques for process modeling and enterprise architectures.

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

Munganahalli, D.

Sedco Forex is a drilling contractor that operates approximately 80 rigs on land and offshore worldwide. The HSE management system developed by Sedco Forex is an effort to prevent accidents and minimize losses. An integral part of the HSE management system is establishing risk profiles and thereby minimizing risk and reducing loss exposures. Risk profiles are established based on accident reports, potential accident reports and other risk identification reports (RIR) like the Du Pont STOP system. A rig could fill in as many as 30 accident reports, 30 potential accident reports and 500 STOP cards each year. Statistics are importantmore » for an HSE management system, since they are indicators of success or failure of HSE systems. It is however difficult to establish risk profiles based on statistical information, unless tools are available at the rig site to aid with the analysis. Risk profiles are then used to identify important areas in the operation that may require specific attention to minimize the loss exposure. Programs to address the loss exposure can then be identified and implemented with either a local or corporate approach. In January 1995, Sedco Forex implemented a uniform HSE Database on all the rigs worldwide. In one year companywide, the HSE database would contain information on approximately 500 accident and potential accident reports, and 10,000 STOP cards. This paper demonstrates the salient features of the database and describes how it has helped in establishing key risk profiles. It also shows a recent example of how risk profiles have been established at the corporate level and used to identify the key contributing factors to hands and finger injuries. Based on this information, a campaign was launched to minimize the frequency of occurrence and associated loss attributed to hands and fingers accidents.« less

Risk management strategies in the Physicians' Desk Reference product labels for pregnancy category X drugs.

PubMed

Uhl, Kathleen; Kennedy, Dianne L; Kweder, Sandra L

2002-01-01

Drugs that carry a concern for teratogenicity are often classified as pregnancy category X in the drug label and contraindicated for use during pregnancy. Many drug labels can be found in the Physicians' Desk Reference (PDR), a widely used source of drug information by American clinicians and patients. To review product labelling in the electronic PDR for the pregnancy category X products for pregnancy prevention risk management components in labelling. The electronic version of the 2001 and 2002 PDR was searched for 'pregnancy category X' products using the full text search feature. All product labels identified were retrieved and reviewed for trade name, generic name, manufacturer and indication. Product labels were manually searched for any pregnancy prevention risk management strategies included in labelling. Those labels that had specific pregnancy prevention risk management strategies were further evaluated. One hundred and seventeen pregnancy category X products were obtained from 2249 products searched in the 2001 PDR database and 124 pregnancy category X products were obtained from the 2150 products in the 2002 PDR database. All pregnancy category X products identified were drug products. The label/package insert for each drug was reviewed to identify risk management strategies for pregnancy prevention. The majority of the labels include as the sole risk management strategy either a black box warning and/or a contraindication for use in women who are or may become pregnant. Only 13 drugs contained specific pregnancy prevention risk management strategies in the label directing the clinician and/or patient, e.g. frequency of pregnancy testing, number and type of contraception methods. Two drugs, bexarotene capsules and gel, were only included in the 2001 PDR. Three drugs, isotretinoin, acitretin, and thalidomide, have formal pregnancy prevention risk management programmes. This study demonstrates the varied risk management approaches in labelling for pregnancy prevention for pregnancy category X drugs. There is a need for consistency in the classification of pregnancy category X products and the pregnancy prevention risk management strategies utilised in the labelling for them.

Integration of Evidence Base into a Probabilistic Risk Assessment

NASA Technical Reports Server (NTRS)

Saile, Lyn; Lopez, Vilma; Bickham, Grandin; Kerstman, Eric; FreiredeCarvalho, Mary; Byrne, Vicky; Butler, Douglas; Myers, Jerry; Walton, Marlei

2011-01-01

INTRODUCTION: A probabilistic decision support model such as the Integrated Medical Model (IMM) utilizes an immense amount of input data that necessitates a systematic, integrated approach for data collection, and management. As a result of this approach, IMM is able to forecasts medical events, resource utilization and crew health during space flight. METHODS: Inflight data is the most desirable input for the Integrated Medical Model. Non-attributable inflight data is collected from the Lifetime Surveillance for Astronaut Health study as well as the engineers, flight surgeons, and astronauts themselves. When inflight data is unavailable cohort studies, other models and Bayesian analyses are used, in addition to subject matters experts input on occasion. To determine the quality of evidence of a medical condition, the data source is categorized and assigned a level of evidence from 1-5; the highest level is one. The collected data reside and are managed in a relational SQL database with a web-based interface for data entry and review. The database is also capable of interfacing with outside applications which expands capabilities within the database itself. Via the public interface, customers can access a formatted Clinical Findings Form (CLiFF) that outlines the model input and evidence base for each medical condition. Changes to the database are tracked using a documented Configuration Management process. DISSCUSSION: This strategic approach provides a comprehensive data management plan for IMM. The IMM Database s structure and architecture has proven to support additional usages. As seen by the resources utilization across medical conditions analysis. In addition, the IMM Database s web-based interface provides a user-friendly format for customers to browse and download the clinical information for medical conditions. It is this type of functionality that will provide Exploratory Medicine Capabilities the evidence base for their medical condition list. CONCLUSION: The IMM Database in junction with the IMM is helping NASA aerospace program improve the health care and reduce risk for the astronauts crew. Both the database and model will continue to expand to meet customer needs through its multi-disciplinary evidence based approach to managing data. Future expansion could serve as a platform for a Space Medicine Wiki of medical conditions.

Global building inventory for earthquake loss estimation and risk management

USGS Publications Warehouse

Jaiswal, Kishor; Wald, David; Porter, Keith

2010-01-01

We develop a global database of building inventories using taxonomy of global building types for use in near-real-time post-earthquake loss estimation and pre-earthquake risk analysis, for the U.S. Geological Survey’s Prompt Assessment of Global Earthquakes for Response (PAGER) program. The database is available for public use, subject to peer review, scrutiny, and open enhancement. On a country-by-country level, it contains estimates of the distribution of building types categorized by material, lateral force resisting system, and occupancy type (residential or nonresidential, urban or rural). The database draws on and harmonizes numerous sources: (1) UN statistics, (2) UN Habitat’s demographic and health survey (DHS) database, (3) national housing censuses, (4) the World Housing Encyclopedia and (5) other literature.

The Global Earthquake Model - Past, Present, Future

NASA Astrophysics Data System (ADS)

Smolka, Anselm; Schneider, John; Stein, Ross

2014-05-01

The Global Earthquake Model (GEM) is a unique collaborative effort that aims to provide organizations and individuals with tools and resources for transparent assessment of earthquake risk anywhere in the world. By pooling data, knowledge and people, GEM acts as an international forum for collaboration and exchange. Sharing of data and risk information, best practices, and approaches across the globe are key to assessing risk more effectively. Through consortium driven global projects, open-source IT development and collaborations with more than 10 regions, leading experts are developing unique global datasets, best practice, open tools and models for seismic hazard and risk assessment. The year 2013 has seen the completion of ten global data sets or components addressing various aspects of earthquake hazard and risk, as well as two GEM-related, but independently managed regional projects SHARE and EMME. Notably, the International Seismological Centre (ISC) led the development of a new ISC-GEM global instrumental earthquake catalogue, which was made publicly available in early 2013. It has set a new standard for global earthquake catalogues and has found widespread acceptance and application in the global earthquake community. By the end of 2014, GEM's OpenQuake computational platform will provide the OpenQuake hazard/risk assessment software and integrate all GEM data and information products. The public release of OpenQuake is planned for the end of this 2014, and will comprise the following datasets and models: • ISC-GEM Instrumental Earthquake Catalogue (released January 2013) • Global Earthquake History Catalogue [1000-1903] • Global Geodetic Strain Rate Database and Model • Global Active Fault Database • Tectonic Regionalisation Model • Global Exposure Database • Buildings and Population Database • Earthquake Consequences Database • Physical Vulnerabilities Database • Socio-Economic Vulnerability and Resilience Indicators • Seismic Source Models • Ground Motion (Attenuation) Models • Physical Exposure Models • Physical Vulnerability Models • Composite Index Models (social vulnerability, resilience, indirect loss) • Repository of national hazard models • Uniform global hazard model Armed with these tools and databases, stakeholders worldwide will then be able to calculate, visualise and investigate earthquake risk, capture new data and to share their findings for joint learning. Earthquake hazard information will be able to be combined with data on exposure (buildings, population) and data on their vulnerability, for risk assessment around the globe. Furthermore, for a truly integrated view of seismic risk, users will be able to add social vulnerability and resilience indices and estimate the costs and benefits of different risk management measures. Having finished its first five-year Work Program at the end of 2013, GEM has entered into its second five-year Work Program 2014-2018. Beyond maintaining and enhancing the products developed in Work Program 1, the second phase will have a stronger focus on regional hazard and risk activities, and on seeing GEM products used for risk assessment and risk management practice at regional, national and local scales. Furthermore GEM intends to partner with similar initiatives underway for other natural perils, which together are needed to meet the need for advanced risk assessment methods, tools and data to underpin global disaster risk reduction efforts under the Hyogo Framework for Action #2 to be launched in Sendai/Japan in spring 2015

Radioactive and mixed waste - risk as a basis for waste classification. Symposium proceedings No. 2

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

NONE

The management of risks from radioactive and chemical materials has been a major environmental concern in the United states for the past two or three decades. Risk management of these materials encompasses the remediation of past disposal practices as well as development of appropriate strategies and controls for current and future operations. This symposium is concerned primarily with low-level radioactive wastes and mixed wastes. Individual reports were processed separately for the Department of Energy databases.

Toward an Open-Access Global Database for Mapping, Control, and Surveillance of Neglected Tropical Diseases

PubMed Central

Hürlimann, Eveline; Schur, Nadine; Boutsika, Konstantina; Stensgaard, Anna-Sofie; Laserna de Himpsl, Maiti; Ziegelbauer, Kathrin; Laizer, Nassor; Camenzind, Lukas; Di Pasquale, Aurelio; Ekpo, Uwem F.; Simoonga, Christopher; Mushinge, Gabriel; Saarnak, Christopher F. L.; Utzinger, Jürg; Kristensen, Thomas K.; Vounatsou, Penelope

2011-01-01

Background After many years of general neglect, interest has grown and efforts came under way for the mapping, control, surveillance, and eventual elimination of neglected tropical diseases (NTDs). Disease risk estimates are a key feature to target control interventions, and serve as a benchmark for monitoring and evaluation. What is currently missing is a georeferenced global database for NTDs providing open-access to the available survey data that is constantly updated and can be utilized by researchers and disease control managers to support other relevant stakeholders. We describe the steps taken toward the development of such a database that can be employed for spatial disease risk modeling and control of NTDs. Methodology With an emphasis on schistosomiasis in Africa, we systematically searched the literature (peer-reviewed journals and ‘grey literature’), contacted Ministries of Health and research institutions in schistosomiasis-endemic countries for location-specific prevalence data and survey details (e.g., study population, year of survey and diagnostic techniques). The data were extracted, georeferenced, and stored in a MySQL database with a web interface allowing free database access and data management. Principal Findings At the beginning of 2011, our database contained more than 12,000 georeferenced schistosomiasis survey locations from 35 African countries available under http://www.gntd.org. Currently, the database is expanded to a global repository, including a host of other NTDs, e.g. soil-transmitted helminthiasis and leishmaniasis. Conclusions An open-access, spatially explicit NTD database offers unique opportunities for disease risk modeling, targeting control interventions, disease monitoring, and surveillance. Moreover, it allows for detailed geostatistical analyses of disease distribution in space and time. With an initial focus on schistosomiasis in Africa, we demonstrate the proof-of-concept that the establishment and running of a global NTD database is feasible and should be expanded without delay. PMID:22180793

A global building inventory for earthquake loss estimation and risk management

USGS Publications Warehouse

Jaiswal, K.; Wald, D.; Porter, K.

2010-01-01

We develop a global database of building inventories using taxonomy of global building types for use in near-real-time post-earthquake loss estimation and pre-earthquake risk analysis, for the U.S. Geological Survey's Prompt Assessment of Global Earthquakes for Response (PAGER) program. The database is available for public use, subject to peer review, scrutiny, and open enhancement. On a country-by-country level, it contains estimates of the distribution of building types categorized by material, lateral force resisting system, and occupancy type (residential or nonresidential, urban or rural). The database draws on and harmonizes numerous sources: (1) UN statistics, (2) UN Habitat's demographic and health survey (DHS) database, (3) national housing censuses, (4) the World Housing Encyclopedia and (5) other literature. ?? 2010, Earthquake Engineering Research Institute.

Local Community Verification of Coastal Erosion Risks in the Arctic: Insights from Alaska's North Slope

NASA Astrophysics Data System (ADS)

Brady, M.

2016-12-01

During his historic trip to Alaska in 2015, U.S. President Barack Obama announced a collaborative effort to update maps of the Arctic region in anticipation of increased maritime access and resource development and to support climate resilience. Included in this effort is development of an Arctic-wide satellite-based digital elevation model (DEM) to provide a baseline to monitor landscape change such as coastal erosion. Focusing in Alaska's North Slope, an objective of this study is to transform emerging Arctic environment spatial data products including the new DEM into information that can support local level planning and decision-making in the face of extreme coastal erosion and related environmental threats. In pursuit of this, in 2016, 4 workshops were held in three North Slope villages highly exposed to coastal erosion. The first workshop with approximately 10 managers in Barrow solicited feedback on an erosion risk database developed in a previous research stage and installed onto the North Slope's planning Web portal. The database includes a physical risk indicator based on factors such as historical erosion and effects of sea ice loss summarized at asset locations. After a demonstration of the database, participants discussed usability aspects such as data reliability. The focus of the mapping workshops in Barrow and two smaller villages Wainwright and Kaktovik was to verify and expand the risk database by interactively mapping erosion observations and community asset impacts. Using coded stickers and paper maps of the shoreline showing USGS erosion rates, a total of 50 participants provided feedback on erosion data accuracy. Approximately 25 of the total 50 participants were elders and hunters who also provided in-depth community risk information. The workshop with managers confirmed physical risk factors used in the risk database, and revealed that the information may be relied upon to support some development decisions and better engage developers about erosion risks. Results from the three mapping workshops revealed that most participants agree that the USGS data are consistent with their observations. Also, in-depth contributions from elders and hunters confirmed that there is a need to monitor loss of specific assets including hunting grounds and historic places and associated community impacts.

Design and Development of a Clinical Risk Management Tool Using Radio Frequency Identification (RFID)

PubMed Central

Pourasghar, Faramarz; Tabrizi, Jafar Sadegh; Yarifard, Khadijeh

2016-01-01

Background: Patient safety is one of the most important elements of quality of healthcare. It means preventing any harm to the patients during medical care process. Objective: This paper introduces a cost-effective tool in which the Radio Frequency Identification (RFID) technology is used to identify medical errors in hospital. Methods: The proposed clinical error management system (CEMS) is consisted of a reader device, a transfer/receiver device, a database and managing software. The reader device works using radio waves and is wireless. The reader sends and receives data to/from the database via the transfer/receiver device which is connected to the computer via USB port. The database contains data about patients’ medication orders. Results: The CEMS has the ability to identify the clinical errors before they occur and then warns the care-giver with voice and visual messages to prevent the error. This device reduces the errors and thus improves the patient safety. Conclusion: A new tool including software and hardware was developed in this study. Application of this tool in clinical settings can help the nurses prevent medical errors. It can also be a useful tool for clinical risk management. Using this device can improve the patient safety to a considerable extent and thus improve the quality of healthcare. PMID:27147802

Design and Development of a Clinical Risk Management Tool Using Radio Frequency Identification (RFID).

PubMed

Pourasghar, Faramarz; Tabrizi, Jafar Sadegh; Yarifard, Khadijeh

2016-04-01

Patient safety is one of the most important elements of quality of healthcare. It means preventing any harm to the patients during medical care process. This paper introduces a cost-effective tool in which the Radio Frequency Identification (RFID) technology is used to identify medical errors in hospital. The proposed clinical error management system (CEMS) is consisted of a reader device, a transfer/receiver device, a database and managing software. The reader device works using radio waves and is wireless. The reader sends and receives data to/from the database via the transfer/receiver device which is connected to the computer via USB port. The database contains data about patients' medication orders. The CEMS has the ability to identify the clinical errors before they occur and then warns the care-giver with voice and visual messages to prevent the error. This device reduces the errors and thus improves the patient safety. A new tool including software and hardware was developed in this study. Application of this tool in clinical settings can help the nurses prevent medical errors. It can also be a useful tool for clinical risk management. Using this device can improve the patient safety to a considerable extent and thus improve the quality of healthcare.

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

PubMed

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

2009-08-15

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

Probability concepts in quality risk management.

PubMed

Claycamp, H Gregg

2012-01-01

Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although risk is generally a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management tools are relatively silent on the meaning and uses of "probability." The probability concept is typically applied by risk managers as a combination of frequency-based calculation and a "degree of belief" meaning of probability. Probability as a concept that is crucial for understanding and managing risk is discussed through examples from the most general, scenario-defining and ranking tools that use probability implicitly to more specific probabilistic tools in risk management. A rich history of probability in risk management applied to other fields suggests that high-quality risk management decisions benefit from the implementation of more thoughtful probability concepts in both risk modeling and risk management. Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although "risk" generally describes a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management methodologies and respective tools focus on managing severity but are relatively silent on the in-depth meaning and uses of "probability." Pharmaceutical manufacturers are expanding their use of quality risk management to identify and manage risks to the patient that might occur in phases of the pharmaceutical life cycle from drug development to manufacture, marketing to product discontinuation. A probability concept is typically applied by risk managers as a combination of data-based measures of probability and a subjective "degree of belief" meaning of probability. Probability as a concept that is crucial for understanding and managing risk is discussed through examples from the most general, scenario-defining and ranking tools that use probability implicitly to more specific probabilistic tools in risk management.

How ISO/IEC 17799 can be used for base lining information assurance among entities using data mining for defense, homeland security, commercial, and other civilian/commercial domains

NASA Astrophysics Data System (ADS)

Perry, William G.

2006-04-01

One goal of database mining is to draw unique and valid perspectives from multiple data sources. Insights that are fashioned from closely-held data stores are likely to possess a high degree of reliability. The degree of information assurance comes into question, however, when external databases are accessed, combined and analyzed to form new perspectives. ISO/IEC 17799, Information technology-Security techniques-Code of practice for information security management, can be used to establish a higher level of information assurance among disparate entities using data mining in the defense, homeland security, commercial and other civilian/commercial domains. Organizations that meet ISO/IEC information security standards have identified and assessed risks, threats and vulnerabilities and have taken significant proactive steps to meet their unique security requirements. The ISO standards address twelve domains: risk assessment and treatment, security policy, organization of information security, asset management, human resources security, physical and environmental security, communications and operations management, access control, information systems acquisition, development and maintenance, information security incident management and business continuity management and compliance. Analysts can be relatively confident that if organizations are ISO 17799 compliant, a high degree of information assurance is likely to be a characteristic of the data sets being used. The reverse may be true. Extracting, fusing and drawing conclusions based upon databases with a low degree of information assurance may be wrought with all of the hazards that come from knowingly using bad data to make decisions. Using ISO/IEC 17799 as a baseline for information assurance can help mitigate these risks.

DESIGN AND PERFORMANCE OF A XENOBIOTIC METABOLISM DATABASE MANAGER FOR METABOLIC SIMULATOR ENHANCEMENT AND CHEMICAL RISK ANALYSIS

EPA Science Inventory

A major uncertainty that has long been recognized in evaluating chemical toxicity is accounting for metabolic activation of chemicals resulting in increased toxicity. In silico approaches to predict chemical metabolism and to subsequently screen and prioritize chemicals for risk ...

School-Based Obesity Interventions: A Literature Review

ERIC Educational Resources Information Center

Shaya, Fadia T.; Flores, David; Gbarayor, Confidence M.; Wang, Jingshu

2008-01-01

Background: Childhood obesity is an impending epidemic. This article is an overview of different interventions conducted in school settings so as to guide efforts for an effective management of obesity in children, thus minimizing the risk of adult obesity and related cardiovascular risk. Methods: PubMed and OVID Medline databases were searched…

[Informatics support for risk assessment and identification of preventive measures in small and micro-enterprises: occupational hazard datasheets].

PubMed

de Merich, D; Forte, Giulia

2011-01-01

Risk assessment is the fundamental process of an enterprise's prevention system and is the principal mandatory provision contained in the Health and Safety Law (Legislative Decree 81/2008) amended by Legislative Decree 106/2009. In order to properly comply with this obligation also in small-sized enterprises, the appropriate regulatory bodies should provide the enterprises with standardized tools and methods for identifying, assessing and managing risks. To assist in particular small and micro-enterprises (SMEs) with risk assessment, by providing a flexible tool that can also be standardized in the form of a datasheet, that can be updated with more detailed information on the various work contexts in Italy. Official efforts to provide Italian SMEs with information may initially make use of the findings of research conducted by ISPESL over the past 20 years, thanks in part to cooperation with other institutions (Regions, INAIL-National Insurance Institute for Occupational Accidents and Diseases), which have led to the creation of an information system on prevention consisting of numerous databases, both statistical and documental ("National System of Surveillance on fatal and serious accidents", "National System of Surveillance on work-related diseases", "Sector hazard profiles" database, "Solutions and Best Practices" database, "Technical Guidelines" database, "Training packages for prevention professionals in enterprises" database). With regard to evaluation criteria applicable within the enterprise, the possibility of combining traditional and uniform areas of assessment (by sector or by risk factor) with assessments by job/occupation has become possible thanks to the cooperation agreement made in 2009 by ISPESL, the ILO (International Labour Organisation) of Geneva and IIOSH (Israel Institute for Occupational Health and Hygiene) regarding the creation of an international Database (HDODB) based on risk datasheets per occupation. The project sets out to assist in particular small and micro-enterprises with risk assessment, providing a flexible and standardized tool in the form of a datasheet, that can be updated with more detailed information on the various work contexts in Italy. The model proposed by ISPESL selected the ILO's "Hazard Datasheet on Occupation" as an initial information tool to steer efforts to assess and manage hazards in small and micro-enterprises. In addition to being an internationally validated tool, the occupation datasheet has a very simple structure that is very effective in communicating and updating information in relation to the local context. According to the logic based on the providing support to enterprises by means of a collaborative network among institutions, local supervisory services and social partners, standardised hazard assessment procedures should be, irrespective of any legal obligations, the preferred tools of an "updatable information system" capable of providing support for the need to improve the process of assessing and managing hazards in enterprises.

A New Breed of Database System: Volcano Global Risk Identification and Analysis Project (VOGRIPA)

NASA Astrophysics Data System (ADS)

Crosweller, H. S.; Sparks, R. S.; Siebert, L.

2009-12-01

VOGRIPA originated as part of the Global Risk Identification Programme (GRIP) that is being co-ordinated from the Earth Institute of Columbia University under the auspices of the United Nations and World Bank. GRIP is a five-year programme aiming at improving global knowledge about risk from natural hazards and is part of the international response to the catastrophic 2004 Asian tsunami. VOGRIPA is also a formal IAVCEI project. The objectives of VOGRIPA are to create a global database of volcanic activity, hazards and vulnerability information that can be analysed to identify locations at high risk from volcanism, gaps in knowledge about hazards and risk, and will allow scientists and disaster managers at specific locations to analyse risk within a global context of systematic information. It is this added scope of risk and vulnerability as well as hazard which sets VOGRIPA apart from most previous databases. The University of Bristol is the central coordinating centre for the project, which is an international partnership including the Smithsonian Institution, the Geological Survey of Japan, the Earth Observatory of Singapore (Chris Newhall), the British Geological Survey, the University of Buffalo (SUNY) and Munich Re. The partnership is intended to grow and any individuals or institutions who are able to contribute resources to VOGRIPA objectives are welcome to participate. Work has already begun (funded principally by Munich Re) on populating a database of large magnitude explosive eruptions reaching back to the Quaternary, with extreme-value statistics being used to evaluate the magnitude-frequency relationship of such events, and also an assessment of how the quality of records affect the results. The following 4 years of funding from the European Research Council for VOGRIPA will be used to establish further international collaborations in order to develop different aspects of the database, with the data being accessible online once it is sufficiently complete and analyses have been carried out. It is anticipated that such a resource would be of use to the scientific community, civil authorities with responsibility for mitigating and managing volcanic hazards, and the public.

[Approaching the "evidence-practice gap" in pharmaceutical risk management: analysis of healthcare claim data].

PubMed

Nakayama, Takeo

2012-01-01

The concept of evidence-based medicine (EBM) has promulgated among healthcare professionals in recent years, on the other hand, the problem of underuse of useful clinical evidence is coming to be important. This is called as evidence-practice gap. The major concern about evidence-practice gap is insufficient implementation of evidence-based effective treatment, however, the perspective can be extended to measures to improve drug safety and prevention of drug related adverse events. First, this article reviews the characteristics of the database of receipt (healthcare claims) and the usefulness for research purpose of pharmacoepidemiology. Second, as the real example of the study on evidence-practice gap by using the receipt database, the case of ergot-derived anti-Parkinson drugs, of which risk of valvulopathy has been identified, is introduced. The receipt analysis showed that more than 70% of Parkinson's disease patients prescribed with cabergoline or pergolide did not undergo echocardiography despite the revision of the product label recommendation. Afterwards, the issues of pharmaceutical risk management and risk communication will be discussed.

Prevention of MSD within OHSMS/IMS: a systematic review of risk assessment strategies.

PubMed

Yazdani, Amin; Wells, Richard

2012-01-01

The purpose of this systematic review was to identify and summarize the research evidence on prevention of Musculoskeletal Disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS) and Integrated Management Systems (IMS). Databases in business, management, engineering and health and safety were systematically searched and relevant publications were synthesized. The number of papers that could address the research questions was small. However, the review revealed that many of the techniques to address MSD hazards require substantial background knowledge and training. This may limit employees' involvement in the technical aspects of the risk assessment process. Also these techniques did not usually fit into techniques used by companies to address other risk factors within their management systems. This could result in MSD prevention becoming a separate issue that cannot be managed with company-wide tools. In addition, this review also suggested that there is a research gap concerning the MSD prevention within companies' management systems.

Challenges in global ballast water management.

PubMed

Endresen, Øyvind; Lee Behrens, Hanna; Brynestad, Sigrid; Bjørn Andersen, Aage; Skjong, Rolf

2004-04-01

Ballast water management is a complex issue raising the challenge of merging international regulations, ship's specific configurations along with ecological conservation. This complexity is illustrated in this paper by considering ballast water volume, discharge frequency, ship safety and operational issues aligned with regional characteristics to address ecological risk for selected routes. A re-estimation of ballast water volumes gives a global annual level of 3500 Mton. Global ballast water volume discharged into open sea originating from ballast water exchange operations is estimated to approximately 2800 Mton. Risk based decision support systems coupled to databases for different ports and invasive species characteristics and distributions can allow for differentiated treatment levels while maintaining low risk levels. On certain routes, the risk is estimated to be unacceptable and some kind of ballast water treatment or management should be applied.

Effects of Disasters: Risk and Resilience Factors

MedlinePlus

... VA for Vets Performance Based Interviewing Clinical Trainees (Academic Affiliations) Employees & Contractors Talent Management System (TMS) VA ... stress. Search Pilots Search PILOTS *, the largest citation database on PTSD. What is PILOTS? Subscribe Sign up ...

Models, Tools, and Databases for Land and Waste Management Research

EPA Pesticide Factsheets

These publicly available resources can be used for such tasks as simulating biodegradation or remediation of contaminants such as hydrocarbons, measuring sediment accumulation at superfund sites, or assessing toxicity and risk.

Recurrent urinary tract infections in women.

PubMed

Aydin, Abdullatif; Ahmed, Kamran; Zaman, Iftikhar; Khan, Muhammad Shamim; Dasgupta, Prokar

2015-06-01

Recurrent urinary tract infections (UTIs) are more common in women and are frequently defined as ≥2 episodes in the last 6 months or ≥3 episodes in the last 12 months. In a primary care setting, 53 % of women above the age of 55 years and 36 % of younger women report a recurrence within 1 year. Thus, management and prevention of recurrent UTI is of utmost significance. This review aims to highlight the latest research in prevention strategies and suggest a management pathway. A search was conducted on MEDLINE, Embase and the Cochrane Database of Systematic Reviews databases for the latest systematic reviews and high-quality randomized controlled trials. Special emphasis was placed on the remit "recurrent" and strongly adhered to. Furthermore, a Google search was conducted for current guidelines on the management of UTIs. Current prevention strategies include eliminating risk factors that increase the risk of acquiring recurrent UTI and continuous, post-coital and self-initiated antimicrobial prophylaxis. Other prospective preventative strategies, currently under trial, include use of vaccinations, D-mannose and lactobacillus (probiotics). Although risk factors should be identified and addressed accordingly, individualized antibiotic prophylaxis remains the most effective method of management. Non-antibiotic prevention strategies such as cranberry, vitamin C and methenamine salts lack strong evidence to be introduced as routine management options and as alternatives to antibiotics. Based on current evidence and guidelines, a management pathway is recommended. Emerging therapies require further evaluation before they can be recommended.

Data Model for Multi Hazard Risk Assessment Spatial Support Decision System

NASA Astrophysics Data System (ADS)

Andrejchenko, Vera; Bakker, Wim; van Westen, Cees

2014-05-01

The goal of the CHANGES Spatial Decision Support System is to support end-users in making decisions related to risk reduction measures for areas at risk from multiple hydro-meteorological hazards. The crucial parts in the design of the system are the user requirements, the data model, the data storage and management, and the relationships between the objects in the system. The implementation of the data model is carried out entirely with an open source database management system with a spatial extension. The web application is implemented using open source geospatial technologies with PostGIS as the database, Python for scripting, and Geoserver and javascript libraries for visualization and the client-side user-interface. The model can handle information from different study areas (currently, study areas from France, Romania, Italia and Poland are considered). Furthermore, the data model handles information about administrative units, projects accessible by different types of users, user-defined hazard types (floods, snow avalanches, debris flows, etc.), hazard intensity maps of different return periods, spatial probability maps, elements at risk maps (buildings, land parcels, linear features etc.), economic and population vulnerability information dependent on the hazard type and the type of the element at risk, in the form of vulnerability curves. The system has an inbuilt database of vulnerability curves, but users can also add their own ones. Included in the model is the management of a combination of different scenarios (e.g. related to climate change, land use change or population change) and alternatives (possible risk-reduction measures), as well as data-structures for saving the calculated economic or population loss or exposure per element at risk, aggregation of the loss and exposure using the administrative unit maps, and finally, producing the risk maps. The risk data can be used for cost-benefit analysis (CBA) and multi-criteria evaluation (SMCE). The data model includes data-structures for CBA and SMCE. The model is at the stage where risk and cost-benefit calculations can be stored but the remaining part is currently under development. Multi-criteria information, user management and the relation of these with the rest of the model is our next step. Having a carefully designed data model plays a crucial role in the development of the whole system for rapid development, keeping the data consistent, and in the end, support the end-user in making good decisions in risk-reduction measures related to multiple natural hazards. This work is part of the EU FP7 Marie Curie ITN "CHANGES"project (www.changes-itn.edu)

Efficacy of Auriculotherapy for Constipation in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

PubMed Central

Yang, Li-Hua; Du, Shi-Zheng; Sun, Jin-Fang; Mei, Si-Juan; Wang, Xiao-Qing; Zhang, Yuan-Yuan

2014-01-01

Abstract Objectives: To assess the clinical evidence of auriculotherapy for constipation treatment and to identify the efficacy of groups using Semen vaccariae or magnetic pellets as taped objects in managing constipation. Methods: Databases were searched, including five English-language databases (the Cochrane Library, PubMed, Embase, CINAHL, and AMED) and four Chinese medical databases. Only randomized controlled trials were included in the review process. Critical appraisal was conducted using the Cochrane risk of bias tool. Results: Seventeen randomized, controlled trials (RCTs) met the inclusion criteria, of which 2 had low risk of bias. The primary outcome measures were the improvement rate and total effective rate. A meta-analysis of 15 RCTs showed a moderate, significant effect of auriculotherapy in managing constipation compared with controls (relative risk [RR], 2.06; 95% confidence interval [CI], 1.52– 2.79; p<0.00001). The 15 RCTs also showed a moderate, significant effect of auriculotherapy in relieving constipation (RR, 1.28; 95% CI, 1.13–1.44; p<0.0001). For other symptoms associated with constipation, such as abdominal distension or anorexia, results of the meta-analyses showed no statistical significance. Subgroup analysis revealed that use of S. vaccariae and use of magnetic pellets were both statistically favored over the control in relieving constipation. Conclusions: Current evidence illustrated that auriculotherapy, a relatively safe strategy, is probably beneficial in managing constipation. However, most of the eligible RCTs had a high risk of bias, and all were conducted in China. No definitive conclusion can be made because of cultural and geographic differences. Further rigorous RCTs from around the world are warranted to confirm the effect and safety of auriculotherapy for constipation. PMID:25020089

Efficacy of auriculotherapy for constipation in adults: a systematic review and meta-analysis of randomized controlled trials.

PubMed

Yang, Li-Hua; Duan, Pei-Bei; Du, Shi-Zheng; Sun, Jin-Fang; Mei, Si-Juan; Wang, Xiao-Qing; Zhang, Yuan-Yuan

2014-08-01

To assess the clinical evidence of auriculotherapy for constipation treatment and to identify the efficacy of groups using Semen vaccariae or magnetic pellets as taped objects in managing constipation. Databases were searched, including five English-language databases (the Cochrane Library, PubMed, Embase, CINAHL, and AMED) and four Chinese medical databases. Only randomized controlled trials were included in the review process. Critical appraisal was conducted using the Cochrane risk of bias tool. Seventeen randomized, controlled trials (RCTs) met the inclusion criteria, of which 2 had low risk of bias. The primary outcome measures were the improvement rate and total effective rate. A meta-analysis of 15 RCTs showed a moderate, significant effect of auriculotherapy in managing constipation compared with controls (relative risk [RR], 2.06; 95% confidence interval [CI], 1.52- 2.79; p<0.00001). The 15 RCTs also showed a moderate, significant effect of auriculotherapy in relieving constipation (RR, 1.28; 95% CI, 1.13-1.44; p<0.0001). For other symptoms associated with constipation, such as abdominal distension or anorexia, results of the meta-analyses showed no statistical significance. Subgroup analysis revealed that use of S. vaccariae and use of magnetic pellets were both statistically favored over the control in relieving constipation. Current evidence illustrated that auriculotherapy, a relatively safe strategy, is probably beneficial in managing constipation. However, most of the eligible RCTs had a high risk of bias, and all were conducted in China. No definitive conclusion can be made because of cultural and geographic differences. Further rigorous RCTs from around the world are warranted to confirm the effect and safety of auriculotherapy for constipation.

An image database management system for conducting CAD research

NASA Astrophysics Data System (ADS)

Gruszauskas, Nicholas; Drukker, Karen; Giger, Maryellen L.

2007-03-01

The development of image databases for CAD research is not a trivial task. The collection and management of images and their related metadata from multiple sources is a time-consuming but necessary process. By standardizing and centralizing the methods in which these data are maintained, one can generate subsets of a larger database that match the specific criteria needed for a particular research project in a quick and efficient manner. A research-oriented management system of this type is highly desirable in a multi-modality CAD research environment. An online, webbased database system for the storage and management of research-specific medical image metadata was designed for use with four modalities of breast imaging: screen-film mammography, full-field digital mammography, breast ultrasound and breast MRI. The system was designed to consolidate data from multiple clinical sources and provide the user with the ability to anonymize the data. Input concerning the type of data to be stored as well as desired searchable parameters was solicited from researchers in each modality. The backbone of the database was created using MySQL. A robust and easy-to-use interface for entering, removing, modifying and searching information in the database was created using HTML and PHP. This standardized system can be accessed using any modern web-browsing software and is fundamental for our various research projects on computer-aided detection, diagnosis, cancer risk assessment, multimodality lesion assessment, and prognosis. Our CAD database system stores large amounts of research-related metadata and successfully generates subsets of cases that match the user's desired search criteria.

Development of a statewide landslide inventory program.

DOT National Transportation Integrated Search

2003-02-01

Development of a comprehensive geotechnical database for risk management of highway landslide problems is described. Computer software selected to program the client/server application in a data window, components and structure of the geotechnical da...

Risks of cervical intraepithelial neoplasia grade 3 or invasive cancers in ASCUS women with different management: a population-based cohort study.

PubMed

Tai, Yi Jou; Chen, Yun Yuan; Hsu, Huang Cheng; Chiang, Chun Ju; You, San Lin; Chen, Chi An; Cheng, Wen Fang

2018-07-01

To investigate the progression risk of atypical squamous cells of undetermined significance (ASCUS) with different clinical managements. Women with their first diagnosis of ASCUS cytology were retrieved from the national cervical cancer screening database and linked to the national health insurance research database to identify the management of these women. The incidences of developing cervical intraepithelial neoplasia grade 3 and invasive cervical cancer (CIN3+) were calculated, and the hazard ratios (HRs) were estimated using a Cox proportional hazards model. This study was approved by the Research Ethics Committee of the National Taiwan University Hospital and is registered at ClinicalTrials.gov (Identifier: NCT02063152). There were total 69,741 women included. Various management strategies including colposcopy, cervical biopsies and/or endocervical curettage, and cryotherapy, failed to reduce the risk of subsequent CIN3+ compared with repeat cervical smears. Loop electrosurgical excision procedure/conization significantly decreased risk of subsequent CIN3+ lesions (HR=0.22; 95% confidence interval [CI]=0.07-0.68; p=0.010). Women in their 40s-50s had an approximately 30% risk reduction compared to other age groups. Women with a previous screening history >5 years from the present ASCUS diagnosis were at increased risk for CIN3+ (HR=1.24; 95% CI=1.03-1.49; p=0.020). In women of first-time ASCUS cytology, a program of repeat cytology can be an acceptable clinical option in low-resource settings. Caution should be taken especially in women with remote cervical screening history more than 5 years. Copyright © 2018. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

A review on risk assessment techniques for hydraulic fracturing water and produced water management implemented in onshore unconventional oil and gas production.

PubMed

Torres, Luisa; Yadav, Om Prakash; Khan, Eakalak

2016-01-01

The objective of this paper is to review different risk assessment techniques applicable to onshore unconventional oil and gas production to determine the risks to water quantity and quality associated with hydraulic fracturing and produced water management. Water resources could be at risk without proper management of water, chemicals, and produced water. Previous risk assessments in the oil and gas industry were performed from an engineering perspective leaving aside important social factors. Different risk assessment methods and techniques are reviewed and summarized to select the most appropriate one to perform a holistic and integrated analysis of risks at every stage of the water life cycle. Constraints to performing risk assessment are identified including gaps in databases, which require more advanced techniques such as modeling. Discussions on each risk associated with water and produced water management, mitigation strategies, and future research direction are presented. Further research on risks in onshore unconventional oil and gas will benefit not only the U.S. but also other countries with shale oil and gas resources. Copyright © 2015 Elsevier B.V. All rights reserved.

Project management tool

NASA Technical Reports Server (NTRS)

Maluf, David A. (Inventor); Bell, David G. (Inventor); Gurram, Mohana M. (Inventor); Gawdiak, Yuri O. (Inventor)

2009-01-01

A system for managing a project that includes multiple tasks and a plurality of workers. Input information includes characterizations based upon a human model, a team model and a product model. Periodic reports, such as a monthly report, a task plan report, a budget report and a risk management report, are generated and made available for display or further analysis. An extensible database allows searching for information based upon context and upon content.

Epidemiology and clinical management of type 2 diabetes mellitus and associated comorbidities in Spain (e-Management study).

PubMed

Franch Nadal, Josep; Mata Cases, Manel; Mauricio Puente, Dídac

2016-11-01

Type 2 diabetes mellitus is currently the most frequent chronic metabolic disease. In spain, according to the di@bet.es study, its prevalence is 13.8% in the adult population (although it is undiagnosed in 6%). The main risk factor for type 2 diabetes mellitus is obesity. The severity of type 2 diabetes mellitus is determined not only by the presence of hyperglycaemia, but also by the coexistence of other risk factors such as hypertension or dyslipidaemia, which are often associated with the disease. Its impact on the presence of chronic diabetic complications varies. While hyperglycaemia mainly influences the presence of microvascular complications, hypertension, dyslipidaemia and smoking play a greater role in macrovascular atherosclerotic disease. One of the most powerful ways to study the epidemiology of the disease is through the use of large databases that analyse the situation in the routine clinical management of huge numbers of patients. Recently, the data provided by the e-Management Project, based on the SIDIAP database, have allowed updating of many data on the health care of diabetic persons in Catalonia. This not only allows determination of the epidemiology of the disease but is also a magnificent starting point for the design of future studies that will provide answers to more questions. However, the use of large databases is not free of certain problems, especially those concerning the reliability of registries. This article analyses some of the data obtained by the e-Management study and other spanish epidemiological studies of equal importance. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

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

NASA Astrophysics Data System (ADS)

Fraisse, C.

2014-12-01

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

Efficacy of Noninvasive Stellate Ganglion Blockade Performed Using Physical Agent Modalities in Patients with Sympathetic Hyperactivity-Associated Disorders: A Systematic Review and Meta-Analysis.

PubMed

Liao, Chun-De; Tsauo, Jau-Yih; Liou, Tsan-Hon; Chen, Hung-Chou; Rau, Chi-Lun

2016-01-01

Stellate ganglion blockade (SGB) is mainly used to relieve symptoms of neuropathic pain in conditions such as complex regional pain syndrome and has several potential complications. Noninvasive SGB performed using physical agent modalities (PAMs), such as light irradiation and electrical stimulation, can be clinically used as an alternative to conventional invasive SGB. However, its application protocols vary and its clinical efficacy remains controversial. This study investigated the use of noninvasive SGB for managing neuropathic pain or other disorders associated with sympathetic hyperactivity. We performed a comprehensive search of the following online databases: Medline, PubMed, Excerpta Medica Database, Cochrane Library Database, Ovid MEDLINE, Europe PubMed Central, EBSCOhost Research Databases, CINAHL, ProQuest Research Library, Physiotherapy Evidence Database, WorldWideScience, BIOSIS, and Google Scholar. We identified and included quasi-randomized or randomized controlled trials reporting the efficacy of SGB performed using therapeutic ultrasound, transcutaneous electrical nerve stimulation, light irradiation using low-level laser therapy, or xenon light or linearly polarized near-infrared light irradiation near or over the stellate ganglion region in treating complex regional pain syndrome or disorders requiring sympatholytic management. The included articles were subjected to a meta-analysis and risk of bias assessment. Nine randomized and four quasi-randomized controlled trials were included. Eleven trials had good methodological quality with a Physiotherapy Evidence Database (PEDro) score of ≥6, whereas the remaining two trials had a PEDro score of <6. The meta-analysis results revealed that the efficacy of noninvasive SGB on 100-mm visual analog pain score is higher than that of a placebo or active control (weighted mean difference, -21.59 mm; 95% CI, -34.25, -8.94; p = 0.0008). Noninvasive SGB performed using PAMs effectively relieves pain of various etiologies, making it a valuable addition to the contemporary pain management armamentarium. However, this evidence is limited by the potential risk of bias.

Monitoring product safety in the postmarketing environment.

PubMed

Sharrar, Robert G; Dieck, Gretchen S

2013-10-01

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

Recovery and money management.

PubMed

Rowe, Michael; Serowik, Kristin L; Ablondi, Karen; Wilber, Charles; Rosen, Marc I

2013-06-01

Social recovery and external money management are important approaches in contemporary mental health care, but little research has been done on the relationship between the two or on application of recovery principles to money management for people at risk of being assigned a representative payee or conservator. Out of 49 total qualitative interviews, 25 transcripts with persons receiving Social Security insurance or Social Security disability insurance who were at risk of being assigned a money manager were analyzed to assess the presence of recognized recovery themes. The recovery principles of self-direction and responsibility were strong themes in participant comments related to money management. Money management interventions should incorporate peoples' recovery-related motivations to acquire financial management skills as a means to direct and assume responsibility for one's finances. Staff involved in money management should receive training to support client's recovery-related goals. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Multifactorial risk index for prediction of intraoperative blood transfusion in endovascular aneurysm repair.

PubMed

Mahmood, Eitezaz; Matyal, Robina; Mueller, Ariel; Mahmood, Feroze; Tung, Avery; Montealegre-Gallegos, Mario; Schermerhorn, Marc; Shahul, Sajid

2018-03-01

In some institutions, the current blood ordering practice does not discriminate minimally invasive endovascular aneurysm repair (EVAR) from open procedures, with consequent increasing costs and likelihood of blood product wastage for EVARs. This limitation in practice can possibly be addressed with the development of a reliable prediction model for transfusion risk in EVAR patients. We used the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database to create a model for prediction of intraoperative blood transfusion occurrence in patients undergoing EVAR. Afterward, we tested our predictive model on the Vascular Study Group of New England (VSGNE) database. We used the ACS NSQIP database for patients who underwent EVAR from 2011 to 2013 (N = 4709) as our derivation set for identifying a risk index for predicting intraoperative blood transfusion. We then developed a clinical risk score and validated this model using patients who underwent EVAR from 2003 to 2014 in the VSGNE database (N = 4478). The transfusion rates were 8.4% and 6.1% for the ACS NSQIP (derivation set) and VSGNE (validation) databases, respectively. Hemoglobin concentration, American Society of Anesthesiologists class, age, and aneurysm diameter predicted blood transfusion in the derivation set. When it was applied on the validation set, our risk index demonstrated good discrimination in both the derivation and validation set (C statistic = 0.73 and 0.70, respectively) and calibration using the Hosmer-Lemeshow test (P = .27 and 0.31) for both data sets. We developed and validated a risk index for predicting the likelihood of intraoperative blood transfusion in EVAR patients. Implementation of this index may facilitate the blood management strategies specific for EVAR. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Big data and high-performance analytics in structural health monitoring for bridge management

NASA Astrophysics Data System (ADS)

Alampalli, Sharada; Alampalli, Sandeep; Ettouney, Mohammed

2016-04-01

Structural Health Monitoring (SHM) can be a vital tool for effective bridge management. Combining large data sets from multiple sources to create a data-driven decision-making framework is crucial for the success of SHM. This paper presents a big data analytics framework that combines multiple data sets correlated with functional relatedness to convert data into actionable information that empowers risk-based decision-making. The integrated data environment incorporates near real-time streams of semi-structured data from remote sensors, historical visual inspection data, and observations from structural analysis models to monitor, assess, and manage risks associated with the aging bridge inventories. Accelerated processing of dataset is made possible by four technologies: cloud computing, relational database processing, support from NOSQL database, and in-memory analytics. The framework is being validated on a railroad corridor that can be subjected to multiple hazards. The framework enables to compute reliability indices for critical bridge components and individual bridge spans. In addition, framework includes a risk-based decision-making process that enumerate costs and consequences of poor bridge performance at span- and network-levels when rail networks are exposed to natural hazard events such as floods and earthquakes. Big data and high-performance analytics enable insights to assist bridge owners to address problems faster.

Effect of health information technology interventions on lipid management in clinical practice: a systematic review of randomized controlled trials.

PubMed

Aspry, Karen E; Furman, Roy; Karalis, Dean G; Jacobson, Terry A; Zhang, Audrey M; Liptak, Gregory S; Cohen, Jerome D

2013-01-01

Large gaps in lipid treatment and medication adherence persist in high-risk outpatients in the United States. Health information technology (HIT) is being applied to close quality gaps in chronic illness care, but its utility for lipid management has not been widely studied. To perform a qualitative review of the impact of HIT interventions on lipid management processes of care (screening or testing; drug initiation, titration or adherence; or referrals) or clinical outcomes (percent at low density lipoprotein cholesterol goal; absolute lipid levels; absolute risk scores; or cardiac hospitalizations) in outpatients with coronary heart disease or at increased risk. PubMed and Google Scholar databases were searched using Medical Subject Headings related to clinical informatics and cholesterol or lipid management. English language articles that described a randomized controlled design, tested at least one HIT tool in high risk outpatients, and reported at least 1 lipid management process measure or clinical outcome, were included. Thirty-four studies that enrolled 87,874 persons were identified. Study ratings, outcomes, and magnitude of effects varied widely. Twenty-three trials reported a significant positive effect from a HIT tool on lipid management, but only 14 showed evidence that HIT interventions improve clinical outcomes. There was mixed evidence that provider-level computerized decision support improves outcomes. There was more evidence in support of patient-level tools that provide connectivity to the healthcare system, as well as system-level interventions that involve database monitoring and outreach by centralized care teams. Randomized controlled trials show wide variability in the effects of HIT on lipid management outcomes. Evidence suggests that multilevel HIT approaches that target not only providers but include patients and systems approaches will be needed to improve lipid treatment, adherence and quality. Copyright © 2013 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Proceedings of the tenth annual DOE low-level waste management conference: Session 2: Site performance assessment

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

Not Available

1988-12-01

This document contains twelve papers on various aspects of low-level radioactive waste management. Topics of this volume include: performance assessment methodology; remedial action alternatives; site selection and site characterization procedures; intruder scenarios; sensitivity analysis procedures; mathematical models for mixed waste environmental transport; and risk assessment methodology. Individual papers were processed separately for the database. (TEM)

Risk management in mental health: applying lessons from commercial aviation.

PubMed

Hatcher, Simon

2010-02-01

Risk management in mental health focuses on risks in patients and fails to predict rare but catastrophic events such as suicide. Commercial aviation has a similar task in preventing rare but catastrophic accidents. This article describes the systems in place in commercial aviation that allows that industry to prevent disasters and contrasts this with the situation in mental health. In mental health we should learn from commercial aviation by having: national policies to promote patient safety; a national body responsible for implementing this policy which maintains a database of safety occurrences, sets targets and investigates adverse outcomes; legislation in place which encourages clinicians to report safety occurrences; and a common method and language for investigating safety occurrences.

Status of lipid management using lifestyle modification in Japanese adults: an analysis of the 2009 Japan Society of Ningen Dock database.

PubMed

Takahashi, Eiko; Moriyama, Kengo; Yamakado, Minoru

2013-01-01

The Japan Atherosclerosis Society (JAS) has recommended serum lipid management goals (SLMGs) based on the coronary heart disease (CHD) risk classification included in its 2007 guidelines for the diagnosis and prevention of atherosclerotic cardiovascular disease in the Japanese population (JAS GL 2007). The Japan Society of Ningen Dock created a database of subjects receiving annual health examinations. Using this database, we evaluated the lifestyles of patients with dyslipidemia by identifying risk factors for CHD development based on the JAS recommendations. A total of 223,407 adults (men: 138,435; women: 84,972) aged between 20 and 79 years were enrolled in the analysis. Those who were already being treated for dyslipidemia and had a history of CHD were excluded. CHD risk factors in the JAS GL 2007, such as an advanced age, hypertension, diabetes mellitus, smoking habits, a family history of coronary artery disease, and low high-density lipoprotein cholesterol levels, were used for the evaluation. The subjects were categorized into three groups (Categories I, II and III) according to the number of risk factors other than the low-density lipoprotein cholesterol (LDL-C) level. We evaluated the percentage of goals met during primary prevention in each group. The serum LDL-C levels were calculated using the Friedewald formula. The LDL-C levels were measured using a direct homogeneous assay if the triglyceride level was ≥400 mg/dL. Overall, 72.9% of the subjects achieved their SLMGs. Most subjects (>90%) with no CHD risk factors other than the LDL-C level in Category I achieved their SLMGs, while less than half of the subjects in Category III achieved their goal. Smoking cessation and medication administration should be considered in patients in Categories II and III.

Integrated Geo Hazard Management System in Cloud Computing Technology

NASA Astrophysics Data System (ADS)

Hanifah, M. I. M.; Omar, R. C.; Khalid, N. H. N.; Ismail, A.; Mustapha, I. S.; Baharuddin, I. N. Z.; Roslan, R.; Zalam, W. M. Z.

2016-11-01

Geo hazard can result in reducing of environmental health and huge economic losses especially in mountainous area. In order to mitigate geo-hazard effectively, cloud computer technology are introduce for managing geo hazard database. Cloud computing technology and it services capable to provide stakeholder's with geo hazards information in near to real time for an effective environmental management and decision-making. UNITEN Integrated Geo Hazard Management System consist of the network management and operation to monitor geo-hazard disaster especially landslide in our study area at Kelantan River Basin and boundary between Hulu Kelantan and Hulu Terengganu. The system will provide easily manage flexible measuring system with data management operates autonomously and can be controlled by commands to collects and controls remotely by using “cloud” system computing. This paper aims to document the above relationship by identifying the special features and needs associated with effective geohazard database management using “cloud system”. This system later will use as part of the development activities and result in minimizing the frequency of the geo-hazard and risk at that research area.

Vesicant extravasation part I: Mechanisms, pathogenesis, and nursing care to reduce risk.

PubMed

Sauerland, Carmel; Engelking, Constance; Wickham, Rita; Corbi, Dominick

2006-11-27

To review the literature regarding the incidence, current practice, guideline recommendations, nursing management, and knowledge gaps relevant to vesicant extravasation. Published research articles, books, case reports, and national guidelines. Vesicant extravasation is a relatively rare but significant complication of chemotherapy administration. Extravasation may have a range of consequences that can cause serious physical and quality-of-life effects. Knowledge of risk factors and preventive measures can reduce patient risk. Data-based and empirical management strategies such as immediate local measures (agent withdrawal, comfort measures, and medical interventions) may minimize risk for extravasation, as well as lead to timely recognition and management and decreased morbidity should extravasation occur. Vesicant extravasation and sequelae constitute a complex patient problem that clinicians should strive to prevent or to minimize injury should it occur. To this end, clinicians must demonstrate awareness of risks and use specialized knowledge while administering vesicant agents. Only nurses knowledgeable about extravasation and skilled in associated techniques should assume responsibility for vesicant administration.

The Assessment and Management of Suicide Risk: State of Workshop Education

PubMed Central

Pisani, Anthony R.; Cross, Wendi F.; Gould, Madelyn S.

2012-01-01

A systematic search of popular and scholarly databases identified workshops that addressed general clinical competence in the assessment or management of suicide risk, targeted mental health professionals, and had at least one peerreviewed publication. We surveyed workshop developers and examined empirical articles associated with each workshop. The state of workshop education is characterized by presenting the learning objectives, educational formats, instructor factors, and evaluation studies. Workshops are efficacious for transferring knowledge and shifting attitudes; however, their role in improving clinical care and outcomes of suicidal patients has yet to be determined. PMID:21477093

Are cardiovascular disease risk assessment and management programmes cost effective? A systematic review of the evidence.

PubMed

Lee, John Tayu; Lawson, Kenny D; Wan, Yizhou; Majeed, Azeem; Morris, Stephen; Soljak, Michael; Millett, Christopher

2017-06-01

The World Health Organization recommends that countries implement population-wide cardiovascular disease (CVD) risk assessment and management programmes. The aim of this study was to conduct a systematic review to evaluate whether this recommendation is supported by cost-effectiveness evidence. Published economic evaluations were identified via electronic medical and social science databases (including Medline, Web of Science, and the NHS Economic Evaluation Database) from inception to March 2016. Study quality was evaluated using a modified version of the Consolidated Health Economic Evaluation Reporting Standards. Fourteen economic evaluations were included: five studies based on randomised controlled trials, seven studies based on observational studies and two studies using hypothetical modelling synthesizing secondary data. Trial based studies measured CVD risk factor changes over 1 to 3years, with modelled projections of longer term events. Programmes were either not, or only, cost-effective under non-verified assumptions such as sustained risk factor changes. Most observational and hypothetical studies suggested programmes were likely to be cost-effective; however, study deigns are subject to bias and subsequent empirical evidence has contradicted key assumptions. No studies assessed impacts on inequalities. In conclusion, recommendations for population-wide risk assessment and management programmes lack a robust, real world, evidence basis. Given implementation is resource intensive there is a need for robust economic evaluation, ideally conducted alongside trials, to assess cost effectiveness. Further, the efficiency and equity impact of different delivery models should be investigated, and also the combination of targeted screening with whole population interventions recognising that there multiple approaches to prevention. Copyright © 2017. Published by Elsevier Inc.

Database assessment of CMIP5 and hydrological models to determine flood risk areas

NASA Astrophysics Data System (ADS)

Limlahapun, Ponthip; Fukui, Hiromichi

2016-11-01

Solutions for water-related disasters may not be solved with a single scientific method. Based on this premise, we involved logic conceptions, associate sequential result amongst models, and database applications attempting to analyse historical and future scenarios in the context of flooding. The three main models used in this study are (1) the fifth phase of the Coupled Model Intercomparison Project (CMIP5) to derive precipitation; (2) the Integrated Flood Analysis System (IFAS) to extract amount of discharge; and (3) the Hydrologic Engineering Center (HEC) model to generate inundated areas. This research notably focused on integrating data regardless of system-design complexity, and database approaches are significantly flexible, manageable, and well-supported for system data transfer, which makes them suitable for monitoring a flood. The outcome of flood map together with real-time stream data can help local communities identify areas at-risk of flooding in advance.

Assessing homeland chemical hazards outside the military gates: industrial hazard threat assessments for department of defense installations.

PubMed

Kirkpatrick, Jeffrey S; Howard, Jacqueline M; Reed, David A

2002-04-08

As part of comprehensive joint medical surveillance measures outlined by the Department of Defense, the US Army Center for Health Promotion and Preventive Medicine (USACHPPM) is beginning to assess environmental health threats to continental US military installations. A common theme in comprehensive joint medical surveillance, in support of Force Health Protection, is the identification and assessment of potential environmental health hazards, and the evaluation and documentation of actual exposures in both a continental US and outside a continental US setting. For the continental US assessments, the USACHPPM has utilized the US Environmental Protection Agency (EPA) database for risk management plans in accordance with Public Law 106-40, and the toxic release inventory database, in a state-of the art geographic information systems based program, termed the Consequence Assessment and Management Tool Set, or CATS, for assessing homeland industrial chemical hazards outside the military gates. As an example, the US EPA toxic release inventory and risk management plans databases are queried to determine the types and locations of industries surrounding a continental US military installation. Contaminants of concern are then ranked with respect to known toxicological and physical hazards, where they are then subject to applicable downwind hazard simulations using applicable meteorological and climatological data sets. The composite downwind hazard areas are mapped in relation to emergency response planning guidelines (ERPG), which were developed by the American Industrial Hygiene Association to assist emergency response personnel planning for catastrophic chemical releases. In addition, other geographic referenced data such as transportation routes, satellite imagery and population data are included in the operational, equipment, and morale risk assessment and management process. These techniques have been developed to assist military medical planners and operations personnel in determining the industrial hazards, vulnerability assessments and health risk assessments to continental United States military installations. These techniques and procedures support the Department of Defense Force Protection measures, which provides awareness of a terrorism threat, appropriate measures to prevent terrorist attacks and mitigate terrorism's effects in the event that preventive measures are ineffective.

Struggling with Excellence in All We Do: Is the Lure of New Technology Affecting How We Process Out Members’ Information

DTIC Science & Technology

2016-02-01

Approved for public release: distribution unlimited. ii Disclaimer The views expressed in this academic research paper are those of the author...is managed today is far too complex and riddled with risk. Why is a members’ information duplicated across multiple disparate databases ? To better... databases . The purpose of this paper is to provide a viable solution within a given set of constrains that the Air Force can implement. Utilizing the

Superior Labral Anterior-Posterior (SLAP) Tears in the Military.

PubMed

Rossy, William; Sanchez, George; Sanchez, Anthony; Provencher, Matthew T

Given the notable physical demands placed on active members of the military, comprehension of recent trends in management and outcomes of superior labral anterior-posterior (SLAP) tears in this patient population is critical for successful treatment. Electronic databases, including PubMed, MEDLINE, and Embase, were reviewed for the years 1985 through 2016. Database review. Level 5. Active members of the military are at increased risk of sustaining shoulder injuries, particularly SLAP tears. Recent trends in management of SLAP lesions have shifted toward operative intervention. In the correct patient population, repairs of superior labrum tears demonstrate improved function and pain. Surgical repair of SLAP tears, especially in young and active military personnel, is supported. Military personnel are at greater risk of suffering a SLAP tear in comparison with their civilian counterparts. Surgical repair of these lesions is advocated in this subpopulation when the patient is younger than approximately 36 years of age, and if older, biceps tenodesis is likely superior.

Whither Risk Assessment: New Challenges and Opportunities a Third of a Century After the Red Book.

PubMed

Greenberg, Michael; Goldstein, Bernard D; Anderson, Elizabeth; Dourson, Michael; Landis, Wayne; North, D Warner

2015-11-01

Six multi-decade-long members of SRA reflect on the 1983 Red Book in order to examine the evolving relationship between risk assessment and risk management; the diffusion of risk assessment practice to risk areas such as homeland security and transportation; the quality of chemical risk databases; challenges from other groups to elements at the core of risk assessment practice; and our collective efforts to communicate risk assessment to a diverse set of critical groups that do not understand risk, risk assessment, or many other risk-related issues. The authors reflect on the 10 recommendations in the Red Book and present several pressing challenges for risk assessment practitioners. © 2015 Society for Risk Analysis.

Remote sensing as tool for development of landslide databases: The case of the Messina Province (Italy) geodatabase

NASA Astrophysics Data System (ADS)

Ciampalini, Andrea; Raspini, Federico; Bianchini, Silvia; Frodella, William; Bardi, Federica; Lagomarsino, Daniela; Di Traglia, Federico; Moretti, Sandro; Proietti, Chiara; Pagliara, Paola; Onori, Roberta; Corazza, Angelo; Duro, Andrea; Basile, Giuseppe; Casagli, Nicola

2015-11-01

Landslide geodatabases, including inventories and thematic data, today are fundamental tools for national and/or local authorities in susceptibility, hazard and risk management. A well organized landslide geo-database contains different kinds of data such as past information (landslide inventory maps), ancillary data and updated remote sensing (space-borne and ground based) data, which can be integrated in order to produce landslide susceptibility maps, updated landslide inventory maps and hazard and risk assessment maps. Italy is strongly affected by landslide phenomena which cause victims and significant economic damage to buildings and infrastructure, loss of productive soils and pasture lands. In particular, the Messina Province (southern Italy) represents an area where landslides are recurrent and characterized by high magnitude, due to several predisposing factors (e.g. morphology, land use, lithologies) and different triggering mechanisms (meteorological conditions, seismicity, active tectonics and volcanic activity). For this area, a geodatabase was created by using different monitoring techniques, including remote sensing (e.g. SAR satellite ERS1/2, ENVISAT, RADARSAT-1, TerraSAR-X, COSMO-SkyMed) data, and in situ measurements (e.g. GBInSAR, damage assessment). In this paper a complete landslide geodatabase of the Messina Province, designed following the requirements of the local and national Civil Protection authorities, is presented. This geo-database was used to produce maps (e.g. susceptibility, ground deformation velocities, damage assessment, risk zonation) which today are constantly used by the Civil Protection authorities to manage the landslide hazard of the Messina Province.

Risk of incident cardiovascular events amongst individuals with anxiety and depression: A prospective cohort study in the east London primary care database.

PubMed

Mathur, R; Pérez-Pinar, M; Foguet-Boreu, Q; Ayis, S; Ayerbe, L

2016-12-01

It is unknown how risk of myocardial infarction and stroke differ for patients with and without anxiety or depression, and whether this risk can be explained by demographics, medication use, cardiovascular risk factors. The aim of this study is to quantify differences in risk of non-fatal MI or stroke among patients with anxiety or depression. Prospective cohort study examining risk of incident MI and stroke between March 2005 and March 2015 for 524,952 patients aged 30 and over from the east London primary care database for patients with anxiety or depression. Amongst 21,811 individuals with depression at baseline, 1.2% had MI and 0.4% had stroke. Of 22,128 individuals with anxiety at baseline, 1.1% had MI and 0.3% had stroke. Depression was independently associated with both MI and stroke, whereas anxiety was associated with MI only before adjustment for cardiovascular risk factors. Antidepressant use increased risk for MI but not stroke. Mean age at first MI was lower in those with anxiety, while mean age at first stroke was lower in those with depression. The study was limited to patients currently registered in the database and thus we did not have any patients that died during the course of follow-up. Patients with depression have increased risk of cardiovascular events. The finding of no increased cardiovascular risk in those with anxiety after adjusting for cardiovascular risk factors is of clinical importance and highlights that the adequate control of traditional risk factors is the cornerstone of cardiovascular disease prevention. Targeting management of classical cardiovascular risk factors and evaluating the risks of antidepressant prescribing should be prioritized. Copyright © 2016 Elsevier B.V. All rights reserved.

Real-world use of the risk-need-responsivity model and the level of service/case management inventory with community-supervised offenders.

PubMed

Dyck, Heather L; Campbell, Mary Ann; Wershler, Julie L

2018-06-01

The risk-need-responsivity model (RNR; Bonta & Andrews, 2017) has become a leading approach for effective offender case management, but field tests of this model are still required. The present study first assessed the predictive validity of the RNR-informed Level of Service/Case Management Inventory (LS/CMI; Andrews, Bonta, & Wormith, 2004) with a sample of Atlantic Canadian male and female community-supervised provincial offenders (N = 136). Next, the case management plans prepared from these LS/CMI results were analyzed for adherence to the principles of risk, need, and responsivity. As expected, the LS/CMI was a strong predictor of general recidivism for both males (area under the curve = .75, 95% confidence interval [.66, .85]), and especially females (area under the curve = .94, 95% confidence interval [.84, 1.00]), over an average 3.42-year follow-up period. The LS/CMI was predictive of time to recidivism, with lower risk cases taking longer to reoffend than higher risk cases. Despite the robust predictive validity of the LS/CMI, case management plans developed by probation officers generally reflected poor adherence to the RNR principles. These findings highlight the need for better training on how to transfer risk appraisal information from valid risk tools to case plans to better meet the best-practice principles of risk, need, and responsivity for criminal behavior risk reduction. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

From Cultural Path to Cultural Route: a Value-Led Risk Management Method for via Iulia Augusta in Albenga (italy)

NASA Astrophysics Data System (ADS)

Van Meerbeek, L.; Barazzetti, L.; Valente, R.

2017-08-01

Today, the field of cultural heritage faces many challenges: cultural heritage is always at risk, the large amount of heritage information is often fragmented, climate change impacts cultural heritage and heritage recording can be time-consuming and often results in low accuracy. Four objectives, related to the challenges, were defined during this research work. It proposes a relevant value-led risk management method for cultural heritage, it identifies climate change impact on cultural heritage, it suggests a database lay-out for cultural heritage and demonstrates the potential of remote sensing tools for cultural heritage. The Via Iulia Augusta, a former Roman road in Albenga, was used as case study.

Enhanced project management tool

NASA Technical Reports Server (NTRS)

Hsu, Chen-Jung (Inventor); Patel, Hemil N. (Inventor); Maluf, David A. (Inventor); Moh Hashim, Jairon C. (Inventor); Tran, Khai Peter B. (Inventor)

2012-01-01

A system for managing a project that includes multiple tasks and a plurality of workers. Input information includes characterizations based upon a human model, a team model and a product model. Periodic reports, such as one or more of a monthly report, a task plan report, a schedule report, a budget report and a risk management report, are generated and made available for display or further analysis or collection into a customized report template. An extensible database allows searching for information based upon context and upon content. Seven different types of project risks are addressed, including non-availability of required skill mix of workers. The system can be configured to exchange data and results with corresponding portions of similar project analyses, and to provide user-specific access to specified information.

DATABASE OF THE NONINDIGENOUS SPECIES IN THE ESTUARIES OF CALIFORNIA, OREGON, AND WASHINGTON

EPA Science Inventory

The number and composition of the native and nonindigenous species is a key component in invasive species risk assessments and regional prioritizations. The problem for both managers and researchers is that this information is scattered in the peer-reviewed literature, gray liter...

Integration of Rs/gis for Surface Water Pollution Risk Modeling. Case Study: Al-Abrash Syrian Coastal Basin

NASA Astrophysics Data System (ADS)

Yaghi, Y.; Salim, H.

2017-09-01

Recently the topic of the quality of surface water (rivers - lakes) and the sea is an important topics at different levels. It is known that there are two major groups of pollutants: Point Source Pollution (PSP) and non-point Source pollution (NPSP). Historically most of the surface water pollution protection programs dealing with the first set of pollutants which comes from sewage pipes and factories drainage. With the growing need for current and future water security must stand on the current reality of the coastal rivers basin in terms of freshness and cleanliness and condition of water pollution. This research aims to assign the NPS pollutants that reach Al Abrash River and preparation of databases and producing of risk Pollution map for NPS pollutants in order to put the basin management plan to ensure the reduction of pollutants that reach the river. This research resulted of establishing of Databases of NPSP (Like pesticides and fertilizers) and producing of thematic maps for pollution severity and pollution risk based on the pollution models designed in GIS environment and utilizing from remote sensing data. Preliminary recommendations for managing these pollutants were put.

Efficacy of Noninvasive Stellate Ganglion Blockade Performed Using Physical Agent Modalities in Patients with Sympathetic Hyperactivity-Associated Disorders: A Systematic Review and Meta-Analysis

PubMed Central

Liao, Chun-De; Tsauo, Jau-Yih; Liou, Tsan-Hon

2016-01-01

Background Stellate ganglion blockade (SGB) is mainly used to relieve symptoms of neuropathic pain in conditions such as complex regional pain syndrome and has several potential complications. Noninvasive SGB performed using physical agent modalities (PAMs), such as light irradiation and electrical stimulation, can be clinically used as an alternative to conventional invasive SGB. However, its application protocols vary and its clinical efficacy remains controversial. This study investigated the use of noninvasive SGB for managing neuropathic pain or other disorders associated with sympathetic hyperactivity. Materials and Methods We performed a comprehensive search of the following online databases: Medline, PubMed, Excerpta Medica Database, Cochrane Library Database, Ovid MEDLINE, Europe PubMed Central, EBSCOhost Research Databases, CINAHL, ProQuest Research Library, Physiotherapy Evidence Database, WorldWideScience, BIOSIS, and Google Scholar. We identified and included quasi-randomized or randomized controlled trials reporting the efficacy of SGB performed using therapeutic ultrasound, transcutaneous electrical nerve stimulation, light irradiation using low-level laser therapy, or xenon light or linearly polarized near-infrared light irradiation near or over the stellate ganglion region in treating complex regional pain syndrome or disorders requiring sympatholytic management. The included articles were subjected to a meta-analysis and risk of bias assessment. Results Nine randomized and four quasi-randomized controlled trials were included. Eleven trials had good methodological quality with a Physiotherapy Evidence Database (PEDro) score of ≥6, whereas the remaining two trials had a PEDro score of <6. The meta-analysis results revealed that the efficacy of noninvasive SGB on 100-mm visual analog pain score is higher than that of a placebo or active control (weighted mean difference, −21.59 mm; 95% CI, −34.25, −8.94; p = 0.0008). Conclusions Noninvasive SGB performed using PAMs effectively relieves pain of various etiologies, making it a valuable addition to the contemporary pain management armamentarium. However, this evidence is limited by the potential risk of bias. PMID:27911934

Claims-based risk model for first severe COPD exacerbation.

PubMed

Stanford, Richard H; Nag, Arpita; Mapel, Douglas W; Lee, Todd A; Rosiello, Richard; Schatz, Michael; Vekeman, Francis; Gauthier-Loiselle, Marjolaine; Merrigan, J F Philip; Duh, Mei Sheng

2018-02-01

To develop and validate a predictive model for first severe chronic obstructive pulmonary disease (COPD) exacerbation using health insurance claims data and to validate the risk measure of controller medication to total COPD treatment (controller and rescue) ratio (CTR). A predictive model was developed and validated in 2 managed care databases: Truven Health MarketScan database and Reliant Medical Group database. This secondary analysis assessed risk factors, including CTR, during the baseline period (Year 1) to predict risk of severe exacerbation in the at-risk period (Year 2). Patients with COPD who were 40 years or older and who had at least 1 COPD medication dispensed during the year following COPD diagnosis were included. Subjects with severe exacerbations in the baseline year were excluded. Risk factors in the baseline period were included as potential predictors in multivariate analysis. Performance was evaluated using C-statistics. The analysis included 223,824 patients. The greatest risk factors for first severe exacerbation were advanced age, chronic oxygen therapy usage, COPD diagnosis type, dispensing of 4 or more canisters of rescue medication, and having 2 or more moderate exacerbations. A CTR of 0.3 or greater was associated with a 14% lower risk of severe exacerbation. The model performed well with C-statistics, ranging from 0.711 to 0.714. This claims-based risk model can predict the likelihood of first severe COPD exacerbation. The CTR could also potentially be used to target populations at greatest risk for severe exacerbations. This could be relevant for providers and payers in approaches to prevent severe exacerbations and reduce costs.

Management and Risk Reduction of Rheumatoid Arthritis in Individuals with Obstructive Sleep Apnea: A Nationwide Population-Based Study in Taiwan.

PubMed

Chen, Wei-Sheng; Chang, Yu-Sheng; Chang, Chi-Ching; Chang, Deh-Ming; Chen, Yi-Hsuan; Tsai, Chang-Youh; Chen, Jin-Hua

2016-10-01

To explore associations between obstructive sleep apnea (OSA) and autoimmune diseases and evaluate whether OSA management reduces the incidence of autoimmune diseases. This was a retrospective cohort study using nationwide database research. The data was from 105,846 adult patients in whom OSA was diagnosed and recorded in the Taiwan National Health Insurance Research Database between 2002 and 2011 were the patients were analyzed retrospectively. Patients with antecedent autoimmune diseases were excluded. A comparison cohort of 423,384 participants without OSA served as age- and sex-matched controls. Multivariable Cox regression analysis was performed on both cohorts to compute risk of autoimmune diseases during follow-up. Time-dependent OSA treatment effect was analyzed among patients with OSA. There were no interventions. Among patients with OSA, overall risk for incident autoimmune diseases was significantly higher than that in controls (adjusted hazard ratio [HR] = 1.95, 95% confidence interval [CI] = 1.66-2.27). Risk for individual autoimmune diseases, including rheumatoid arthritis (RA), Sjögren syndrome (SS), and Behçet disease, was significantly higher in patients with OSA than in controls (HRs [95% CI]: RA 1.33 [1.03-1.72, SS 3.45 [2.67-4.45] and Behçet disease 5.33 [2.45-12.66]). Increased risk for systemic lupus erythematosus (HR 1.00 [0.54-1.84]) and systemic sclerosis (HR 1.43 [0.51-3.96]) did not reach statistical significance. Patients with OSA receiving treatment had an overall reduced risk of RA and other autoimmune diseases (time-dependent HRs [95% CI]: 0.22 [0.05-0.94] and 0.51 [0.28-0.92], respectively). Patients with OSA are associated with higher risk for developing RA, SS, and Behçet disease. OSA management is associated with reduced risk of RA. © 2016 Associated Professional Sleep Societies, LLC.

Proceedings from the 2001 NASA Occupational Health Conference: Risk Assessment and Management in 2001

NASA Technical Reports Server (NTRS)

Roberson, Sheri (Editor); Kelly, Bruce (Editor); Gettleman, Alan G. (Technical Monitor)

2001-01-01

This Conference convened approximately 86 registered participants of invited guest speakers, NASA presenters, and a broad spectrum of the Occupational Health disciplines representing NASA Headquarters and all NASA Field Centers. Two days' Professional Development Courses on Exposure Assessment Strategies and Statistics and on Advanced Cardiac Life Support training and recertification preceded the Conference. With the theme, 'Risk Assessment and Management in 2001,' conferees were first provided updates from the Program Principal Center Office and the Headquarters Office. Plenary sessions elaborated on several topics: biological terrorism, OSHA recordability, Workers' Compensation issues, Federal ergonomic standards, bridging aerospace medicine and occupational health-especially in management of risk in spaceflight, and EAP operations with mission failures. A keynote address dealt with resiliency skills for 21st century workers and two NASA astronaut speakers highlighted a tour of the Johnson Space Center. During discipline specific breakout sessions, current issues in occupational health management and policy, credentialing and privileging, health risk assessment, measurement and standardization, audits, database development, prevention and rehabilitation, international travel and infection control, employee assistance, nursing process, and environmental health were presented.

United States Army Medical Materiel Development Activity: 1997 Annual Report.

DTIC Science & Technology

1997-01-01

business planning and execution information management system (Project Management Division Database ( PMDD ) and Product Management Database System (PMDS...MANAGEMENT • Project Management Division Database ( PMDD ), Product Management Database System (PMDS), and Special Users Database System:The existing...System (FMS), were investigated. New Product Managers and Project Managers were added into PMDS and PMDD . A separate division, Support, was

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

Nordon, Ian M., E-mail: inordon@sgul.ac.uk; Hinchliffe, Robert J.; Loftus, Ian M.

Acute aortic syndrome (AAS) describes several life-threatening aortic pathologies. These include intramural hematoma, penetrating aortic ulcer, and acute aortic dissection (AAD). Advances in both imaging and endovascular treatment have led to an increase in diagnosis and improved management of these often catastrophic pathologies. Patients, who were previously consigned to medical management or high-risk open surgical repair, can now be offered minimally invasive solutions with reduced morbidity and mortality. Information from the International Registry of Acute Aortic Dissection (IRAD) database demonstrates how in selected patients with complicated AAD the 30-day mortality from open surgery is 17% and endovascular stenting is 6%.more » Despite these improvements in perioperative deaths, the risks of stroke and paraplegia remain with endovascular treatment (combined outcome risk 4%). The pathophysiology of each aspect of AAS is described. The best imaging techniques and the evolving role of endovascular techniques in the definitive management of AAS are discussed incorporating strategies to reduce perioperative morbidity.« less

Managing the risks of on-site health centers.

PubMed

Gorman, Kathleen M; Miller, Ross M

2011-11-01

This review sought to assess compliance concerns, determine risk management strategies, and identify opportunities for future research to contribute to employers' understanding of the laws and regulations that apply to on-site care. A comprehensive review of databases, professional organizations' websites, and journals resulted in 22 publications reporting on the consequences of noncompliance among on-site health centers accepted for inclusion. None of those studies reported a study design or quantifiable outcome data. Two noncompliance themes were repeated among the publications. First, direct penalties included fines, civil actions, loss of licensure, and, potentially, criminal charges. Second, noncompliance also resulted in indirect costs such as employee mistrust and lowered standards of care, which jeopardize on-site health centers' ability to demonstrate a return on investment. Further research with rigorous methodology is needed to inform employer decisions about on-site health services and associated risk management. Copyright 2011, SLACK Incorporated.

Investigating the connections between health lean management and clinical risk management.

PubMed

Crema, Maria; Verbano, Chiara

2015-01-01

The purpose of this paper is to investigate connections and overlaps between health lean management (HLM) and clinical risk management (CRM) understanding whether and how these two approaches can be combined together to pursue efficiency and patient safety improvements simultaneously. A systematic literature review has been carried out. Searching in academic databases, papers that focus not only on HLM, but also on clinical errors and risk reduction, were included. The general characteristics of the selected papers were analysed and a content analysis was conducted. In most of the papers, pursing objectives of HLM and CRM and adopting tools and practices of both approaches, results of quality and, particularly, of safety improvements were obtained. A two-way arrow between HLM and CRM emerged but so far, none of the studies has been focused on the relationship between HLM and CRM. Results highlight an emerging research stream, with many useful theoretical and practical implications and opportunities for further research.

Using data and quality monitoring to enhance maternity outcomes: a qualitative study of risk managers' perspectives.

PubMed

Simms, Rebecca A; Yelland, Andrew; Ping, Helen; Beringer, Antonia J; Draycott, Timothy J; Fox, Robert

2014-06-01

Risk management is a core part of healthcare practice, especially within maternity services, where litigation and societal costs are high. There has been little investigation into the experiences and opinions of those staff directly involved in risk management: lead obstetricians and specialist risk midwives, who are ideally placed to identify how current implementation of risk management strategies can be improved. A qualitative study of consultant-led maternity units in an English region. Semistructured interviews were conducted with the obstetric and midwifery risk management leads for each unit. We explored their approach to risk management, particularly their opinions regarding quality monitoring and related barriers/issues. Interviews were recorded, transcribed and thematically analysed. Twenty-seven staff from 12/15 maternity units participated. Key issues identified included: concern for the accuracy and validity of their local data, potential difficulties related to data collation, the negative impact of external interference by national regulatory bodies on local clinical priorities, the influence of the local culture of the maternity unit on levels of engagement in the risk management process, and scepticism about the value of benchmarking of maternity units without adjustment for population characteristics. Local maternity risk managers may provide valuable, clinically relevant insights into current issues in clinical data monitoring. Improvements should focus on the accuracy and ease of data collation with a need for an agreed maternity indicators set, populated from validated databases, and not reliant on data collection systems that distract clinicians from patient activity and quality improvement. It is clear that working relationships between risk managers, their own clinical teams and external national bodies require improvement and alignment. Further discussion regarding benchmarking between maternity units is required prior to implementation. These findings are likely to be relevant to other clinical specialties. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

HYDROGEOLOGIC FOUNDATION IN SUPPORT OF ECOSYSTEM RESTORATION: BASE-FLOW LOADINGS OF NITRATE IN MID-ATLANTIC AGRICULTURAL WATERSHEDS

EPA Science Inventory

The study is a consortium between the U.S. Environmental Protection Agency (National Risk Management Research Laboratory) and the U.S. Geological Survey (Baltimore and Dover). The objectives of this study are: (1) to develop a geohydrological database for paired agricultural wate...

75 FR 44000 - Agency Information Collection Activities: Proposed Collection; Comment Request, OMB No. 1660-0089...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-27

...) FEMA has established the FEMA Mitigation Best Practices success story process to collect and..., FEMA can translate hazard data into useable information for community risk management. The stories... Practices Portfolio (formerly known as FEMA Mitigation Success Story Database). Type of Information...

Characteristics of infants at risk of hypoglycaemia secondary to being 'infant of a diabetic mother'.

PubMed

VanHaltren, Karen; Malhotra, Atul

2013-01-01

Infants of diabetic mothers (IDMs) are at risk of hypoglycaemia in the neonatal period. The prediction of which of these infants are at higher risk of developing hypoglycaemia is complex. To determine the characteristics of infants of diabetic mothers who are more likely to need an admission to the neonatal intensive care unit to manage their hypoglycaemia. Retrospective chart review of maternal and infant characteristics of 'at-risk' infants. Electronic patient records and neonatal and obstetric database accessed to obtain data. A total of 326 infants were identified in a study period accessible to electronic patient records. Macrosomia was present in 15% of the infants. Hypoglycaemic episodes occurred in 109 (33.4%) infants. Maternal diabetes type, HbA1c, prematurity, macrosomia, and temperature instability were identified as risk factors most commonly associated in infants who actually went on to develop hypoglycaemia. A weighted risk score to predict hypoglycaemia in this at-risk population may serve to rationalise admission to the neonatal unit and management of IDMs.

A systematic review of risk factors associated with accidental falls, outcome measures and interventions to manage fall risk in non-ambulatory adults.

PubMed

Rice, Laura A; Ousley, Cherita; Sosnoff, Jacob J

2015-01-01

To systematically review peer-reviewed literature pertaining to risk factors, outcome measures and interventions managing fall risk in non-ambulatory adults. Twenty-one papers were selected for inclusion from databases including PubMed/Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Scopus, Consumer Health Complete and Web of Science. Selected studies involved a description of fall related risk factors, outcomes to assess fall risk and intervention studies describing protocols to manage fall risk in non-ambulatory adults. Studies were selected by two reviewers and consultation provided by a third reviewer. The most frequently cited risk factors/characteristics associated with falls included: wheelchair related characteristics, transfer activities, impaired seated balance and environmental factors. The majority of the outcomes were found to evaluate seated postural control. One intervention study was identified describing a protocol targeting specific problems of individual participants. A global fall prevention program was not identified. Several risk factors associated with falls were identified and must be understood by clinicians to better serve their clients. To improve objective assessment, a comprehensive outcome assessment specific to non-ambulatory adults is needed. Finally, additional research is needed to examine the impact of structured protocols to manage fall risk in non-ambulatory adults. Falls are a common health concern for non-ambulatory adults. Risk factors commonly associated with falls include wheelchair related characteristics, transfer activities, impaired seated balance and environmental factors. Limited outcome measures are available to assess fall risk in non-ambulatory adults. Clinicians must be aware of the known risk factors and provide comprehensive education to their clients on the potential for falls. Additional research is needed to develop and evaluate protocols to clinically manage fall risk.

From design to implementation--the Joint Asia Diabetes Evaluation (JADE) program: a descriptive report of an electronic web-based diabetes management program.

PubMed

Ko, Gary T; So, Wing-Yee; Tong, Peter C; Le Coguiec, Francois; Kerr, Debborah; Lyubomirsky, Greg; Tamesis, Beaver; Wolthers, Troels; Nan, Jennifer; Chan, Juliana

2010-05-13

The Joint Asia Diabetes Evaluation (JADE) Program is a web-based program incorporating a comprehensive risk engine, care protocols, and clinical decision support to improve ambulatory diabetes care. The JADE Program uses information technology to facilitate healthcare professionals to create a diabetes registry and to deliver an evidence-based care and education protocol tailored to patients' risk profiles. With written informed consent from participating patients and care providers, all data are anonymized and stored in a databank to establish an Asian Diabetes Database for research and publication purpose. The JADE electronic portal (e-portal: http://www.jade-adf.org) is implemented as a Java application using the Apache web server, the mySQL database and the Cocoon framework. The JADE e-portal comprises a risk engine which predicts 5-year probability of major clinical events based on parameters collected during an annual comprehensive assessment. Based on this risk stratification, the JADE e-portal recommends a care protocol tailored to these risk levels with decision support triggered by various risk factors. Apart from establishing a registry for quality assurance and data tracking, the JADE e-portal also displays trends of risk factor control at each visit to promote doctor-patient dialogues and to empower both parties to make informed decisions. The JADE Program is a prototype using information technology to facilitate implementation of a comprehensive care model, as recommended by the International Diabetes Federation. It also enables health care teams to record, manage, track and analyze the clinical course and outcomes of people with diabetes.

Analysis of national and regional landslide inventories in Europe

NASA Astrophysics Data System (ADS)

Hervás, J.; Van Den Eeckhaut, M.

2012-04-01

A landslide inventory can be defined as a detailed register of the distribution and characteristics of past landslides in an area. Today most landslide inventories have the form of digital databases including landslide distribution maps and associated alphanumeric information for each landslide. While landslide inventories are of the utmost importance for land use planning and risk management through the generation of landslide zonation (susceptibility, hazard and risk) maps, landslide databases are thought to greatly differ from one country to another and often also within the same country. This hampers the generation of comparable, harmonised landslide zonation maps at national and continental scales, which is needed for policy and decision making at EU level as regarded for instance in the INSPIRE Directive and the Thematic Strategy for Soil Protection. In order to have a clear understanding of the landslide inventories available in Europe and their potential to produce landslide zonation maps as well as to draw recommendations to improve harmonisation and interoperability between landslide databases, we have surveyed 37 countries. In total, information has been collected and analysed for 24 national databases in 22 countries (Albania, Andorra, Austria, Bosnia and Herzegovina, Bulgaria, Czech Republic, Former Yugoslav Republic of Macedonia, France, Greece, Hungary, Iceland, Ireland, Italy, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, Switzerland and UK) and 22 regional databases in 10 countries. At the moment, over 633,000 landslides are recorded in national databases, representing on average less than 50% of the estimated landslides occurred in these countries. The sample of regional databases included over 103,000 landslides, with an estimated completeness substantially higher than that of national databases, as more attention can be paid for data collection over smaller regions. Yet, both for national and regional coverage, the data collection methods only occasionally included advanced technologies such as remote sensing. With regard to the inventory maps of most databases, the analysis illustrates the high variability of scales (between 1:10 000 and 1:1 M for national inventories, and from 1:10 000 to 1:25 000 for regional inventories), landslide classification systems and representation symbology. It also shows the difficulties to precisely locate landslides referred to in historical documents only. In addition, information on landslide magnitude, geometrical characteristics and age reported in national and regional databases greatly differs, even within the same database, as it strongly depends on the objectives of the database, the data collection methods used, the resources employed and the remaining landslide expression. In particular, landslide initiation and/or reactivation dates are generally estimated in less than 25% of records, thus making hazard and hence risk assessment difficult. In most databases, scarce information on landslide impact (damage and casualties) further hinders risk assessment at regional and national scales. Estimated landslide activity, which is very relevant to early warning and emergency management, is only included in half of the national databases and restricted to part of the landslides registered. Moreover, the availability of this information is not substantially higher in regional databases than in national ones. Most landslide databases further included information on geo-environmental characteristics at the landslide site, which is very important for modelling landslide zoning. Although a number of national and regional agencies provide free web-GIS visualisation services, the potential of existing landslide databases is often not fully exploited as, in many cases, access by the general public and external researchers is restricted. Additionally, the availability of information only in the national or local language is common to most national and regional databases, thus hampering consultation for most foreigners. Finally, some suggestions for a minimum set of attributes to be collected and made available by European countries for building up a continental landslide database in support of EU policies are presented. This study has been conducted in the framework of the EU-FP7 project SafeLand (Grant Agreement 22647).

Identifying high risk medications causing potential drug-drug interactions in outpatients: A prescription database study based on an online surveillance system.

PubMed

Toivo, T M; Mikkola, J A V; Laine, K; Airaksinen, M

2016-01-01

Drug-drug interactions (DDIs) are a significant cause for adverse drug events (ADEs). DDIs are often predictable and preventable, but their prevention and management require systematic service development. Most DDI studies focus on interaction rates in hospitalized patients. Less is known of DDIs in outpatients, particularly how community pharmacists could contribute to DDI management by applying their surveillance systems for identifying high-risk medications. The study was related to the implementation of the first online DDI surveillance system in Finnish community pharmacies. The goal was to demonstrate how community pharmacies can utilize their prospective surveillance system 1) for identifying high risk medications causing potential DDIs in outpatients, 2) for collaborative service development with local physicians, and 3) for academic risk management research purposes. All DDI alerts given by the online surveillance system were collected during a one-month period in 16 out of 17 University Pharmacy outlets in Finland, covering approximately 10% of the national outpatient prescription volume. The surveillance system was based on the FASS database, which categorizes DDIs into four classes (A-D) according to their clinical significance. Potential drug-drug DDIs were analyzed for 276,891 dispensed community pharmacy prescriptions. Potential DDIs were associated with 10.8%, or 31,110 of these prescriptions. Clinically significant interaction alerts categorized as FASS classes D (most severe, should be avoided) and C (clinically significant but controllable) were associated with 0.5% and 7.0% of the prescriptions, respectively. Methotrexate and warfarin had the highest risk of causing potentially serious (class D) interactions. These interaction alerts were most frequently between methotrexate and NSAIDs and warfarin and NSAIDs. In general, NSAIDs were the most commonly interacting drugs in this study. This study demonstrates that community pharmacies can actively contribute to DDI risk management and systematically use their surveillance systems for identifying patients having clinically significant DDIs. The findings also indicate that the majority of potentially serious interactions in outpatients involve a limited number of drugs, particularly NSAIDs, warfarin and methotrexate. Further research should focus on community pharmacists' involvement in DDI risk management in collaboration with local health care providers. Copyright © 2015 Elsevier Inc. All rights reserved.

Transparent Global Seismic Hazard and Risk Assessment

NASA Astrophysics Data System (ADS)

Smolka, Anselm; Schneider, John; Pinho, Rui; Crowley, Helen

2013-04-01

Vulnerability to earthquakes is increasing, yet advanced reliable risk assessment tools and data are inaccessible to most, despite being a critical basis for managing risk. Also, there are few, if any, global standards that allow us to compare risk between various locations. The Global Earthquake Model (GEM) is a unique collaborative effort that aims to provide organizations and individuals with tools and resources for transparent assessment of earthquake risk anywhere in the world. By pooling data, knowledge and people, GEM acts as an international forum for collaboration and exchange, and leverages the knowledge of leading experts for the benefit of society. Sharing of data and risk information, best practices, and approaches across the globe is key to assessing risk more effectively. Through global projects, open-source IT development and collaborations with more than 10 regions, leading experts are collaboratively developing unique global datasets, best practice, open tools and models for seismic hazard and risk assessment. Guided by the needs and experiences of governments, companies and citizens at large, they work in continuous interaction with the wider community. A continuously expanding public-private partnership constitutes the GEM Foundation, which drives the collaborative GEM effort. An integrated and holistic approach to risk is key to GEM's risk assessment platform, OpenQuake, that integrates all above-mentioned contributions and will become available towards the end of 2014. Stakeholders worldwide will be able to calculate, visualise and investigate earthquake risk, capture new data and to share their findings for joint learning. Homogenized information on hazard can be combined with data on exposure (buildings, population) and data on their vulnerability, for loss assessment around the globe. Furthermore, for a true integrated view of seismic risk, users can add social vulnerability and resilience indices to maps and estimate the costs and benefits of different risk management measures. The following global data, models and methodologies will be available in the platform. Some of these will be released to the public already before, such as the ISC-GEM global instrumental catalogue (released January 2013). Datasets: • Global Earthquake History Catalogue [1000-1903] • Global Instrumental Catalogue [1900-2009] • Global Geodetic Strain Rate Model • Global Active Fault Database • Tectonic Regionalisation • Buildings and Population Database • Earthquake Consequences Database • Physical Vulnerability Database • Socio-Economic Vulnerability and Resilience Indicators Models: • Seismic Source Models • Ground Motion (Attenuation) Models • Physical Exposure Models • Physical Vulnerability Models • Composite Index Models (social vulnerability, resilience, indirect loss) The aforementioned models developed under the GEM framework will be combined to produce estimates of hazard and risk at a global scale. Furthermore, building on many ongoing efforts and knowledge of scientists worldwide, GEM will integrate state-of-the-art data, models, results and open-source tools into a single platform that is to serve as a "clearinghouse" on seismic risk. The platform will continue to increase in value, in particular for use in local contexts, through contributions and collaborations with scientists and organisations worldwide.

Development of a GIS-based spill management information system.

PubMed

Martin, Paul H; LeBoeuf, Eugene J; Daniel, Edsel B; Dobbins, James P; Abkowitz, Mark D

2004-08-30

Spill Management Information System (SMIS) is a geographic information system (GIS)-based decision support system designed to effectively manage the risks associated with accidental or intentional releases of a hazardous material into an inland waterway. SMIS provides critical planning and impact information to emergency responders in anticipation of, or following such an incident. SMIS couples GIS and database management systems (DBMS) with the 2-D surface water model CE-QUAL-W2 Version 3.1 and the air contaminant model Computer-Aided Management of Emergency Operations (CAMEO) while retaining full GIS risk analysis and interpretive capabilities. Live 'real-time' data links are established within the spill management software to utilize current meteorological information and flowrates within the waterway. Capabilities include rapid modification of modeling conditions to allow for immediate scenario analysis and evaluation of 'what-if' scenarios. The functionality of the model is illustrated through a case study of the Cheatham Reach of the Cumberland River near Nashville, TN.

Developing a ubiquitous health management system with healthy diet control for metabolic syndrome healthcare in Taiwan.

PubMed

Kan, Yao-Chiang; Chen, Kai-Hong; Lin, Hsueh-Chun

2017-06-01

Self-management in healthcare can allow patients managing their health data anytime and everywhere for prevention of chronic diseases. This study established a prototype of ubiquitous health management system (UHMS) with healthy diet control (HDC) for people who need services of metabolic syndrome healthcare in Taiwan. System infrastructure comprises of three portals and a database tier with mutually supportive components to achieve functionality of diet diaries, nutrition guides, and health risk assessments for self-health management. With the diet, nutrition, and personal health database, the design enables the analytical diagrams on the interactive interface to support a mobile application for diet diary, a Web-based platform for health management, and the modules of research and development for medical care. For database integrity, dietary data can be stored at offline mode prior to transformation between mobile device and server site at online mode. The UHMS-HDC was developed by open source technology for ubiquitous health management with personalized dietary criteria. The system integrates mobile, internet, and electronic healthcare services with the diet diary functions to manage healthy diet behaviors of users. The virtual patients were involved to simulate the self-health management procedure. The assessment functions were approved by capturing the screen snapshots in the procedure. The proposed system development was capable for practical intervention. This approach details the expandable framework with collaborative components regarding the self-developed UHMS-HDC. The multi-disciplinary applications for self-health management can support the healthcare professionals to reduce medical resources and improve healthcare effects for the patient who requires monitoring personal health condition with diet control. The proposed system can be practiced for intervention in the hospital. Copyright © 2017 Elsevier B.V. All rights reserved.

The Seoul Metropolitan Lifestyle Intervention Program and Metabolic Syndrome Risk: A Retrospective Database Study

PubMed Central

Choo, Jina; Yoon, Seok-Jun; Ryu, Hosihn; Park, Mi-Suk; Lee, Hyang Sook; Park, Yoo Mi; Lim, Do-Sun

2016-01-01

Since 2011, the Seoul Metabolic Syndrome Management (SMESY) program has been employed as a community-wide, lifestyle modification intervention in Seoul, Korea. We aimed to determine if the SMESY intervention would be significantly associated with improvements in metabolic syndrome (MetS) risk factors. This retrospective database study included data from 25,449 participants aged 30–64 years between 1 January 2013 and 30 June 2013. In the SMESY program, 3 risk-stratified groups by the number of MetS factors were followed for 12 months with different intensity and timeframe of intervention. Among the high-(n = 7116) and moderate-risk groups (n = 14,762), all MetS factors (except triglycerides among the moderate-risk group) as well as MetS z-scores significantly improved over 12 months (all p < 0.05). Among the low-risk group (n = 3571), all factors aggravated significantly over 12 months (all p < 0.05). We observed temporal associations between the implementation of the SMESY program and improvements in MetS risk factors. However, such improvements differed by risk-stratified group, being most robust for the high-risk group, modest for the moderate-risk group, and aggravated for the low-risk group. Thus, more intensive interventions targeting different risk-stratified groups are needed, given a better understanding of the increase in risk factors observed in the low-risk group. PMID:27384576

An Introduction to Database Structure and Database Machines.

ERIC Educational Resources Information Center

Detweiler, Karen

1984-01-01

Enumerates principal management objectives of database management systems (data independence, quality, security, multiuser access, central control) and criteria for comparison (response time, size, flexibility, other features). Conventional database management systems, relational databases, and database machines used for backend processing are…

[Surgical assessment of complications after thyroid gland operations].

PubMed

Dralle, H

2015-01-01

The extent, magnitude and technical equipment used for thyroid surgery has changed considerably in Germany during the last decade. The number of thyroidectomies due to benign goiter have decreased while the extent of thyroidectomy, nowadays preferentially total thyroidectomy, has increased. Due to an increased awareness of surgical complications the number of malpractice claims is increasing. In contrast to surgical databases the frequency of complications in malpractice claims reflects the individual impact of complications on the quality of life. In contrast to surgical databases unilateral and bilateral vocal fold palsy are therefore at the forefront of malpractice claims. As guidelines are often not applicable for the individual surgical expert review, the question arises which are the relevant criteria for the professional expert witness assessing the severity of the individual complication. While in surgical databases major complications after thyroidectomy, such as vocal fold palsy, hypoparathyroidism, hemorrhage and infections are equally frequent (1-3 %), in malpractice claims vocal fold palsy is significantly more frequent (50 %) compared to hypoparathyroidism (15 %), hemorrhage and infections (about 5 % each). To avoid bilateral nerve palsy intraoperative nerve monitoring has become of utmost importance for surgical strategy and malpractice suits alike. For surgical expert review documentation of individual risk-oriented indications, the surgical approach and postoperative management are highly important. Guidelines only define the treatment corridors of good clinical practice. Surgical expert reviews in malpractice suits concerning quality of care and causality between surgical management, complications and sequelae of complications are therefore highly dependent on the grounds and documentation of risk-oriented indications for thyroidectomy, intraoperative and postoperative surgical management.

Aquatic models, genomics and chemical risk management.

PubMed

Cheng, Keith C; Hinton, David E; Mattingly, Carolyn J; Planchart, Antonio

2012-01-01

The 5th Aquatic Animal Models for Human Disease meeting follows four previous meetings (Nairn et al., 2001; Schmale, 2004; Schmale et al., 2007; Hinton et al., 2009) in which advances in aquatic animal models for human disease research were reported, and community discussion of future direction was pursued. At this meeting, discussion at a workshop entitled Bioinformatics and Computational Biology with Web-based Resources (20 September 2010) led to an important conclusion: Aquatic model research using feral and experimental fish, in combination with web-based access to annotated anatomical atlases and toxicological databases, yields data that advance our understanding of human gene function, and can be used to facilitate environmental management and drug development. We propose here that the effects of genes and environment are best appreciated within an anatomical context - the specifically affected cells and organs in the whole animal. We envision the use of automated, whole-animal imaging at cellular resolution and computational morphometry facilitated by high-performance computing and automated entry into toxicological databases, as anchors for genetic and toxicological data, and as connectors between human and model system data. These principles should be applied to both laboratory and feral fish populations, which have been virtually irreplaceable sentinals for environmental contamination that results in human morbidity and mortality. We conclude that automation, database generation, and web-based accessibility, facilitated by genomic/transcriptomic data and high-performance and cloud computing, will potentiate the unique and potentially key roles that aquatic models play in advancing systems biology, drug development, and environmental risk management. Copyright © 2011 Elsevier Inc. All rights reserved.

Enhancing Disaster Management: Development of a Spatial Database of Day Care Centers in the USA

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

Singh, Nagendra; Tuttle, Mark A.; Bhaduri, Budhendra L.

Children under the age of five constitute around 7% of the total U.S. population and represent a segment of the population, which is totally dependent on others for day-to-day activities. A significant proportion of this population spends time in some form of day care arrangement while their parents are away from home. Accounting for those children during emergencies is of high priority, which requires a broad understanding of the locations of such day care centers. As concentrations of at risk population, the spatial location of day care centers is critical for any type of emergency preparedness and response (EPR). However,more » until recently, the U.S. emergency preparedness and response community did not have access to a comprehensive spatial database of day care centers at the national scale. This paper describes an approach for the development of the first comprehensive spatial database of day care center locations throughout the USA utilizing a variety of data harvesting techniques to integrate information from widely disparate data sources followed by geolocating for spatial precision. In the context of disaster management, such spatially refined demographic databases hold tremendous potential for improving high resolution population distribution and dynamics models and databases.« less

Enhancing Disaster Management: Development of a Spatial Database of Day Care Centers in the USA

DOE PAGES

Singh, Nagendra; Tuttle, Mark A.; Bhaduri, Budhendra L.

2015-07-30

Children under the age of five constitute around 7% of the total U.S. population and represent a segment of the population, which is totally dependent on others for day-to-day activities. A significant proportion of this population spends time in some form of day care arrangement while their parents are away from home. Accounting for those children during emergencies is of high priority, which requires a broad understanding of the locations of such day care centers. As concentrations of at risk population, the spatial location of day care centers is critical for any type of emergency preparedness and response (EPR). However,more » until recently, the U.S. emergency preparedness and response community did not have access to a comprehensive spatial database of day care centers at the national scale. This paper describes an approach for the development of the first comprehensive spatial database of day care center locations throughout the USA utilizing a variety of data harvesting techniques to integrate information from widely disparate data sources followed by geolocating for spatial precision. In the context of disaster management, such spatially refined demographic databases hold tremendous potential for improving high resolution population distribution and dynamics models and databases.« less

Is Case Management Effective for Long-Lasting Suicide Prevention?

PubMed

Wang, Liang-Jen; Wu, Ya-Wen; Chen, Chih-Ken

2015-01-01

Case management services have been implemented in suicide prevention programs. To investigate whether case management is an effective strategy for reducing the risks of repeated suicide attempts and completed suicides in a city with high suicide rates in northern Taiwan. The Suicide Prevention Center of Keelung City (KSPC) was established in April 2005. Subjects included a consecutive sample of individuals (N = 2,496) registered in KSPC databases between January 1, 2006, and December 31, 2011, with at least one episode of nonfatal self-harm. Subjects were tracked for the duration of the study. Of all the subjects, 1,013 (40.6%) received case management services; 416 (16.7%) had at least one other deliberate self-harm episode and 52 (2.1%) eventually died by suicide. No significant differences were found in the risks of repeated self-harm and completed suicides between suicide survivors who received case management and those who refused the services. However, a significant reduction in suicide rates was found after KSPC was established. Findings suggest that case management services might not reduce the risks of suicide repetition among suicide survivors during long-term follow-up. Future investigation is warranted to determine factors impacting the downward trend of suicide rates.

The Children's Hepatic tumors International Collaboration (CHIC): Novel global rare tumor database yields new prognostic factors in hepatoblastoma and becomes a research model

PubMed Central

Czauderna, Piotr; Haeberle, Beate; Hiyama, Eiso; Rangaswami, Arun; Krailo, Mark; Maibach, Rudolf; Rinaldi, Eugenia; Feng, Yurong; Aronson, Daniel; Malogolowkin, Marcio; Yoshimura, Kenichi; Leuschner, Ivo; Lopez-Terrada, Dolores; Hishiki, Tomoro; Perilongo, Giorgio; von Schweinitz, Dietrich; Schmid, Irene; Watanabe, Kenichiro; Derosa, Marisa; Meyers, Rebecka

2016-01-01

Introduction Contemporary state-of-the-art management of cancer is increasingly defined by individualized treatment strategies. For very rare tumors, like hepatoblastoma, the development of biologic markers, and the identification of reliable prognostic risk factors for tailoring treatment, remains very challenging. The Children's Hepatic tumors International Collaboration (CHIC) is a novel international response to this challenge. Methods Four multicenter trial groups in the world, who have performed prospective controlled studies of hepatoblastoma over the past two decades (COG; SIOPEL; GPOH; and JPLT), joined forces to form the CHIC consortium. With the support of the data management group CINECA, CHIC developed a centralized online platform where data from eight completed hepatoblastoma trials were merged to form a database of 1605 hepatoblastoma cases treated between 1988 and 2008. The resulting dataset is described and the relationships between selected patient and tumor characteristics, and risk for adverse disease outcome (event-free survival; EFS) are examined. Results Significantly increased risk for EFS-event was noted for advanced PRETEXT group, macrovascular venous or portal involvement, contiguous extrahepatic disease, primary tumor multifocality and tumor rupture at enrollment. Higher age (≥8 years), low AFP (<100 ng/ml) and metastatic disease were associated with the worst outcome. Conclusion We have identified novel prognostic factors for hepatoblastoma, as well as confirmed established factors, that will be used to develop a future common global risk stratification system. The mechanics of developing the globally accessible web-based portal, building and refining the database, and performing this first statistical analysis has laid the foundation for future collaborative efforts. This is an important step for refining of the risk based grouping and approach to future treatment stratification, thus we think our collaboration offers a template for others to follow in the study of rare tumors and diseases. PMID:26655560

The Children's Hepatic tumors International Collaboration (CHIC): Novel global rare tumor database yields new prognostic factors in hepatoblastoma and becomes a research model.

PubMed

Czauderna, Piotr; Haeberle, Beate; Hiyama, Eiso; Rangaswami, Arun; Krailo, Mark; Maibach, Rudolf; Rinaldi, Eugenia; Feng, Yurong; Aronson, Daniel; Malogolowkin, Marcio; Yoshimura, Kenichi; Leuschner, Ivo; Lopez-Terrada, Dolores; Hishiki, Tomoro; Perilongo, Giorgio; von Schweinitz, Dietrich; Schmid, Irene; Watanabe, Kenichiro; Derosa, Marisa; Meyers, Rebecka

2016-01-01

Contemporary state-of-the-art management of cancer is increasingly defined by individualized treatment strategies. For very rare tumors, like hepatoblastoma, the development of biologic markers, and the identification of reliable prognostic risk factors for tailoring treatment, remains very challenging. The Children's Hepatic tumors International Collaboration (CHIC) is a novel international response to this challenge. Four multicenter trial groups in the world, who have performed prospective controlled studies of hepatoblastoma over the past two decades (COG; SIOPEL; GPOH; and JPLT), joined forces to form the CHIC consortium. With the support of the data management group CINECA, CHIC developed a centralized online platform where data from eight completed hepatoblastoma trials were merged to form a database of 1605 hepatoblastoma cases treated between 1988 and 2008. The resulting dataset is described and the relationships between selected patient and tumor characteristics, and risk for adverse disease outcome (event-free survival; EFS) are examined. Significantly increased risk for EFS-event was noted for advanced PRETEXT group, macrovascular venous or portal involvement, contiguous extrahepatic disease, primary tumor multifocality and tumor rupture at enrollment. Higher age (≥ 8 years), low AFP (<100 ng/ml) and metastatic disease were associated with the worst outcome. We have identified novel prognostic factors for hepatoblastoma, as well as confirmed established factors, that will be used to develop a future common global risk stratification system. The mechanics of developing the globally accessible web-based portal, building and refining the database, and performing this first statistical analysis has laid the foundation for future collaborative efforts. This is an important step for refining of the risk based grouping and approach to future treatment stratification, thus we think our collaboration offers a template for others to follow in the study of rare tumors and diseases. Copyright © 2015 Elsevier Ltd. All rights reserved.

Assessing the Health-Care Risk: The Clinical-VaR, a Key Indicator for Sound Management.

PubMed

Jiménez-Rodríguez, Enrique; Feria-Domínguez, José Manuel; Sebastián-Lacave, Alonso

2018-03-30

Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE). The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs). Therefore, the importance of the health-care risk management is a current and relevant issue on the agenda of many public and private institutions. The objective of the management has been evolving from the identification of AE to the assessment of cost-effective and efficient measures that improve the quality control through monitoring. Consequently, the goal of this paper is to propose a Key Risk Indicator (KRI) that enhances the advancement of the health-care management system. Thus, the application of the Value at Risk (VaR) concept in combination to the Loss Distribution Approach (LDA) is proved to be a proactive tool, within the frame of balanced scorecard (BSC), in health organizations. For this purpose, the historical events recorded in the Algo-OpData ® database (Algorithmics Inc., Toronto, ON, Canada, IBM, Armonk, NY, USA) have been used. The analysis highlights the importance of risk in the financials outcomes of the sector. The results of paper show the usefulness of the Clinical-VaR to identify and monitor the risk and sustainability of the implemented controls.

Assessing the Health-Care Risk: The Clinical-VaR, a Key Indicator for Sound Management

PubMed Central

Jiménez-Rodríguez, Enrique; Sebastián-Lacave, Alonso

2018-01-01

Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE). The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs). Therefore, the importance of the health-care risk management is a current and relevant issue on the agenda of many public and private institutions. The objective of the management has been evolving from the identification of AE to the assessment of cost-effective and efficient measures that improve the quality control through monitoring. Consequently, the goal of this paper is to propose a Key Risk Indicator (KRI) that enhances the advancement of the health-care management system. Thus, the application of the Value at Risk (VaR) concept in combination to the Loss Distribution Approach (LDA) is proved to be a proactive tool, within the frame of balanced scorecard (BSC), in health organizations. For this purpose, the historical events recorded in the Algo-OpData® database (Algorithmics Inc., Toronto, ON, Canada, IBM, Armonk, NY, USA) have been used. The analysis highlights the importance of risk in the financials outcomes of the sector. The results of paper show the usefulness of the Clinical-VaR to identify and monitor the risk and sustainability of the implemented controls. PMID:29601529

Developing the U.S. Wildland Fire Decision Support System

Treesearch

Erin Noonan-Wright; Tonja S. Opperman; Mark A. Finney; Tom Zimmerman; Robert C. Seli; Lisa M. Elenz; David E. Calkin; John R. Fiedler

2011-01-01

A new decision support tool, the Wildland Fire Decision Support System (WFDSS) has been developed to support risk-informed decision-making for individual fires in the United States. WFDSS accesses national weather data and forecasts, fire behavior prediction, economic assessment, smoke management assessment, and landscape databases to efficiently formulate and apply...

Better Building Blocks

Treesearch

Cheryl R. Renner; Terry K. Haines; Margaret A. Reams

2010-01-01

As researchers for the National Database of State and Local Wildfire Mitigation Programs, we began cataloging programs to reduce wildfire risk on private land in 2001. Over the years, more than 250 programs in 35 states were described at www.wildfireprograms.usda.gov, and we wondered about their relative success. Was there one type of program that wildfire managers...

Managing equipment innovations in mining: A review.

PubMed

Trudel, Bryan; Nadeau, Sylvie; Zaras, Kazimierz; Deschamps, Isabelle

2015-01-01

Technological innovations in mining equipment have led to increased productivity and occupational health and safety (OHS) performance, but their introduction also brings new risks for workers. The aim of this study is to provide support for mining industry managers who are required to reconcile equipment choices with OHS and productivity. Examination of the literature through interdisciplinary digital databases. Databases were searched using specific combinations of keywords and limited to studies dating back no farther than 1992. The ``snowball'' technique was also used to examining the references listed in research articles initially identified with the databases. A total of 19 contextual factors were identified as having the potential to influence the OHS and productivity leverage of equipment innovations. The most often cited among these factors are the level of training provided to the equipment operators, operator experience and age, supervisor leadership abilities, and maintaining good relations within work crews. Interactions between these factors are not discussed in mining innovation literature. It would be helpful to use a systems thinking approach which incorporates interaction between relevant actors and factors to define properly the most sensitive aspects of innovation management as it applies to mining equipment.

Integration of environmental simulation models with satellite remote sensing and geographic information systems technologies: case studies

USGS Publications Warehouse

Steyaert, Louis T.; Loveland, Thomas R.; Brown, Jesslyn F.; Reed, Bradley C.

1993-01-01

Environmental modelers are testing and evaluating a prototype land cover characteristics database for the conterminous United States developed by the EROS Data Center of the U.S. Geological Survey and the University of Nebraska Center for Advanced Land Management Information Technologies. This database was developed from multi temporal, 1-kilometer advanced very high resolution radiometer (AVHRR) data for 1990 and various ancillary data sets such as elevation, ecological regions, and selected climatic normals. Several case studies using this database were analyzed to illustrate the integration of satellite remote sensing and geographic information systems technologies with land-atmosphere interactions models at a variety of spatial and temporal scales. The case studies are representative of contemporary environmental simulation modeling at local to regional levels in global change research, land and water resource management, and environmental simulation modeling at local to regional levels in global change research, land and water resource management and environmental risk assessment. The case studies feature land surface parameterizations for atmospheric mesoscale and global climate models; biogenic-hydrocarbons emissions models; distributed parameter watershed and other hydrological models; and various ecological models such as ecosystem, dynamics, biogeochemical cycles, ecotone variability, and equilibrium vegetation models. The case studies demonstrate the important of multi temporal AVHRR data to develop to develop and maintain a flexible, near-realtime land cover characteristics database. Moreover, such a flexible database is needed to derive various vegetation classification schemes, to aggregate data for nested models, to develop remote sensing algorithms, and to provide data on dynamic landscape characteristics. The case studies illustrate how such a database supports research on spatial heterogeneity, land use, sensitivity analysis, and scaling issues involving regional extrapolations and parameterizations of dynamic land processes within simulation models.

Temporal changes and risk factors for foot-pad dermatitis in Danish broilers.

PubMed

Kyvsgaard, Niels Chr; Jensen, Henrik Bang; Ambrosen, Thorkil; Toft, Nils

2013-01-01

Foot-pad dermatitis is a major welfare concern of broilers caused by ammonia irritation from the bedding material. In Denmark, an action plan to control the condition was implemented in 2002 with monitoring through a foot scoring system at slaughter and with predefined limits that trigger sanctions. The objective of the present study was to study time trends and to identify predisposing factors on the flock lesion scores. The analysis was carried out on a database created by merging abattoir lesion data with antemortem evaluation data, and the flock productivity database managed by the farmers' association. The database had a record for each flock and variables containing information on both flock foot-pad scores and a range of management factors. We observed a dramatic decline in flock lesion scores between the years 2002 and 2005 followed by a minimal decline hereafter. Mean flock lesion scores differed between abattoirs, and subsequent analysis was performed in a mixed effect model where abattoir was considered a random effect. The analysis showed that flock lesion scores increased when the litter quality was evaluated as poor during the on-site antemortem evaluation. Other significant risk factors were winter season as opposed to summer, low daily weight gain, straw as bedding material in contrast to wood shavings and sphagnum peat, and high age at slaughter. Stocking density was only weakly associated with flock lesion scores.

Integrative medicine for managing the symptoms of lupus nephritis: A protocol for systematic review and meta-analysis.

PubMed

Choi, Tae-Young; Jun, Ji Hee; Lee, Myeong Soo

2018-03-01

Integrative medicine is claimed to improve symptoms of lupus nephritis. No systematic reviews have been performed for the application of integrative medicine for lupus nephritis on patients with systemic lupus erythematosus (SLE). Thus, this review will aim to evaluate the current evidence on the efficacy of integrative medicine for the management of lupus nephritis in patients with SLE. The following electronic databases will be searched for studies published from their dates of inception February 2018: Medline, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL), as well as 6 Korean medical databases (Korea Med, the Oriental Medicine Advanced Search Integrated System [OASIS], DBpia, the Korean Medical Database [KM base], the Research Information Service System [RISS], and the Korean Studies Information Services System [KISS]), and 1 Chinese medical database (the China National Knowledge Infrastructure [CNKI]). Study selection, data extraction, and assessment will be performed independently by 2 researchers. The risk of bias (ROB) will be assessed using the Cochrane ROB tool. This systematic review will be published in a peer-reviewed journal and disseminated both electronically and in print. The review will be updated to inform and guide healthcare practice and policy. PROSPERO 2018 CRD42018085205.

Database for the degradation risk assessment of groundwater resources (Southern Italy)

NASA Astrophysics Data System (ADS)

Polemio, M.; Dragone, V.; Mitolo, D.

2003-04-01

The risk characterisation of quality degradation and availability lowering of groundwater resources has been pursued for a wide coastal plain (Basilicata region, Southern Italy), an area covering 40 km along the Ionian Sea and 10 km inland. The quality degradation is due two phenomena: pollution due to discharge of waste water (coming from urban areas) and due to salt pollution, related to seawater intrusion but not only. The availability lowering is due to overexploitation but also due to drought effects. To this purpose the historical data of 1,130 wells have been collected. Wells, homogenously distributed in the area, were the source of geological, stratigraphical, hydrogeological, geochemical data. In order to manage space-related information via a GIS, a database system has been devised to encompass all the surveyed wells and the body of information available per well. Geo-databases were designed to comprise the four types of data collected: a database including geometrical, geological and hydrogeological data on wells (WDB), a database devoted to chemical and physical data on groundwater (CDB), a database including the geotechnical parameters (GDB), a database concering piezometric and hydrological (rainfall, air temperature, river discharge) data (HDB). The record pertaining to each well is identified in these databases by the progressive number of the well itself. Every database is designed as follows: a) the HDB contains 1,158 records, 28 of and 31 fields, mainly describing the geometry of the well and of the stratigraphy; b) the CDB encompasses data about 157 wells, based on which the chemical and physical analyses of groundwater have been carried out. More than one record has been associated with these 157 wells, due to periodic monitoring and analysis; c) the GDB covers 61 wells to which the geotechnical parameters obtained by soil samples taken at various depths; the HDB is designed to permit the analysis of long time series (from 1918) of piezometric data, monitored by more than 60 wells, temperature, rainfall and river discharge data. Based on geo-databases, the geostatistical processing of data has permitted to characterise the degradation risk of groundwater resources of a wide coastal aquifer.

Applications of GIS and database technologies to manage a Karst Feature Database

USGS Publications Warehouse

Gao, Y.; Tipping, R.G.; Alexander, E.C.

2006-01-01

This paper describes the management of a Karst Feature Database (KFD) in Minnesota. Two sets of applications in both GIS and Database Management System (DBMS) have been developed for the KFD of Minnesota. These applications were used to manage and to enhance the usability of the KFD. Structured Query Language (SQL) was used to manipulate transactions of the database and to facilitate the functionality of the user interfaces. The Database Administrator (DBA) authorized users with different access permissions to enhance the security of the database. Database consistency and recovery are accomplished by creating data logs and maintaining backups on a regular basis. The working database provides guidelines and management tools for future studies of karst features in Minnesota. The methodology of designing this DBMS is applicable to develop GIS-based databases to analyze and manage geomorphic and hydrologic datasets at both regional and local scales. The short-term goal of this research is to develop a regional KFD for the Upper Mississippi Valley Karst and the long-term goal is to expand this database to manage and study karst features at national and global scales.

From design to implementation - The Joint Asia Diabetes Evaluation (JADE) program: A descriptive report of an electronic web-based diabetes management program

PubMed Central

2010-01-01

Background The Joint Asia Diabetes Evaluation (JADE) Program is a web-based program incorporating a comprehensive risk engine, care protocols, and clinical decision support to improve ambulatory diabetes care. Methods The JADE Program uses information technology to facilitate healthcare professionals to create a diabetes registry and to deliver an evidence-based care and education protocol tailored to patients' risk profiles. With written informed consent from participating patients and care providers, all data are anonymized and stored in a databank to establish an Asian Diabetes Database for research and publication purpose. Results The JADE electronic portal (e-portal: http://www.jade-adf.org) is implemented as a Java application using the Apache web server, the mySQL database and the Cocoon framework. The JADE e-portal comprises a risk engine which predicts 5-year probability of major clinical events based on parameters collected during an annual comprehensive assessment. Based on this risk stratification, the JADE e-portal recommends a care protocol tailored to these risk levels with decision support triggered by various risk factors. Apart from establishing a registry for quality assurance and data tracking, the JADE e-portal also displays trends of risk factor control at each visit to promote doctor-patient dialogues and to empower both parties to make informed decisions. Conclusions The JADE Program is a prototype using information technology to facilitate implementation of a comprehensive care model, as recommended by the International Diabetes Federation. It also enables health care teams to record, manage, track and analyze the clinical course and outcomes of people with diabetes. PMID:20465815

Problem reporting management system performance simulation

NASA Technical Reports Server (NTRS)

Vannatta, David S.

1993-01-01

This paper proposes the Problem Reporting Management System (PRMS) model as an effective discrete simulation tool that determines the risks involved during the development phase of a Trouble Tracking Reporting Data Base replacement system. The model considers the type of equipment and networks which will be used in the replacement system as well as varying user loads, size of the database, and expected operational availability. The paper discusses the dynamics, stability, and application of the PRMS and addresses suggested concepts to enhance the service performance and enrich them.

Enabling Civilian Low-Altitude Airspace and Unmanned Aerial System (UAS) Operations

NASA Technical Reports Server (NTRS)

Kopardekar, Parimal

2014-01-01

UAS operations will be safer if a UTM system is available to support the functions associated with Airspace management and geo-fencing (reduce risk of accidents, impact to other operations, and community concerns); Weather and severe wind integration (avoid severe weather areas based on prediction); Predict and manage congestion (mission safety);Terrain and man-made objects database and avoidance; Maintain safe separation (mission safety and assurance of other assets); Allow only authenticated operations (avoid unauthorized airspace use).

Terra Incognita: Absence of Concentrated Animal Feeding Operations from the National Land Cover Database and Implications for Environmental Risk

NASA Astrophysics Data System (ADS)

Martin, K. L.; Emanuel, R. E.; Vose, J. M.

2016-12-01

The number of concentrated animal feeding operations (CAFOs) has increased rapidly in recent decades. Although important to food supplies, CAFOs may present significant risks to human health and environmental quality. The National land cover database (NLCD) is a publically available database of land cover whose purpose is to provide assessment of ecosystem health, facilitate nutrient modeling, land use planning, and developing land management practices. However, CAFOs do not align with any existing NLCD land cover classes. This is especially concerning due to their distinct nutrient loading characteristics, potential for other environmental impacts, and given that individual CAFOs may occupy several NLCD pixels worth of ground area. Using 2011 NLCD data, we examined the land cover classification of CAFO sites in North Carolina (USA). Federal regulations require CAFOs with a liquid waste disposal system to obtain a water quality permit. In North Carolina, there were 2679 permitted sites as of 2015, primarily in the southeastern part of the state. As poultry operations most frequently use dry waste disposal systems, they are not required to obtain a permit and thus, their locations are undocumented. For each permitted CAFO, we determined the mode of the NLCD land uses within a 50m buffer surrounding point coordinates. We found permitted CAFOS were most likely to be classified as hay/pasture (58%). An additional 13% were identified as row crops, leaving 29% as a non-agricultural land cover class, including wetlands (12%). This misclassification of CAFOs can have implications for environmental management and public policy. Scientists and land managers need access to better spatial data on the distribution of these operations to monitor the environmental impacts and identify the best landscape scale mitigation strategies. We recommend adding a new land cover class (concentrated animal operations) to the NLCD database.

Anterior Shoulder Instability in the Military Athlete.

PubMed

Waterman, Brian; Owens, Brett D; Tokish, John M

Given its young, predominately male demographics and intense physical demands, the US military remains an ideal cohort for the study of anterior shoulder instability. A literature search of PubMed, MEDLINE, and the Cochrane Database was performed to identify all peer-reviewed publications from 1950 to 2016 from US military orthopaedic surgeons focusing on the management of anterior shoulder instability. Clinical review. Level 4. The incidence of anterior shoulder instability events in the military occurs at an order of magnitude greater than in civilian populations, with rates as high as 3% per year among high-risk groups. With more than 90% risk of a Bankart lesion and high risk for instability recurrence, the military has advocated for early intervention of first-time shoulder instability while documenting up to 76% relative risk reduction versus nonoperative treatment. Preoperative evaluation with advanced radiographic imaging should be used to evaluate for attritional bone loss or "off-track" engaging defects to guide comprehensive surgical management. With complex recurrent shoulder instability and/or cases of clinically significant osseous lesions, potential options such as remplissage, anterior open capsular procedures, or bone augmentation procedures may be preferentially considered. Careful risk stratification, clinical evaluation, and selective surgical management for at-risk military patients with anterior shoulder instability can optimize the recurrence risk and functional outcome in this population.

Cyber Risk Management for Critical Infrastructure: A Risk Analysis Model and Three Case Studies.

PubMed

Paté-Cornell, M-Elisabeth; Kuypers, Marshall; Smith, Matthew; Keller, Philip

2018-02-01

Managing cyber security in an organization involves allocating the protection budget across a spectrum of possible options. This requires assessing the benefits and the costs of these options. The risk analyses presented here are statistical when relevant data are available, and system-based for high-consequence events that have not happened yet. This article presents, first, a general probabilistic risk analysis framework for cyber security in an organization to be specified. It then describes three examples of forward-looking analyses motivated by recent cyber attacks. The first one is the statistical analysis of an actual database, extended at the upper end of the loss distribution by a Bayesian analysis of possible, high-consequence attack scenarios that may happen in the future. The second is a systems analysis of cyber risks for a smart, connected electric grid, showing that there is an optimal level of connectivity. The third is an analysis of sequential decisions to upgrade the software of an existing cyber security system or to adopt a new one to stay ahead of adversaries trying to find their way in. The results are distributions of losses to cyber attacks, with and without some considered countermeasures in support of risk management decisions based both on past data and anticipated incidents. © 2017 Society for Risk Analysis.

Developing a synthetic national population to investigate the impact of different cardiovascular disease risk management strategies: A derivation and validation study

PubMed Central

Jackson, Rod

2017-01-01

Background Many national cardiovascular disease (CVD) risk factor management guidelines now recommend that drug treatment decisions should be informed primarily by patients’ multi-variable predicted risk of CVD, rather than on the basis of single risk factor thresholds. To investigate the potential impact of treatment guidelines based on CVD risk thresholds at a national level requires individual level data representing the multi-variable CVD risk factor profiles for a country’s total adult population. As these data are seldom, if ever, available, we aimed to create a synthetic population, representing the joint CVD risk factor distributions of the adult New Zealand population. Methods and results A synthetic population of 2,451,278 individuals, representing the actual age, gender, ethnicity and social deprivation composition of people aged 30–84 years who completed the 2013 New Zealand census was generated using Monte Carlo sampling. Each ‘synthetic’ person was then probabilistically assigned values of the remaining cardiovascular disease (CVD) risk factors required for predicting their CVD risk, based on data from the national census national hospitalisation and drug dispensing databases and a large regional cohort study, using Monte Carlo sampling and multiple imputation. Where possible, the synthetic population CVD risk distributions for each non-demographic risk factor were validated against independent New Zealand data sources. Conclusions We were able to develop a synthetic national population with realistic multi-variable CVD risk characteristics. The construction of this population is the first step in the development of a micro-simulation model intended to investigate the likely impact of a range of national CVD risk management strategies that will inform CVD risk management guideline updates in New Zealand and elsewhere. PMID:28384217

Developing a synthetic national population to investigate the impact of different cardiovascular disease risk management strategies: A derivation and validation study.

PubMed

Knight, Josh; Wells, Susan; Marshall, Roger; Exeter, Daniel; Jackson, Rod

2017-01-01

Many national cardiovascular disease (CVD) risk factor management guidelines now recommend that drug treatment decisions should be informed primarily by patients' multi-variable predicted risk of CVD, rather than on the basis of single risk factor thresholds. To investigate the potential impact of treatment guidelines based on CVD risk thresholds at a national level requires individual level data representing the multi-variable CVD risk factor profiles for a country's total adult population. As these data are seldom, if ever, available, we aimed to create a synthetic population, representing the joint CVD risk factor distributions of the adult New Zealand population. A synthetic population of 2,451,278 individuals, representing the actual age, gender, ethnicity and social deprivation composition of people aged 30-84 years who completed the 2013 New Zealand census was generated using Monte Carlo sampling. Each 'synthetic' person was then probabilistically assigned values of the remaining cardiovascular disease (CVD) risk factors required for predicting their CVD risk, based on data from the national census national hospitalisation and drug dispensing databases and a large regional cohort study, using Monte Carlo sampling and multiple imputation. Where possible, the synthetic population CVD risk distributions for each non-demographic risk factor were validated against independent New Zealand data sources. We were able to develop a synthetic national population with realistic multi-variable CVD risk characteristics. The construction of this population is the first step in the development of a micro-simulation model intended to investigate the likely impact of a range of national CVD risk management strategies that will inform CVD risk management guideline updates in New Zealand and elsewhere.

Negative Effects of Learning Spreadsheet Management on Learning Database Management

ERIC Educational Resources Information Center

Vágner, Anikó; Zsakó, László

2015-01-01

A lot of students learn spreadsheet management before database management. Their similarities can cause a lot of negative effects when learning database management. In this article, we consider these similarities and explain what can cause problems. First, we analyse the basic concepts such as table, database, row, cell, reference, etc. Then, we…

Traceability System For Agricultural Productsbased on Rfid and Mobile Technology

NASA Astrophysics Data System (ADS)

Sugahara, Koji

In agriculture, it is required to establish and integrate food traceability systems and risk management systems in order to improve food safety in the entire food chain. The integrated traceability system for agricultural products was developed, based on innovative technology of RFID and mobile computing. In order to identify individual products on the distribution process efficiently,small RFID tags with unique ID and handy RFID readers were applied. On the distribution process, the RFID tags are checked by using the readers, and transit records of the products are stored to the database via wireless LAN.Regarding agricultural production, the recent issues of pesticides misuse affect consumer confidence in food safety. The Navigation System for Appropriate Pesticide Use (Nouyaku-navi) was developed, which is available in the fields by Internet cell-phones. Based on it, agricultural risk management systems have been developed. These systems collaborate with traceability systems and they can be applied for process control and risk management in agriculture.

The Identification of Children with, or at Significant Risk of, Intellectual Disabilities in Low- and Middle-Income Countries: A Review

ERIC Educational Resources Information Center

Robertson, Janet; Hatton, Chris; Emerson, Eric; Yasamy, M. Taghi

2012-01-01

Background: Developmental monitoring of children is an important strategy for the early detection and management of intellectual disabilities (ID) in high-income countries. This review summarizes the literature on identifying children with ID in low- and middle-income (LAMI) countries. Materials and methods: Electronic literature database searches…

40 CFR 1400.5 - Internet access to certain off-site consequence analysis data elements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Internet access to certain off-site... DISTRIBUTION OF OFF-SITE CONSEQUENCE ANALYSIS INFORMATION Public Access § 1400.5 Internet access to certain off... elements in the risk management plan database available on the Internet: (a) The concentration of the...

Epidemiology of Nonfatal Deliberate Self-Harm in the United States as Described in Three Medical Databases

ERIC Educational Resources Information Center

Claassen, Cynthia A.; Trivedi, Madhukar H.; Shimizu, Iris; Stewart, Sunita; Larkin, Gregory Luke; Litovitz, Toby

2006-01-01

The absence of validated U.S. rates of nonfatal suicidal behavior places risk management and injury prevention programs at danger of being poorly informed and inadequately conceptualized. In this study we compare estimated rates of intentional self-harm from two ongoing surveys (National Electronic Injury Surveillance System-All Injury…

76 FR 59170 - Hartford Financial Services, Inc., Corporate/EIT/CTO Database Management Division, Hartford, CT...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-23

... Services, Inc., Corporate/EIT/CTO Database Management Division, Hartford, CT; Notice of Negative... Services, Inc., Corporate/EIT/CTO Database Management Division, Hartford, Connecticut (The Hartford, Corporate/EIT/CTO Database Management Division). The negative determination was issued on August 19, 2011...

Acceptability of Health Care-Related Risks: A Literature Review.

PubMed

Quintard, Bruno; Roberts, Tamara; Nitaro, Léa; Quenon, Jean-Luc; Michel, Philippe

2016-03-01

Risk management aims at reducing risks associated with hospital care to an acceptable level, both in their frequency and their impact on health. The social acceptability of risk on the part of the general population and of the health-care professionals, faced with regular information about adverse events, is undoubtedly evolving rapidly.In contrast to risk acceptability, the concept of risk perception is of limited interest to risk managers because it does not inform on the behaviors and actions resulting from these perceptions. The aim of this work was to define the concept of social acceptability of risk through an in-depth examination of a wide-ranging and multidisciplinary literature. A 1990-2010 English and French literature review was carried out in medical, epidemiological, and human and social sciences online databases, gray literature, and books. Of the 5931 references retrieved, 203 met the inclusion criteria. We identified contributions from 5 major research fields: economic, sociocognitive, psychometric, sociological/anthropological, and interactionist. When assessing risks, individuals use a variety of psychological and social processes that include their perception not only of a given risk but also of their own personal and social resources. This global perception has a direct impact on the responses and actual behavior of individuals and groups, enabling them to cope with the risk and/or manage it. Social acceptability includes perceptions related to risks and the stated intentions of individual behavior. This concept may therefore be relevant for defining local and national patient safety priorities.

Herbal medicine (Hyeolbuchukeo-tang or Xuefu Zhuyu decoction) for treating primary dysmenorrhoea: protocol for a systematic review of randomised controlled trials.

PubMed

Jo, Junyoung; Leem, Jungtae; Lee, Jin Moo; Park, Kyoung Sun

2017-06-15

Primary dysmenorrhoea is menstrual pain without pelvic pathology and is the most common gynaecological condition in women. Xuefu Zhuyudecoction (XZD) or Hyeolbuchukeo-tang, a traditional herbal formula, has been used as a treatment for primary dysmenorrhoea. The purpose of this study is to assess the current published evidence regarding XZD as treatment for primary dysmenorrhoea. The following databases will be searched from their inception until April 2017: MEDLINE (via PubMed), Allied and Complementary Medicine Database (AMED), EMBASE, The Cochrane Library, six Korean medical databases (Korean Studies Information Service System, DBPia, Oriental Medicine Advanced Searching Integrated System, Research Information Service System, Korea Med and the Korean Traditional Knowledge Portal), three Chinese medical databases (China National Knowledge Infrastructure (CNKI), Wan Fang Database and Chinese Scientific Journals Database (VIP)) and one Japanese medical database (CiNii). Randomised clinical trials (RCTs) that will be included in this systematic review comprise those that used XZD or modified XZD. The control groups in the RCTs include no treatment, placebo, conventional medication or other treatments. Trials testing XZD as an adjunct to other treatments and studies where the control group received the same treatment as the intervention group will be also included. Data extraction and risk of bias assessments will be performed by two independent reviewers. The risk of bias will be assessed with the Cochrane risk of bias tool. All statistical analyses will be conducted using Review Manager software (RevMan V.5.3.0). This systematic review will be published in a peer-reviewed journal. The review will also be disseminated electronically and in print. The review will benefit patients and practitioners in the fields of traditional and conventional medicine. CRD42016050447. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Malpractice risk and cost are significantly reduced after tort reform.

PubMed

Stewart, Ronald M; Geoghegan, Kathy; Myers, John G; Sirinek, Kenneth R; Corneille, Michael G; Mueller, Deborah; Dent, Daniel L; Wolf, Steven E; Pruitt, Basil A

2011-04-01

Rising medical malpractice premiums have reached a crisis point in many areas of the United States. In 2003 the Texas legislature passed a comprehensive package of tort reform laws that included a cap at $250,000 on noneconomic damages in most medical malpractice cases. We hypothesized that tort reform laws significantly reduce the risk of malpractice lawsuit in an academic medical center. We compared malpractice prevalence, incidence, and liability costs before and after comprehensive state tort reform measures were implemented. Two prospectively maintained institutional databases were used to calculate and characterize malpractice risk: a surgical operation database and a risk management and malpractice database. Risk groups were divided into pretort reform (1992 to 2004) and post-tort reform groups (2004 to the present). Operative procedures were included for elective, urgent, and emergency general surgery procedures. During the study period, 98,513 general surgical procedures were performed. A total of 28 lawsuits (25 pre-reform, 3 postreform) were filed, naming general surgery faculty or residents. The prevalence of lawsuits filed/100,000 procedures performed is as follows: before reform, 40 lawsuits/100,000 procedures, and after reform, 8 lawsuits/100,000 procedures (p < 0.01, relative risk 0.21 [95% CI 0.063 to 0.62]). Virtually all of the liability and defense cost was in the pretort reform period: $595,000/year versus $515/year in the postreform group (p < 0.01). Implementation of comprehensive tort reform in Texas was associated with a significant decrease in the prevalence and cost of surgical malpractice lawsuits at one academic medical center. Copyright © 2011. Published by Elsevier Inc.

Frequency and risk factors for donor reactions in an anonymous blood donor survey.

PubMed

Goldman, Mindy; Osmond, Lori; Yi, Qi-Long; Cameron-Choi, Keltie; O'Brien, Sheila F

2013-09-01

Adverse donor reactions can result in injury and decrease the likelihood of donor return. Reaction reports captured in the blood center's database provide an incomplete picture of reaction rates and risk factors. We performed an anonymous survey, mailed to 40,000 donors in 2008, including questions about symptoms, height, weight, sex, and donation status. Reaction rates were compared to those recorded in our database. Possible risk factors were assessed for various reactions. The response rate was 45.5%. A total of 32% of first-time and 14% of repeat donors reported having any adverse symptom, most frequently bruising (84.9 per 1000 donors) or feeling faint or weak (66.2 per 1000). Faint reactions were two to eight times higher than reported in our database, although direct comparison was difficult. Younger age, female sex, and first-time donation status were risk factors for systemic and arm symptoms. In females, low estimated blood volume (EBV) was a risk factor for systemic symptoms. Only 51% of donors who consulted an outside physician also called Canadian Blood Services. A total of 10% of first-time donors with reactions found adverse effects information inadequate. This study allowed us to collect more information about adverse reactions, including minor symptoms and delayed reactions. Based on our findings of the risk factors and frequency of adverse reactions, we are implementing more stringent EBV criteria for younger donors and providing more detailed information to donors about possible adverse effects and their management. © 2012 American Association of Blood Banks.

Clinical pharmacy cardiac risk service for managing patients with coronary artery disease in a health maintenance organization.

PubMed

Sandhoff, Brian G; Nies, Leslie K; Olson, Kari L; Nash, James D; Rasmussen, Jon R; Merenich, John A

2007-01-01

A clinical pharmacy service for managing the treatment of coronary artery disease in a health maintenance organization is described. Despite the proven benefits of aggressive risk factor modification for patients with coronary artery disease (CAD), there remains a treatment gap between consensus- and evidence-based recommendations and their application in patient care. In 1998, Kaiser Permanente of Colorado developed the Clinical Pharmacy Cardiac Risk Service (CPCRS) to focus on the long-term management of patients with CAD to improve clinical outcomes. The primary goals of the CPCRS are to increase the number of CAD patients on lipid-lowering therapy, manage medications shown to decrease the risk of future CAD-related events, assist in the monitoring and control of other diseases that increase cardiovascular risk, provide patient education and recommendations for nonpharmacologic therapy, and act as a CAD information resource for physicians and other health care providers. Using an electronic medical record and tracking database, the service works in close collaboration with primary care physicians, cardiologists, cardiac rehabilitation nurses, and other health care providers to reduce cardiac risk in the CAD population. Particular attention is given to dyslipidemia, blood pressure, diabetes mellitus, and tobacco cessation. Treatment with evidence-based regimens is initiated and adjusted as necessary. Over 11,000 patients are currently being followed by the CPCRS. A clinical pharmacy service in a large health maintenance organization provides cardiac risk reduction for patients with CAD and helps close treatment gaps that may exist for these patients.

Effectiveness of Case Management for 'At Risk' Patients in Primary Care: A Systematic Review and Meta-Analysis.

PubMed

Stokes, Jonathan; Panagioti, Maria; Alam, Rahul; Checkland, Kath; Cheraghi-Sohi, Sudeh; Bower, Peter

2015-01-01

An ageing population with multimorbidity is putting pressure on health systems. A popular method of managing this pressure is identification of patients in primary care 'at-risk' of hospitalisation, and delivering case management to improve outcomes and avoid admissions. However, the effectiveness of this model has not been subjected to rigorous quantitative synthesis. We carried out a systematic review and meta-analysis of the effectiveness of case management for 'at-risk' patients in primary care. Six bibliographic databases were searched using terms for 'case management', 'primary care', and a methodology filter (Cochrane EPOC group). Effectiveness compared to usual care was measured across a number of relevant outcomes: Health--self-assessed health status, mortality; Cost--total cost of care, healthcare utilisation (primary and non-specialist care and secondary care separately), and; Satisfaction--patient satisfaction. We conducted secondary subgroup analyses to assess whether effectiveness was moderated by the particular model of case management, context, and study design. A total of 15,327 titles and abstracts were screened, 36 unique studies were included. Meta-analyses showed no significant differences in total cost, mortality, utilisation of primary or secondary care. A very small significant effect favouring case management was found for self-reported health status in the short-term (0.07, 95% CI 0.00 to 0.14). A small significant effect favouring case management was found for patient satisfaction in the short- (0.26, 0.16 to 0.36) and long-term (0.35, 0.04 to 0.66). Secondary subgroup analyses suggested the effectiveness of case management may be increased when delivered by a multidisciplinary team, when a social worker was involved, and when delivered in a setting rated as low in initial 'strength' of primary care. This was the first meta-analytic review which examined the effects of case management on a wide range of outcomes and considered also the effects of key moderators. Current results do not support case management as an effective model, especially concerning reduction of secondary care use or total costs. We consider reasons for lack of effect and highlight key research questions for the future. The review protocol is available as part of the PROSPERO database (registration number: CRD42014010824).

Pathobiology and management of laboratory rodents administered CDC category A agents.

PubMed

He, Yongqun; Rush, Howard G; Liepman, Rachel S; Xiang, Zuoshuang; Colby, Lesley A

2007-02-01

The Centers for Disease Control and Prevention Category A infectious agents include Bacillus anthracis (anthrax), Clostridium botulinum toxin (botulism), Yersinia pestis (plague), variola major virus (smallpox), Francisella tularensis (tularemia), and the filoviruses and arenaviruses that induce viral hemorrhagic fevers. These agents are regarded as having the greatest potential for adverse impact on public health and therefore are a focus of renewed attention in infectious disease research. Frequently rodent models are used to study the pathobiology of these agents. Although much is known regarding naturally occurring infections in humans, less is documented on the sources of exposures and potential risks of infection to researchers and animal care personnel after the administration of these hazardous substances to laboratory animals. Failure to appropriately manage the animals can result both in the creation of workplace hazards if human exposures occur and in disruption of the research if unintended animal exposures occur. Here we review representative Category A agents, with a focus on comparing the biologic effects in naturally infected humans and rodent models and on considerations specific to the management of infected rodent subjects. The information reviewed for each agent has been curated manually and stored in a unique Internet-based database system called HazARD (Hazards in Animal Research Database, http://helab.bioinformatics.med.umich.edu/hazard/) that is designed to assist researchers, administrators, safety officials, Institutional Biosafety Committees, and veterinary personnel seeking information on the management of risks associated with animal studies involving hazardous substances.

TWRS technical baseline database manager definition document

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

Acree, C.D.

1997-08-13

This document serves as a guide for using the TWRS Technical Baseline Database Management Systems Engineering (SE) support tool in performing SE activities for the Tank Waste Remediation System (TWRS). This document will provide a consistent interpretation of the relationships between the TWRS Technical Baseline Database Management software and the present TWRS SE practices. The Database Manager currently utilized is the RDD-1000 System manufactured by the Ascent Logic Corporation. In other documents, the term RDD-1000 may be used interchangeably with TWRS Technical Baseline Database Manager.

How effective are risk assessments/measures for predicting future aggressive behaviour in adults with intellectual disabilities (ID): A systematic review and meta-analysis.

PubMed

Lofthouse, Rachael; Golding, Laura; Totsika, Vasiliki; Hastings, Richard; Lindsay, William

2017-12-01

Risk assessments assist professionals in the identification and management of risk of aggression. The present study aimed to systematically review evidence on the efficacy of assessments for managing the risk of physical aggression in adults with intellectual disabilities (ID). A literature search was conducted using the databases PsycINFO, EMBASE, MEDLINE, Web of Science, and Google Scholar. Electronic and hand searches identified 14 studies that met the inclusion criteria. Standardised mean difference effect sizes Area Under Curve (AUC) were calculated for studies. Random effects subgroup analysis was used to compare different types of risk measures (Actuarial, Structured Professional Judgment and dynamic), and prospective vs. catch-up longitudinal study designs. Overall, evidence of predictive validity was found for risk measures with ID populations: (AUC)=0.724, 95% CI [0.681, 0.768]. There was no variation in the performance of different types of risk measures, or different study design. Risk assessment measures predict the likelihood of aggression in ID population and are comparable to those in mainstream populations. Further meta-analysis is necessary when risk measures are more established in this population. Copyright © 2017 Elsevier Ltd. All rights reserved.

Design and implementation of a fault-tolerant and dynamic metadata database for clinical trials

NASA Astrophysics Data System (ADS)

Lee, J.; Zhou, Z.; Talini, E.; Documet, J.; Liu, B.

2007-03-01

In recent imaging-based clinical trials, quantitative image analysis (QIA) and computer-aided diagnosis (CAD) methods are increasing in productivity due to higher resolution imaging capabilities. A radiology core doing clinical trials have been analyzing more treatment methods and there is a growing quantity of metadata that need to be stored and managed. These radiology centers are also collaborating with many off-site imaging field sites and need a way to communicate metadata between one another in a secure infrastructure. Our solution is to implement a data storage grid with a fault-tolerant and dynamic metadata database design to unify metadata from different clinical trial experiments and field sites. Although metadata from images follow the DICOM standard, clinical trials also produce metadata specific to regions-of-interest and quantitative image analysis. We have implemented a data access and integration (DAI) server layer where multiple field sites can access multiple metadata databases in the data grid through a single web-based grid service. The centralization of metadata database management simplifies the task of adding new databases into the grid and also decreases the risk of configuration errors seen in peer-to-peer grids. In this paper, we address the design and implementation of a data grid metadata storage that has fault-tolerance and dynamic integration for imaging-based clinical trials.

A Database of Historical Information on Landslides and Floods in Italy

NASA Astrophysics Data System (ADS)

Guzzetti, F.; Tonelli, G.

2003-04-01

For the past 12 years we have maintained and updated a database of historical information on landslides and floods in Italy, known as the National Research Council's AVI (Damaged Urban Areas) Project archive. The database was originally designed to respond to a specific request of the Minister of Civil Protection, and was aimed at helping the regional assessment of landslide and flood risk in Italy. The database was first constructed in 1991-92 to cover the period 1917 to 1990. Information of damaging landslide and flood event was collected by searching archives, by screening thousands of newspaper issues, by reviewing the existing technical and scientific literature on landslides and floods in Italy, and by interviewing landslide and flood experts. The database was then updated chiefly through the analysis of hundreds of newspaper articles, and it now covers systematically the period 1900 to 1998, and non-systematically the periods 1900 to 1916 and 1999 to 2002. Non systematic information on landslide and flood events older than 20th century is also present in the database. The database currently contains information on more than 32,000 landslide events occurred at more than 25,700 sites, and on more than 28,800 flood events occurred at more than 15,600 sites. After a brief outline of the history and evolution of the AVI Project archive, we present and discuss: (a) the present structure of the database, including the hardware and software solutions adopted to maintain, manage, use and disseminate the information stored in the database, (b) the type and amount of information stored in the database, including an estimate of its completeness, and (c) examples of recent applications of the database, including a web-based GIS systems to show the location of sites historically affected by landslides and floods, and an estimate of geo-hydrological (i.e., landslide and flood) risk in Italy based on the available historical information.

Evidence for Public Health Risks of Wastewater and Excreta Management Practices in Southeast Asia: A Scoping Review

PubMed Central

Lam, Steven; Nguyen-Viet, Hung; Tuyet-Hanh, Tran Thi; Nguyen-Mai, Huong; Harper, Sherilee

2015-01-01

The use of wastewater and excreta in agriculture is a common practice in Southeast Asia; however, concerns remain about the potential public health risks of this practice. We undertook a scoping review to examine the extent, range, and nature of literature, as well as synthesize the evidence for associations between wastewater and excreta management practices and public health risks in Southeast Asia. Three electronic databases (PubMed, CAB Direct, and Web of Science) were searched and a total of 27 relevant studies were included and evaluated. The available evidence suggested that possible occupational health risks of wastewater and excreta management practices include diarrhea, skin infection, parasitic infection, bacterial infection, and epilepsy. Community members can be at risk for adverse health outcomes through consuming contaminated fish, vegetables, or fruits. Results suggested that practices including handling, treatment, and use of waste may be harmful to human health, particularly farmer’s health. Many studies in this review, however, had limitations including lack of gender analyses, exposure assessment, and longitudinal study designs. These findings suggest that more studies on identifying, quantitatively assessing, and mitigating health risks are needed if sustainable benefits are to be obtained from wastewater and excreta reuse in agriculture in Southeast Asia. PMID:26501297

Development of a risk assessment tool for projecting individualized probabilities of developing breast cancer for Chinese women.

PubMed

Wang, Yuan; Gao, Ying; Battsend, Munkhzul; Chen, Kexin; Lu, Wenli; Wang, Yaogang

2014-11-01

The optimal approach regarding breast cancer screening for Chinese women is unclear due to the relative low incidence rate. A risk assessment tool may be useful for selection of high-risk subsets of population for mammography screening in low-incidence and resource-limited developing country. The odd ratios for six main risk factors of breast cancer were pooled by review manager after a systematic research of literature. Health risk appraisal (HRA) model was developed to predict an individual's risk of developing breast cancer in the next 5 years from current age. The performance of this HRA model was assessed based on a first-round screening database. Estimated risk of breast cancer increased with age. Increases in the 5-year risk of developing breast cancer were found with the existence of any of included risk factors. When individuals who had risk above median risk (3.3‰) were selected from the validation database, the sensitivity is 60.0% and the specificity is 47.8%. The unweighted area under the curve (AUC) was 0.64 (95% CI = 0.50-0.78). The risk-prediction model reported in this article is based on a combination of risk factors and shows good overall predictive power, but it is still weak at predicting which particular women will develop the disease. It would be very helpful for the improvement of a current model if more population-based prospective follow-up studies were used for the validation.

[Quality management and participation into clinical database].

PubMed

Okubo, Suguru; Miyata, Hiroaki; Tomotaki, Ai; Motomura, Noboru; Murakami, Arata; Ono, Minoru; Iwanaka, Tadashi

2013-07-01

Quality management is necessary for establishing useful clinical database in cooperation with healthcare professionals and facilities. The ways of management are 1) progress management of data entry, 2) liaison with database participants (healthcare professionals), and 3) modification of data collection form. In addition, healthcare facilities are supposed to consider ethical issues and information security for joining clinical databases. Database participants should check ethical review boards and consultation service for patients.

Ecological risk Evaluation and Green Infrastructure planning for coping with global climate change, a case study of Shanghai, China

NASA Astrophysics Data System (ADS)

Li, Pengyao; Xiao, He; Li, Xiang; Hu, Wenhao; Gu, Shoubai; Yu, Zhenrong

2018-01-01

Coping with various ecological risks caused by extreme weather events of global climate change has become an important issue in regional planning, and storm water management for sustainable development. In this paper, taking Shanghai, China as a case study, four potential ecological risks were identified including flood disaster, sea-source disaster, urban heat island effect, and land subsidence. Based on spatial database, the spatial variation of these four ecological risks was evaluated, and the planning area was divided into seven responding regions with different green infrastructure strategy. The methodology developed in this study combining ecological risk evaluation with spatial regionalization planning could contribute to coping with global climate change.

Software for pest-management science: computer models and databases from the United States Department of Agriculture-Agricultural Research Service.

PubMed

Wauchope, R Don; Ahuja, Lajpat R; Arnold, Jeffrey G; Bingner, Ron; Lowrance, Richard; van Genuchten, Martinus T; Adams, Larry D

2003-01-01

We present an overview of USDA Agricultural Research Service (ARS) computer models and databases related to pest-management science, emphasizing current developments in environmental risk assessment and management simulation models. The ARS has a unique national interdisciplinary team of researchers in surface and sub-surface hydrology, soil and plant science, systems analysis and pesticide science, who have networked to develop empirical and mechanistic computer models describing the behavior of pests, pest responses to controls and the environmental impact of pest-control methods. Historically, much of this work has been in support of production agriculture and in support of the conservation programs of our 'action agency' sister, the Natural Resources Conservation Service (formerly the Soil Conservation Service). Because we are a public agency, our software/database products are generally offered without cost, unless they are developed in cooperation with a private-sector cooperator. Because ARS is a basic and applied research organization, with development of new science as our highest priority, these products tend to be offered on an 'as-is' basis with limited user support except for cooperating R&D relationship with other scientists. However, rapid changes in the technology for information analysis and communication continually challenge our way of doing business.

Method ranks competing projects by priorities, risk. [A method to help prioritize oil and gas pipeline project goals

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

Moeckel, D.R.

A practical, objective guide for ranking projects based on risk-based priorities has been developed by Sun Pipe Line Co. The deliberately simple system guides decisions on how to allocate scarce company resources because all managers employ the same criteria in weighing potential risks to the company versus benefits. Managers at all levels are continuously having to comply with an ever growing amount of legislative and regulatory requirements while at the same time trying to run their businesses effectively. The system primarily is designed for use as a compliance oversight and tracking process to document, categorize, and follow-up on work concerningmore » various issues or projects. That is, the system consists of an electronic database which is updated periodically, and is used by various levels of management to monitor progress of health, safety, environmental and compliance-related projects. Criteria used in determining a risk factor and assigning a priority also have been adapted and found useful for evaluating other types of projects. The process enables management to better define potential risks and/or loss of benefits that are being accepted when a project is rejected from an immediate work plan or budget. In times of financial austerity, it is extremely important that the right decisions are made at the right time.« less

Theater Blood Application Was Not Effectively Developed and Implemented

DTIC Science & Technology

2015-07-17

blood product by unit; and • monitor non- Food and Drug Administration Blood Product Testing. The CONOPS document also identified over 400 specific...time of a transfusion. However, this requirement was not identified in the CONOPS document. Further, PEO DHCS officials provided a traceability ...the CONOPS document, requirements management database, and the traceability matrix increased the risk that the Theater Blood Application

A spatial database for restoration management capability on national forests in the Pacific Northwest USA

Treesearch

Chris Ringo; Alan A. Ager; Michelle A. Day; Sarah Crim

2016-01-01

Understanding the capacity to reduce wildfire risk and restore dry forests on Western national forests is a key part of prioritizing new accelerated restoration programs initiated by the Forest Service. Although a number of social and biophysical factors influence the ability to implement restoration programs, one key driver is the suite of forest plan land...

Rapid development of entity-based data models for bioinformatics with persistence object-oriented design and structured interfaces.

PubMed

Ezra Tsur, Elishai

2017-01-01

Databases are imperative for research in bioinformatics and computational biology. Current challenges in database design include data heterogeneity and context-dependent interconnections between data entities. These challenges drove the development of unified data interfaces and specialized databases. The curation of specialized databases is an ever-growing challenge due to the introduction of new data sources and the emergence of new relational connections between established datasets. Here, an open-source framework for the curation of specialized databases is proposed. The framework supports user-designed models of data encapsulation, objects persistency and structured interfaces to local and external data sources such as MalaCards, Biomodels and the National Centre for Biotechnology Information (NCBI) databases. The proposed framework was implemented using Java as the development environment, EclipseLink as the data persistency agent and Apache Derby as the database manager. Syntactic analysis was based on J3D, jsoup, Apache Commons and w3c.dom open libraries. Finally, a construction of a specialized database for aneurysms associated vascular diseases is demonstrated. This database contains 3-dimensional geometries of aneurysms, patient's clinical information, articles, biological models, related diseases and our recently published model of aneurysms' risk of rapture. Framework is available in: http://nbel-lab.com.

Clinical management of iron deficiency anemia in adults: Systemic review on advances in diagnosis and treatment.

PubMed

De Franceschi, Lucia; Iolascon, Achille; Taher, Ali; Cappellini, Maria Domenica

2017-07-01

Global burden disease studies point out that one of the top cause-specific anemias is iron deficiency (ID). Recent advances in knowledge of iron homeostasis have shown that fragile patients are a new target population in which the correction of ID might impact their morbidity, mortality and quality of life. We did a systematic review using specific search strategy, carried out the review of PubMed database, Cochrane Database of systemic reviews and international guidelines on diagnosis and clinical management of ID from 2010 to 2016. The International guidelines were limited to those with peer-review process and published in journal present in citation index database. The eligible studies show that serum ferritin and transferrin saturation are the key tests in early decision-making process to identify iron deficiency anemia (IDA). The clinician has to carefully consider fragile and high-risk subset of patients such as elders or individuals with chronic diseases (i.e chronic kidney disease, inflammatory bowel disease, chronic heart failure). Treatment is based on iron supplementation. Infusion route should be preferentially considered in frail patients especially in the view of new iron available formulations. The available evidences indicate that (i) recurrent IDA should always be investigated, considering uncommon causes; (ii) IDA might worse the performance and the clinical outcome of fragile and high-risk patients and require an intensive treatment. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Short Fiction on Film: A Relational DataBase.

ERIC Educational Resources Information Center

May, Charles

Short Fiction on Film is a database that was created and will run on DataRelator, a relational database manager created by Bill Finzer for the California State Department of Education in 1986. DataRelator was designed for use in teaching students database management skills and to provide teachers with examples of how a database manager might be…

47 CFR 0.241 - Authority delegated.

Code of Federal Regulations, 2012 CFR

2012-10-01

... database functions for unlicensed devices operating in the television broadcast bands (TV bands) as set... methods that will be used to designate TV bands database managers, to designate these database managers; to develop procedures that these database managers will use to ensure compliance with the...

47 CFR 0.241 - Authority delegated.

Code of Federal Regulations, 2013 CFR

2013-10-01

... database functions for unlicensed devices operating in the television broadcast bands (TV bands) as set... methods that will be used to designate TV bands database managers, to designate these database managers; to develop procedures that these database managers will use to ensure compliance with the...

47 CFR 0.241 - Authority delegated.

Code of Federal Regulations, 2011 CFR

2011-10-01

... database functions for unlicensed devices operating in the television broadcast bands (TV bands) as set... methods that will be used to designate TV bands database managers, to designate these database managers; to develop procedures that these database managers will use to ensure compliance with the...

[From biodiversity to biodiversification: a new economy of nature?].

PubMed

Höhler, Sabine

2014-03-01

This paper explores the relations between economy and ecology in the last quarter of the 20th century with the example of biodiversity. From its definition in the 1980s, the concept of biodiversity responded not only to conservational concerns but also to hopes and demands of economic profitability. The paper argues that archival systems of inventorying and surveying nature, the biodiversity database and the biodiversity portfolio, changed the view on nature from a resource to an investment. The paper studies the alliances of ecologists and environmental economists in managing nature according to economic principles of successful asset management, "diversification", with the aim to distribute risk, minimize ecological loss and maximize overall ecosystem performance. Finally, the paper discusses the assumptions and the consequences of transferring principles from financial risk management to landscape management. How has the substitution of the existential values of nature by shareholder value affected the relations between ecology, environment, and ecosystem conservation? Who gains and who looses in exchanging natural capital and financial capital, yields, and profits?

Emissions & Measurements - Black Carbon | Science ...

EPA Pesticide Factsheets

Emissions and Measurement (EM) research activities performed within the National Risk Management Research Lab NRMRL) of EPA's Office of Research and Development (ORD) support measurement and laboratory analysis approaches to accurately characterize source emissions, and near source concentrations of air pollutants. They also support integrated Agency research programs (e.g., source to health outcomes) and the development of databases and inventories that assist Federal, state, and local air quality managers and industry implement and comply with air pollution standards. EM research underway in NRMRL supports the Agency's efforts to accurately characterize, analyze, measure and manage sources of air pollution. This pamphlet focuses on the EM research that NRMRL researchers conduct related to black carbon (BC). Black Carbon is a pollutant of concern to EPA due to its potential impact on human health and climate change. There are extensive uncertainties in emissions of BC from stationary and mobile sources. Emissions and Measurement (EM) research activities performed within the National Risk Management Research Lab NRMRL) of EPA's Office of Research and Development (ORD)

Integrative medicine for managing the symptoms of lupus nephritis

PubMed Central

Choi, Tae-Young; Jun, Ji Hee; Lee, Myeong Soo

2018-01-01

Abstract Background: Integrative medicine is claimed to improve symptoms of lupus nephritis. No systematic reviews have been performed for the application of integrative medicine for lupus nephritis on patients with systemic lupus erythematosus (SLE). Thus, this review will aim to evaluate the current evidence on the efficacy of integrative medicine for the management of lupus nephritis in patients with SLE. Methods and analyses: The following electronic databases will be searched for studies published from their dates of inception February 2018: Medline, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL), as well as 6 Korean medical databases (Korea Med, the Oriental Medicine Advanced Search Integrated System [OASIS], DBpia, the Korean Medical Database [KM base], the Research Information Service System [RISS], and the Korean Studies Information Services System [KISS]), and 1 Chinese medical database (the China National Knowledge Infrastructure [CNKI]). Study selection, data extraction, and assessment will be performed independently by 2 researchers. The risk of bias (ROB) will be assessed using the Cochrane ROB tool. Dissemination: This systematic review will be published in a peer-reviewed journal and disseminated both electronically and in print. The review will be updated to inform and guide healthcare practice and policy. Trial registration number: PROSPERO 2018 CRD42018085205 PMID:29595669

Failure Modes and Effects Analysis (FMEA): A Bibliography

NASA Technical Reports Server (NTRS)

2000-01-01

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

Updated Palaeotsunami Database for Aotearoa/New Zealand

NASA Astrophysics Data System (ADS)

Gadsby, M. R.; Goff, J. R.; King, D. N.; Robbins, J.; Duesing, U.; Franz, T.; Borrero, J. C.; Watkins, A.

2016-12-01

The updated configuration, design, and implementation of a national palaeotsunami (pre-historic tsunami) database for Aotearoa/New Zealand (A/NZ) is near completion. This tool enables correlation of events along different stretches of the NZ coastline, provides information on frequency and extent of local, regional and distant-source tsunamis, and delivers detailed information on the science and proxies used to identify the deposits. In A/NZ a plethora of data, scientific research and experience surrounds palaeotsunami deposits, but much of this information has been difficult to locate, has variable reporting standards, and lacked quality assurance. The original database was created by Professor James Goff while working at the National Institute of Water & Atmospheric Research in A/NZ, but has subsequently been updated during his tenure at the University of New South Wales. The updating and establishment of the national database was funded by the Ministry of Civil Defence and Emergency Management (MCDEM), led by Environment Canterbury Regional Council, and supported by all 16 regions of A/NZ's local government. Creation of a single database has consolidated a wide range of published and unpublished research contributions from many science providers on palaeotsunamis in A/NZ. The information is now easily accessible and quality assured and allows examination of frequency, extent and correlation of events. This provides authoritative scientific support for coastal-marine planning and risk management. The database will complement the GNS New Zealand Historical Database, and contributes to a heightened public awareness of tsunami by being a "one-stop-shop" for information on past tsunami impacts. There is scope for this to become an international database, enabling the pacific-wide correlation of large events, as well as identifying smaller regional ones. The Australian research community has already expressed an interest, and the database is also compatible with a similar one currently under development in Japan. Expressions of interest in collaborating with the A/NZ team to expand the database are invited from other Pacific nations.

Development of an electronic database for Acute Pain Service outcomes

PubMed Central

Love, Brandy L; Jensen, Louise A; Schopflocher, Donald; Tsui, Ban CH

2012-01-01

BACKGROUND: Quality assurance is increasingly important in the current health care climate. An electronic database can be used for tracking patient information and as a research tool to provide quality assurance for patient care. OBJECTIVE: An electronic database was developed for the Acute Pain Service, University of Alberta Hospital (Edmonton, Alberta) to record patient characteristics, identify at-risk populations, compare treatment efficacies and guide practice decisions. METHOD: Steps in the database development involved identifying the goals for use, relevant variables to include, and a plan for data collection, entry and analysis. Protocols were also created for data cleaning quality control. The database was evaluated with a pilot test using existing data to assess data collection burden, accuracy and functionality of the database. RESULTS: A literature review resulted in an evidence-based list of demographic, clinical and pain management outcome variables to include. Time to assess patients and collect the data was 20 min to 30 min per patient. Limitations were primarily software related, although initial data collection completion was only 65% and accuracy of data entry was 96%. CONCLUSIONS: The electronic database was found to be relevant and functional for the identified goals of data storage and research. PMID:22518364

Microcomputer Database Management Systems for Bibliographic Data.

ERIC Educational Resources Information Center

Pollard, Richard

1986-01-01

Discusses criteria for evaluating microcomputer database management systems (DBMS) used for storage and retrieval of bibliographic data. Two popular types of microcomputer DBMS--file management systems and relational database management systems--are evaluated with respect to these criteria. (Author/MBR)

The Data Base and Decision Making in Public Schools.

ERIC Educational Resources Information Center

Hedges, William D.

1984-01-01

Describes generic types of databases--file management systems, relational database management systems, and network/hierarchical database management systems--with their respective strengths and weaknesses; discusses factors to be considered in determining whether a database is desirable; and provides evaluative criteria for use in choosing…

47 CFR 52.101 - General definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Center (“NASC”). The entity that provides user support for the Service Management System database and administers the Service Management System database on a day-to-day basis. (b) Responsible Organization (“Resp... regional databases in the toll free network. (d) Service Management System Database (“SMS Database”). The...

47 CFR 52.101 - General definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Center (“NASC”). The entity that provides user support for the Service Management System database and administers the Service Management System database on a day-to-day basis. (b) Responsible Organization (“Resp... regional databases in the toll free network. (d) Service Management System Database (“SMS Database”). The...

47 CFR 52.101 - General definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Center (“NASC”). The entity that provides user support for the Service Management System database and administers the Service Management System database on a day-to-day basis. (b) Responsible Organization (“Resp... regional databases in the toll free network. (d) Service Management System Database (“SMS Database”). The...

47 CFR 52.101 - General definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Center (“NASC”). The entity that provides user support for the Service Management System database and administers the Service Management System database on a day-to-day basis. (b) Responsible Organization (“Resp... regional databases in the toll free network. (d) Service Management System Database (“SMS Database”). The...

47 CFR 52.101 - General definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Center (“NASC”). The entity that provides user support for the Service Management System database and administers the Service Management System database on a day-to-day basis. (b) Responsible Organization (“Resp... regional databases in the toll free network. (d) Service Management System Database (“SMS Database”). The...

47 CFR 0.241 - Authority delegated.

Code of Federal Regulations, 2014 CFR

2014-10-01

... individual database managers; and to perform other functions as needed for the administration of the TV bands... database functions for unlicensed devices operating in the television broadcast bands (TV bands) as set... methods that will be used to designate TV bands database managers, to designate these database managers...

MERINOVA: Meteorological risks as drivers of environmental innovation in agro-ecosystem management

NASA Astrophysics Data System (ADS)

Gobin, Anne; Oger, Robert; Marlier, Catherine; Van De Vijver, Hans; Vandermeulen, Valerie; Van Huylenbroeck, Guido; Zamani, Sepideh; Curnel, Yannick; Mettepenningen, Evi

2013-04-01

The BELSPO funded project 'MERINOVA' deals with risks associated with extreme weather phenomena and with risks of biological origin such as pests and diseases. The major objectives of the proposed project are to characterise extreme meteorological events, assess the impact on Belgian agro-ecosystems, characterise their vulnerability and resilience to these events, and explore innovative adaptation options to agricultural risk management. The project comprises of five major parts that reflect the chain of risks: (i) Hazard: Assessing the likely frequency and magnitude of extreme meteorological events by means of probability density functions; (ii) Impact: Analysing the potential bio-physical and socio-economic impact of extreme weather events on agro-ecosystems in Belgium using process-based modelling techniques commensurate with the regional scale; (iii) Vulnerability: Identifying the most vulnerable agro-ecosystems using fuzzy multi-criteria and spatial analysis; (iv) Risk Management: Uncovering innovative risk management and adaptation options using actor-network theory and fuzzy cognitive mapping techniques; and, (v) Communication: Communicating to research, policy and practitioner communities using web-based techniques. The different tasks of the MERINOVA project require expertise in several scientific disciplines: meteorology, statistics, spatial database management, agronomy, bio-physical impact modelling, socio-economic modelling, actor-network theory, fuzzy cognitive mapping techniques. These expertises are shared by the four scientific partners who each lead one work package. The MERINOVA project will concentrate on promoting a robust and flexible framework by demonstrating its performance across Belgian agro-ecosystems, and by ensuring its relevance to policy makers and practitioners. Impacts developed from physically based models will not only provide information on the state of the damage at any given time, but also assist in understanding the links between different factors causing damage and determining bio-physical vulnerability. Socio-economic impacts will enlarge the basis for vulnerability mapping, risk management and adaptation options. A strong expert and end-user network will be established to help disseminating and exploiting project results to meet user needs.

Adolescent Asthma Self-Management: A Concept Analysis and Operational Definition.

PubMed

Mammen, Jennifer; Rhee, Hyekyun

2012-12-01

BACKGROUND: Adolescents with asthma have a higher risk of morbidity and mortality than other age groups. Asthma self-management has been shown to improve outcomes; however, the concept of asthma self-management is not explicitly defined. METHODS: We use the Norris method of concept clarification to delineate what constitutes the concept of asthma self-management in adolescents. Five databases were searched to identify components of the concept of adolescent asthma self-management, and lists of relevant subconcepts were compiled and categorized. RESULTS: Analysis revealed 4 specific domains of self-management behaviors: (1) symptom prevention; (2) symptom monitoring; (3) acute symptom management; and (4) communication with important others. These domains of self-management were mediated by intrapersonal/cognitive and interpersonal/contextual factors. CONCLUSIONS: Based on the analysis, we offer a research-based operational definition for adolescent asthma self-management and a preliminary model that can serve as a conceptual base for further research.

Use of labour induction and risk of cesarean delivery: a systematic review and meta-analysis

PubMed Central

Mishanina, Ekaterina; Rogozinska, Ewelina; Thatthi, Tej; Uddin-Khan, Rehan; Khan, Khalid S.; Meads, Catherine

2014-01-01

Background: Induction of labour is common, and cesarean delivery is regarded as its major complication. We conducted a systematic review and meta-analysis to investigate whether the risk of cesarean delivery is higher or lower following labour induction compared with expectant management. Methods: We searched 6 electronic databases for relevant articles published through April 2012 to identify randomized controlled trials (RCTs) in which labour induction was compared with placebo or expectant management among women with a viable singleton pregnancy. We assessed risk of bias and obtained data on rates of cesarean delivery. We used regression analysis techniques to explore the effect of patient characteristics, induction methods and study quality on risk of cesarean delivery. Results: We identified 157 eligible RCTs (n = 31 085). Overall, the risk of cesarean delivery was 12% lower with labour induction than with expectant management (pooled relative risk [RR] 0.88, 95% confidence interval [CI] 0.84–0.93; I2 = 0%). The effect was significant in term and post-term gestations but not in preterm gestations. Meta-regression analysis showed that initial cervical score, indication for induction and method of induction did not alter the main result. There was a reduced risk of fetal death (RR 0.50, 95% CI 0.25–0.99; I2 = 0%) and admission to a neonatal intensive care unit (RR 0.86, 95% CI 0.79–0.94), and no impact on maternal death (RR 1.00, 95% CI 0.10–9.57; I2 = 0%) with labour induction. Interpretation: The risk of cesarean delivery was lower among women whose labour was induced than among those managed expectantly in term and post-term gestations. There were benefits for the fetus and no increased risk of maternal death. PMID:24778358

Dynamic taxonomies applied to a web-based relational database for geo-hydrological risk mitigation

NASA Astrophysics Data System (ADS)

Sacco, G. M.; Nigrelli, G.; Bosio, A.; Chiarle, M.; Luino, F.

2012-02-01

In its 40 years of activity, the Research Institute for Geo-hydrological Protection of the Italian National Research Council has amassed a vast and varied collection of historical documentation on landslides, muddy-debris flows, and floods in northern Italy from 1600 to the present. Since 2008, the archive resources have been maintained through a relational database management system. The database is used for routine study and research purposes as well as for providing support during geo-hydrological emergencies, when data need to be quickly and accurately retrieved. Retrieval speed and accuracy are the main objectives of an implementation based on a dynamic taxonomies model. Dynamic taxonomies are a general knowledge management model for configuring complex, heterogeneous information bases that support exploratory searching. At each stage of the process, the user can explore or browse the database in a guided yet unconstrained way by selecting the alternatives suggested for further refining the search. Dynamic taxonomies have been successfully applied to such diverse and apparently unrelated domains as e-commerce and medical diagnosis. Here, we describe the application of dynamic taxonomies to our database and compare it to traditional relational database query methods. The dynamic taxonomy interface, essentially a point-and-click interface, is considerably faster and less error-prone than traditional form-based query interfaces that require the user to remember and type in the "right" search keywords. Finally, dynamic taxonomy users have confirmed that one of the principal benefits of this approach is the confidence of having considered all the relevant information. Dynamic taxonomies and relational databases work in synergy to provide fast and precise searching: one of the most important factors in timely response to emergencies.

Synthesis of common management concerns associated with dam removal

USGS Publications Warehouse

Tullos, Desiree D.; Collins, Mathias J.; Bellmore, J. Ryan; Bountry, Jennifer A.; Connolly, Patrick J.; Shafroth, Patrick B.; Wilcox, Andrew C.

2016-01-01

Managers make decisions regarding if and how to remove dams in spite of uncertainty surrounding physical and ecological responses, and stakeholders often raise concerns about certain negative effects, regardless of whether or not these concerns are warranted at a particular site. We used a dam-removal science database supplemented with other information sources to explore seven frequently-raised concerns, herein Common Management Concerns (CMCs). We investigate the occurrence of these concerns and the contributing biophysical controls. The CMCs addressed are: degree and rate of reservoir sediment erosion, excessive channel incision upstream of reservoirs, downstream sediment aggradation, elevated downstream turbidity, drawdown impacts on local water infrastructure, colonization of reservoir sediments by non-native plants, and expansion of invasive fish. Biophysical controls emerged for some of the concerns, providing managers with information to assess whether a given concern is likely to occur at a site. To fully assess CMC risk, managers should concurrently evaluate site conditions and identify the ecosystem or human uses that will be negatively affected if the biophysical phenomenon producing the CMC occurs. We show how many CMCs have one or more controls in common, facilitating the identification of multiple risks at a site, and demonstrate why CMC risks should be considered in the context of other factors like natural watershed variability and disturbance history.

Management of high-risk Myeloma: an evidence-based review of treatment strategies.

PubMed

Lehners, Nicola; Hayden, Patrick J; Goldschmidt, Hartmut; Raab, Marc-Steffen

2016-08-01

Despite the progress made in the treatment of patients with multiple myeloma over recent decades, a significant cohort with high-risk disease as defined by specific clinical and genetic criteria continue to respond poorly to standard treatment. These patients represent a particular challenge to the treating physician and require early identification as well as personalized treatment strategies. In this review, we discuss the prognostic impact of adverse clinical, radiological and genetic factors, evaluate available scoring systems and highlight key aspects of the therapeutic management of high-risk myeloma. MEDLINE and recent scientific meetings' databases were searched for the keywords 'high-risk' and 'multiple myeloma' and relevant studies relating to both diagnostic and therapeutic approaches were identified. Expert commentary: A case is made for intensive induction using combinations of novel agents, early high-dose therapy supported by autologous stem cell transplantation and the widespread use of maintenance therapies. Novel therapeutic options, especially in the field of immunotherapy, are currently explored in clinical trials and have the potential to further improve outcomes for patients with high-risk multiple myeloma.

Database Management Systems: New Homes for Migrating Bibliographic Records.

ERIC Educational Resources Information Center

Brooks, Terrence A.; Bierbaum, Esther G.

1987-01-01

Assesses bibliographic databases as part of visionary text systems such as hypertext and scholars' workstations. Downloading is discussed in terms of the capability to search records and to maintain unique bibliographic descriptions, and relational database management systems, file managers, and text databases are reviewed as possible hosts for…

23 CFR 970.204 - Management systems requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the management systems and their associated databases; and (5) A process for data collection, processing, analysis and updating for each management system. (d) All management systems will use databases with a geographical reference system that can be used to geolocate all database information. (e...

23 CFR 970.204 - Management systems requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... the management systems and their associated databases; and (5) A process for data collection, processing, analysis and updating for each management system. (d) All management systems will use databases with a geographical reference system that can be used to geolocate all database information. (e...

23 CFR 970.204 - Management systems requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the management systems and their associated databases; and (5) A process for data collection, processing, analysis and updating for each management system. (d) All management systems will use databases with a geographical reference system that can be used to geolocate all database information. (e...

Selecting Data-Base Management Software for Microcomputers in Libraries and Information Units.

ERIC Educational Resources Information Center

Pieska, K. A. O.

1986-01-01

Presents a model for the evaluation of database management systems software from the viewpoint of librarians and information specialists. The properties of data management systems, database management systems, and text retrieval systems are outlined and compared. (10 references) (CLB)

23 CFR 970.204 - Management systems requirements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... the management systems and their associated databases; and (5) A process for data collection, processing, analysis and updating for each management system. (d) All management systems will use databases with a geographical reference system that can be used to geolocate all database information. (e...

Construction of databases: advances and significance in clinical research.

PubMed

Long, Erping; Huang, Bingjie; Wang, Liming; Lin, Xiaoyu; Lin, Haotian

2015-12-01

Widely used in clinical research, the database is a new type of data management automation technology and the most efficient tool for data management. In this article, we first explain some basic concepts, such as the definition, classification, and establishment of databases. Afterward, the workflow for establishing databases, inputting data, verifying data, and managing databases is presented. Meanwhile, by discussing the application of databases in clinical research, we illuminate the important role of databases in clinical research practice. Lastly, we introduce the reanalysis of randomized controlled trials (RCTs) and cloud computing techniques, showing the most recent advancements of databases in clinical research.

Prognosis and management of myocardial infarction: Comparisons between the French FAST-MI 2010 registry and the French public health database.

PubMed

Massoullié, Grégoire; Wintzer-Wehekind, Jérome; Chenaf, Chouki; Mulliez, Aurélien; Pereira, Bruno; Authier, Nicolas; Eschalier, Alain; Clerfond, Guillaume; Souteyrand, Géraud; Tabassome, Simon; Danchin, Nicolas; Citron, Bernard; Lusson, Jean-René; Puymirat, Étienne; Motreff, Pascal; Eschalier, Romain

2016-05-01

Multicentre registries of myocardial infarction management show a steady improvement in prognosis and greater access to myocardial revascularization in a more timely manner. While French registries are the standard references, the question arises: are data stemming solely from the activity of French cardiac intensive care units (ICUs) a true reflection of the entire French population with ST-segment elevation myocardial infarction (STEMI)? To compare data on patients hospitalized for STEMI from two French registries: the French registry of acute ST-elevation or non-ST-elevation myocardial infarction (FAST-MI) and the Échantillon généraliste des bénéficiaires (EGB) database. We compared patients treated for STEMI listed in the FAST-MI 2010 registry (n=1716) with those listed in the EGB database, which comprises a sample of 1/97th of the French population, also from 2010 (n=403). Compared with the FAST-MI 2010 registry, the EGB database population were older (67.2±15.3 vs 63.3±14.5 years; P<0.001), had a higher percentage of women (36.0% vs 24.7%; P<0.001), were less likely to undergo emergency coronary angiography (75.2% vs 96.3%; P<0.001) and were less often treated in university hospitals (27.1% vs 37.0%; P=0.001). There were no significant differences between the two registries in terms of cardiovascular risk factors, comorbidities and drug treatment at admission. Thirty-day mortality was higher in the EGB database (10.2% vs 4.4%; P<0.001). Registries such as FAST-MI are indispensable, not only for assessing epidemiological changes over time, but also for evaluating the prognostic effect of modern STEMI management. Meanwhile, exploitation of data from general databases, such as EGB, provides additional relevant information, as they include a broader population not routinely admitted to cardiac ICUs. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

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

PubMed

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

2003-01-01

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

The management of menopause in women with a history of endometriosis: a systematic review

PubMed Central

Gemmell, L.C.; Webster, K.E.; Kirtley, S.; Vincent, K.; Zondervan, K.T.; Becker, C.M.

2017-01-01

Abstract BACKGROUND Endometriosis is typically regarded as a premenopausal disease, resolving after natural or iatrogenic menopause due to declining oestrogen levels. Nonetheless, case reports over the years have highlighted the incidence of recurrent postmenopausal endometriosis. It is now clear that both recurrence and malignant transformation of endometriotic foci can occur in the postmenopausal period. Postmenopausal women are commonly treated with hormone replacement therapy (HRT) to treat climacteric symptoms and prevent bone loss; however, HRT may reactivate endometriosis and stimulate malignant transformation in women with a history of endometriosis. Given the uncertain risks of initiating HRT, it is difficult to determine the best menopausal management for this group of women. OBJECTIVE AND RATIONAL The aim of this study was to systematically review the existing literature on management of menopausal symptoms in women with a history of endometriosis. We also aimed to evaluate the published literature on the risks associated with HRT in these women, and details regarding optimal formulations and timing (i.e. initiation and duration) of HRT. SEARCH METHODS Four electronic databases (MEDLINE via OVID, Embase via OVID, PsycINFO via OVID and CINAHL via EbscoHost) were searched from database inception until June 2016, using a combination of relevant controlled vocabulary terms and free-text terms related to ‘menopause’ and ‘endometriosis’. Inclusion criteria were: menopausal women with a history of endometriosis and menopausal treatment including HRT or other preparations. Case reports/series, observational studies and clinical trials were included. Narrative review articles, organizational guidelines and conference abstracts were excluded, as were studies that did not report on any form of menopausal management. Articles were assessed for risk of bias and quality using GRADE criteria. OUTCOMES We present a synthesis of the existing case reports of endometriosis recurrence or malignant transformation in women undergoing treatment for menopausal symptoms. We highlight common presenting symptoms, potential risk factors and outcomes amongst the studies. Sparse high-quality evidence was identified, with few observational studies and only two randomized controlled trials. Given this paucity of data, no definitive conclusions can be drawn concerning risk. WIDER IMPLICATIONS Due to the lack of high-quality studies, it remains unclear how to advise women with a history of endometriosis regarding the management of menopausal symptoms. The absolute risk of disease recurrence and malignant transformation cannot be quantified, and the impact of HRT use on these outcomes is not known. Multicentre randomized trials or large observational studies are urgently needed to inform clinicians and patients alike. PMID:28498913

The management of menopause in women with a history of endometriosis: a systematic review.

PubMed

Gemmell, L C; Webster, K E; Kirtley, S; Vincent, K; Zondervan, K T; Becker, C M

2017-07-01

Endometriosis is typically regarded as a premenopausal disease, resolving after natural or iatrogenic menopause due to declining oestrogen levels. Nonetheless, case reports over the years have highlighted the incidence of recurrent postmenopausal endometriosis. It is now clear that both recurrence and malignant transformation of endometriotic foci can occur in the postmenopausal period. Postmenopausal women are commonly treated with hormone replacement therapy (HRT) to treat climacteric symptoms and prevent bone loss; however, HRT may reactivate endometriosis and stimulate malignant transformation in women with a history of endometriosis. Given the uncertain risks of initiating HRT, it is difficult to determine the best menopausal management for this group of women. The aim of this study was to systematically review the existing literature on management of menopausal symptoms in women with a history of endometriosis. We also aimed to evaluate the published literature on the risks associated with HRT in these women, and details regarding optimal formulations and timing (i.e. initiation and duration) of HRT. Four electronic databases (MEDLINE via OVID, Embase via OVID, PsycINFO via OVID and CINAHL via EbscoHost) were searched from database inception until June 2016, using a combination of relevant controlled vocabulary terms and free-text terms related to 'menopause' and 'endometriosis'. Inclusion criteria were: menopausal women with a history of endometriosis and menopausal treatment including HRT or other preparations. Case reports/series, observational studies and clinical trials were included. Narrative review articles, organizational guidelines and conference abstracts were excluded, as were studies that did not report on any form of menopausal management. Articles were assessed for risk of bias and quality using GRADE criteria. We present a synthesis of the existing case reports of endometriosis recurrence or malignant transformation in women undergoing treatment for menopausal symptoms. We highlight common presenting symptoms, potential risk factors and outcomes amongst the studies. Sparse high-quality evidence was identified, with few observational studies and only two randomized controlled trials. Given this paucity of data, no definitive conclusions can be drawn concerning risk. Due to the lack of high-quality studies, it remains unclear how to advise women with a history of endometriosis regarding the management of menopausal symptoms. The absolute risk of disease recurrence and malignant transformation cannot be quantified, and the impact of HRT use on these outcomes is not known. Multicentre randomized trials or large observational studies are urgently needed to inform clinicians and patients alike. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology.

Towards AN Inventory for Archaeological Heritage Management in Israel

NASA Astrophysics Data System (ADS)

Alef, Y.

2017-08-01

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

[The future of clinical laboratory database management system].

PubMed

Kambe, M; Imidy, D; Matsubara, A; Sugimoto, Y

1999-09-01

To assess the present status of the clinical laboratory database management system, the difference between the Clinical Laboratory Information System and Clinical Laboratory System was explained in this study. Although three kinds of database management systems (DBMS) were shown including the relational model, tree model and network model, the relational model was found to be the best DBMS for the clinical laboratory database based on our experience and developments of some clinical laboratory expert systems. As a future clinical laboratory database management system, the IC card system connected to an automatic chemical analyzer was proposed for personal health data management and a microscope/video system was proposed for dynamic data management of leukocytes or bacteria.

Assessment of iron deficiency and anemia in pregnant women: an observational French study.

PubMed

Harvey, Thierry; Zkik, Asmaa; Auges, Marie; Clavel, Thierry

2016-01-01

We explored the prevalence and management of iron deficiency and anemia among pregnant women in France. In this prospective, observational, multicenter registry study, randomly selected investigators (gynecologists/obstetricians/midwives registered in the CEGEDIM(®) database) assessed pregnant women presenting for a consultation. Participants completed a questionnaire at study inclusion. A total of 1506 patients were enrolled by 95 investigators. Overall, investigators estimated a moderate or significant risk of iron deficiency in almost 60% of women. The overall prevalence of anemia (15.8%) increased with longer pregnancy duration. Medication (mainly iron-based) was prescribed to 57.3% of patients. In French clinical practice, the estimated risk of iron deficiency and prevalence of anemia during pregnancy align with expectations and are managed according to national/international recommendations.

23 CFR 971.204 - Management systems requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... maintain the management systems and their associated databases; and (5) A process for data collection, processing, analysis, and updating for each management system. (c) All management systems will use databases with a common or coordinated reference system, that can be used to geolocate all database information...

23 CFR 971.204 - Management systems requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... maintain the management systems and their associated databases; and (5) A process for data collection, processing, analysis, and updating for each management system. (c) All management systems will use databases with a common or coordinated reference system, that can be used to geolocate all database information...

23 CFR 971.204 - Management systems requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... maintain the management systems and their associated databases; and (5) A process for data collection, processing, analysis, and updating for each management system. (c) All management systems will use databases with a common or coordinated reference system, that can be used to geolocate all database information...

23 CFR 971.204 - Management systems requirements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... maintain the management systems and their associated databases; and (5) A process for data collection, processing, analysis, and updating for each management system. (c) All management systems will use databases with a common or coordinated reference system, that can be used to geolocate all database information...

Information Management Tools for Classrooms: Exploring Database Management Systems. Technical Report No. 28.

ERIC Educational Resources Information Center

Freeman, Carla; And Others

In order to understand how the database software or online database functioned in the overall curricula, the use of database management (DBMs) systems was studied at eight elementary and middle schools through classroom observation and interviews with teachers and administrators, librarians, and students. Three overall areas were addressed:…

78 FR 28756 - Defense Federal Acquisition Regulation Supplement: System for Award Management Name Changes...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

... Excluded Parties Listing System (EPLS) databases into the System for Award Management (SAM) database. DATES... combined the functional capabilities of the CCR, ORCA, and EPLS procurement systems into the SAM database... identification number and the type of organization from the System for Award Management database. 0 3. Revise the...

An Examination of Selected Software Testing Tools: 1992

DTIC Science & Technology

1992-12-01

Report ....................................................... 27-19 Figure 27-17. Metrics Manager Database Full Report...historical test database , the test management and problem reporting tools were examined using the sample test database provided by each supplier. 4-4...track the impact of new methods, organi- zational structures, and technologies. Metrics Manager is supported by an industry database that allows

Understanding youthful risk taking and driving : database report

DOT National Transportation Integrated Search

1995-11-01

This report catalogs national databases that contain information about adolescents and risk taking behaviors. It contains descriptions of the major areas, unique characteristics, and risk-related aspects of each database. Detailed information is prov...

Understanding Youthful Risk Taking and Driving: Database Report

DOT National Transportation Integrated Search

1995-11-01

This report catalogs national databases that contain information about adolescents and risk taking behaviors. It contains descriptions of the major areas, unique characteristics, and risk-related aspects of each database. Detailed information is prov...

National Levee Database: monitoring, vulnerability assessment and management in Italy

NASA Astrophysics Data System (ADS)

Barbetta, Silvia; Camici, Stefania; Maccioni, Pamela; Moramarco, Tommaso

2015-04-01

A properly designed and constructed levees system can often be an effective device for repelling floodwaters and provide barriers against inundation to protect urbanized and industrial areas. However, the delineation of flooding-prone areas and the related hydraulic hazard mapping taking account of uncertainty (Apel et al., 2008) are usually developed with a scarce consideration of the possible occurrence of levee failures along river channels (Mazzoleni et al., 2014). Indeed, it is well known that flooding is frequently the result of levee failures that can be triggered by several factors, as: (1) overtopping, (2) scouring of the foundation, (3) seepage/piping of levee body/foundation, and (4) sliding of the foundation. Among these failure mechanisms that are influenced by the levee's geometrical configuration, hydraulic conditions (e.g. river level and seepage), and material properties (e.g. permeability, cohesion, porosity, compaction), the piping caused by seepage (ICOLD, http://www.icold-cigb.org) is considered one of the most dominant levee failure mechanisms (Colleselli F., 1994; Wallingford H. R., 2003). The difficulty of estimating the hydraulic parameters to properly describe the seepage line within the body and foundation of the levee implies that the study of the critical flood wave routing is typically carried out by assuming that the levee system is undamaged during the flood event. In this context, implementing and making operational a National Levee Database (NLD), effectively structured and continuously updated, becomes fundamental to have a searchable inventory of information about levees available as a key resource supporting decisions and actions affecting levee safety. The ItaliaN LEvee Database (INLED) has been recently developed by the Research Institute for Geo-Hydrological Protection (IRPI) for the Civil Protection Department of the Presidency of Council of Ministers. INLED has the main focus of collecting comprehensive information about Italian levees and historical breach failures to be exploited in the framework of an operational procedure addressed to the seepage vulnerability assessment of river reaches where the levee system is an important structural measure against flooding. For its structure, INLED is a dynamic geospatial database with ongoing efforts to add levee data from authorities with the charge of hydraulic risk mitigation. In particular, the database is aimed to provide the available information about: i) location and condition of levees; ii) morphological and geometrical properties; iii) photographic documentation; iv) historical levee failures; v) assessment of vulnerability to overtopping and seepage carried out through a procedure based on simple vulnerability indexes (Camici et al. 2014); vi) management, control and maintenance; vii)flood hazard maps developed by assuming the levee system undamaged/damaged during the flood event. Currently, INLED contains data of levees that are mostly located in the Tiber basin, Central Italy. References Apel H., Merz B. & Thieken A.H. Quantification of uncertainties in flood risk assessments. Int J River Basin Manag 2008, 6, (2), 149-162. Camici S,, Barbetta S., Moramarco T., Levee body vulnerability to seepage: the case study of the levee failure along the Foenna stream on 1st January 2006 (central Italy)", Journal of Flood Risk Management, in press. Colleselli F. Geotechnical problems related to river and channel embankments. Rotterdam, the Netherlands: Springer, 1994. H. R.Wallingford Consultants (HRWC). Risk assessment for flood and coastal defence for strategic planning: high level methodology technical report, London, 2003. Mazzoleni M., Bacchi B., Barontini S., Di Baldassarre G., Pilotti M. & Ranzi R. Flooding hazard mapping in floodplain areas affected by piping breaches in the Po River, Italy. J Hydrol Eng 2014, 19, (4), 717-731.

The past, present and perhaps future of pharmacovigilance: homage to Folke Sjoqvist.

PubMed

Moore, Nicholas

2013-05-01

Over the years since 1961 and the identification of thalidomide as the common link in thousands of birth defects, daily pharmacovigilance activities and signal generation have evolved from the analysis of individual case reports and imputology, to case series and underreporting, to spontaneous report databases and disproportionality analyses, to data mining in population databases. Regulatory requirements have also changed from purely passive monitoring and reacting to alerts to a proactive approach that includes risk management plans and risk minimization, and from reporting only by healthcare professionals to patient reporting and exploration of social media. The emphasis only on risk assessment is changing towards assessment of the risk/benefit ratio and the exploration of real-life efficacy studies to complement the measure of real-life risk. The interactions between industry and regulators have been amplified and strengthened. However, most adverse reactions, including severe ones, are related to well-known and often pharmacological effects of the older drugs, possibly with genetic predispositions. Prevention is the next frontier for pharmacovigilance, beyond simply generating alerts, and it involves not only the removal of drugs from the market, but also promotion of proper drug prescribing by better trained physicians and the proper use of drugs by better informed patients.

Management of antithrombotic therapy in patients with coronary artery disease or atrial fibrillation who underwent abdominal surgical operations.

PubMed

Schizas, Dimitrios; Kariori, Maria; Boudoulas, Konstantinos Dean; Siasos, Gerasimos; Patelis, Nikolaos; Kalantzis, Charalampos; Carmen-Maria, Moldovan; Vavuranakis, Manolis

2018-04-02

Patients treated with antithrombotic therapy that require abdominal surgical procedures has progressively increased overtime. The management of antithrombotics during both the peri- and post- operative period is of crucial importance. The goal of this review is to present current data concerning the management of antiplatelets in patients with coronary artery disease and of anticoagulants in patients with atrial fibrillation who had to undergo abdominal surgical operations. For this purpose, incidence of major adverse cardiovascular events (MACE) and risk of antithrombotic use during surgical procedures, as well as the recommendations based on recent guidelines were reported. A thorough search of PubMed, Scopus and the Cochrane Databases was conducted to identify randomized controlled trials, observational studies, novel current reviews, and ESC and ACC/AHA guidelines on the subject. Antithrombotic use in daily clinical practice results to two different pathways: reduction of thromboembolic risk, but a simultaneous increase of bleeding risk. This may cause a therapeutic dilemma during the perioperative period. Nevertheless, careless cessation of antithrombotics can increase MACE and thromboembolic events, however, maintenance of antithrombotic therapy may increase bleeding complications. Studies and current guidelines can assist clinicians in making decisions for the treatment of patients that undergo abdominal surgical operations while on antithrombotic therapy. Aspirin should not be stopped perioperatively in the majority of surgical operations. Determining whether to discontinue the use of anticoagulants before surgery depends on the surgical procedure. In surgical operations with a low risk for bleeding, oral anticoagulants should not be discontinued. Bridging therapy should only be considered in patients with a high risk of thromboembolism. Finally, patients with an intermediate risk for thromboembolism, management should be individualized according to patient's thrombotic and bleeding risk. Management of antithrombotics therapy during the perioperative period in patients undergoing abdominal surgery should follow a patient-centered approach according to a patient's medical history and thrombotic risk weighted for bleeding risk. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Database Searching by Managers.

ERIC Educational Resources Information Center

Arnold, Stephen E.

Managers and executives need the easy and quick access to business and management information that online databases can provide, but many have difficulty articulating their search needs to an intermediary. One possible solution would be to encourage managers and their immediate support staff members to search textual databases directly as they now…

Effect of HIV/AIDS on the control environment.

PubMed

Coetzee, Philna

2006-07-01

The management of organizations is responsible for risk management and control systems. HIV/AIDS could be a great threat in the achievement of strategic business objectives, implicating a great concern for management. Management needs to understand this possible risk. This study aims to identify the effect that HIV/AIDS could have on the different elements of the control environment. The archival research method was used. It was established that no formal research was conducted to date on the effect of HIV/AIDS on the control environment as a whole. Various studies have included the effect of HIV/AIDS on certain factors of the control environment. These studies will be discussed briefly to identify relevant findings. The study indicated that the disease could affect various aspects of the control environment, namely: competency of the workforce (e.g. productivity, quality of work, absenteeism, loss of skills and knowledge, training and recruitment, etc.); organizational structure (e.g. increase use of technology labour, disruption of processes, level of employees affected by the disease); human resource (HR) policies and practices (e.g. legislation applicable, prevention and awareness programmes, compensation and benefits). Research limitation: HIV/AIDS is a relatively new potential risk to organizations. Knowledge of the disease is limited. HIV/AIDS is also a very sensitive issue as people fear the disease and do not like to discuss its existence. Government determined that it should be a non-notifiable disease and the disease is currently greatly stigmatized. The databases of companies investigated by other research studies were not developed to gather all the relevant information. Management should be aware that HIV/AIDS poses a possible risk to organizations. Data on the effect of HIV/AIDS should be gathered and used in the decision-making process on how to manage this risk. To be able to fulfil this duty, management first has to determine: whether HIV/AIDS is a risk; the relevant cost involved that the disease is costing the organization; how to control these costs.

Generalized Database Management System Support for Numeric Database Environments.

ERIC Educational Resources Information Center

Dominick, Wayne D.; Weathers, Peggy G.

1982-01-01

This overview of potential for utilizing database management systems (DBMS) within numeric database environments highlights: (1) major features, functions, and characteristics of DBMS; (2) applicability to numeric database environment needs and user needs; (3) current applications of DBMS technology; and (4) research-oriented and…

Attitudes and compliance of clinical management after genetic testing for hereditary breast and ovarian cancer among high-risk Southern Chinese females with breast cancer history.

PubMed

Kwong, Ava; Chu, Annie Tsz-Wai; Wu, Christine Teen-Sum; Tse, Desiree Man-Sik

2014-09-01

Western studies have shown that the uptake rates of surveillance and prophylaxis may vary among BRCA mutation carriers between ethnicities. The present study is the first to investigate the behavioural impact and subjective attitudes in Southern Chinese high-risk families who had undergone BRCA1 and BRCA2 genetic testing up to 2.5 years post-testing. Individuals who had such genetic testing and have consented to participate in the prospective database of Hong Kong Hereditary Breast Cancer Family Registry were recruited and surveyed by a face-to-face or telephone interview. Sociodemographic information, genetic test results, pre- and post-testing surveillance, medical regimes, and attitudes towards the choice of clinical management were obtained by interviews and retrieval of medical records using this prospective database. 69 females with breast cancer history were recruited into the study. Twenty-nine female carriers (15 BRCA1 mutated gene-carriers and 14 BRCA2 mutated gene-carriers) and 40 non-carriers of a BRCA 1/2 mutations were interviewed. The uptake rate of high risk breast screening i.e. clinical breast examination, mammography, and breast MRI is significantly higher among female carriers (48.3 %) after knowing genetic testing results than before (p < 0.01). A strong significant relationship between any increase or decrease of ovarian ultrasound screening (OS) and genetic status is found (p < .001), with more females did OS and with a higher frequency after knowing genetic testing results among both carriers (22.7 % → 86.4 %) and non-carriers (37.5 % → 50.0 %). Among carriers, very few opted for prophylactic surgeries. The present cohort might see prophylaxis as last resort and would use traditional Chinese medicine in cancer risk management.

Functional-analytical capabilities of GIS technology in the study of water use risks

NASA Astrophysics Data System (ADS)

Nevidimova, O. G.; Yankovich, E. P.; Yankovich, K. S.

2015-02-01

Regional security aspects of economic activities are of great importance for legal regulation in environmental management. This has become a critical issue due to climate change, especially in regions where severe climate conditions have a great impact on almost all types of natural resource uses. A detailed analysis of climate and hydrological situation in Tomsk Oblast considering water use risks was carried out. Based on developed author's techniques an informational and analytical database was created using ArcGIS software platform, which combines statistical (quantitative) and spatial characteristics of natural hazards and socio-economic factors. This system was employed to perform areal zoning according to the degree of water use risks involved.

EXPOSURES AND INTERNAL DOSES OF ...

EPA Pesticide Factsheets

The National Center for Environmental Assessment (NCEA) has released a final report that presents and applies a method to estimate distributions of internal concentrations of trihalomethanes (THMs) in humans resulting from a residential drinking water exposure. The report presents simulations of oral, dermal and inhalation exposures and demonstrates the feasibility of linking the US EPA’s information Collection Rule database with other databases on external exposure factors and physiologically based pharmacokinetic modeling to refine population-based estimates of exposure. Review Draft - by 2010, develop scientifically sound data and approaches to assess and manage risks to human health posed by exposure to specific regulated waterborne pathogens and chemicals, including those addressed by the Arsenic, M/DBP and Six-Year Review Rules.

Determining when to conduct a violence risk assessment: Development and initial validation of the Fordham Risk Screening Tool (FRST).

PubMed

Rosenfeld, Barry; Foellmi, Melodie; Khadivi, Ali; Wijetunga, Charity; Howe, Jacqueline; Nijdam-Jones, Alicia; Grover, Shana; Rotter, Merrill

2017-08-01

Techniques to assess violence risk are increasingly common, but no systematic approach exists to help clinicians decide which psychiatric patients are most in need of a violence risk assessment. The Fordham Risk Screening Tool (FRST) was designed to fill this void, providing a structured, systematic approach to screening psychiatric patients and determining the need for further, more thorough violence risk assessment. The FRST was administered to a sample of 210 consecutive admissions to the civil psychiatric units of an urban medical center, 159 of whom were subsequently evaluated using the Historical Clinical Risk Management-20, version 3, to determine violence risk. The FRST showed a high degree of sensitivity (93%) in identifying patients subsequently deemed to be at high risk for violence (based on the Case Prioritization risk rating). The FRST also identified all of the patients (100%) rated high in potential for severe violence (based on the Serious Physical Harm Historical Clinical Risk Management-20, version 3, summary risk rating). Sensitivity was more modest when individuals rated as moderate risk were included as the criterion (rather than only those identified as high risk). Specificity was also moderate, screening out approximately half of all participants as not needing further risk assessment. A systematic approach to risk screening is clearly needed to prioritize psychiatric admissions for thorough risk assessment, and the FRST appears to be a potentially valuable step in that process. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Wireless LAN security management with location detection capability in hospitals.

PubMed

Tanaka, K; Atarashi, H; Yamaguchi, I; Watanabe, H; Yamamoto, R; Ohe, K

2012-01-01

In medical institutions, unauthorized access points and terminals obstruct the stable operation of a large-scale wireless local area network (LAN) system. By establishing a real-time monitoring method to detect such unauthorized wireless devices, we can improve the efficiency of security management. We detected unauthorized wireless devices by using a centralized wireless LAN system and a location detection system at 370 access points at the University of Tokyo Hospital. By storing the detected radio signal strength and location information in a database, we evaluated the risk level from the detection history. We also evaluated the location detection performance in our hospital ward using Wi-Fi tags. The presence of electric waves outside the hospital and those emitted from portable game machines with wireless communication capability was confirmed from the detection result. The location detection performance showed an error margin of approximately 4 m in detection accuracy and approximately 5% in false detection. Therefore, it was effective to consider the radio signal strength as both an index of likelihood at the detection location and an index for the level of risk. We determined the location of wireless devices with high accuracy by filtering the detection results on the basis of radio signal strength and detection history. Results of this study showed that it would be effective to use the developed location database containing radio signal strength and detection history for security management of wireless LAN systems and more general-purpose location detection applications.

The Best Anticoagulation Therapy in Multiple-Trauma Patients with Mechanical Heart Valves: Evaluation of Latest Guidelines and Studies.

PubMed

Moeinipour, Aliasghar; Zarifian, Ahmadreza; Sheikh Andalibi, Mohammad Sobhan; Shamloo, Alireza Sepehri; Ahmadabadi, Ali; Amouzeshi, Ahmad; Hoseinikhah, Hamid

2015-12-22

It is common practice for patients with prosthetic cardiac devices, especially heart valve prosthesis, arterial stents, defibrillators, and pacemaker devices, to use anticoagulation treatment. When these patients suffer from multiple trauma after motor vehicle accidents, the best medical management for this challenging position is mandatory. This strategy should include a rapid diagnosis of all possible multiple organ injuries, with special attention to anticoagulation therapy so as to minimize the risk of thromboembolism complication in prosthetic devices. In this review, we describe the best medical management for patients with multiple trauma who use anticoagulants after heart valve replacement. We searched electronic databases PubMed/Medline, Scopus, Embase, and Google Scholar using the following terms: anticoagulant, warfarin, heparin, and multiple trauma. Also, similar studies suggested by the databases were included. Non-English articles were excluded from the review. For patients who use anticoagulation therapy, teamwork between cardiac surgeons, general surgeons, anesthesiologists, and cardiologists is essential. For optimal medical management, multiple consults between members of this team is mandatory for rapid diagnosis of all possible damaged organs, with special attention to the central nervous system, chest, and abdominal traumas. With this strategy, it is important to take note of anticoagulation drugs to minimize the risk of thromboembolism complications in cardiac devices. The best anticoagulant agents for emergency operations in patients with multiple trauma who are using an anticoagulant after heart valve replacement are fresh frozen plasma (FFP) and prothrombin complex concentrates (PCC).

Building Databases for Education. ERIC Digest.

ERIC Educational Resources Information Center

Klausmeier, Jane A.

This digest provides a brief explanation of what a database is; explains how a database can be used; identifies important factors that should be considered when choosing database management system software; and provides citations to sources for finding reviews and evaluations of database management software. The digest is concerned primarily with…

Attention to detail helps Clarian measure ROI.

PubMed

2007-01-01

Clarian Health takes a risk and embarks on a branding strategy. Taking a multi-integrated approach, with The Heavy Weights in Indianapolis, Clarian started managing its marketing by tracking return on investment (ROI) and making the most of a CRM database. In a groundbreaking approach, it found that it was actually able to turn its marketing effort into a money-maker, leading higher-ups to see its outreach efforts as necessity.

Economic evaluation of manual therapy for musculoskeletal diseases: a protocol for a systematic review and narrative synthesis of evidence.

PubMed

Kim, Chang-Gon; Mun, Su-Jeong; Kim, Ka-Na; Shin, Byung-Cheul; Kim, Nam-Kwen; Lee, Dong-Hyo; Lee, Jung-Han

2016-05-13

Manual therapy is the non-surgical conservative management of musculoskeletal disorders using the practitioner's hands on the patient's body for diagnosing and treating disease. The aim of this study is to systematically review trial-based economic evaluations of manual therapy relative to other interventions used for the management of musculoskeletal diseases. Randomised clinical trials (RCTs) on the economic evaluation of manual therapy for musculoskeletal diseases will be included in the review. The following databases will be searched from their inception: Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Econlit, Mantis, Index to Chiropractic Literature, Science Citation Index, Social Science Citation Index, Allied and Complementary Medicine Database (AMED), Cochrane Database of Systematic Reviews (CDSR), National Health Service Database of Abstracts of Reviews of Effects (NHS DARE), National Health Service Health Technology Assessment Database (NHS HTA), National Health Service Economic Evaluation Database (NHS EED), CENTRAL, five Korean medical databases (Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Service System (RISS), DBPIA, Korean Traditional Knowledge Portal (KTKP) and KoreaMed) and three Chinese databases (China National Knowledge Infrastructure (CNKI), VIP and Wanfang). The evidence for the cost-effectiveness, cost-utility and cost-benefit of manual therapy for musculoskeletal diseases will be assessed as the primary outcome. Health-related quality of life and adverse effects will be assessed as secondary outcomes. We will critically appraise the included studies using the Cochrane risk of bias tool and the Drummond checklist. Results will be summarised using Slavin's qualitative best-evidence synthesis approach. The results of the study will be disseminated via a peer-reviewed journal and/or conference presentations. PROSPERO CRD42015026757. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

An integrated environmental risk assessment and management framework for enhancing the sustainability of marine protected areas: the Cape d'Aguilar Marine Reserve case study in Hong Kong.

PubMed

Xu, Elvis G B; Leung, Kenneth M Y; Morton, Brian; Lee, Joseph H W

2015-02-01

Marine protected areas (MPAs), such as marine parks and reserves, contain natural resources of immense value to the environment and mankind. Since MPAs may be situated in close proximity to urbanized areas and influenced by anthropogenic activities (e.g. continuous discharges of contaminated waters), the marine organisms contained in such waters are probably at risk. This study aimed at developing an integrated environmental risk assessment and management (IERAM) framework for enhancing the sustainability of such MPAs. The IERAM framework integrates conventional environmental risk assessment methods with a multi-layer-DPSIR (Driver-Pressure-State-Impact-Response) conceptual approach, which can simplify the complex issues embraced by environmental management strategies and provide logical and concise management information. The IERAM process can generate a useful database, offer timely update on the status of MPAs, and assist in the prioritization of management options. We use the Cape d'Aguilar Marine Reserve in Hong Kong as an example to illustrate the IERAM framework. A comprehensive set of indicators were selected, aggregated and analyzed using this framework. Effects of management practices and programs were also assessed by comparing the temporal distributions of these indicators over a certain timeframe. Based on the obtained results, we have identified the most significant components for safeguarding the integrity of the marine reserve, and indicated the existing information gaps concerned with the management of the reserve. Apart from assessing the MPA's present condition, a successful implementation of the IERAM framework as evocated here would also facilitate better-informed decision-making and, hence, indirectly enhance the protection and conservation of the MPA's marine biodiversity. Copyright © 2014 Elsevier B.V. All rights reserved.

Database Management: Building, Changing and Using Databases. Collected Papers and Abstracts of the Mid-Year Meeting of the American Society for Information Science (15th, Portland, Oregon, May 1986).

ERIC Educational Resources Information Center

American Society for Information Science, Washington, DC.

This document contains abstracts of papers on database design and management which were presented at the 1986 mid-year meeting of the American Society for Information Science (ASIS). Topics considered include: knowledge representation in a bilingual art history database; proprietary database design; relational database design; in-house databases;…

The Network Configuration of an Object Relational Database Management System

NASA Technical Reports Server (NTRS)

Diaz, Philip; Harris, W. C.

2000-01-01

The networking and implementation of the Oracle Database Management System (ODBMS) requires developers to have knowledge of the UNIX operating system as well as all the features of the Oracle Server. The server is an object relational database management system (DBMS). By using distributed processing, processes are split up between the database server and client application programs. The DBMS handles all the responsibilities of the server. The workstations running the database application concentrate on the interpretation and display of data.

Duties and functions of veterinary public health for the management of food safety: present needs and evaluation of efficiency.

PubMed

Trevisani, M; Rosmini, R

2008-09-01

Functions of veterinarians in the context of food safety assurance have changed very much in the last ten years as a consequence of new legislation. The aim of this review is to evaluate the management tools in veterinary public health that shall be used in response to the actual need and consider some possible key performance indicators. This review involved an examination of the legislation, guidelines and literature, which was then discussed to analyse the actual need, the strategies and the procedures with which the public veterinary service shall comply. The management of information gathered at different stages of the food chain, from both food production operators and veterinary inspectors operating in primary production, food processing and feed production should be exchanged and integrated in a database, not only to produce annual reports and plan national sampling plans, but also to verify and validate the effectiveness of procedures and strategies implemented by food safety operators to control risks. Further, the surveillance data from environmental agencies and human epidemiological units should be used for assessing risks and addressing management options.

The use of GIS tools for road infrastructure safety management

NASA Astrophysics Data System (ADS)

Budzyński, Marcin; Kustra, Wojciech; Okraszewska, Romanika; Jamroz, Kazimierz; Pyrchla, Jerzy

2018-01-01

There are many factors that influence accidents and their severity. They can be grouped within the system of man, vehicle and environment. The article focuses on how GIS tools can be used to manage road infrastructure safety. To ensure a better understanding and identification of road factors, GIS tools help with the acquisition of road parameter data. Their other role is helping with a clear and effective presentation of risk ranking. GIS is key to identifying high-risk sections and supports the effective communication of safety levels. This makes it a vital element of safety management. The article describes the use of GIS for the collection and visualisation of road parameter data which are not available in any of the existing databases, i.e. horizontal curve parameters. As we know from research and statistics, they are important factors that determine the safety of road infrastructure. Finally, new research is proposed as well as the possibilities for applying GIS tools for the purposes of road safety inspection.

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

Bower, J.C.; Burford, M.J.; Downing, T.R.

The Integrated Baseline System (IBS) is an emergency management planning and analysis tool that is being developed under the direction of the US Army Nuclear and Chemical Agency (USANCA). The IBS Data Management Guide provides the background, as well as the operations and procedures needed to generate and maintain a site-specific map database. Data and system managers use this guide to manage the data files and database that support the administrative, user-environment, database management, and operational capabilities of the IBS. This document provides a description of the data files and structures necessary for running the IBS software and using themore » site map database.« less

Pharmaceutical supply chain risks: a systematic review.

PubMed

Jaberidoost, Mona; Nikfar, Shekoufeh; Abdollahiasl, Akbar; Dinarvand, Rassoul

2013-12-19

Supply of medicine as a strategic product in any health system is a top priority. Pharmaceutical companies, a major player of the drug supply chain, are subject to many risks. These risks disrupt the supply of medicine in many ways such as their quantity and quality and their delivery to the right place and customers and at the right time. Therefore risk identification in the supply process of pharmaceutical companies and mitigate them is highly recommended. In this study it is attempted to investigate pharmaceutical supply chain risks with perspective of manufacturing companies. Scopus, PubMed, Web of Science bibliographic databases and Google scholar scientific search engines were searched for pharmaceutical supply chain risk management studies with 6 different groups of keywords. All results found by keywords were reviewed and none-relevant articles were excluded by outcome of interests and researcher boundaries of study within 4 steps and through a systematic method. Nine articles were included in the systematic review and totally 50 main risks based on study outcome of interest extracted which classified in 7 categories. Most of reported risks were related to supply and supplier issues. Organization and strategy issues, financial, logistic, political, market and regulatory issues were in next level of importance. It was shown that the majority of risks in pharmaceutical supply chain were internal risks due to processes, people and functions mismanagement which could be managed by suitable mitigation strategies.

Status of dyslipidemia treatment in Japanese adults: an analysis of the 2009 Japan Society of Ningen Dock database.

PubMed

Takahashi, Eiko; Moriyama, Kengo; Yamakado, Minoru

2013-01-01

The Japan Atherosclerosis Society (JAS) has recommended serum lipid management goals (SLMGs) based on the coronary heart disease (CHD) risk classification included in its 2007 guidelines for the diagnosis and prevention of atherosclerotic cardiovascular disease in the Japanese population (JAS GL 2007). The Japan Society of Ningen Dock created a database of subjects receiving annual health examinations at 21 institutes nationwide. Using this database, we evaluated the efficacy of current treatment for patients with dyslipidemia by identifying risk factors for CHD development, based on the JAS recommendations. This multicenter, retrospective study was conducted using data obtained from 21 institutions across Japan. 17,991 adults taking dyslipidemia medications were enrolled. The JAS GL 2007 was used for evaluation. Since the guideline indicated separate goals (secondary prevention for subjects with a prior history of CHD and primary prevention for those with other CHD risk factors), we evaluated the percentages of goals met. The serum low-density lipoprotein cholesterol (LDL-C) levels were calculated using the Friedewald formula. The LDL-C level was measured using a direct homogeneous assay if the triglycerides (TG) level was 400 mg/dL or higher. The achievement rates of the SLMGs were as follows: LDL-C, 72.3%; high-density lipoprotein cholesterol (HDL-C), 94.6%; and TG, 69.7%. Our results regarding Japanese patients receiving dyslipidemia treatment for CHD prevention identified insufficient reductions in the levels of LDL-C and TG in those at high risk for CHD and suggest the need for more aggressive lipid-lowering therapy.

Work-related stress risk assessment in Italy: a methodological proposal adapted to regulatory guidelines.

PubMed

Persechino, Benedetta; Valenti, Antonio; Ronchetti, Matteo; Rondinone, Bruna Maria; Di Tecco, Cristina; Vitali, Sara; Iavicoli, Sergio

2013-06-01

Work-related stress is one of the major causes of occupational ill health. In line with the regulatory framework on occupational health and safety (OSH), adequate models for assessing and managing risk need to be identified so as to minimize the impact of this stress not only on workers' health, but also on productivity. After close analysis of the Italian and European reference regulatory framework and work-related stress assessment and management models used in some European countries, we adopted the UK Health and Safety Executive's (HSE) Management Standards (MS) approach, adapting it to the Italian context in order to provide a suitable methodological proposal for Italy. We have developed a work-related stress risk assessment strategy, meeting regulatory requirements, now available on a specific web platform that includes software, tutorials, and other tools to assist companies in their assessments. This methodological proposal is new on the Italian work-related stress risk assessment scene. Besides providing an evaluation approach using scientifically validated instruments, it ensures the active participation of occupational health professionals in each company. The assessment tools provided enable companies not only to comply with the law, but also to contribute to a database for monitoring and assessment and give access to a reserved area for data analysis and comparisons.

Work-Related Stress Risk Assessment in Italy: A Methodological Proposal Adapted to Regulatory Guidelines

PubMed Central

Persechino, Benedetta; Valenti, Antonio; Ronchetti, Matteo; Rondinone, Bruna Maria; Di Tecco, Cristina; Vitali, Sara; Iavicoli, Sergio

2013-01-01

Background Work-related stress is one of the major causes of occupational ill health. In line with the regulatory framework on occupational health and safety (OSH), adequate models for assessing and managing risk need to be identified so as to minimize the impact of this stress not only on workers' health, but also on productivity. Methods After close analysis of the Italian and European reference regulatory framework and work-related stress assessment and management models used in some European countries, we adopted the UK Health and Safety Executive's (HSE) Management Standards (MS) approach, adapting it to the Italian context in order to provide a suitable methodological proposal for Italy. Results We have developed a work-related stress risk assessment strategy, meeting regulatory requirements, now available on a specific web platform that includes software, tutorials, and other tools to assist companies in their assessments. Conclusion This methodological proposal is new on the Italian work-related stress risk assessment scene. Besides providing an evaluation approach using scientifically validated instruments, it ensures the active participation of occupational health professionals in each company. The assessment tools provided enable companies not only to comply with the law, but also to contribute to a database for monitoring and assessment and give access to a reserved area for data analysis and comparisons. PMID:23961332

Risk-Significant Adverse Condition Awareness Strengthens Assurance of Fault Management Systems

NASA Technical Reports Server (NTRS)

Fitz, Rhonda

2017-01-01

As spaceflight systems increase in complexity, Fault Management (FM) systems are ranked high in risk-based assessment of software criticality, emphasizing the importance of establishing highly competent domain expertise to provide assurance. Adverse conditions (ACs) and specific vulnerabilities encountered by safety- and mission-critical software systems have been identified through efforts to reduce the risk posture of software-intensive NASA missions. Acknowledgement of potential off-nominal conditions and analysis to determine software system resiliency are important aspects of hazard analysis and FM. A key component of assuring FM is an assessment of how well software addresses susceptibility to failure through consideration of ACs. Focus on significant risk predicted through experienced analysis conducted at the NASA Independent Verification & Validation (IV&V) Program enables the scoping of effective assurance strategies with regard to overall asset protection of complex spaceflight as well as ground systems. Research efforts sponsored by NASAs Office of Safety and Mission Assurance (OSMA) defined terminology, categorized data fields, and designed a baseline repository that centralizes and compiles a comprehensive listing of ACs and correlated data relevant across many NASA missions. This prototype tool helps projects improve analysis by tracking ACs and allowing queries based on project, mission type, domain/component, causal fault, and other key characteristics. Vulnerability in off-nominal situations, architectural design weaknesses, and unexpected or undesirable system behaviors in reaction to faults are curtailed with the awareness of ACs and risk-significant scenarios modeled for analysts through this database. Integration within the Enterprise Architecture at NASA IV&V enables interfacing with other tools and datasets, technical support, and accessibility across the Agency. This paper discusses the development of an improved workflow process utilizing this database for adaptive, risk-informed FM assurance that critical software systems will safely and securely protect against faults and respond to ACs in order to achieve successful missions.

Limited Evidence on the Management of Respiratory Tract Infections in Down’s Syndrome

PubMed Central

Reed, Kate; Venekamp, Roderick P.; Hayward, Andrew; Littlejohns, Peter; Schilder, Anne; Lakhanpaul, Monica

2016-01-01

Aims: To systematically review the effectiveness of preventative and therapeutic interventions for respiratory tract infections (RTIs) in people with Down’s syndrome. Methods: Databases were searched for any published and ongoing studies of respiratory tract diseases in children and adults with Down’s syndrome. These databases were searched for controlled trials, cohort studies and controlled before–after studies. Trial registries were searched for ongoing studies. Initially, all study types were included to provide a broad overview of the existing evidence base. However, those with a critical risk of bias were excluded using the Cochrane Risk of Bias tool. Results: A total of 13,575 records were identified from which 5 studies fulfilled the eligibility criteria and 3 fulfilled our criteria for data extraction. One randomized controlled trial of moderate risk of bias compared zinc therapy with placebo. Outcome data were only reported for 50 (78%) children who presented with extreme symptoms; no benefit of zinc therapy was found. One non-randomized controlled trial with serious risk of bias included 26 children and compared pidotimod (an immunostimulant) with no treatment; pidotimod was associated with fewer upper RTI recurrences compared with no treatment (1.43 vs. 3.82). A prospective cohort study with moderate risk of bias compared 532 palivizumab treated children with 233 untreated children and found that children treated with palivizumab had fewer respiratory syncytial virus-related hospitalization (23 untreated and 8 treated), but the same number of overall RTI-related hospitalizations (73 untreated and 74 treated) in the first 2 years of life. Conclusions: The evidence base for the management of RTIs in people with Down’s syndrome is incomplete; current studies included children only and carry a moderate to serious risk of bias. Methodologic rigorous studies are warranted to guide clinicians in how best to prevent and treat RTIs in children with Down’s syndrome. PMID:27273687

Risk-Significant Adverse Condition Awareness Strengthens Assurance of Fault Management Systems

NASA Technical Reports Server (NTRS)

Fitz, Rhonda

2017-01-01

As spaceflight systems increase in complexity, Fault Management (FM) systems are ranked high in risk-based assessment of software criticality, emphasizing the importance of establishing highly competent domain expertise to provide assurance. Adverse conditions (ACs) and specific vulnerabilities encountered by safety- and mission-critical software systems have been identified through efforts to reduce the risk posture of software-intensive NASA missions. Acknowledgement of potential off-nominal conditions and analysis to determine software system resiliency are important aspects of hazard analysis and FM. A key component of assuring FM is an assessment of how well software addresses susceptibility to failure through consideration of ACs. Focus on significant risk predicted through experienced analysis conducted at the NASA Independent Verification Validation (IVV) Program enables the scoping of effective assurance strategies with regard to overall asset protection of complex spaceflight as well as ground systems. Research efforts sponsored by NASA's Office of Safety and Mission Assurance defined terminology, categorized data fields, and designed a baseline repository that centralizes and compiles a comprehensive listing of ACs and correlated data relevant across many NASA missions. This prototype tool helps projects improve analysis by tracking ACs and allowing queries based on project, mission type, domaincomponent, causal fault, and other key characteristics. Vulnerability in off-nominal situations, architectural design weaknesses, and unexpected or undesirable system behaviors in reaction to faults are curtailed with the awareness of ACs and risk-significant scenarios modeled for analysts through this database. Integration within the Enterprise Architecture at NASA IVV enables interfacing with other tools and datasets, technical support, and accessibility across the Agency. This paper discusses the development of an improved workflow process utilizing this database for adaptive, risk-informed FM assurance that critical software systems will safely and securely protect against faults and respond to ACs in order to achieve successful missions.

Atrial fibrillation: stroke prevention in focus.

PubMed

Ferguson, Caleb; Inglis, Sally C; Newton, Phillip J; Middleton, Sandy; Macdonald, Peter S; Davidson, Patricia M

2014-05-01

Atrial fibrillation (AF) is a common arrhythmia and a risk factor for stroke and other, adverse events. Internationally there have been recent advancements in the therapies available for, stroke prevention in AF. Nurses will care for individuals with AF across a variety of primary and acute, care settings and should be familiar with evidence based therapies. This paper provides a review of the epidemiology of AF and stroke, stroke and bleeding risk, assessment tools and evidence based treatments for the prevention of stroke in AF including the use of, novel anti-thrombin agents. A review of key databases was conducted from 2002 to 2012 using the key search terms 'atrial, fibrillation' 'anticoagulation' 'risk assessment' and 'clinical management'. The following electronic, databases were searched: CINAHL, Medline, Scopus, the Cochrane Library and Google Scholar., Reference lists were manually hand searched. Key clinical guidelines from National Institute for, Clinical Excellence (NICE, UK), American Heart Association (AHA, USA), American College of Cardiology, (ACC, USA) and the European Society of Cardiology (ESC) and key government policy documents were, also included. Articles were included in the review if they addressed nursing management with a focus, on Australia. Many treatment options exist for AF. Best practice guidelines make a variety of, recommendations which include cardioversion, ablation, pulmonary vein isolation, pharmacological, agents for rate or rhythm control approaches, and antithrombotic therapy (including anticoagulation, and antiplatelet therapy). Treatment should be patient centred and individualised based upon, persistency of the rhythm, causal nature, risk and co-morbid conditions. AF is a common and burdensome condition where treatment is complex and not without, risk. Nurses will encounter individuals with AF across a variety of primary and acute care areas, understanding the risk of AF and appropriate therapies is important across all care settings. Treatment, must be individually tailored to the needs of the patient and balanced with the best available evidence. Copyright © 2013 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

System hazards in managing laboratory test requests and results in primary care: medical protection database analysis and conceptual model.

PubMed

Bowie, Paul; Price, Julie; Hepworth, Neil; Dinwoodie, Mark; McKay, John

2015-11-27

To analyse a medical protection organisation's database to identify hazards related to general practice systems for ordering laboratory tests, managing test results and communicating test result outcomes to patients. To integrate these data with other published evidence sources to inform design of a systems-based conceptual model of related hazards. A retrospective database analysis. General practices in the UK and Ireland. 778 UK and Ireland general practices participating in a medical protection organisation's clinical risk self-assessment (CRSA) programme from January 2008 to December 2014. Proportion of practices with system risks; categorisation of identified hazards; most frequently occurring hazards; development of a conceptual model of hazards; and potential impacts on health, well-being and organisational performance. CRSA visits were undertaken to 778 UK and Ireland general practices of which a range of systems hazards were recorded across the laboratory test ordering and results management systems in 647 practices (83.2%). A total of 45 discrete hazard categories were identified with a mean of 3.6 per practice (SD=1.94). The most frequently occurring hazard was the inadequate process for matching test requests and results received (n=350, 54.1%). Of the 1604 instances where hazards were recorded, the most frequent was at the 'postanalytical test stage' (n=702, 43.8%), followed closely by 'communication outcomes issues' (n=628, 39.1%). Based on arguably the largest data set currently available on the subject matter, our study findings shed new light on the scale and nature of hazards related to test results handling systems, which can inform future efforts to research and improve the design and reliability of these systems. 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/

[Selected aspects of computer-assisted literature management].

PubMed

Reiss, M; Reiss, G

1998-01-01

We want to report about our own experiences with a database manager. Bibliography database managers are used to manage information resources: specifically, to maintain a database to references and create bibliographies and reference lists for written works. A database manager allows to enter summary information (record) for articles, book sections, books, dissertations, conference proceedings, and so on. Other features that may be included in a database manager include the ability to import references from different sources, such as MEDLINE. The word processing components allow to generate reference list and bibliographies in a variety of different styles, generates a reference list from a word processor manuscript. The function and the use of the software package EndNote 2 for Windows are described. Its advantages in fulfilling different requirements for the citation style and the sort order of reference lists are emphasized.

The effectiveness of risk communication regarding drug safety information: a nationwide survey by the Japanese public health insurance claims data.

PubMed

Hagiwara, Hiromi; Nakano, Shun; Ogawa, Yoshihiro; Tohkin, Masahiro

2015-06-01

We evaluated the effectiveness of warning letters published by the pharmaceutical regulatory agency in Japan on communication of drug safety and risk by quantitative analysis of the national health insurance claims database (NHICD). We then explored what factors may have affected risk communication. We measured the implementation rate of the hepatitis virus-monitoring test among methotrexate (MTX)-treated patients; a warning letter had been issued regarding the use of MTX, as it apparently activates the hepatitis virus. Data from the NHICD, which include 99·3% of Japanese residents, were used. A total of 4,933,481 patients with rheumatoid arthritis (RA) (January-June, 2010) were the focus of this study. The implementation rate of the hepatitis virus-monitoring test increased from 1·4% before to 1·8% after the warning letter announcement. Logistic regression analysis suggested that the installation of a drug information management room is one of the important factors affecting risk communication. Further analysis revealed that the hepatitis virus monitoring rates in hospitals without drug information management rooms increased from 2·3% to 4·1% due to the issue of the warning letter. The warning letter from the regulatory agency plays an important role in risk communication in hospitals without drug information management rooms. © 2015 John Wiley & Sons Ltd.

Rainfall Induced Natural Disaster in Central America, a challenge for Regional Risk Management

NASA Astrophysics Data System (ADS)

Estuardo Guinea Barrientos, Héctor; Swain, Ashok

2013-04-01

Rainfall induced natural disasters rank first among all natural disasters in Central America. According to the records of the EM-DAT international database, 248 out of 486 disasters registered in Central America were disasters triggered by rainfall invents, in countries like Belize and Honduras, rainfall-induced natural disasters, mainly floods and landslides, account for more than 90% of the total number of casualties as well as the economic damage of all the disasters. Due to the natural conditions of the Central American Isthmus, precipitation events often struck more than one country at the time, for example Hurricane Mitch in 1998 affected the entire Central American region causing more than 18,000 casualties. In this context, the Central America countries have been working on joint programs and policies aiming transboundary cooperation and management of natural disasters, a clear example of this effort is CEPREDENAC which is the intergovernmental body with the mandate of promoting activities, projects and programs towards reduction of the risks to disasters in order to avoid loss of life and economic assets in the Central America, however, transnational management face several challenges that fall mostly in the political, economical and technical areas. In this paper we described and analyzed the rainfall induced natural disasters, their impacts and the inherent management challenges in the Central American context. Key words: Central America, Natural Disasters, Risk Management, International Cooperation

Temporal Trends and the Impact of Race, Insurance, and Socioeconomic Status in the Management of Localized Prostate Cancer.

PubMed

Gray, Phillip J; Lin, Chun Chieh; Cooperberg, Matthew R; Jemal, Ahmedin; Efstathiou, Jason A

2017-05-01

Numerous management options exist for patients with prostate cancer; however, recent trends and their influencing factors are not well described. To describe modern patterns of care and factors associated with management choice using the National Cancer Database. Patients with localized prostate cancer diagnosed between 2004 and 2012 were included and grouped according to National Comprehensive Cancer Network guidelines into low, intermediate, or high risk. Trend analyses and multivariate logistic regression was used to identify factors associated with management. There were 598 640 patients who met the study criteria; 36.3% were classified as low risk, 43.8% intermediate risk, and 20.0% high risk. Over the study period, among low-risk patients, observation increased from 9.2% to 21.3%, while radical prostatectomy (RP) increased from 29.5% to 51.1% (p<0.001 for both). In contrast, external beam radiotherapy decreased from 24.3% to 14.5%, while brachytherapy decreased from 31.7% to 11.1%. A similar pattern was seen for patients with intermediate-risk or high-risk disease. Among high-risk patients, RP increased from 25.1% to 43.4% replacing external beam radiotherapy as the dominant therapy. On multivariate analysis, racial minorities, the uninsured, and low-income patients were less likely to receive RP. Low-risk patients in similar subgroups were significantly more likely to be observed. Limitations include potential miscoding or misclassification of variables. Patterns of care in localized prostate cancer are changing rapidly. While use of observation is increasing in low-risk groups, the use of RP is increasing across all risk groups with a concomitant decline in use of radiotherapy. Socioeconomic factors appear to influence management choice. In this report we identify a recent significant increase in the use of radical prostatectomy for prostate cancer patients. Socioeconomic factors such as race, insurance type, and income may affect treatments offered to and received by patients. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Increased risk of Eustachian tube disorders in patients with sleep-disordered breathing.

PubMed

Chou, Meng-Shih; Chang, Wen-Dien; Lin, Che-Chen; Li, Yu-Fen; Tsou, Yung-An

2017-08-01

Sleep-disordered breathing (SDB) and Eustachian tube disorders (ETDs) share the same risk factors. The specific aim of this study was to determine the correlation between these 2 conditions and to determine whether treatments for SDB reduce the risk of ETD.This is a retrospective and large population-based cohort study. According to Taiwan's National Health Insurance Research Database, out of 1,000,000 insured patients, 24,251 patients were newly diagnosed with SDB from year 2000 through 2009. The control group for this study comprised 96,827 patients without SDB who were randomly selected from the same database at a ratio of 1:4, frequency matched for sex, age, and index year of SDB. The incidence of developing ETD was compared between these 2 groups; the main covariates were demographic data, interventions, and medical comorbidities.There was an increased risk of developing ETD among the SDB cohort compared with the control group (hazard ratio = 1.51, 95% confidence interval = 1.41-1.63). Compared with SDB patients who did not receive treatment, those who received the treatment, that is, pharyngeal or nasal surgery, CPAP, or multiple modalities (both surgery and CPAP), had a significantly reduced risk of developing ETD.This study showed that patients with SDB are at an increased risk of developing ETD and other comorbidities. The risk of developing ETD can be reduced by implementing prompt treatment for SDB. Multidisciplinary evaluation including ETD should be conducted in the management of patients presenting with SDB.

The risk of paradoxical embolism (RoPE) study: initial description of the completed database.

PubMed

Thaler, David E; Di Angelantonio, Emanuele; Di Tullio, Marco R; Donovan, Jennifer S; Griffith, John; Homma, Shunichi; Jaigobin, Cheryl; Mas, Jean-Louis; Mattle, Heinrich P; Michel, Patrik; Mono, Marie-Luise; Nedeltchev, Krassen; Papetti, Federica; Ruthazer, Robin; Serena, Joaquín; Weimar, Christian; Elkind, Mitchell S V; Kent, David M

2013-12-01

Detecting a benefit from closure of patent foramen ovale in patients with cryptogenic stroke is hampered by low rates of stroke recurrence and uncertainty about the causal role of patent foramen ovale in the index event. A method to predict patent foramen ovale-attributable recurrence risk is needed. However, individual databases generally have too few stroke recurrences to support risk modeling. Prior studies of this population have been limited by low statistical power for examining factors related to recurrence. The aim of this study was to develop a database to support modeling of patent foramen ovale-attributable recurrence risk by combining extant data sets. We identified investigators with extant databases including subjects with cryptogenic stroke investigated for patent foramen ovale, determined the availability and characteristics of data in each database, collaboratively specified the variables to be included in the Risk of Paradoxical Embolism database, harmonized the variables across databases, and collected new primary data when necessary and feasible. The Risk of Paradoxical Embolism database has individual clinical, radiologic, and echocardiographic data from 12 component databases, including subjects with cryptogenic stroke both with (n = 1925) and without (n = 1749) patent foramen ovale. In the patent foramen ovale subjects, a total of 381 outcomes (stroke, transient ischemic attack, death) occurred (median follow-up 2·2 years). While there were substantial variations in data collection between studies, there was sufficient overlap to define a common set of variables suitable for risk modeling. While individual studies are inadequate for modeling patent foramen ovale-attributable recurrence risk, collaboration between investigators has yielded a database with sufficient power to identify those patients at highest risk for a patent foramen ovale-related stroke recurrence who may have the greatest potential benefit from patent foramen ovale closure. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

Clinical assessment and crisis intervention for the suicidal bipolar disorder patient.

PubMed

Saunders, Kate E A; Hawton, Keith

2013-08-01

Suicidal behaviour is common in people suffering with bipolar disorder, and suicide is a leading cause of death in this group. Our aim in this review is to provide an overview of key assessment and management strategies, highlight research findings relevant to suicide prevention, and identify important areas for future research. We reviewed the published literature regarding the risk factors for and management of suicida\\l behaviour in individuals with bipolar disorder using the Pubmed and PsychINFO databases. Where available, we focused our search on systematic reviews. Suicide is usually associated with a depressive phase, although mixed affective states also convey increased risk. All individuals with bipolar disorder should have an up-to-date crisis management plan which outlines the action to be taken should suicidal behaviour emerge. Timely clinical assessment is essential in ensuring that those at high risk are identified. This should include mental state examination, consideration of risk factors, and evaluation of issues such as access to means, preparatory acts before suicide, and also protective factors. While pharmacological approaches are the mainstay of management, less specific measures, such as the removal of access to means, are also important in ensuring safety in the acute situation. Intensifying the clinical support of both patients and relatives, and the sharing of risk information with other health agencies are essential in management. Specific psychological treatments are likely to be helpful in preventing crises, although the evidence base is limited. The aetiology of suicidal behaviour in bipolar disorder is multifactorial and requires proactive crisis planning and management. A range of issues need to be addressed in the assessment of at-risk patients. Determining the efficacy of interventions specific to reducing suicidality in bipolar disorder should be a research priority. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Asia-Pacific Region Global Earthquake and Volcanic Eruption Risk Management (G-EVER) project and a next-generation real-time volcano hazard assessment system

NASA Astrophysics Data System (ADS)

Takarada, S.

2012-12-01

The first Workshop of Asia-Pacific Region Global Earthquake and Volcanic Eruption Risk Management (G-EVER1) was held in Tsukuba, Ibaraki Prefecture, Japan from February 23 to 24, 2012. The workshop focused on the formulation of strategies to reduce the risks of disasters worldwide caused by the occurrence of earthquakes, tsunamis, and volcanic eruptions. More than 150 participants attended the workshop. During the workshop, the G-EVER1 accord was approved by the participants. The Accord consists of 10 recommendations like enhancing collaboration, sharing of resources, and making information about the risks of earthquakes and volcanic eruptions freely available and understandable. The G-EVER Hub website (http://g-ever.org) was established to promote the exchange of information and knowledge among the Asia-Pacific countries. Several G-EVER Working Groups and Task Forces were proposed. One of the working groups was tasked to make the next-generation real-time volcano hazard assessment system. The next-generation volcano hazard assessment system is useful for volcanic eruption prediction, risk assessment, and evacuation at various eruption stages. The assessment system is planned to be developed based on volcanic eruption scenario datasets, volcanic eruption database, and numerical simulations. Defining volcanic eruption scenarios based on precursor phenomena leading up to major eruptions of active volcanoes is quite important for the future prediction of volcanic eruptions. Compiling volcanic eruption scenarios after a major eruption is also important. A high quality volcanic eruption database, which contains compilations of eruption dates, volumes, and styles, is important for the next-generation volcano hazard assessment system. The volcanic eruption database is developed based on past eruption results, which only represent a subset of possible future scenarios. Hence, different distributions from the previous deposits are mainly observed due to the differences in vent position, volume, eruption rate, wind directions and topography. Therefore, numerical simulations with controlled parameters are needed for more precise volcanic eruption predictions. The use of the next-generation system should enable the visualization of past volcanic eruptions datasets such as distributions, eruption volumes and eruption rates, on maps and diagrams using timeline and GIS technology. Similar volcanic eruptions scenarios should be easily searchable from the eruption database. Using the volcano hazard assessment system, prediction of the time and area that would be affected by volcanic eruptions at any locations near the volcano should be possible, using numerical simulations. The system should estimate volcanic hazard risks by overlaying the distributions of volcanic deposits on major roads, houses and evacuation areas using a GIS enabled systems. Probabilistic volcanic hazards maps in active volcano sites should be made based on numerous numerical simulations. The next-generation real-time hazard assessment system would be implemented with user-friendly interface, making the risk assessment system easily usable and accessible online.

Keeping Track of Our Treasures: Managing Historical Data with Relational Database Software.

ERIC Educational Resources Information Center

Gutmann, Myron P.; And Others

1989-01-01

Describes the way a relational database management system manages a large historical data collection project. Shows that such databases are practical to construct. States that the programing tasks involved are not for beginners, but the rewards of having data organized are worthwhile. (GG)

Content Independence in Multimedia Databases.

ERIC Educational Resources Information Center

de Vries, Arjen P.

2001-01-01

Investigates the role of data management in multimedia digital libraries, and its implications for the design of database management systems. Introduces the notions of content abstraction and content independence. Proposes a blueprint of a new class of database technology, which supports the basic functionality for the management of both content…

Development of expert systems for analyzing electronic documents

NASA Astrophysics Data System (ADS)

Abeer Yassin, Al-Azzawi; Shidlovskiy, S.; Jamal, A. A.

2018-05-01

The paper analyses a Database Management System (DBMS). Expert systems, Databases, and database technology have become an essential component of everyday life in the modern society. As databases are widely used in every organization with a computer system, data resource control and data management are very important [1]. DBMS is the most significant tool developed to serve multiple users in a database environment consisting of programs that enable users to create and maintain a database. This paper focuses on development of a database management system for General Directorate for education of Diyala in Iraq (GDED) using Clips, java Net-beans and Alfresco and system components, which were previously developed in Tomsk State University at the Faculty of Innovative Technology.

A risk factor-based predictive model of outcomes in carotid endarterectomy: the National Surgical Quality Improvement Program 2005-2010.

PubMed

Bekelis, Kimon; Bakhoum, Samuel F; Desai, Atman; Mackenzie, Todd A; Goodney, Philip; Labropoulos, Nicos

2013-04-01

Accurate knowledge of individualized risks and benefits is crucial to the surgical management of patients undergoing carotid endarterectomy (CEA). Although large randomized trials have determined specific cutoffs for the degree of stenosis, precise delineation of patient-level risks remains a topic of debate, especially in real world practice. We attempted to create a risk factor-based predictive model of outcomes in CEA. We performed a retrospective cohort study involving patients who underwent CEAs from 2005 to 2010 and were registered in the American College of Surgeons National Quality Improvement Project database. Of the 35 698 patients, 20 015 were asymptomatic (56.1%) and 15 683 were symptomatic (43.9%). These patients demonstrated a 1.64% risk of stroke, 0.69% risk of myocardial infarction, and 0.75% risk of death within 30 days after CEA. Multivariate analysis demonstrated that increasing age, male sex, history of chronic obstructive pulmonary disease, myocardial infarction, angina, congestive heart failure, peripheral vascular disease, previous stroke or transient ischemic attack, and dialysis were independent risk factors associated with an increased risk of the combined outcome of postoperative stroke, myocardial infarction, or death. A validated model for outcome prediction based on individual patient characteristics was developed. There was a steep effect of age on the risk of myocardial infarction and death. This national study confirms that that risks of CEA vary dramatically based on patient-level characteristics. Because of limited discrimination, it cannot be used for individual patient risk assessment. However, it can be used as a baseline for improvement and development of more accurate predictive models based on other databases or prospective studies.

Ciguatera fish poisoning in East Asia and southeast Asia.

PubMed

Chan, Thomas Y K

2015-06-02

In the coastal countries of East Asia and Southeast Asia, ciguatera should be common because of the extensive tropical and subtropical coral reefs along the coasts and in the neighboring seas with ciguatoxic fishes. An extensive search of journal databases, the Internet and the government websites was performed to identify all reports of ciguatera from the regions. Based on the official data and large published case series, the incidence of ciguatera was higher in the coastal cities (Hong Kong, Foshan, Zhongshan) of southern China than in Japan (Okinawa Prefecture). In Singapore, ciguatera appeared to be almost unknown. In other countries, only isolated cases or small case series were reported, but under-reporting was assumed to be common. Ciguatera may cause severe acute illness and prolonged neurological symptoms. Ciguatera represents an important public health issue for endemic regions, with significant socio-economic impact. Coordinated strategies to improve risk assessment, risk management and risk communication are required. The systematic collection of accurate data on the incidence and epidemiology of ciguatera should enable better assessment and management of its risk. Much more work needs to be done to define the size threshold for important coral reef fish species from different regions, above which the risk of ciguatera significantly increases.

Resident database interfaces to the DAVID system, a heterogeneous distributed database management system

NASA Technical Reports Server (NTRS)

Moroh, Marsha

1988-01-01

A methodology for building interfaces of resident database management systems to a heterogeneous distributed database management system under development at NASA, the DAVID system, was developed. The feasibility of that methodology was demonstrated by construction of the software necessary to perform the interface task. The interface terminology developed in the course of this research is presented. The work performed and the results are summarized.

[Design and implementation of Geographical Information System on prevention and control of cholera].

PubMed

Li, Xiu-jun; Fang, Li-qun; Wang, Duo-chun; Wang, Lu-xi; Li, Ya-pin; Li, Yan-li; Yang, Hong; Kan, Biao; Cao, Wu-chun

2012-04-01

To build the Geographical Information System (GIS) database for prevention and control of cholera programs as well as using management analysis and function demonstration to show the spatial attribute of cholera. Data from case reporting system regarding diarrhoea, vibrio cholerae, serotypes of vibrio cholerae at the surveillance spots and seafoods, as well as surveillance data on ambient environment and climate were collected. All the data were imported to system database to show the incidence of vibrio cholerae in different provinces, regions and counties to support the spatial analysis through the spatial analysis of GIS. The epidemic trends of cholera, seasonal characteristics of the cholera and the variation of the vibrio cholerae with times were better understood. Information on hotspots, regions and time of epidemics was collected, and helpful in providing risk prediction on the incidence of vibrio cholerae. The exploitation of the software can predict and simulate the spatio-temporal risks, so as to provide guidance for the prevention and control of the disease.

Human immunodeficiency virus prevalence, incidence, and residual transmission risk in first-time and repeat blood donations in Zimbabwe: implications on blood safety.

PubMed

Mapako, Tonderai; Mvere, David A; Chitiyo, McLeod E; Rusakaniko, Simbarashe; Postma, Maarten J; van Hulst, Marinus

2013-10-01

National Blood Service Zimbabwe human immunodeficiency virus (HIV) risk management strategy includes screening and discarding of first-time donations, which are collected in blood packs without an anticoagulant (dry pack). To evaluate the impact of discarding first-time donations on blood safety the HIV prevalence, incidence, and residual risk in first-time and repeat donations (wet packs) were compared. Donor data from 2002 to 2010 were retrieved from a centralized national electronic donor database and retrospectively analyzed. Chi-square test was used to compare HIV prevalence with relative risk (RR), and the RR point estimates and 95% confidence interval (CI) are reported. Trend analysis was done using Cochran-Armitage trend test. HIV residual risk estimates were determined using published residual risk estimation models. Over the 9 years the overall HIV prevalence estimates are 1.29% (n = 116,058) and 0.42% (n = 434,695) for first-time and repeat donations, respectively. The overall RR was 3.1 (95% CI, 2.9-3.3; p < 0.0001). The overall mean residual transmission risk of HIV window phase donations in first-time was 1:7384 (range, 1:11,308-1:5356) and in repeat donors it was 1:5496 (range, 1:9943-1:3347). The significantly high HIV prevalence estimates recorded in first-time over repeat donations is indicative of the effectiveness of the HIV risk management strategy. However, comparable residual transmission risk estimates in first-time and repeat donors point to the need to further review the risk management strategies. Given the potential wastage of valuable resources, future studies should focus on the cost-effectiveness and utility of screening and discarding first-time donations. © 2013 American Association of Blood Banks.

Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials

PubMed Central

Chang, John T; Morton, Sally C; Rubenstein, Laurence Z; Mojica, Walter A; Maglione, Margaret; Suttorp, Marika J; Roth, Elizabeth A; Shekelle, Paul G

2004-01-01

Objective To assess the relative effectiveness of interventions to prevent falls in older adults to either a usual care group or control group. Design Systematic review and meta-analyses. Data sources Medline, HealthSTAR, Embase, the Cochrane Library, other health related databases, and the reference lists from review articles and systematic reviews. Data extraction Components of falls intervention: multifactorial falls risk assessment with management programme, exercise, environmental modifications, or education. Results 40 trials were identified. A random effects analysis combining trials with risk ratio data showed a reduction in the risk of falling (risk ratio 0.88, 95% confidence interval 0.82 to 0.95), whereas combining trials with incidence rate data showed a reduction in the monthly rate of falling (incidence rate ratio 0.80, 0.72 to 0.88). The effect of individual components was assessed by meta-regression. A multifactorial falls risk assessment and management programme was the most effective component on risk of falling (0.82, 0.72 to 0.94, number needed to treat 11) and monthly fall rate (0.63, 0.49 to 0.83; 11.8 fewer falls in treatment group per 100 patients per month). Exercise interventions also had a beneficial effect on the risk of falling (0.86, 0.75 to 0.99, number needed to treat 16) and monthly fall rate (0.86, 0.73 to 1.01; 2.7). Conclusions Interventions to prevent falls in older adults are effective in reducing both the risk of falling and the monthly rate of falling. The most effective intervention was a multifactorial falls risk assessment and management programme. Exercise programmes were also effective in reducing the risk of falling. PMID:15031239

Health and productivity as a business strategy.

PubMed

Loeppke, Ronald; Taitel, Michael; Richling, Dennis; Parry, Thomas; Kessler, Ronald C; Hymel, Pam; Konicki, Doris

2007-07-01

The objective of this study is to assess the magnitude of health-related lost productivity relative to medical and pharmacy costs for four employers and assess the business implications of a "full-cost" approach to managing health. A database was developed by integrating medical and pharmacy claims data with employee self-report productivity and health information collected through the Health and Work Performance Questionnaire (HPQ). Information collected on employer business measures were combined with this database to model health-related lost productivity. 1) Health-related productivity costs were more than four times greater than medical and pharmacy costs. 2) The full cost of poor health is driven by different health conditions than those driving medical and pharmacy costs alone. This study demonstrates that Integrated Population Health & Productivity Management should be built on a foundation of Integrated Population Health & Productivity Measurement. Therefore, employers would reveal a blueprint for action for their integrated health and productivity enhancement strategies by measuring the full health and productivity costs related to the burdens of illness and health risk in their population.

The predictive validity of the Two-Tiered Violence Risk Estimates Scale (TTV) in a long-term follow-up of violent offenders.

PubMed

Churcher, Frances P; Mills, Jeremy F; Forth, Adelle E

2016-08-01

Over the past few decades many structured risk appraisal measures have been created to respond to this need. The Two-Tiered Violence Risk Estimates Scale (TTV) is a measure designed to integrate both an actuarial estimate of violence risk with critical risk management indicators. The current study examined interrater reliability and the predictive validity of the TTV in a sample of violent offenders (n = 120) over an average follow-up period of 17.75 years. The TTV was retrospectively scored and compared with the Violence Risk Appraisal Guide (VRAG), the Statistical Information of Recidivism Scale-Revised (SIR-R1), and the Psychopathy Checklist-Revised (PCL-R). Approximately 53% of the sample reoffended violently, with an overall recidivism rate of 74%. Although the VRAG was the strongest predictor of violent recidivism in the sample, the Actuarial Risk Estimates (ARE) scale of the TTV produced a small, significant effect. The Risk Management Indicators (RMI) produced nonsignificant area under the curve (AUC) values for all recidivism outcomes. Comparisons between measures using AUC values and Cox regression showed that there were no statistical differences in predictive validity. The results of this research will be used to inform the validation and reliability literature on the TTV, and will contribute to the overall risk assessment literature. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Computer Security Products Technology Overview

DTIC Science & Technology

1988-10-01

13 3. DATABASE MANAGEMENT SYSTEMS ................................... 15 Definition...this paper addresses fall into the areas of multi-user hosts, database management systems (DBMS), workstations, networks, guards and gateways, and...provide a portion of that protection, for example, a password scheme, a file protection mechanism, a secure database management system, or even a

An Introduction to Database Management Systems.

ERIC Educational Resources Information Center

Warden, William H., III; Warden, Bette M.

1984-01-01

Description of database management systems for microcomputers highlights system features and factors to consider in microcomputer system selection. A method for ranking database management systems is explained and applied to a defined need, i.e., software support for indexing a weekly newspaper. A glossary of terms and 32-item bibliography are…

The feasibility and acceptability of nurse-led chronic disease management interventions in primary care: An integrative review.

PubMed

Stephen, Catherine; McInnes, Susan; Halcomb, Elizabeth

2018-02-01

To explore the feasibility and acceptability of nurse-led chronic disease management and lifestyle risk factor reduction interventions in primary care (general practice/family practice). Growing international evidence suggests that interventions delivered by primary care nurses can assist in modifying lifestyle risk factors and managing chronic disease. To date, there has been limited exploration of the feasibility and acceptability of such interventions. Integrative review guided by the work of Whittemore and Knafl (). Database search of CINAHL, Medline and Web of Science was conducted to identify relevant literature published between 2000-2015. Papers were assessed for methodological quality and data abstracted before thematic analysis was undertaken. Eleven papers met the inclusion criteria. Analysis uncovered four themes: (1) facilitators of interventions; (2) barriers to interventions; (3) consumer satisfaction; and (4) primary care nurse role. Literature supports the feasibility and acceptability of nurse-led interventions in primary care for lifestyle risk factor modification. The ongoing sustainability of these interventions rests largely on organizational factors such as funding, educational pathways and professional support of the primary care nursing role. Further robust research around primary care nurse interventions is required to strengthen the evidence base. © 2017 John Wiley & Sons Ltd.

Ocular toxicities associated with targeted anticancer agents: an analysis of clinical data with management suggestions

PubMed Central

Fu, Chen; Gombos, Dan S; Lee, Jared; George, Goldy C; Hess, Kenneth; Whyte, Andrew; Hong, David S

2017-01-01

Ocular toxicities are among the most common adverse events resulting from targeted anticancer agents and are becoming increasingly relevant in the management of patients on these agents. The purpose of this study is to provide a framework for management of these challenging toxicities based on objective data from FDA labels and from analysis of the literature. All oncologic drugs approved by the FDA up to March 14, 2015, were screened for inclusion. A total of 16 drugs (12 small-molecule drugs and 4 monoclonal antibodies) were analyzed for ocular toxicity profiles based on evidence of ocular toxicity. Trials cited by FDA labels were retrieved, and a combination search in Medline, Google Scholar, the Cochrane database, and the NIH Clinical Trials Database was conducted. The majority of ocular toxicities reported were low severity, and the most common were conjunctivitis and “visual disturbances.” However, severe events including incidents of blindness, retinal vascular occlusion, and corneal ulceration occurred. The frequency and severity at which ocular toxicities occur merits a more multidisciplinary approach to managing patients with agents that are known to cause ocular issues. We suggest a standardized methodology for referral and surveillance of patients who are potentially at risk of severe ocular toxicity. PMID:28938590

Data management with a landslide inventory of the Franconian Alb (Germany) using a spatial database and GIS tools

NASA Astrophysics Data System (ADS)

Bemm, Stefan; Sandmeier, Christine; Wilde, Martina; Jaeger, Daniel; Schwindt, Daniel; Terhorst, Birgit

2014-05-01

The area of the Swabian-Franconian cuesta landscape (Southern Germany) is highly prone to landslides. This was apparent in the late spring of 2013, when numerous landslides occurred as a consequence of heavy and long-lasting rainfalls. The specific climatic situation caused numerous damages with serious impact on settlements and infrastructure. Knowledge on spatial distribution of landslides, processes and characteristics are important to evaluate the potential risk that can occur from mass movements in those areas. In the frame of two projects about 400 landslides were mapped and detailed data sets were compiled during years 2011 to 2014 at the Franconian Alb. The studies are related to the project "Slope stability and hazard zones in the northern Bavarian cuesta" (DFG, German Research Foundation) as well as to the LfU (The Bavarian Environment Agency) within the project "Georisks and climate change - hazard indication map Jura". The central goal of the present study is to create a spatial database for landslides. The database should contain all fundamental parameters to characterize the mass movements and should provide the potential for secure data storage and data management, as well as statistical evaluations. The spatial database was created with PostgreSQL, an object-relational database management system and PostGIS, a spatial database extender for PostgreSQL, which provides the possibility to store spatial and geographic objects and to connect to several GIS applications, like GRASS GIS, SAGA GIS, QGIS and GDAL, a geospatial library (Obe et al. 2011). Database access for querying, importing, and exporting spatial and non-spatial data is ensured by using GUI or non-GUI connections. The database allows the use of procedural languages for writing advanced functions in the R, Python or Perl programming languages. It is possible to work directly with the (spatial) data entirety of the database in R. The inventory of the database includes (amongst others), informations on location, landslide types and causes, geomorphological positions, geometries, hazards and damages, as well as assessments related to the activity of landslides. Furthermore, there are stored spatial objects, which represent the components of a landslide, in particular the scarps and the accumulation areas. Besides, waterways, map sheets, contour lines, detailed infrastructure data, digital elevation models, aspect and slope data are included. Examples of spatial queries to the database are intersections of raster and vector data for calculating values for slope gradients or aspects of landslide areas and for creating multiple, overlaying sections for the comparison of slopes, as well as distances to the infrastructure or to the next receiving drainage. Furthermore, getting informations on landslide magnitudes, distribution and clustering, as well as potential correlations concerning geomorphological or geological conditions. The data management concept in this study can be implemented for any academic, public or private use, because it is independent from any obligatory licenses. The created spatial database offers a platform for interdisciplinary research and socio-economic questions, as well as for landslide susceptibility and hazard indication mapping. Obe, R.O., Hsu, L.S. 2011. PostGIS in action. - pp 492, Manning Publications, Stamford

[Role and management of cancer clinical database in the application of gastric cancer precision medicine].

PubMed

Li, Yuanfang; Zhou, Zhiwei

2016-02-01

Precision medicine is a new medical concept and medical model, which is based on personalized medicine, rapid progress of genome sequencing technology and cross application of biological information and big data science. Precision medicine improves the diagnosis and treatment of gastric cancer to provide more convenience through more profound analyses of characteristics, pathogenesis and other core issues in gastric cancer. Cancer clinical database is important to promote the development of precision medicine. Therefore, it is necessary to pay close attention to the construction and management of the database. The clinical database of Sun Yat-sen University Cancer Center is composed of medical record database, blood specimen bank, tissue bank and medical imaging database. In order to ensure the good quality of the database, the design and management of the database should follow the strict standard operation procedure(SOP) model. Data sharing is an important way to improve medical research in the era of medical big data. The construction and management of clinical database must also be strengthened and innovated.

Diabetes self-management education is not associated with a reduction in long-term diabetes complications: an effectiveness study in an elderly population.

PubMed

Shah, Baiju R; Hwee, Jeremiah; Cauch-Dudek, Karen; Ng, Ryan; Victor, J Charles

2015-08-01

The efficacy of diabetes self-management education on glycaemic control, self-care behaviour and knowledge has been established by short-term studies in experimental settings. The objective of this study was to assess its effectiveness to improve quality of care and reduce the risk of long-term diabetes complications in unselected older patients with recently diagnosed diabetes in routine clinical care. Using population-level health care administrative databases and registries, all patients aged ≥66 years in Ontario, Canada with diabetes for <5 years were identified. Self-management education programme attendees (n = 8485) in 2006 were matched with non-attendees using high-dimensional propensity scores, creating extremely well-balanced study arms. Quality of care measures and the long-term risk of diabetes complications were compared. Self-management programme attendees were more likely than non-attendees to achieve process measures of quality of care such as retinal screening examinations (75.3% versus 70.3%, adjusted relative risk 1.05, 99% confidence interval 1.03-1.08), and ≥2 glycated haemoglobin tests (57.5% versus 53.3%, adjusted relative risk 1.08, 99% confidence interval 1.05-1.11). However, with a median follow-up of 5.3 years, diabetes complications and mortality were not different between arms. In real-world clinical care, self-management education for older patients with recently diagnosed diabetes was associated with modest improvements in quality of care, but no reductions in long-term clinical events. © 2015 John Wiley & Sons, Ltd.

[The theme of disaster in health care: profile of technical and scientific production in the specialized database on disasters of the Virtual Health Library - VHL].

PubMed

Rocha, Vania; Ximenes, Elisa Francioli; Carvalho, Mauren Lopes de; Alpino, Tais de Moura Ariza; Freitas, Carlos Machado de

2014-09-01

In the specialized database of the Virtual Health Library (VHL), the DISASTER database highlights the importance of the theme for the health sector. The scope of this article is to identify the profiles of technical and scientific publications in the specialized database. Based on systematic searches and the analysis of results it is possible to determine: the type of publication; the main topics addressed; the most common type of disasters mentioned in published materials, countries and regions as subjects, historic periods with the most publications and the current trend of publications. When examining the specialized data in detail, it soon becomes clear that the number of major topics is very high, making a specific search process in this database a challenging exercise. On the other hand, it is encouraging that the disaster topic is discussed and assessed in a broad and diversified manner, associated with different aspects of the natural and social sciences. The disaster issue requires the production of interdisciplinary knowledge development to reduce the impacts of disasters and for risk management. In this way, since the health sector is a interdisciplinary area, it can contribute to knowledge production.

Downscaling catchment scale flood risk to contributing sub-catchments to determine the optimum location for flood management.

NASA Astrophysics Data System (ADS)

Pattison, Ian; Lane, Stuart; Hardy, Richard; Reaney, Sim

2010-05-01

The recent increase in flood frequency and magnitude has been hypothesised to have been caused by either climate change or land management. Field scale studies have found that changing land management practices does affect local runoff and streamflow, but upscaling these effects to the catchment scale continues to be problematic, both conceptually and more importantly methodologically. The impact on downstream flood risk is highly dependent upon where the changes are in the catchment, indicating that some areas of the catchment are more important in determining downstream flood risk than others. This is a major flaw in the traditional approach to studying the effect of land use on downstream flood risk: catchment scale hydrological models, which treat every cell in the model equally. We are proposing an alternative ideological approach for doing flood management research, which is underpinned by downscaling the downstream effect (problem i.e. flooding) to the upstream causes (contributing sub-catchments). It is hoped that this approach could have several benefits over the traditional upscaling approach. Firstly, it provides an efficient method to prioritise areas for land use management changes to be implemented to reduce downstream flood risk. Secondly, targets for sub-catchment hydrograph change can be determined which will deliver the required downstream effect. Thirdly, it may be possible to detect the effect of land use changes in upstream areas on downstream flood risk, by weighting the areas of most importance in hydrological models. Two methods for doing this downscaling are proposed; 1) data-based statistical analysis; and 2) hydraulic modelling-based downscaling. These will be outlined using the case study of the River Eden, Cumbria, NW England. The data-based methodology uses the timing and magnitude of floods for each sub-catchment. Principal components analysis (PCA) is used to simplify sub-catchment interactions and optimising stepwise regression is used to predict downstream flood magnitude from the significant principal components. Two particular sub-catchments, the Eamont and the Upper Eden were highlighted as explaining the highest proportion of downstream flood risk, with 21.0% and 19.6% respectively. This approach uses the concept of data mining, whereby commonly available discharge data is used in an innovative way to learn about catchment behaviour. An alternative downscaling approach is hydraulic modelling whereby the input hydrographs from each tributary are changed in turn, both in terms of the magnitudes and the timing of the flows. This basic scenario testing approach can be used to assess the sensitivity of downstream flood risk to upstream contributing tributaries. This approach also highlighted the Upper Eden and Eamont as the most sensitive sub-catchments. A 25% reduction in the flows from these sub-catchments resulted in a 33.1cm and 21.9cm stage reduction downstream respectively, while an 8 hour delay of the peak flow caused a 32.3cm and 27.4cm decrease in downstream stage respectively. This alternative flood management approach is not a replacement to traditional hydrological modelling (upscaling), but a pre-step which allows for more focussed and informed investigation of land management scenarios, in the area where they are most likely to have beneficial impacts on downstream flooding.

The future application of GML database in GIS

NASA Astrophysics Data System (ADS)

Deng, Yuejin; Cheng, Yushu; Jing, Lianwen

2006-10-01

In 2004, the Geography Markup Language (GML) Implementation Specification (version 3.1.1) was published by Open Geospatial Consortium, Inc. Now more and more applications in geospatial data sharing and interoperability depend on GML. The primary purpose of designing GML is for exchange and transportation of geo-information by standard modeling and encoding of geography phenomena. However, the problems of how to organize and access lots of GML data effectively arise in applications. The research on GML database focuses on these problems. The effective storage of GML data is a hot topic in GIS communities today. GML Database Management System (GDBMS) mainly deals with the problem of storage and management of GML data. Now two types of XML database, namely Native XML Database, and XML-Enabled Database are classified. Since GML is an application of the XML standard to geographic data, the XML database system can also be used for the management of GML. In this paper, we review the status of the art of XML database, including storage, index and query languages, management systems and so on, then move on to the GML database. At the end, the future prospect of GML database in GIS application is presented.

Reducing risk for mother-to-infant transmission of hepatitis C virus: a systematic review for the U.S. Preventive Services Task Force.

PubMed

Cottrell, Erika Barth; Chou, Roger; Wasson, Ngoc; Rahman, Basmah; Guise, Jeanne-Marie

2013-01-15

Mother-to-infant transmission is the leading cause of childhood hepatitis C virus (HCV) infection, with up to 4000 new cases each year in the United States. To evaluate effects of mode of delivery, labor management strategies, and breastfeeding practices on risk for mother-to-infant transmission of HCV. MEDLINE (1947 to May 2012), the Cochrane Library Database, clinical trial registries, and reference lists. Randomized trials and observational studies on mode of delivery, labor management strategies, and breastfeeding practices and risk for mother-to-infant transmission of HCV. Investigators abstracted and reviewed study details and quality using predefined criteria. Eighteen observational studies evaluated the association between mode of delivery, labor management strategies, or breastfeeding practices and risk for mother-to-infant HCV transmission. Fourteen studies (2 good-quality, 4 fair-quality, and 8 poor-quality studies) found no clear association between mode of delivery (vaginal versus cesarean delivery) and risk for transmission. Two studies (1 good-quality and 1 poor-quality study) reported an association between prolonged duration of ruptured membranes and increased risk for transmission. Fourteen studies (2 good-quality, 2 fair-quality, and 10 poor-quality studies) found no association between breastfeeding and risk for transmission. Only English-language articles were included. Studies were observational, and most had important methodological shortcomings, including failure to adjust for potential confounders and small sample sizes. No intervention has been clearly demonstrated to reduce the risk for mother-to-infant HCV transmission. Avoidance of breastfeeding does not seem to be indicated for reducing transmission risk. Agency for Healthcare Research and Quality.

Database Systems. Course Three. Information Systems Curriculum.

ERIC Educational Resources Information Center

O'Neil, Sharon Lund; Everett, Donna R.

This course is the third of seven in the Information Systems curriculum. The purpose of the course is to familiarize students with database management concepts and standard database management software. Databases and their roles, advantages, and limitations are explained. An overview of the course sets forth the condition and performance standard…

23 CFR 972.204 - Management systems requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... to operate and maintain the management systems and their associated databases; and (5) A process for... systems will use databases with a geographical reference system that can be used to geolocate all database...

23 CFR 972.204 - Management systems requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... to operate and maintain the management systems and their associated databases; and (5) A process for... systems will use databases with a geographical reference system that can be used to geolocate all database...

23 CFR 972.204 - Management systems requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... to operate and maintain the management systems and their associated databases; and (5) A process for... systems will use databases with a geographical reference system that can be used to geolocate all database...

23 CFR 972.204 - Management systems requirements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... to operate and maintain the management systems and their associated databases; and (5) A process for... systems will use databases with a geographical reference system that can be used to geolocate all database...

Spatial aspects of building and population exposure data and their implications for global earthquake exposure modeling

USGS Publications Warehouse

Dell’Acqua, F.; Gamba, P.; Jaiswal, K.

2012-01-01

This paper discusses spatial aspects of the global exposure dataset and mapping needs for earthquake risk assessment. We discuss this in the context of development of a Global Exposure Database for the Global Earthquake Model (GED4GEM), which requires compilation of a multi-scale inventory of assets at risk, for example, buildings, populations, and economic exposure. After defining the relevant spatial and geographic scales of interest, different procedures are proposed to disaggregate coarse-resolution data, to map them, and if necessary to infer missing data by using proxies. We discuss the advantages and limitations of these methodologies and detail the potentials of utilizing remote-sensing data. The latter is used especially to homogenize an existing coarser dataset and, where possible, replace it with detailed information extracted from remote sensing using the built-up indicators for different environments. Present research shows that the spatial aspects of earthquake risk computation are tightly connected with the availability of datasets of the resolution necessary for producing sufficiently detailed exposure. The global exposure database designed by the GED4GEM project is able to manage datasets and queries of multiple spatial scales.

An offline-online Web-GIS Android application for fast data acquisition of landslide hazard and risk

NASA Astrophysics Data System (ADS)

Olyazadeh, Roya; Sudmeier-Rieux, Karen; Jaboyedoff, Michel; Derron, Marc-Henri; Devkota, Sanjaya

2017-04-01

Regional landslide assessments and mapping have been effectively pursued by research institutions, national and local governments, non-governmental organizations (NGOs), and different stakeholders for some time, and a wide range of methodologies and technologies have consequently been proposed. Land-use mapping and hazard event inventories are mostly created by remote-sensing data, subject to difficulties, such as accessibility and terrain, which need to be overcome. Likewise, landslide data acquisition for the field navigation can magnify the accuracy of databases and analysis. Open-source Web and mobile GIS tools can be used for improved ground-truthing of critical areas to improve the analysis of hazard patterns and triggering factors. This paper reviews the implementation and selected results of a secure mobile-map application called ROOMA (Rapid Offline-Online Mapping Application) for the rapid data collection of landslide hazard and risk. This prototype assists the quick creation of landslide inventory maps (LIMs) by collecting information on the type, feature, volume, date, and patterns of landslides using open-source Web-GIS technologies such as Leaflet maps, Cordova, GeoServer, PostgreSQL as the real DBMS (database management system), and PostGIS as its plug-in for spatial database management. This application comprises Leaflet maps coupled with satellite images as a base layer, drawing tools, geolocation (using GPS and the Internet), photo mapping, and event clustering. All the features and information are recorded into a GeoJSON text file in an offline version (Android) and subsequently uploaded to the online mode (using all browsers) with the availability of Internet. Finally, the events can be accessed and edited after approval by an administrator and then be visualized by the general public.

NeuPAT: an intranet database supporting translational research in neuroblastic tumors.

PubMed

Villamón, Eva; Piqueras, Marta; Meseguer, Javier; Blanquer, Ignacio; Berbegall, Ana P; Tadeo, Irene; Hernández, Vicente; Navarro, Samuel; Noguera, Rosa

2013-03-01

Translational research in oncology is directed mainly towards establishing a better risk stratification and searching for appropriate therapeutic targets. This research generates a tremendous amount of complex clinical and biological data needing speedy and effective management. The authors describe the design, implementation and early experiences of a computer-aided system for the integration and management of data for neuroblastoma patients. NeuPAT facilitates clinical and translational research, minimizes the workload in consolidating the information, reduces errors and increases correlation of data through extensive coding. This design can also be applied to other tumor types. Copyright © 2012 Elsevier Ltd. All rights reserved.

Bioinformatics for Exploration

NASA Technical Reports Server (NTRS)

Johnson, Kathy A.

2006-01-01

For the purpose of this paper, bioinformatics is defined as the application of computer technology to the management of biological information. It can be thought of as the science of developing computer databases and algorithms to facilitate and expedite biological research. This is a crosscutting capability that supports nearly all human health areas ranging from computational modeling, to pharmacodynamics research projects, to decision support systems within autonomous medical care. Bioinformatics serves to increase the efficiency and effectiveness of the life sciences research program. It provides data, information, and knowledge capture which further supports management of the bioastronautics research roadmap - identifying gaps that still remain and enabling the determination of which risks have been addressed.

A comparative study of the risk profile of hemodialysis patients in a for profit network and in two regional registries of the Italian Society of Nephrology.

PubMed

Postorino, Maurizio; Amato, Claudia; Mancini, Elena; Carioni, Paola; D'Arrigo, Graziella; Di Benedetto, Attilio; Cerino, Fabrizio; Marino, Carmela; Vilasi, Antonio; Tripepi, Giovanni; Stuard, Stefano; Capasso, Giovanbattista; Santoro, Antonio; Zoccali, Carmine

2018-02-01

In 2013, the Italian Society of Nephrology joined forces with Nephrocare-Italy to create a clinical research cohort of patients on file in the data-rich clinical management system (EUCLID) of this organization for the performance of observational studies in the hemodialysis (HD) population. To see whether patients in EUCLID are representative of the HD population in Italy, we set out to compare the whole EUCLID population with patients included in the regional HD registries in Emilia-Romagna (Northern Italy) and in Calabria (Southern Italy), the sole regions in Italy which have systematically collected an enlarged clinical data set allowing comparison with the data-rich EUCLID system. An analysis of prevalent and incident patients in 2010 and 2011 showed that EUCLID patients had a lower prevalence of coronary heart disease, peripheral vascular disease, heart failure, valvular heart disease, liver disease, peptic ulcer and other comorbidities and risk factors and a higher fractional urea clearance (Kt/V) than those in the Emilia Romagna and Calabria registries. Accordingly, survival analysis showed a lower mortality risk in the EUCLID 2010 and 2011 cohorts than in the combined two regional registries in the corresponding years: for 2010, hazard ratio (HR) EUCLID vs. Regional registries: 0.80 [95% confidence interval: 0.71-0.90]; for 2011, HR: 0.76 [0.65-0.90]. However, this difference was nullified by statistical adjustment for the difference in comorbidities and risk factors, indicating that the longer survival in the EUCLID database was attributable to the lower risk profile of patients included in that database. This preliminary analysis sets the stage for future observational studies and indicates that appropriate adjustment for difference in comorbidities and risk factors is needed to generalize to the Italian HD population analyses based on the data-rich EUCLID database.

Caring for children with special healthcare needs in the managed care environment.

PubMed

Hawkins, Michelle R; Diehl-Svrjcek, Beth; Dunbar, Linda J

2006-01-01

Dramatic medical and technological advances over the past 15 years have resulted in the survival into adulthood of children with chronic health conditions. As this population subset has increased, the demand of caring for these children in the managed care arena has become challenging from a clinical, fiscal, and member satisfaction perspective. A disease management program was designed for children, ages birth through age 18, identified as having special needs at the time of birth or at any point throughout childhood related to disease processes such as diabetes, sickle cell disease, genetic aberrations, or the multiple complications of extreme prematurity. Components of the program included identification of the population, coordinated risk assessment, and ongoing case management interventions. Most important, outcome indicators were tracked to demonstrate program effectiveness. The formulation and function of a dedicated disease management database is also discussed.

In-game Management of Common Joint Dislocations

PubMed Central

Skelley, Nathan W.; McCormick, Jeremy J.; Smith, Matthew V.

2014-01-01

Context: Sideline management of sports-related joint dislocations often places the treating medical professional in a challenging position. These injuries frequently require prompt evaluation, diagnosis, reduction, and postreduction management before they can be evaluated at a medical facility. Our objective is to review the mechanism, evaluation, reduction, and postreduction management of sports-related dislocations to the shoulder, elbow, finger, knee, patella, and ankle joints. Evidence Acquisition: A literature review was performed using the PubMed database to evaluate previous and current publications focused on joint dislocations. This review focused on articles published between 1980 and 2013. Study Design: Clinical review. Level of Evidence: Level 4. Results: The clinician should weigh the benefits and risks of on-field reduction based on their knowledge of the injury and the presence of associated injuries. Conclusion: When properly evaluated and diagnosed, most sports-related dislocations can be reduced and initially managed at the game. PMID:24790695

Periodontal therapy for the management of cardiovascular disease in patients with chronic periodontitis.

PubMed

Li, Chunjie; Lv, Zongkai; Shi, Zongdao; Zhu, Ye; Wu, Yafei; Li, Longjiang; Iheozor-Ejiofor, Zipporah

2014-08-15

There is an association between chronic periodontitis and cardiovascular disease (CVD). However, it is not known whether periodontal therapy could prevent or manage CVD in patients with chronic periodontitis. The objective of this systematic review was to investigate the effects of periodontal therapy in preventing the occurrence of, and management or recurrence of, CVD in patients with chronic periodontitis. The electronic databases that were searched were the Cochrane Oral Health Group's Trials Register (to 7 April 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 3), MEDLINE via OVID (1946 to 7 April 2014), EMBASE via OVID (1980 to 7 April 2014), CINAHL via EBSCO (1937 to 7 April 2014), OpenGrey (to 7 April 2014), the Chinese BioMedical Literature Database (1978 to April 2014), the China National Knowledge Infrastructure (1994 to April 2014) and the VIP database (1989 to April 2014). We searched the US National Institutes of Health Trials Register, the World Health Organization (WHO) Clinical Trials Registry Platform and Sciencepaper Online for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. Randomised controlled trials (RCTs) and quasi-RCTs were considered eligible. Studies were selected if they included patients with a diagnosis of chronic periodontitis and previous CVD (secondary prevention studies) or no CVD (primary prevention studies); patients in the intervention group received active periodontal therapy compared to maintenance therapy, no periodontal treatment or another kind of periodontal treatment in the control group. Two review authors carried out the study identification, data extraction and risk of bias assessment independently and in duplicate. Any discrepancies between the two authors were resolved by discussion or with a third review author. A formal pilot-tested data extraction form was adopted for the data extraction, and the Cochrane Collaboration's tool for risk of bias assessment was used for the critical appraisal of the literature. No studies were identified that assessed primary prevention of CVD in people with periodontitis. One study involving 303 participants with ≥ 50% blockage of one coronary artery or a coronary event within three years, but not the three months prior, was included. The study was at high risk of bias due to deviation from the protocol treatment allocation and lack of follow-up data. The trial compared scaling and root planing (SRP) with community care for a follow-up period of six to 25 months. No data on deaths (all-cause or CVD-related) were reported. There was insufficient evidence to determine the effect of SRP and community care in reducing the risk of CVD recurrence in patients with chronic periodontitis (risk ratio (RR) 0.72; 95% confidence interval (CI) 0.23 to 2.22; very low quality evidence). The effects of SRP compared with community care on high-sensitivity C-reactive protein (hs-CRP) (mean difference (MD) 0.62; -1.45 to 2.69), the number of patients with high hs-CRP (RR 0.77; 95% CI 0.32 to 1.85) and adverse events (RR 9.06; 95% CI 0.49 to 166.82) were also not statistically significant. The study did not assess modifiable cardiovascular risk factors, other blood test results, heart function parameters or revascularisation procedures. We found very low quality evidence that was insufficient to support or refute whether periodontal therapy can prevent the recurrence of CVD in the long term in patients with chronic periodontitis. No evidence on primary prevention was found.

Information systems in food safety management.

PubMed

McMeekin, T A; Baranyi, J; Bowman, J; Dalgaard, P; Kirk, M; Ross, T; Schmid, S; Zwietering, M H

2006-12-01

Information systems are concerned with data capture, storage, analysis and retrieval. In the context of food safety management they are vital to assist decision making in a short time frame, potentially allowing decisions to be made and practices to be actioned in real time. Databases with information on microorganisms pertinent to the identification of foodborne pathogens, response of microbial populations to the environment and characteristics of foods and processing conditions are the cornerstone of food safety management systems. Such databases find application in: Identifying pathogens in food at the genus or species level using applied systematics in automated ways. Identifying pathogens below the species level by molecular subtyping, an approach successfully applied in epidemiological investigations of foodborne disease and the basis for national surveillance programs. Predictive modelling software, such as the Pathogen Modeling Program and Growth Predictor (that took over the main functions of Food Micromodel) the raw data of which were combined as the genesis of an international web based searchable database (ComBase). Expert systems combining databases on microbial characteristics, food composition and processing information with the resulting "pattern match" indicating problems that may arise from changes in product formulation or processing conditions. Computer software packages to aid the practical application of HACCP and risk assessment and decision trees to bring logical sequences to establishing and modifying food safety management practices. In addition there are many other uses of information systems that benefit food safety more globally, including: Rapid dissemination of information on foodborne disease outbreaks via websites or list servers carrying commentary from many sources, including the press and interest groups, on the reasons for and consequences of foodborne disease incidents. Active surveillance networks allowing rapid dissemination of molecular subtyping information between public health agencies to detect foodborne outbreaks and limit the spread of human disease. Traceability of individual animals or crops from (or before) conception or germination to the consumer as an integral part of food supply chain management. Provision of high quality, online educational packages to food industry personnel otherwise precluded from access to such courses.

Educational interventions for general practitioners to identify and manage depression as a suicide risk factor in young people: a systematic review and meta-analysis protocol.

PubMed

Tait, Lynda; Michail, Maria

2014-12-15

Suicide is a major public health problem and globally is the second leading cause of death in young adults. Globally, there are 164,000 suicides per year in young people under 25 years. Depression is a strong risk factor for suicide. Evidence shows that 45% of those completing suicide, including young adults, contact their general practitioner rather than a mental health professional in the month before their death. Further evidence indicates that risk factors or early warning signs of suicide in young people go undetected and untreated by general practitioners. Healthcare-based suicide prevention interventions targeted at general practitioners are designed to increase identification of at-risk young people. The rationale of this type of intervention is that early identification and improved clinical management of at-risk individuals will reduce morbidity and mortality. This systematic review will synthesise evidence on the effectiveness of education interventions for general practitioners in identifying and managing depression as a suicide risk factor in young people. We shall conduct a systematic review and meta-analysis following the Cochrane Handbook for Systematic Reviews of Interventions guidelines and conform to the reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement recommendations. Electronic databases will be systematically searched for randomised controlled trials and quasi-experimental studies investigating the effectiveness of interventions for general practitioners in identifying and managing depression as a suicide risk factor in young people in comparison to any other intervention, no intervention, usual care or waiting list. Grey literature will be searched by screening trial registers. Only studies published in English will be included. No date restrictions will be applied. Two authors will independently screen titles and abstracts of potential studies. The primary outcome is identification and management of depression. Secondary outcomes are suicidal ideation, suicide attempts, deliberate self-harm, knowledge of suicide risk factors and suicide-related behaviours, attitudes towards suicide risk and suicide-related behaviours, confidence in dealing with suicide risk factors and suicide-related behaviour. Our study will inform the development of future education interventions and provide feasibility and acceptability evidence, to help general practitioners identify and manage suicidal behaviour in young people. PROSPERO registration number: CRD42014009110.

New perspectives in toxicological information management, and the role of ISSTOX databases in assessing chemical mutagenicity and carcinogenicity.

PubMed

Benigni, Romualdo; Battistelli, Chiara Laura; Bossa, Cecilia; Tcheremenskaia, Olga; Crettaz, Pierre

2013-07-01

Currently, the public has access to a variety of databases containing mutagenicity and carcinogenicity data. These resources are crucial for the toxicologists and regulators involved in the risk assessment of chemicals, which necessitates access to all the relevant literature, and the capability to search across toxicity databases using both biological and chemical criteria. Towards the larger goal of screening chemicals for a wide range of toxicity end points of potential interest, publicly available resources across a large spectrum of biological and chemical data space must be effectively harnessed with current and evolving information technologies (i.e. systematised, integrated and mined), if long-term screening and prediction objectives are to be achieved. A key to rapid progress in the field of chemical toxicity databases is that of combining information technology with the chemical structure as identifier of the molecules. This permits an enormous range of operations (e.g. retrieving chemicals or chemical classes, describing the content of databases, finding similar chemicals, crossing biological and chemical interrogations, etc.) that other more classical databases cannot allow. This article describes the progress in the technology of toxicity databases, including the concepts of Chemical Relational Database and Toxicological Standardized Controlled Vocabularies (Ontology). Then it describes the ISSTOX cluster of toxicological databases at the Istituto Superiore di Sanitá. It consists of freely available databases characterised by the use of modern information technologies and by curation of the quality of the biological data. Finally, this article provides examples of analyses and results made possible by ISSTOX.

Combining new technologies for effective collection development: a bibliometric study using CD-ROM and a database management program.

PubMed Central

Burnham, J F; Shearer, B S; Wall, J C

1992-01-01

Librarians have used bibliometrics for many years to assess collections and to provide data for making selection and deselection decisions. With the advent of new technology--specifically, CD-ROM databases and reprint file database management programs--new cost-effective procedures can be developed. This paper describes a recent multidisciplinary study conducted by two library faculty members and one allied health faculty member to test a bibliometric method that used the MEDLINE and CINAHL databases on CD-ROM and the Papyrus database management program to produce a new collection development methodology. PMID:1600424

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

PubMed

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

2018-01-01

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

Creating databases for biological information: an introduction.

PubMed

Stein, Lincoln

2013-06-01

The essence of bioinformatics is dealing with large quantities of information. Whether it be sequencing data, microarray data files, mass spectrometric data (e.g., fingerprints), the catalog of strains arising from an insertional mutagenesis project, or even large numbers of PDF files, there inevitably comes a time when the information can simply no longer be managed with files and directories. This is where databases come into play. This unit briefly reviews the characteristics of several database management systems, including flat file, indexed file, relational databases, and NoSQL databases. It compares their strengths and weaknesses and offers some general guidelines for selecting an appropriate database management system. Copyright 2013 by JohnWiley & Sons, Inc.

Close relationships and the management of chronic illness: Associations and interventions.

PubMed

Martire, Lynn M; Helgeson, Vicki S

2017-09-01

Self-management of a chronic illness involves not only monitoring symptoms, adhering to medication regimens, and keeping medical appointments but also making and maintaining difficult lifestyle changes. This article highlights correlational and intervention research suggesting family members are influential in children's and adults' illness management. The argument is made that a dyadic approach to chronic illness management that targets the influence of close relationships may yield more sustainable effects on patient behavior than has been achieved in the past. In particular, dyadic approaches aimed at helping patients and family members to find ways to collaborate in goal setting for these behaviors is recommended. Such dyadic interventions may also benefit family members who are ill or are at risk because of poor health behaviors. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Prevention of musculoskeletal disorders within management systems: A scoping review of practices, approaches, and techniques.

PubMed

Yazdani, Amin; Neumann, W Patrick; Imbeau, Daniel; Bigelow, Philip; Pagell, Mark; Wells, Richard

2015-11-01

The purpose of this study was to identify and summarize the current research evidence on approaches to preventing musculoskeletal disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS). Databases in business, engineering, and health and safety were searched and 718 potentially relevant publications were identified and examined for their relevance. Twenty-one papers met the selection criteria and were subjected to thematic analysis. There was very little literature describing the integration of MSD risk assessment and prevention into management systems. This lack of information may isolate MSD prevention, leading to difficulties in preventing these disorders at an organizational level. The findings of this review argue for further research to integrate MSD prevention into management systems and to evaluate the effectiveness of the approach. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Federated Web-accessible Clinical Data Management within an Extensible NeuroImaging Database

PubMed Central

Keator, David B.; Wei, Dingying; Fennema-Notestine, Christine; Pease, Karen R.; Bockholt, Jeremy; Grethe, Jeffrey S.

2010-01-01

Managing vast datasets collected throughout multiple clinical imaging communities has become critical with the ever increasing and diverse nature of datasets. Development of data management infrastructure is further complicated by technical and experimental advances that drive modifications to existing protocols and acquisition of new types of research data to be incorporated into existing data management systems. In this paper, an extensible data management system for clinical neuroimaging studies is introduced: The Human Clinical Imaging Database (HID) and Toolkit. The database schema is constructed to support the storage of new data types without changes to the underlying schema. The complex infrastructure allows management of experiment data, such as image protocol and behavioral task parameters, as well as subject-specific data, including demographics, clinical assessments, and behavioral task performance metrics. Of significant interest, embedded clinical data entry and management tools enhance both consistency of data reporting and automatic entry of data into the database. The Clinical Assessment Layout Manager (CALM) allows users to create on-line data entry forms for use within and across sites, through which data is pulled into the underlying database via the generic clinical assessment management engine (GAME). Importantly, the system is designed to operate in a distributed environment, serving both human users and client applications in a service-oriented manner. Querying capabilities use a built-in multi-database parallel query builder/result combiner, allowing web-accessible queries within and across multiple federated databases. The system along with its documentation is open-source and available from the Neuroimaging Informatics Tools and Resource Clearinghouse (NITRC) site. PMID:20567938

Federated web-accessible clinical data management within an extensible neuroimaging database.

PubMed

Ozyurt, I Burak; Keator, David B; Wei, Dingying; Fennema-Notestine, Christine; Pease, Karen R; Bockholt, Jeremy; Grethe, Jeffrey S

2010-12-01

Managing vast datasets collected throughout multiple clinical imaging communities has become critical with the ever increasing and diverse nature of datasets. Development of data management infrastructure is further complicated by technical and experimental advances that drive modifications to existing protocols and acquisition of new types of research data to be incorporated into existing data management systems. In this paper, an extensible data management system for clinical neuroimaging studies is introduced: The Human Clinical Imaging Database (HID) and Toolkit. The database schema is constructed to support the storage of new data types without changes to the underlying schema. The complex infrastructure allows management of experiment data, such as image protocol and behavioral task parameters, as well as subject-specific data, including demographics, clinical assessments, and behavioral task performance metrics. Of significant interest, embedded clinical data entry and management tools enhance both consistency of data reporting and automatic entry of data into the database. The Clinical Assessment Layout Manager (CALM) allows users to create on-line data entry forms for use within and across sites, through which data is pulled into the underlying database via the generic clinical assessment management engine (GAME). Importantly, the system is designed to operate in a distributed environment, serving both human users and client applications in a service-oriented manner. Querying capabilities use a built-in multi-database parallel query builder/result combiner, allowing web-accessible queries within and across multiple federated databases. The system along with its documentation is open-source and available from the Neuroimaging Informatics Tools and Resource Clearinghouse (NITRC) site.

Soil pH Errors Propagation from Measurements to Spatial Predictions - Cost Benefit Analysis and Risk Assessment Implications for Practitioners and Modelers

NASA Astrophysics Data System (ADS)

Owens, P. R.; Libohova, Z.; Seybold, C. A.; Wills, S. A.; Peaslee, S.; Beaudette, D.; Lindbo, D. L.

2017-12-01

The measurement errors and spatial prediction uncertainties of soil properties in the modeling community are usually assessed against measured values when available. However, of equal importance is the assessment of errors and uncertainty impacts on cost benefit analysis and risk assessments. Soil pH was selected as one of the most commonly measured soil properties used for liming recommendations. The objective of this study was to assess the error size from different sources and their implications with respect to management decisions. Error sources include measurement methods, laboratory sources, pedotransfer functions, database transections, spatial aggregations, etc. Several databases of measured and predicted soil pH were used for this study including the United States National Cooperative Soil Survey Characterization Database (NCSS-SCDB), the US Soil Survey Geographic (SSURGO) Database. The distribution of errors among different sources from measurement methods to spatial aggregation showed a wide range of values. The greatest RMSE of 0.79 pH units was from spatial aggregation (SSURGO vs Kriging), while the measurement methods had the lowest RMSE of 0.06 pH units. Assuming the order of data acquisition based on the transaction distance i.e. from measurement method to spatial aggregation the RMSE increased from 0.06 to 0.8 pH units suggesting an "error propagation". This has major implications for practitioners and modeling community. Most soil liming rate recommendations are based on 0.1 pH unit increments, while the desired soil pH level increments are based on 0.4 to 0.5 pH units. Thus, even when the measured and desired target soil pH are the same most guidelines recommend 1 ton ha-1 lime, which translates in 111 ha-1 that the farmer has to factor in the cost-benefit analysis. However, this analysis need to be based on uncertainty predictions (0.5-1.0 pH units) rather than measurement errors (0.1 pH units) which would translate in 555-1,111 investment that need to be assessed against the risk. The modeling community can benefit from such analysis, however, error size and spatial distribution for global and regional predictions need to be assessed against the variability of other drivers and impact on management decisions.

Implementation of a data management software system for SSME test history data

NASA Technical Reports Server (NTRS)

Abernethy, Kenneth

1986-01-01

The implementation of a software system for managing Space Shuttle Main Engine (SSME) test/flight historical data is presented. The software system uses the database management system RIM7 for primary data storage and routine data management, but includes several FORTRAN programs, described here, which provide customized access to the RIM7 database. The consolidation, modification, and transfer of data from the database THIST, to the RIM7 database THISRM is discussed. The RIM7 utility modules for generating some standard reports from THISRM and performing some routine updating and maintenance are briefly described. The FORTRAN accessing programs described include programs for initial loading of large data sets into the database, capturing data from files for database inclusion, and producing specialized statistical reports which cannot be provided by the RIM7 report generator utility. An expert system tutorial, constructed using the expert system shell product INSIGHT2, is described. Finally, a potential expert system, which would analyze data in the database, is outlined. This system could use INSIGHT2 as well and would take advantage of RIM7's compatibility with the microcomputer database system RBase 5000.

Pharmaceutical supply chain risks: a systematic review

PubMed Central

2013-01-01

Introduction Supply of medicine as a strategic product in any health system is a top priority. Pharmaceutical companies, a major player of the drug supply chain, are subject to many risks. These risks disrupt the supply of medicine in many ways such as their quantity and quality and their delivery to the right place and customers and at the right time. Therefore risk identification in the supply process of pharmaceutical companies and mitigate them is highly recommended. Objective In this study it is attempted to investigate pharmaceutical supply chain risks with perspective of manufacturing companies. Methods Scopus, PubMed, Web of Science bibliographic databases and Google scholar scientific search engines were searched for pharmaceutical supply chain risk management studies with 6 different groups of keywords. All results found by keywords were reviewed and none-relevant articles were excluded by outcome of interests and researcher boundaries of study within 4 steps and through a systematic method. Results Nine articles were included in the systematic review and totally 50 main risks based on study outcome of interest extracted which classified in 7 categories. Most of reported risks were related to supply and supplier issues. Organization and strategy issues, financial, logistic, political, market and regulatory issues were in next level of importance. Conclusion It was shown that the majority of risks in pharmaceutical supply chain were internal risks due to processes, people and functions mismanagement which could be managed by suitable mitigation strategies. PMID:24355166

Graph Databases for Large-Scale Healthcare Systems: A Framework for Efficient Data Management and Data Services

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

Park, Yubin; Shankar, Mallikarjun; Park, Byung H.

Designing a database system for both efficient data management and data services has been one of the enduring challenges in the healthcare domain. In many healthcare systems, data services and data management are often viewed as two orthogonal tasks; data services refer to retrieval and analytic queries such as search, joins, statistical data extraction, and simple data mining algorithms, while data management refers to building error-tolerant and non-redundant database systems. The gap between service and management has resulted in rigid database systems and schemas that do not support effective analytics. We compose a rich graph structure from an abstracted healthcaremore » RDBMS to illustrate how we can fill this gap in practice. We show how a healthcare graph can be automatically constructed from a normalized relational database using the proposed 3NF Equivalent Graph (3EG) transformation.We discuss a set of real world graph queries such as finding self-referrals, shared providers, and collaborative filtering, and evaluate their performance over a relational database and its 3EG-transformed graph. Experimental results show that the graph representation serves as multiple de-normalized tables, thus reducing complexity in a database and enhancing data accessibility of users. Based on this finding, we propose an ensemble framework of databases for healthcare applications.« less

LOD BIM Element specification for Railway Turnout Systems Risk Mitigation using the Information Delivery Manual

NASA Astrophysics Data System (ADS)

Gigante-Barrera, Ángel; Dindar, Serdar; Kaewunruen, Sakdirat; Ruikar, Darshan

2017-10-01

Railway turnouts are complex systems designed using complex geometries and grades which makes them difficult to be managed in terms of risk prevention. This feature poses a substantial peril to rail users as it is considered a cause of derailment. In addition, derailment deals to financial losses due to operational downtimes and monetary compensations in case of death or injure. These are fundamental drivers to consider mitigating risks arising from poor risk management during design. Prevention through design (PtD) is a process that introduces tacit knowledge from industry professionals during the design process. There is evidence that Building Information Modelling (BIM) can help to mitigate risk since the inception of the project. BIM is considered an Information System (IS) were tacit knowledge can be stored and retrieved from a digital database making easy to take promptly decisions as information is ready to be analysed. BIM at the model element level entails working with 3D elements and embedded data, therefore adding a layer of complexity to the management of information along the different stages of the project and across different disciplines. In order to overcome this problem, the industry has created a framework for model progression specification named Level of Development (LOD). The paper presents an IDM based framework for design risk mitigation through code validation using the LOD. This effort resulted on risk datasets which describe graphically and non-graphically a rail turnout as the model progresses. Thus, permitting its inclusion within risk information systems. The assignment of an LOD construct to a set of data, requires specialised management and process related expertise. Furthermore, the selection of a set of LOD constructs requires a purpose based analysis. Therefore, a framework for LOD constructs implementation within the IDM for code checking is required for the industry to progress in this particular field.

An Evidence-Based Review Literature About Risk Indicators and Management of Unknown-Origin Xerostomia

PubMed Central

Agha-Hosseini, Farzaneh; Moosavi, Mahdieh-Sadat

2013-01-01

This evidence-based article reviews risk indicators and management of unknown-origin xerostomia. Xerostomia and hyposalivation refer to different aspects of dry mouth. Xerostomia is a subjective sensation of dry mouth, whilst hyposalivation is defined as an objective assessment of reduced salivary flow rate. About 30% of the elderly (65 years and older) experience xerostomia and hyposalivation. Structural and functional factors, or both may lead to salivary gland dysfunction. The EBM literature search was conducted by using the medical literature database MEDLINE via PubMed and OvidMedline search engines. Results were limited to English language articles (1965 to present) including clinical trials (CT), randomized controlled trials (RCT), systematic reviews and review articles. Case control or cohort studies were included for the etiology. Neuropathic etiology such as localized oral alteration of thermal sensations, saliva composition change (for example higher levels of K, Cl, Ca, IgA, amylase, calcium, PTH and cortisol), lower levels of estrogen and progesterone, smaller salivary gland size, and illnesses such as lichen planus, are risk indicators for unknown-origin xerostomia. The management is palliative and preventative. Management of symptoms includes drug administration (systemic secretogogues, saliva substitutes and bile secretion-stimulator), night guard, diet and habit modifications. Other managements may be indicated to treat adverse effects. Neuropathic etiology, saliva composition change, smaller salivary gland size, and illnesses such as oral lichen planus can be suggestive causes for unknown-origin xerostomia. However, longitudinal studies will be important to elucidate the causes of unknown-origin xerostomia. PMID:25512755

Modest increase in risk of acute coronary syndrome associated with morphine use in cancer patients: a population-based nested case-control study.

PubMed

Lee, Cynthia Wei-Sheng; Muo, Chih-Hsin; Liang, Ji-An; Sung, Fung-Chang; Kao, Chia-Hung

2014-06-01

Morphine is widely used for pain management in cancer patients. Use of heroin, a morphine derivative, is a risk factor for acute coronary syndrome (ACS). This study investigates the risk of ACS associated with morphine use by comparing the incidence of ACS in cancer patients treated with and without morphine. This is a population-based nested case-control study using the Longitudinal Health Insurance Database 2000 in Taiwan. In total, 31,384 patients on the database were diagnosed with cancer without prior history of ACS during 1998-2010. In this cohort, 499 patients subsequently developed ACS and 30,885 patients did not. The 499 patients were designated as the ACS group; controls were selected from the remaining 30,885 patients and matched 3:1 to each case for age, sex, year of cancer diagnosis, and index year. Logistic regression was used to estimate the odds ratios and 95% confidence intervals, and the multivariable model was applied to control for age, sex, and Charlson comorbidity score. Cancer patients who received morphine had a 32% higher risk of developing ACS than non-morphine users. This increase in risk was significant when evaluating the overall cancer patients, but non-significant when evaluating any specific cancer type. The risk of ACS increased significantly with increasing morphine dosage (to ≥65 mg/y). Morphine treatment is associated with a modest increase in risk of ACS in patients with malignancy, but this association displays low significance in specific cancer types. Copyright © 2014 Elsevier Ltd. All rights reserved.

Increased risk of Eustachian tube disorders in patients with sleep-disordered breathing

PubMed Central

Chou, Meng-Shih; Chang, Wen-Dien; Lin, Che-Chen; Li, Yu-Fen; Tsou, Yung-An

2017-01-01

Abstract Sleep-disordered breathing (SDB) and Eustachian tube disorders (ETDs) share the same risk factors. The specific aim of this study was to determine the correlation between these 2 conditions and to determine whether treatments for SDB reduce the risk of ETD. This is a retrospective and large population-based cohort study. According to Taiwan's National Health Insurance Research Database, out of 1,000,000 insured patients, 24,251 patients were newly diagnosed with SDB from year 2000 through 2009. The control group for this study comprised 96,827 patients without SDB who were randomly selected from the same database at a ratio of 1:4, frequency matched for sex, age, and index year of SDB. The incidence of developing ETD was compared between these 2 groups; the main covariates were demographic data, interventions, and medical comorbidities. There was an increased risk of developing ETD among the SDB cohort compared with the control group (hazard ratio = 1.51, 95% confidence interval = 1.41–1.63). Compared with SDB patients who did not receive treatment, those who received the treatment, that is, pharyngeal or nasal surgery, CPAP, or multiple modalities (both surgery and CPAP), had a significantly reduced risk of developing ETD. This study showed that patients with SDB are at an increased risk of developing ETD and other comorbidities. The risk of developing ETD can be reduced by implementing prompt treatment for SDB. Multidisciplinary evaluation including ETD should be conducted in the management of patients presenting with SDB. PMID:28767574

23 CFR 971.204 - Management systems requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL LANDS HIGHWAYS FOREST SERVICE... maintain the management systems and their associated databases; and (5) A process for data collection, processing, analysis, and updating for each management system. (c) All management systems will use databases...

23 CFR 970.204 - Management systems requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL LANDS HIGHWAYS NATIONAL PARK... the management systems and their associated databases; and (5) A process for data collection, processing, analysis and updating for each management system. (d) All management systems will use databases...

Risks associated with clinical databases.

PubMed

Eleazar, P Y

1991-11-01

Providers will succeed who are evaluating themselves, and who are continuously striving to examine who they are and where they are going. Conscientious providers know that countless other agencies have them under the microscope and that they have to work to stay ahead in assessing their actions through their clinical database. "Medical care value purchasing" is what every employer and payor is looking for, and providers need to find ways to illustrate cost in relation to quality. The basics of data security and protection should be in place in order to concentrate on the bigger picture. The knowledge of the risk associated with individual hospital databases as well as the risk associated with comparative databases is critical. The hospital-level clinical database is the hub of the wheel. If the risk there can be minimized, the data headed for various investigative sites will have less inherent risk. When it is really recognized and accepted that all financial decisions are made based upon the clinical data generated at the site of care, then data integrity will become a strategic advantage for the industry. Clinical database goals will, over time, cause minimization of risk at all levels. As this occurs, variation in treatment will be explained artfully.

Enabling heterogenous multi-scale database for emergency service functions through geoinformation technologies

NASA Astrophysics Data System (ADS)

Bhanumurthy, V.; Venugopala Rao, K.; Srinivasa Rao, S.; Ram Mohan Rao, K.; Chandra, P. Satya; Vidhyasagar, J.; Diwakar, P. G.; Dadhwal, V. K.

2014-11-01

Geographical Information Science (GIS) is now graduated from traditional desktop system to Internet system. Internet GIS is emerging as one of the most promising technologies for addressing Emergency Management. Web services with different privileges are playing an important role in dissemination of the emergency services to the decision makers. Spatial database is one of the most important components in the successful implementation of Emergency Management. It contains spatial data in the form of raster, vector, linked with non-spatial information. Comprehensive data is required to handle emergency situation in different phases. These database elements comprise core data, hazard specific data, corresponding attribute data, and live data coming from the remote locations. Core data sets are minimum required data including base, thematic, infrastructure layers to handle disasters. Disaster specific information is required to handle a particular disaster situation like flood, cyclone, forest fire, earth quake, land slide, drought. In addition to this Emergency Management require many types of data with spatial and temporal attributes that should be made available to the key players in the right format at right time. The vector database needs to be complemented with required resolution satellite imagery for visualisation and analysis in disaster management. Therefore, the database is interconnected and comprehensive to meet the requirement of an Emergency Management. This kind of integrated, comprehensive and structured database with appropriate information is required to obtain right information at right time for the right people. However, building spatial database for Emergency Management is a challenging task because of the key issues such as availability of data, sharing policies, compatible geospatial standards, data interoperability etc. Therefore, to facilitate using, sharing, and integrating the spatial data, there is a need to define standards to build emergency database systems. These include aspects such as i) data integration procedures namely standard coding scheme, schema, meta data format, spatial format ii) database organisation mechanism covering data management, catalogues, data models iii) database dissemination through a suitable environment, as a standard service for effective service dissemination. National Database for Emergency Management (NDEM) is such a comprehensive database for addressing disasters in India at the national level. This paper explains standards for integrating, organising the multi-scale and multi-source data with effective emergency response using customized user interfaces for NDEM. It presents standard procedure for building comprehensive emergency information systems for enabling emergency specific functions through geospatial technologies.

Alternatives to relational databases in precision medicine: Comparison of NoSQL approaches for big data storage using supercomputers

NASA Astrophysics Data System (ADS)

Velazquez, Enrique Israel

Improvements in medical and genomic technologies have dramatically increased the production of electronic data over the last decade. As a result, data management is rapidly becoming a major determinant, and urgent challenge, for the development of Precision Medicine. Although successful data management is achievable using Relational Database Management Systems (RDBMS), exponential data growth is a significant contributor to failure scenarios. Growing amounts of data can also be observed in other sectors, such as economics and business, which, together with the previous facts, suggests that alternate database approaches (NoSQL) may soon be required for efficient storage and management of big databases. However, this hypothesis has been difficult to test in the Precision Medicine field since alternate database architectures are complex to assess and means to integrate heterogeneous electronic health records (EHR) with dynamic genomic data are not easily available. In this dissertation, we present a novel set of experiments for identifying NoSQL database approaches that enable effective data storage and management in Precision Medicine using patients' clinical and genomic information from the cancer genome atlas (TCGA). The first experiment draws on performance and scalability from biologically meaningful queries with differing complexity and database sizes. The second experiment measures performance and scalability in database updates without schema changes. The third experiment assesses performance and scalability in database updates with schema modifications due dynamic data. We have identified two NoSQL approach, based on Cassandra and Redis, which seems to be the ideal database management systems for our precision medicine queries in terms of performance and scalability. We present NoSQL approaches and show how they can be used to manage clinical and genomic big data. Our research is relevant to the public health since we are focusing on one of the main challenges to the development of Precision Medicine and, consequently, investigating a potential solution to the progressively increasing demands on health care.

--No Title--

Science.gov Websites

interoperability emerging infrastructure for data management on computational grids Software Packages Services : ATLAS: Management and Steering: Computing Management Board Software Project Management Board Database Model Group Computing TDR: 4.5 Event Data 4.8 Database and Data Management Services 6.3.4 Production and

Databases for multilevel biophysiology research available at Physiome.jp.

PubMed

Asai, Yoshiyuki; Abe, Takeshi; Li, Li; Oka, Hideki; Nomura, Taishin; Kitano, Hiroaki

2015-01-01

Physiome.jp (http://physiome.jp) is a portal site inaugurated in 2007 to support model-based research in physiome and systems biology. At Physiome.jp, several tools and databases are available to support construction of physiological, multi-hierarchical, large-scale models. There are three databases in Physiome.jp, housing mathematical models, morphological data, and time-series data. In late 2013, the site was fully renovated, and in May 2015, new functions were implemented to provide information infrastructure to support collaborative activities for developing models and performing simulations within the database framework. This article describes updates to the databases implemented since 2013, including cooperation among the three databases, interactive model browsing, user management, version management of models, management of parameter sets, and interoperability with applications.

Prostate cancer surveillance by occupation and industry: the Canadian Census Health and Environment Cohort (CanCHEC).

PubMed

Sritharan, Jeavana; MacLeod, Jill; Harris, Shelley; Cole, Donald C; Harris, Anne; Tjepkema, Michael; Peters, Paul A; Demers, Paul A

2018-04-01

As there are no well-established modifiable risk factors for prostate cancer, further evidence is needed on possible factors such as occupation. Our study uses one of the largest Canadian worker cohorts to examine occupation, industry, and prostate cancer and to assess patterns of prostate cancer rates. The Canadian Census Health and Environment Cohort (CanCHEC) was established by linking the 1991 Canadian Census Cohort to the Canadian Cancer Database (1969-2010), Canadian Mortality Database (1991-2011), and Tax Summary Files (1981-2011). A total of 37,695 prostate cancer cases were identified in men aged 25-74 based on age at diagnosis. Cox proportional hazards models were used to estimate hazards ratios and 95% confidence intervals. In men aged 25-74 years, elevated risks were observed in the following occupations: senior management (HR = 1.12, 95% CI: 1.04-1.20); office and administration (HR = 1.19, 95% CI: 1.11-1.27); finance services (HR = 1.09, 95% CI: 1.04-1.14); education (HR = 1.05, 95% CI: 1.00-1.11); agriculture and farm management (HR = 1.12, 95% CI: 1.06-1.17); farm work (HR = 1.11, 95% CI: 1.01-1.21); construction managers (HR = 1.07, 95% CI: 1.01-1.14); firefighting (HR = 1.17, 95% CI: 1.01-1.36); and police work (HR = 1.22, 95% CI: 1.09-1.36). Decreased risks were observed across other construction and transportation occupations. Results by industry were consistent with occupation results. Associations were identified for white-collar, agriculture, protective services, construction, and transportation occupations. These findings emphasize the need for further study of job-related exposures and the potential influence of nonoccupational factors such as screening practices. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Creating databases for biological information: an introduction.

PubMed

Stein, Lincoln

2002-08-01

The essence of bioinformatics is dealing with large quantities of information. Whether it be sequencing data, microarray data files, mass spectrometric data (e.g., fingerprints), the catalog of strains arising from an insertional mutagenesis project, or even large numbers of PDF files, there inevitably comes a time when the information can simply no longer be managed with files and directories. This is where databases come into play. This unit briefly reviews the characteristics of several database management systems, including flat file, indexed file, and relational databases, as well as ACeDB. It compares their strengths and weaknesses and offers some general guidelines for selecting an appropriate database management system.

Better Quality of Care or Healthier Patients? Hospital Utilization by Medicare Advantage and Fee-for-Service Enrollees

PubMed Central

Nicholas, Lauren Hersch

2013-01-01

Do differences in rates of use among managed care and Fee-for-Service Medicare beneficiaries reflect selection bias or successful care management by insurers? I demonstrate a new method to estimate the treatment effect of insurance status on health care utilization. Using clinical information and risk-adjustment techniques on data on acute admission that are unrelated to recent medical care, I create a proxy measure of unobserved health status. I find that positive selection accounts for between one-quarter and one-third of the risk-adjusted differences in rates of hospitalization for ambulatory care sensitive conditions and elective procedures among Medicare managed care and Fee-for-Service enrollees in 7 years of Healthcare Cost and Utilization Project State Inpatient Databases from Arizona, Florida, New Jersey and New York matched to Medicare enrollment data. Beyond selection effects, I find that managed care plans reduce rates of potentially preventable hospitalizations by 12.5 per 1,000 enrollees (compared to mean of 46 per 1,000) and reduce annual rates of elective admissions by 4 per 1,000 enrollees (mean 18.6 per 1,000). PMID:24533012

Emergency nurses' and department preparedness for an ebola outbreak: A (narrative) literature review.

PubMed

Pincha Baduge, Mihirika Sds; Morphet, Julia; Moss, Cheryle

2018-05-01

The 2014 Ebola Virus Disease outbreak in West Africa triggered a public health emergency of international concern. Emergency departments worldwide responded with Ebola containment and preparation measures. This paper reports a literature inquiry into how emergency departments and emergency nurses prepared to manage the Ebola risk. Narrative review was the method used. Guidelines (n = 5) for organisational and emergency department preparedness were retrieved from relevant websites. Searches for primary studies and case reports were undertaken in the MEDLINE and CINAHL databases. After screening and quality appraisal, 20 papers were included in the review. Research and case reports identified 17 different preparedness strategies, and practical interventions for containment undertaken in emergency departments. These included a requirement for surveillance and reporting, Ebola case management, inventory and logistic management, laboratory management, and communication and education. Emergency nurses' personal preparedness was influenced by the emotional readiness, their willingness to care for people at risk of Ebola, and the provision of psychological support. The preparation efforts reported internationally were generally consistent in strategy and intervention. The findings provide guidance for future preparedness strategies by emergency departments in response to threats like Ebola. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Prospective Quality of Life Outcomes for Low-Risk Prostate Cancer: Active Surveillance versus Radical Prostatectomy

PubMed Central

Jeldres, Claudio; Cullen, Jennifer; Hurwitz, Lauren M.; Wolff, Erika M.; Levie, Katherine; Odem-Davis, Katherine; Johnston, Richard B.; Pham, Khanh N.; Rosner, Inger L; Brand, Timothy C.; L’Esperance, James O.; Sterbis, Joseph R.; Etzioni, Ruth B.; Porter, Christopher R.

2015-01-01

Background For low-risk prostate cancer (PCa), active surveillance (AS) may confer comparable oncological outcomes to radical prostatectomy (RP). Health-related quality of life (HRQoL) outcomes are important to consider, yet few studies have examined HRQoL for patients managed with AS. This study compared longitudinal HRQoL in a prospective, racially diverse, and contemporary cohort of patients who underwent RP or AS for low-risk PCa. Methods Beginning in 2007, HRQoL data from validated questionnaires (EPIC and SF-36) were collected by the Center for Prostate Disease Research in a multi-center national database. Patients aged ≤75 that were diagnosed with low-risk PCa and elected RP or AS for initial disease management were followed for three years. Mean scores were estimated using generalized estimating equations, adjusting for baseline HRQoL, demographic and clinical patient characteristics. Results Of the patients with low-risk PCa, 228 underwent RP and 77 underwent AS. Multivariable analysis revealed that RP patients had significantly worse sexual function, sexual bother, and urinary function at all time points compared to patients on AS. Differences in mental health between groups were below the threshold for clinical significance at one year. Conclusions This study found no differences in mental health outcomes but worse urinary and sexual HRQoL for RP patients compared to AS patients for up to three years. These data offer support for management of low risk PCa with AS as a means for postponing the morbidity associated with RP without concomitant mental health declines. PMID:25845467

Review on the prevalence of diabetes and risk factors and situation of disease management in floating population in China.

PubMed

Han, Kaiyi; Yao, Jingjing; Yin, Xiao; Zhao, Mei; Sun, Qiang

2017-01-01

To give a comprehensive and basic understanding of diabetes and its risk factors in floating people in China. We use "(diabetes or type 2 diabetes or chronic disease) and (floating population or employed floating population)" as the key words to search in the China academic literature database (CNKI), Wan Fang database, PubMed and Web of Science for relevant literature and extract the data about the prevalence of diabetes, relevant risk factors and disease management of the floating population in China. Twenty-one literatures are entered into analysis finally, one is English and the rest are Chinese. According to the national survey, the prevalence rate of diabetes in floating population in China was 5. 1% (95%CI, 4.9% - 5.3%), which is lower than that of the general population(11.6%,95%CI, 11.3%-11.8%),and is consistent with the results of the local surveys. The comparison result between the prevalence of floating population and that of local population in each region differs in local surveys. In addition, the prevalence of male floating population is lower than that of the female population. Finally, as the age of the population rises, so does the prevalence of diabetes. As for the risk factors of chronical diseases, the overweight rate in every region is similar but the obesity rate differs in different regions (Ningxia,26.0%;Xiangshan,14.0%), and the obesity rate of the floating population is less than half of that of the general people(4.7%,11.9%). The awareness rate, treatment rate and control rate in the floating patients differ in the regional researches, but they all can't meet the goals set by the local health departments. Compared with the general population, the prevalence of diabetes in the floating population are lower. However, Considering the growing population number and the poor disease management of the floating patients, the potential threat brought by the diabetes in floating population is imponderable. The government should establish the national surveillance system of diabetes for the floating population, strengthen the construction of the primary medical institutions, and optimize the existing funding system.

Mass-storage management for distributed image/video archives

NASA Astrophysics Data System (ADS)

Franchi, Santina; Guarda, Roberto; Prampolini, Franco

1993-04-01

The realization of image/video database requires a specific design for both database structures and mass storage management. This issue has addressed the project of the digital image/video database system that has been designed at IBM SEMEA Scientific & Technical Solution Center. Proper database structures have been defined to catalog image/video coding technique with the related parameters, and the description of image/video contents. User workstations and servers are distributed along a local area network. Image/video files are not managed directly by the DBMS server. Because of their wide size, they are stored outside the database on network devices. The database contains the pointers to the image/video files and the description of the storage devices. The system can use different kinds of storage media, organized in a hierarchical structure. Three levels of functions are available to manage the storage resources. The functions of the lower level provide media management. They allow it to catalog devices and to modify device status and device network location. The medium level manages image/video files on a physical basis. It manages file migration between high capacity media and low access time media. The functions of the upper level work on image/video file on a logical basis, as they archive, move and copy image/video data selected by user defined queries. These functions are used to support the implementation of a storage management strategy. The database information about characteristics of both storage devices and coding techniques are used by the third level functions to fit delivery/visualization requirements and to reduce archiving costs.

A spatial-temporal system for dynamic cadastral management.

PubMed

Nan, Liu; Renyi, Liu; Guangliang, Zhu; Jiong, Xie

2006-03-01

A practical spatio-temporal database (STDB) technique for dynamic urban land management is presented. One of the STDB models, the expanded model of Base State with Amendments (BSA), is selected as the basis for developing the dynamic cadastral management technique. Two approaches, the Section Fast Indexing (SFI) and the Storage Factors of Variable Granularity (SFVG), are used to improve the efficiency of the BSA model. Both spatial graphic data and attribute data, through a succinct engine, are stored in standard relational database management systems (RDBMS) for the actual implementation of the BSA model. The spatio-temporal database is divided into three interdependent sub-databases: present DB, history DB and the procedures-tracing DB. The efficiency of database operation is improved by the database connection in the bottom layer of the Microsoft SQL Server. The spatio-temporal system can be provided at a low-cost while satisfying the basic needs of urban land management in China. The approaches presented in this paper may also be of significance to countries where land patterns change frequently or to agencies where financial resources are limited.

Clinical Variant Classification: A Comparison of Public Databases and a Commercial Testing Laboratory.

PubMed

Gradishar, William; Johnson, KariAnne; Brown, Krystal; Mundt, Erin; Manley, Susan

2017-07-01

There is a growing move to consult public databases following receipt of a genetic test result from a clinical laboratory; however, the well-documented limitations of these databases call into question how often clinicians will encounter discordant variant classifications that may introduce uncertainty into patient management. Here, we evaluate discordance in BRCA1 and BRCA2 variant classifications between a single commercial testing laboratory and a public database commonly consulted in clinical practice. BRCA1 and BRCA2 variant classifications were obtained from ClinVar and compared with the classifications from a reference laboratory. Full concordance and discordance were determined for variants whose ClinVar entries were of the same pathogenicity (pathogenic, benign, or uncertain). Variants with conflicting ClinVar classifications were considered partially concordant if ≥1 of the listed classifications agreed with the reference laboratory classification. Four thousand two hundred and fifty unique BRCA1 and BRCA2 variants were available for analysis. Overall, 73.2% of classifications were fully concordant and 12.3% were partially concordant. The remaining 14.5% of variants had discordant classifications, most of which had a definitive classification (pathogenic or benign) from the reference laboratory compared with an uncertain classification in ClinVar (14.0%). Here, we show that discrepant classifications between a public database and single reference laboratory potentially account for 26.7% of variants in BRCA1 and BRCA2 . The time and expertise required of clinicians to research these discordant classifications call into question the practicality of checking all test results against a database and suggest that discordant classifications should be interpreted with these limitations in mind. With the increasing use of clinical genetic testing for hereditary cancer risk, accurate variant classification is vital to ensuring appropriate medical management. There is a growing move to consult public databases following receipt of a genetic test result from a clinical laboratory; however, we show that up to 26.7% of variants in BRCA1 and BRCA2 have discordant classifications between ClinVar and a reference laboratory. The findings presented in this paper serve as a note of caution regarding the utility of database consultation. © AlphaMed Press 2017.

Database nurse staffing indicators: explaining risks of staff job dissatisfaction in outpatient care.

PubMed

Kaunonen, Marja; Salin, Sirpa; Aalto, Pirjo

2015-07-01

To explore factors associated with nursing intensity, work environment intensity and nursing resources that may affect nurse job satisfaction and risk of dissatisfaction in outpatient care at one university hospital in Finland. Much research has been done to study how nursing intensity, work environment intensity and nursing resources are associated with nurse job satisfaction, but not in the context of outpatient care. This research used a cross-sectional design. The data were collected from the hospital information systems of outpatient units (n = 12) in autumn 2010. Management style showed a statistically significant association with job satisfaction. The risk of dissatisfaction increased when nursing staff had no influence over the design of their jobs, when conflicts and contradictions were not addressed in the workplace and when feedback was not processed. Nursing intensity and work environment intensity had no effect on nurse job satisfaction. Nursing resources and patient satisfaction, on the other hand, were important to nurses' job satisfaction. The results indicate that nursing management should involve nursing staff in the development of their jobs and the care delivery model. © 2013 John Wiley & Sons Ltd.

Clarifying values, risk perceptions, and attitudes to resolve or avoid social conflicts in invasive species management.

PubMed

Estévez, Rodrigo A; Anderson, Christopher B; Pizarro, J Cristobal; Burgman, Mark A

2015-02-01

Decision makers and researchers recognize the need to effectively confront the social dimensions and conflicts inherent to invasive species research and management. Yet, despite numerous contentious situations that have arisen, no systematic evaluation of the literature has examined the commonalities in the patterns and types of these emergent social issues. Using social and ecological keywords, we reviewed trends in the social dimensions of invasive species research and management and the sources and potential solutions to problems and conflicts that arise around invasive species. We integrated components of cognitive hierarchy theory and risk perceptions theory to provide a conceptual framework to identify, distinguish, and provide understanding of the driving factors underlying disputes associated with invasive species. In the ISI Web of Science database, we found 15,915 peer-reviewed publications on biological invasions, 124 of which included social dimensions of this phenomenon. Of these 124, 28 studies described specific contentious situations. Social approaches to biological invasions have emerged largely in the last decade and have focused on both environmental social sciences and resource management. Despite being distributed in a range of journals, these 124 articles were concentrated mostly in ecology and conservation-oriented outlets. We found that conflicts surrounding invasive species arose based largely on differences in value systems and to a lesser extent stakeholder and decision maker's risk perceptions. To confront or avoid such situations, we suggest integrating the plurality of environmental values into invasive species research and management via structured decision making techniques, which enhance effective risk communication that promotes trust and confidence between stakeholders and decision makers. © 2014 Society for Conservation Biology.

Economic analysis of Heart and Stroke Foundation of Ontario's Hypertension Management Initiative.

PubMed

de Oliveira, Claire; Wijeysundera, Harindra C; Tobe, Sheldon W; Lum-Kwong, Margaret Moy; Von Sychowski, Shirley; Wang, Xuesong; Tu, Jack V; Krahn, Murray D

2012-01-01

Hypertension is suboptimally treated in primary care settings. We evaluated the cost-effectiveness of the Heart and Stroke Foundation of Ontario's Hypertension Management Initiative (HMI), an interdisciplinary, evidence-informed chronic disease management model for primary care that focuses on improving blood pressure management and control by primary care providers and patients according to clinical best practice guidelines. The perspective of our analysis was that of the Ontario Ministry of Health and Long-Term Care with a lifetime horizon and 5% annual discount rate. Using data from a prospective cohort study from the HMI, we created two matched groups: pre-HMI (standard care), and post-HMI (n = 1720). For each patient, we estimated the 10-year risk of cardiovascular disease (CVD) using the Framingham risk equation and life expectancy from life tables. Long-term health care costs incurred with physician visits, acute and chronic care hospitalizations, emergency department visits, same-day surgeries, and medication use were determined through linkage to administrative databases, using a bottom-up approach. The HMI intervention was associated with significant reductions in systolic blood pressure (126 mmHg vs 134 mmHg with standard care; P-value < 0.001). These improvements were associated with a reduction in the 10-year risk of CVD (9.5% risk vs 10.7% in standard care; P-value < 0.001) and a statistically significant improvement in discounted life expectancy (9.536 years vs 9.516 in standard care; P-value < 0.001). The HMI cohort had a discounted mean lifetime cost of $22,884 CAD vs $22,786 CAD for standard care, with an incremental cost-effectiveness ratio of $4939 CAD per life-year gained. We found that the HMI is a cost-effective means of providing evidence-informed, chronic disease management in primary care to patients with hypertension.

Ciguatera Fish Poisoning in East Asia and Southeast Asia

PubMed Central

Chan, Thomas Y. K.

2015-01-01

In the coastal countries of East Asia and Southeast Asia, ciguatera should be common because of the extensive tropical and subtropical coral reefs along the coasts and in the neighboring seas with ciguatoxic fishes. An extensive search of journal databases, the Internet and the government websites was performed to identify all reports of ciguatera from the regions. Based on the official data and large published case series, the incidence of ciguatera was higher in the coastal cities (Hong Kong, Foshan, Zhongshan) of southern China than in Japan (Okinawa Prefecture). In Singapore, ciguatera appeared to be almost unknown. In other countries, only isolated cases or small case series were reported, but under-reporting was assumed to be common. Ciguatera may cause severe acute illness and prolonged neurological symptoms. Ciguatera represents an important public health issue for endemic regions, with significant socio-economic impact. Coordinated strategies to improve risk assessment, risk management and risk communication are required. The systematic collection of accurate data on the incidence and epidemiology of ciguatera should enable better assessment and management of its risk. Much more work needs to be done to define the size threshold for important coral reef fish species from different regions, above which the risk of ciguatera significantly increases. PMID:26042615

Receipt of Guideline-Concordant Treatment in Elderly Prostate Cancer Patients

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

Chen, Ronald C., E-mail: Ronald_chen@med.unc.edu; Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

2014-02-01

Purpose: To examine the proportion of elderly prostate cancer patients receiving guideline-concordant treatment, using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Methods and Materials: A total of 29,001 men diagnosed in 2004-2007 with localized prostate cancer, aged 66 to 79 years, were included. We characterized the proportion of men who received treatment concordant with the National Comprehensive Cancer Network guidelines, stratified by risk group and age. Logistic regression was used to examine covariates associated with receipt of guideline-concordant management. Results: Guideline concordance was 79%-89% for patients with low- or intermediate-risk disease. Among high-risk patients, 66.6% of those agedmore » 66-69 years received guideline-concordant management, compared with 51.9% of those aged 75-79 years. Discordance was mainly due to conservative management—no treatment or hormone therapy alone. Among the subgroup of patients aged ≤76 years with no measured comorbidity, findings were similar. On multivariable analysis, older age (75-79 vs 66-69 years, odds ratio 0.51, 95% confidence interval 0.50-0.57) was associated with a lower likelihood of guideline concordance for high-risk prostate cancer, but comorbidity was not. Conclusions: There is undertreatment of elderly but healthy patients with high-risk prostate cancer, the most aggressive form of this disease.« less

Computer Science and Technology: Modeling and Measurement Techniques for Evaluation of Design Alternatives in the Implementation of Database Management Software. Final Report.

ERIC Educational Resources Information Center

Deutsch, Donald R.

This report describes a research effort that was carried out over a period of several years to develop and demonstrate a methodology for evaluating proposed Database Management System designs. The major proposition addressed by this study is embodied in the thesis statement: Proposed database management system designs can be evaluated best through…

Database Management System

NASA Technical Reports Server (NTRS)

1990-01-01

In 1981 Wayne Erickson founded Microrim, Inc, a company originally focused on marketing a microcomputer version of RIM (Relational Information Manager). Dennis Comfort joined the firm and is now vice president, development. The team developed an advanced spinoff from the NASA system they had originally created, a microcomputer database management system known as R:BASE 4000. Microrim added many enhancements and developed a series of R:BASE products for various environments. R:BASE is now the second largest selling line of microcomputer database management software in the world.

NBIC: National Ballast Information Clearinghouse

Science.gov Websites

Smithsonian Environmental Research Center Logo US Coast Guard Logo Submit BW Report | Search NBIC Database / Database Manager: Tami Huber Senior Analyst / Ecologist: Mark Minton Data Managers Ashley Arnwine Jessica Hardee Amanda Reynolds Database Design and Programming / Application Programming: Paul Winterbauer

AGRICULTURAL BEST MANAGEMENT PRACTICE EFFECTIVENESS DATABASE

EPA Science Inventory

Resource Purpose:The Agricultural Best Management Practice Effectiveness Database contains the results of research projects which have collected water quality data for the purpose of determining the effectiveness of agricultural management practices in reducing pollutants ...

A metasynthesis of risk perception in women with high risk pregnancies.

PubMed

Lee, Suzanne; Ayers, Susan; Holden, Des

2014-04-01

risk perception in women with high risk pregnancies affects their decisions about perinatal care and is of interest to anyone involved in the care of pregnant women. This paper provides a metasynthesis of qualitative studies of risk perception in women with high risk pregnancies. a systematic search of eight electronic databases was conducted. Additional papers were obtained through searching references of identified articles. Six studies were identified that reported qualitative research into risk perception in relation to high risk pregnancy. A metasynthesis was developed to describe and interpret the studies. the synthesis resulted in the identification of five themes: determinants of risk perception; not seeing it the way others do; normality versus risk; if the infant is ok, I׳m ok; managing risk. this metasynthesis suggests women at high risk during pregnancy use multiple sources of information to determine their risk status. It shows women are aware of the risks posed by their pregnancies but do not perceive risk in the same way as healthcare professionals. They will take steps to ensure the health of themselves and their infants but these may not include following all medical recommendations. Copyright © 2013 Elsevier Ltd. All rights reserved.

Evaluation of relational and NoSQL database architectures to manage genomic annotations.

PubMed

Schulz, Wade L; Nelson, Brent G; Felker, Donn K; Durant, Thomas J S; Torres, Richard

2016-12-01

While the adoption of next generation sequencing has rapidly expanded, the informatics infrastructure used to manage the data generated by this technology has not kept pace. Historically, relational databases have provided much of the framework for data storage and retrieval. Newer technologies based on NoSQL architectures may provide significant advantages in storage and query efficiency, thereby reducing the cost of data management. But their relative advantage when applied to biomedical data sets, such as genetic data, has not been characterized. To this end, we compared the storage, indexing, and query efficiency of a common relational database (MySQL), a document-oriented NoSQL database (MongoDB), and a relational database with NoSQL support (PostgreSQL). When used to store genomic annotations from the dbSNP database, we found the NoSQL architectures to outperform traditional, relational models for speed of data storage, indexing, and query retrieval in nearly every operation. These findings strongly support the use of novel database technologies to improve the efficiency of data management within the biological sciences. Copyright © 2016 Elsevier Inc. All rights reserved.

Extreme Weather Risk Assessment: The Case of Jiquilisco, El Salvador

NASA Astrophysics Data System (ADS)

Melendez, Karla; Ceppi, Claudia; Molero, Juanjo; Rios Insua, David

2014-05-01

All major climate models predict increases in both global and regional mean temperatures throughout this century, under different scenarios concerning future trends in population growth or economic and technological development. This consistency of results across models has strengthened the evidence about global warming. Despite the convincing facts and findings of climate researchers, there is still a great deal of skepticism around climate change. There is somewhat less consensus about some of the consequences of climate change, for example in reference to extreme weather changes, in particular as regards more local scales. However, such changes seem to have already considerable impact in many regions across the world in terms of lives, economic losses, and required changes in lifestyles. This may demand appropriate policy responses both at national and local levels. Our work provides a framework for extreme weather multithreat risk management, based on probabilistic risk assessment (PRA). This may be useful in comparing the effectiveness of different actions to manage risks and inform judgment concerning the appropriate resource allocation to mitigate the risks. The methodology has been applied to the case study of the "El Marillo II" community, located in the municipality of Jiquilisco in El Salvador. There, the main problem related with extreme weather conditions are the frequent floods caused by rainfall, hurricanes , and water increases in the Lempa river nearby located. However, droughts are also very relevant. Based on several sources like SNET, newspapers, field visits to the region and interviews, we have built a detailed database that comprises extreme weather daily data from January 1971 until December 2011. Forecasting models for floods and droughts were built suggesting the need to properly manage the risks. We subsequently obtained the optimal portfolio of countermeasures, given the budget constraints. KEYWORDS: CLIMATE CHANGE, EXTREME WEATHER, RISK ANALYSIS, DECISION ANALYSIS, EL SALVADOR.

Screening and Management of Asymptomatic Renal Stones in Astronauts

NASA Technical Reports Server (NTRS)

Reyes, David; Locke, James; Sargsyan, Ashot; Garcia, Kathleen

2017-01-01

Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The true risk for renal stone formation in astronauts due to the space flight environment is unknown. Proper management of this condition is crucial to mitigate health and mission risks. The NASA Flight Medicine Clinic electronic medical record and the Lifetime Surveillance of Astronaut Health databases were reviewed. An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was also done. This work was used to develop a screening and management protocol for renal stones in astronauts that is relevant to the spaceflight operational environment. In the proposed guidelines all astronauts receive a yearly screening and post-flight renal ultrasound using a novel ultrasound protocol. The ultrasound protocol uses a combination of factors, including: size, position, shadow, twinkle and dispersion properties to confirm the presence of a renal calcification. For mission-assigned astronauts, any positive ultrasound study is followed by a low-dose renal computed tomography scan and urologic consult. Other specific guidelines were also created. A small asymptomatic renal stone within the renal collecting system may become symptomatic at any time, and therefore affect launch and flight schedules, or cause incapacitation during a mission. Astronauts in need of definitive care can be evacuated from the International Space Station, but for deep space missions evacuation is impossible. The new screening and management algorithm has been implemented and the initial round of screening ultrasounds is under way. Data from these exams will better define the incidence of renal stones in U.S. astronauts, and will be used to inform risk mitigation for both short and long duration spaceflights.

[Surgical treatment of blunt liver trauma, indications for surgery and results].

PubMed

Morales Uribe, Carlos H; López, Carolina Arenas; Cote, Juan Camilo Correa; Franco, Sebastián Tobón; Saldarriaga, Maria Fernanda; Mosquera, Jackson; Villegas Lanau, María I

2014-01-01

The liver is the most frequently injured organ in blunt abdominal trauma. Patients that are hemodynamically unstable must undergo inmmediate surgical treatment. There are 2 surgical approaches for these patients; Anatomical Liver resection or non-anatomic liver resection. Around 80-90% of patients are candidates for non-operative management. -Several risk factors have been studied to select the patients most suited for a non operative management. We performed a retrospective study based on a prospective database. We searched for risk factors related to immediate surgical management and failed non-operative management. We also described the surgical procedures that were undertaken in this cohort of patients and their outcomes and complications. During the study period 117 patients presented with blunt liver trauma. 19 patients (16.2%) required a laparotomy during the initial 24h after their admission. There were 11 deaths (58%) amongst these patients. Peri-hepatic packing and suturing were the most common procedures performed. A RTS Score<7.8 (RR: 7.3; IC 95%: 1.8-30.1), and ISS Score >20 (RR 2,5 IC 95%: 1.0-6.7), and associated intra-abdominal injuries (RR: 2.95; IC 95%: 1.25-6.92) were risk factors for immediate surgery. In 98 (83.7%) patients a non-operative management was performed. 7 patients had a failed non-operative management. The need for immediate surgical management is related to the presence of associated intra-abdominal injuries, and the ISS and RTS scores. In this series the most frequently performed procedure for blunt liver trauma was peri-hepatic packing. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

Integration of an Evidence Base into a Probabilistic Risk Assessment Model. The Integrated Medical Model Database: An Organized Evidence Base for Assessing In-Flight Crew Health Risk and System Design

NASA Technical Reports Server (NTRS)

Saile, Lynn; Lopez, Vilma; Bickham, Grandin; FreiredeCarvalho, Mary; Kerstman, Eric; Byrne, Vicky; Butler, Douglas; Myers, Jerry; Walton, Marlei

2011-01-01

This slide presentation reviews the Integrated Medical Model (IMM) database, which is an organized evidence base for assessing in-flight crew health risk. The database is a relational database accessible to many people. The database quantifies the model inputs by a ranking based on the highest value of the data as Level of Evidence (LOE) and the quality of evidence (QOE) score that provides an assessment of the evidence base for each medical condition. The IMM evidence base has already been able to provide invaluable information for designers, and for other uses.

Application of cloud database in the management of clinical data of patients with skin diseases.

PubMed

Mao, Xiao-fei; Liu, Rui; DU, Wei; Fan, Xue; Chen, Dian; Zuo, Ya-gang; Sun, Qiu-ning

2015-04-01

To evaluate the needs and applications of using cloud database in the daily practice of dermatology department. The cloud database was established for systemic scleroderma and localized scleroderma. Paper forms were used to record the original data including personal information, pictures, specimens, blood biochemical indicators, skin lesions,and scores of self-rating scales. The results were input into the cloud database. The applications of the cloud database in the dermatology department were summarized and analyzed. The personal and clinical information of 215 systemic scleroderma patients and 522 localized scleroderma patients were included and analyzed using the cloud database. The disease status,quality of life, and prognosis were obtained by statistical calculations. The cloud database can efficiently and rapidly store and manage the data of patients with skin diseases. As a simple, prompt, safe, and convenient tool, it can be used in patients information management, clinical decision-making, and scientific research.

CyberSecurity Monitoring Tools and Projects: A Compendium of Commercial and Government Tools and Government Research Projects

DTIC Science & Technology

2000-08-01

identify changes to the risk levels of business network functions based on proposed modifications. Expert can model networks as well (see special...network from departmental systems to enterprise-wide environments. ACX is scaled with the use of a Policy Model Database(PMDB). The PMDB is a management...This Entry February 8, 2000 Description BlackICE Defender is a host-based intrusion detector designed for use on home or small business systems. It

23 CFR 972.204 - Management systems requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL LANDS HIGHWAYS FISH AND... to operate and maintain the management systems and their associated databases; and (5) A process for... systems will use databases with a geographical reference system that can be used to geolocate all database...

A web based relational database management system for filariasis control

PubMed Central

Murty, Upadhyayula Suryanarayana; Kumar, Duvvuri Venkata Rama Satya; Sriram, Kumaraswamy; Rao, Kadiri Madhusudhan; Bhattacharyulu, Chakravarthula Hayageeva Narasimha Venakata; Praveen, Bhoopathi; Krishna, Amirapu Radha

2005-01-01

The present study describes a RDBMS (relational database management system) for the effective management of Filariasis, a vector borne disease. Filariasis infects 120 million people from 83 countries. The possible re-emergence of the disease and the complexity of existing control programs warrant the development of new strategies. A database containing comprehensive data associated with filariasis finds utility in disease control. We have developed a database containing information on the socio-economic status of patients, mosquito collection procedures, mosquito dissection data, filariasis survey report and mass blood data. The database can be searched using a user friendly web interface. Availability http://www.webfil.org (login and password can be obtained from the authors) PMID:17597846

From a Viewpoint of Clinical Settings: Pharmacoepidemiology as Reverse Translational Research (rTR).

PubMed

Kawakami, Junichi

2017-01-01

Clinical pharmacology and pharmacoepidemiology research may converge in practise. Pharmacoepidemiology is the study of pharmacotherapy and risk management in patient groups. For many drugs, adverse reaction(s) that were not seen and/or clarified during research and development stages have been reported in the real world. Pharmacoepidemiology can detect and verify adverse drug reactions as reverse translational research. Recently, development and effective use of medical information databases (MID) have been conducted in Japan and elsewhere for the purpose of post-marketing safety of drugs. The Ministry of Health, Labour and Welfare, Japan has been promoting the development of 10-million scale database in 10 hospitals and hospital groups as "the infrastructure project of medical information database (MID-NET)". This project enables estimation of the frequency of adverse reactions, the distinction between drug-induced reactions and basal health-condition changes, and usefulness verification of administrative measures of drug safety. However, because the database information is different from detailed medical records, construction of methodologies for the detection and evaluation of adverse reactions is required. We have been performing database research using medical information system in some hospitals to establish and demonstrate useful methods for post-marketing safety. In this symposium, we aim to discuss the possibility of reverse translational research from clinical settings and provide an introduction to our research.

The Prediflood database. A new tool for an integrated approach to historical floods in Catalonia (NE Iberian Peninsula), AD 1033-2013

NASA Astrophysics Data System (ADS)

Barriendos, Mariano; Carles Balasch Solanes, Josep; Tuset, Jordi; Lluís Ruiz-Bellet, Josep

2014-05-01

Available information of historical floods can improve the management of hydroclimatic hazards. This approach is useful in ungauged basins or with short instrumental data series. On the other hand, flood risk is increasing due to both the expansion of human land occupation and the modification of rainfall patterns in the present global climatic change scenario. Within the Prediflood Project, we have designed an integrated database of historical floods in Catalonia with the aim to feed data to: 1) Meteorological reconstruction and modelling. 2) Hydrological and hydraulic reconstruction. 3) Human impacts evaluation, of these floods. The firsts steps of the database design focus on spatial location and on the quality of the data sources in three levels: 1) Historical documentary sources and newspapers contemporary with the floods. 2) Local historiography. 3) Technical reports. After the application of historiographical methodologies, more than 2300 flood records have been added to the database so far. Despite the completion of the database is still a work in progress, the firsts analyses are already underway and focus on the largest floods with catastrophic effects simultaneously on more than 15 catchments: November 1617, October 1787, September 1842, May 1853, September 1874, January 1898, October 1907, October 1940, September 1962, November 1982, October 1994 and others.

Leadership of risk decision making in a complex, technology organization: The deliberative decision making model

NASA Astrophysics Data System (ADS)

Flaming, Susan C.

2007-12-01

The continuing saga of satellite technology development is as much a story of successful risk management as of innovative engineering. How do program leaders on complex, technology projects manage high stakes risks that threaten business success and satellite performance? This grounded theory study of risk decision making portrays decision leadership practices at one communication satellite company. Integrated product team (IPT) leaders of multi-million dollar programs were interviewed and observed to develop an extensive description of the leadership skills required to navigate organizational influences and drive challenging risk decisions to closure. Based on the study's findings the researcher proposes a new decision making model, Deliberative Decision Making, to describe the program leaders' cognitive and organizational leadership practices. This Deliberative Model extends the insights of prominent decision making models including the rational (or classical) and the naturalistic and qualifies claims made by bounded rationality theory. The Deliberative Model describes how leaders proactively engage resources to play a variety of decision leadership roles. The Model incorporates six distinct types of leadership decision activities, undertaken in varying sequence based on the challenges posed by specific risks. Novel features of the Deliberative Decision Model include: an inventory of leadership methods for managing task challenges, potential stakeholder bias and debates; four types of leadership meta-decisions that guide decision processes, and aligned organizational culture. Both supporting and constraining organizational influences were observed as leaders managed major risks, requiring active leadership on the most difficult decisions. Although the company's engineering culture emphasized the importance of data-based decisions, the uncertainties intrinsic to satellite risks required expert engineering judgment to be exercised throughout. An investigation into the co-variation of decision methods with uncertainty suggests that perceived risk severity may serve as a robust indicator for choices about decision practices. The Deliberative Decision processes incorporate multiple organizational and cultural controls as cross-checks to mitigate potential parochial bias of individuals, stakeholder groups, or leaders. Overall the Deliberative Decision framework describes how expert leadership practices, supportive organizational systems along with aligned cultural values and behavioral norms help leaders drive high stakes risk decisions to closure in this complex, advanced-technology setting.

Integrating RFID technique to design mobile handheld inventory management system

NASA Astrophysics Data System (ADS)

Huang, Yo-Ping; Yen, Wei; Chen, Shih-Chung

2008-04-01

An RFID-based mobile handheld inventory management system is proposed in this paper. Differing from the manual inventory management method, the proposed system works on the personal digital assistant (PDA) with an RFID reader. The system identifies electronic tags on the properties and checks the property information in the back-end database server through a ubiquitous wireless network. The system also provides a set of functions to manage the back-end inventory database and assigns different levels of access privilege according to various user categories. In the back-end database server, to prevent improper or illegal accesses, the server not only stores the inventory database and user privilege information, but also keeps track of the user activities in the server including the login and logout time and location, the records of database accessing, and every modification of the tables. Some experimental results are presented to verify the applicability of the integrated RFID-based mobile handheld inventory management system.

Alternatives to relational database: comparison of NoSQL and XML approaches for clinical data storage.

PubMed

Lee, Ken Ka-Yin; Tang, Wai-Choi; Choi, Kup-Sze

2013-04-01

Clinical data are dynamic in nature, often arranged hierarchically and stored as free text and numbers. Effective management of clinical data and the transformation of the data into structured format for data analysis are therefore challenging issues in electronic health records development. Despite the popularity of relational databases, the scalability of the NoSQL database model and the document-centric data structure of XML databases appear to be promising features for effective clinical data management. In this paper, three database approaches--NoSQL, XML-enabled and native XML--are investigated to evaluate their suitability for structured clinical data. The database query performance is reported, together with our experience in the databases development. The results show that NoSQL database is the best choice for query speed, whereas XML databases are advantageous in terms of scalability, flexibility and extensibility, which are essential to cope with the characteristics of clinical data. While NoSQL and XML technologies are relatively new compared to the conventional relational database, both of them demonstrate potential to become a key database technology for clinical data management as the technology further advances. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The use of coffee, chewing-gum and gastrograffin in the management of postoperative ileus: A review of current evidence.

PubMed

Flores-Funes, Diego; Campillo-Soto, Álvaro; Pellicer-Franco, Enrique; Aguayo-Albasini, José Luis

2016-11-01

Postoperative ileus is one of the main complications in the postoperative period. New measures appeared with the introduction of «fast-track surgery» to accelerate recovery: coffee, chewing gum and gastrograffin. We performed a summary of current evidence, reviewing articles from MEDLINE, Cochrane Database of Systematic Reviews, ISI Web of Science, and SCOPUS databases. Employed search terms were «postoperative ileus» AND («definition» OR «epidemiology» OR «risk factors» OR «Management»). We selected 44 articles: 9 systematic reviews 11 narrative reviews, 13 randomized clinical trials, 6 observational studies, and the remaining 5 scientific letters, assumptions, etc. There is little literature about this topic, studies are heterogeneous, with disparity in the results. In addition, they only focus on colorectal and gynecological surgery. New high-quality studies are needed, preferably randomized clinical trials, in order to clarify the usefulness of these measures. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Relationship between Hospital Policies for Labor Induction and Cesarean Delivery and Perinatal Care Quality among Rural U.S. Hospitals.

PubMed

Kozhimannil, Katy B; Hung, Peiyin; Casey, Michelle M; Henning-Smith, Carrie; Prasad, Shailendra; Moscovice, Ira S

2016-01-01

Many hospitals are adopting quality improvement strategies in obstetrics. This study characterized rural U.S. hospitals based on their hospital staffing and clinical management policies for labor induction and cesarean delivery, and assessed the relationship between policies and performance on maternity care quality. We surveyed all 306 rural maternity hospitals in nine states and used data from the Healthcare Cost and Utilization Project Statewide Inpatient Database hospital discharge database. We found staffing policies were more prevalent at lower-volume hospitals (92% vs. 86% for cesarean and 82% vs. 79%, both p < .01). Using multivariable logistic regression, we found hospitals with policies for cesarean delivery had up to 24% lower odds of low-risk cesarean (adjusted odds ratio = 0.76; 95% confidence interval=[0.67-0.86]) and non-indicated cesarean (0.78 [0.70-0.88]), with variability across birth volume. Clinical management and staffing policies are common, but not universal, among rural U.S. hospitals providing obstetric services and are generally positively associated with quality.

Risk evaluation and mitigation strategies: a focus on belatacept.

PubMed

Sam, Teena; Gabardi, Steven; Tichy, Eric M

2013-03-01

To review the elements and components of the risk evaluation and mitigation strategies (REMS) for the costimulation blocker belatacept and associated implications for health care providers working with transplant recipients. The MEDLINE and EMBASE databases (January 1990 to March 2012) were searched by using risk evaluation and mitigation strategies, REMS, belatacept, and organ transplant as search terms (individual organs were also searched). Retrieved articles were supplemented with analysis of information obtained from the Federal Register, the Food and Drug Administration, and the manufacturer of belatacept. REMS are risk-management strategies implemented to ensure that a product's benefits outweigh its known safety risks. Although belatacept offers a novel strategy in maintenance immunosuppression and was associated with superior renal function compared with cyclosporine in phase 2 and 3 trials, belatacept is also associated with increased risk of posttransplant lymphoproliferative disorder and central nervous system infections. The Food and Drug Administration required development of a REMS program as part of belatacept's approval process to ensure safe and appropriate use of the medication and optimization of its risk-benefit profile. Elements of the belatacept REMS include a medication guide that must be dispensed with each infusion and a communication plan. In the management of a complex population of patients, it is essential that those who care for transplant recipients, and patients, recognize the implications of potential and known risks of belatacept. The REMS program aims to facilitate careful selection and education of patients and vigilant monitoring.

Analysis and preliminary design of Kunming land use and planning management information system

NASA Astrophysics Data System (ADS)

Li, Li; Chen, Zhenjie

2007-06-01

This article analyzes Kunming land use planning and management information system from the system building objectives and system building requirements aspects, nails down the system's users, functional requirements and construction requirements. On these bases, the three-tier system architecture based on C/S and B/S is defined: the user interface layer, the business logic layer and the data services layer. According to requirements for the construction of land use planning and management information database derived from standards of the Ministry of Land and Resources and the construction program of the Golden Land Project, this paper divides system databases into planning document database, planning implementation database, working map database and system maintenance database. In the design of the system interface, this paper uses various methods and data formats for data transmission and sharing between upper and lower levels. According to the system analysis results, main modules of the system are designed as follows: planning data management, the planning and annual plan preparation and control function, day-to-day planning management, planning revision management, decision-making support, thematic inquiry statistics, planning public participation and so on; besides that, the system realization technologies are discussed from the system operation mode, development platform and other aspects.

The influence of cognition on self-management of type 2 diabetes in older people

PubMed Central

Tomlin, Ali; Sinclair, Alan

2016-01-01

Diabetes is a growing public health issue, increasing in prevalence, eroding quality of life, and burdening health care systems. The complications of diabetes can be avoided or delayed by maintaining good glycemic control, which is achievable through self-management and, where necessary, medication. Older people with diabetes are at increased risk for cognitive impairment. This review aims to bring together current research that has investigated both cognition and diabetes self-management together. The Cumulative Index to Nursing and Allied Health (Cinahl), Excerpta Medica Database (Embase), Medical Literature Analysis and Retrieval System (Medline), and Psychological Information (PsychInfo) databases were searched. Studies were included if they featured older people with type 2 diabetes and had looked for associations between at least one distinct measure of cognition and at least one distinct measure of diabetes self-management. English language publications from the year 2000 were included. Cognitive measures of executive function, memory, and low scores on tests of global cognitive functioning showed significant correlations with multiple areas of diabetes self-management, including diabetes-specific numeracy ability, diabetes knowledge, insulin adjustment skills, ability to learn to perform insulin injections, worse adherence to medications, decreased frequency of self-care activities, missed appointments, decreased frequency of diabetes monitoring, and increased inaccuracies in reporting blood glucose monitoring. The nature of the subjects studied was quite variable in terms of their disease duration, previous medical histories, associated medical comorbidities, and educational level attained prior to being diagnosed with diabetes. The majority of studies were of an associational nature and not findings confirmed by repeat testing or by the effects of an intervention, neither were the majority of studies designed to give a view or conclusion on the clinical value or implications of the research. This only allows speculation of their importance. Most studies do not separate out the influence of aging itself in altering diabetes self-care behavior. We conclude that older people with type 2 diabetes are at increased risk for cognitive dysfunction. Changes in cognition may negatively affect diabetes self-management behaviors, influencing self-care outcomes. Age and depression may exacerbate any cognitive impairment. PMID:26855601

Pressure Ulcer Risk and Prevention Practices in Pediatric Patients: A Secondary Analysis of Data from the National Database of Nursing Quality Indicators®.

PubMed

Razmus, Ivy; Bergquist-Beringer, Sandra

2017-01-01

Little is known about pressure ulcer prevention practice among pediatric patients. To describe the frequency of pressure ulcer risk assessment in pediatric patients and pressure ulcer prevention intervention use overall and by hospital unit type, a descriptive secondary analysis was performed of data submitted to the National Database for Nursing Quality Indicators® (NDNQI®) for at least 3 of the 4 quarters in 2012. Relevant data on pressure ulcer risk from 271 hospitals across the United States extracted from the NDNQI database included patient skin and pressure ulcer risk assessment on admission, time since the last pressure ulcer risk assessment, method used to assess pressure ulcer risk, and risk status. Extracted data on pressure ulcer prevention included skin assessment, pressure-redistribution surface use, routine repositioning, nutritional support, and moisture management. These data were organized by unit type and merged with data on hospital characteristics for the analysis. The sample included 39 984 patients ages 1 day to 18 years on 678 pediatric acute care units (general pediatrics, pediatric critical care units, neonatal intensive care units, pediatric step-down units, and pediatric rehabilitation units). Descriptive statistics were used to analyze study data. Most of the pediatric patients (33 644; 89.2%) were assessed for pressure ulcer risk within 24 hours of admission. The Braden Q Scale was frequently used to assess risk on general pediatrics units (75.4%), pediatric step-down units (85.5%), pediatric critical care units (81.3%), and pediatric rehabilitation units (56.1%). In the neonatal intensive care units, another scale or method was used more often (55% to 60%) to assess pressure ulcer risk. Of the 11 203 pediatric patients (39%) determined to be at risk for pressure ulcers, the majority (10 741, 95.8%) received some kind of pressure ulcer prevention intervention during the 24 hours preceding the NDNQI pressure ulcer survey. The frequency of prevention intervention use among those at risk ranged from 99.2% for skin assessment to 70.7% for redistribution surface use. Most pediatric patients are being assessed for pressure ulcer risk, but the implementation of interventions to prevent pressure ulcers among children needs to be improved. Future qualitative research should be conducted to determine how and when clinical judgment is used to assess pressure ulcer risk and the type of pressure-redistribution surfaces used among younger pediatric patients.

Serials Management by Microcomputer: The Potential of DBMS.

ERIC Educational Resources Information Center

Vogel, J. Thomas; Burns, Lynn W.

1984-01-01

Describes serials management at Philadelphia College of Textiles and Science library via a microcomputer, a file manager called PFS, and a relational database management system called dBase II. Check-in procedures, programing with dBase II, "static" and "active" databases, and claim procedures are discussed. Check-in forms are…

Some Reliability Issues in Very Large Databases.

ERIC Educational Resources Information Center

Lynch, Clifford A.

1988-01-01

Describes the unique reliability problems of very large databases that necessitate specialized techniques for hardware problem management. The discussion covers the use of controlled partial redundancy to improve reliability, issues in operating systems and database management systems design, and the impact of disk technology on very large…

Tufts Health Sciences Database: Lessons, Issues, and Opportunities.

ERIC Educational Resources Information Center

Lee, Mary Y.; Albright, Susan A.; Alkasab, Tarik; Damassa, David A.; Wang, Paul J.; Eaton, Elizabeth K.

2003-01-01

Describes a seven-year experience with developing the Tufts Health Sciences Database, a database-driven information management system that combines the strengths of a digital library, content delivery tools, and curriculum management. Identifies major effects on teaching and learning. Also addresses issues of faculty development, copyright and…

Lessons learnt from past Flash Floods and Debris Flow events to propose future strategies on risk management

NASA Astrophysics Data System (ADS)

Cabello, Angels; Velasco, Marc; Escaler, Isabel

2010-05-01

Floods, including flash floods and debris flow events, are one of the most important hazards in Europe regarding both economic and life loss. Moreover, changes in precipitation patterns and intensity are very likely to increase due to the observed and predicted global warming, rising the risk in areas that are already vulnerable to floods. Therefore, it is very important to carry out new strategies to improve flood protection, but it is also crucial to take into account historical data to identify high risk areas. The main objective of this paper is to show a comparative analysis of the flood risk management information compiled in four test-bed basins (Llobregat, Guadalhorce, Gardon d'Anduze and Linth basins) from three different European countries (Spain, France and Switzerland) and to identify which are the lessons learnt from their past experiences in order to propose future strategies on risk management. This work is part of the EU 7th FP project IMPRINTS which aims at reducing loss of life and economic damage through the improvement of the preparedness and the operational risk management of flash flood and debris flow (FF & DF) events. The methodology followed includes the following steps: o Specific survey on the effectivity of the implemented emergency plans and risk management procedures sent to the test-bed basin authorities that participate in the project o Analysis of the answers from the questionnaire and further research on their methodologies for risk evaluation o Compilation of available follow-up studies carried out after major flood events in the four test-bed basins analyzed o Collection of the lessons learnt through a comparative analysis of the previous information o Recommendations for future strategies on risk management based on lessons learnt and management gaps detected through the process As the Floods Directive (FD) already states, the flood risks associated to FF & DF events should be assessed through the elaboration of Flood Risk Management Plans (FRMP) with tailored solutions for each basin, evaluating their flood mitigation potential, promoting environmental objectives and increasing the efficiency of the already adopted measures. The FRMP should focus on prevention (and protection), preparedness and response, and these have been the three main risk management phases of a flood crisis that have been assessed when extracting the lessons learnt from past events. Lessons learnt concerning dissemination through the three previously mentioned phases and also related to education initiatives have also been included. A common response to most of the events described in this paper was to upgrade the meteorological and hydrological forecasting systems, making the forecasting lead-time as large as possible. Another common recommendation from the test-beds was the need to implement and accomplish the land use regulations. All the basins also detected that structural measures are necessary to increase the population's protection level, but replacing the traditional safety mentality by a risk culture based on a comprehensive analysis of the flood risk. The four basins studied have also highlighted the importance of collecting information when FF & DF events occur and creating historic databases that will provide extremely useful information in the future.

A new database on contaminant exposure and effects in terrestrial vertebrates for natural resource managers

USGS Publications Warehouse

Rattner, B.A.; Pearson, J.L.; Garrett, L.J.; Erwin, R.M.; Walz, A.; Ottinger, M.A.; Barrett, H.R.

1997-01-01

The Biomonitoring of Environmental Status and Trends (BEST) program of the Department of the Interior is focused to identify and understand effects of contaminant stressors on biological resources under their stewardship. Despite the desire of many to continuously monitor the environmental health of our estuaries, much can be learned by summarizing existing temporal, geographic, and phylogenetic contaminant information. To this end, retrospective contaminant exposure and effects data for amphibians, reptiles, birds, and mammals residing within 30 km of Atlantic coast estuaries are being assembled through searches of published literature (e.g., Fisheries Review, Wildlife Review, BIOSIS Previews) and databases (e.g., US EPA Ecological Incident Information System; USGS Diagnostic and Epizootic Databases), and compilation of summary data from unpublished reports of government natural resource agencies, private conservation groups, and universities. These contaminant exposure and effect data for terrestrial vertebrates (CEE-TV) are being summarized using Borland dBASE in a 96- field format, including species, collection time and site coordinates, sample matrix, contaminant concentration, biomarker and bioindicator responses, and source of information (N>1500 records). This CEE-TV database has been imported into the ARC/INFO geographic information system (GIS), for purposes of examining geographic coverage and trends, and to identify critical data gaps. A preliminary risk assessment will be conducted to identify and characterize contaminants and other stressors potentially affecting terrestrial vertebrates that reside, migrate through or reproduce in these estuaries. Evaluations are underway, using specific measurement and assessment endpoints, to rank and prioritize estuarine ecosystems in which terrestrial vertebrates are potentially at risk for purposes of prediction and focusing future biomonitoring efforts.

Landslide databases review in the Geological Surveys of Europe

NASA Astrophysics Data System (ADS)

Herrera, Gerardo

2017-04-01

Landslides are one of the most widespread geohazards in Europe, producing significant social and economic damages. Rapid population growth in urban areas throughout many countries in Europe and extreme climatic scenarios can considerably increase landslide risk in the near future. However, many European countries do not include landslide risk into their legislation. Countries lack official methodological assessment guidelines and knowledge about landslide impacts. Although regional and national landslide databases exist in most countries, they are often not integrated because they are owed by different institutions. Hence, a European Landslides Directive, that provides a common legal framework for dealing with landslides, is necessary. With this long-term goal in mind, we present a review of the landslide databases from the Geological Surveys of Europe focusing on their interoperability. The same landslide classification was used for the 849,543 landslide records from the Geological Surveys, from which 36% are slides, 10 % falls, 20% flows, 11% complex slides and 24% remain either unclassified or correspond to another typology. A landslide density map was produced from the available records of the Geological Surveys of 17 countries showing the variable distribution of landslides. There are 0.2 million km2 of landslide prone areas. The comparison of this map with the European landslide susceptibility map ELSUS v1 was successful for 73% of the predictions, and permitted identification of 25% of susceptible areas where landslide records are not available from the Geological Surveys. Taking these results into account the completeness of these landslide databases was evaluated, revealing different landslide hazard management approaches between surveys and countries.

Parenteral and oral antibiotic duration for treatment of pediatric osteomyelitis: a systematic review protocol

PubMed Central

2013-01-01

Background Pediatric osteomyelitis is a bacterial infection of bones requiring prolonged antibiotic treatment using parenteral followed by enteral agents. Major complications of pediatric osteomyelitis include transition to chronic osteomyelitis, formation of subperiosteal abscesses, extension of infection into the joint, and permanent bony deformity or limb shortening. Historically, osteomyelitis has been treated with long durations of antibiotics to avoid these complications. However, with improvements in management and antibiotic treatment, standard of care is moving towards short durations of intravenous antibiotics prior to enteral antibiotics. Methods/Design The authors will perform a systematic review based on PRISMA guidelines in order to evaluate the literature, looking for evidence to support the optimal duration of parenteral and enteral therapy. The main goals are to see if literature supports shorter durations of either parenteral antibiotics and/or enteral antibiotics. Multiple databases will be investigated using a thorough search strategy. Databases include Medline, Cochrane, EMBASE, SCOPUS, Dissertation Abstracts, CINAHL, Web of Science, African Index Medicus and LILACS. Search stream will include medical subject heading for pediatric patients with osteomyelitis and antibiotic therapy. We will search for published or unpublished randomized and quasi-randomized controlled trials. Two authors will independently select articles, extract data and assess risk of bias by standard Cochrane methodologies. We will analyze comparisons between dichotomous outcomes using risk ratios and continuous outcomes using mean differences. 95% confidence intervals will be computed. Discussion One of the major dilemmas of management of this disease is the duration of parenteral therapy. Long parenteral therapy has increased risk of serious complications and the necessity for long therapy has been called into question. Our study aims to review the currently available evidence from randomized trials regarding duration of both parenteral and oral therapy for pediatric acute osteomyelitis. Trial registration CRD42013002320 PMID:24099135

Anabolic androgen use in the management of hereditary angioedema: Not so cheap after all.

PubMed

Tse, Kevin Y; Zuraw, Bruce L; Chen, Qiaoling; Christiansen, Sandra C

2017-04-01

Hereditary angioedema due to C1 inhibitor deficiency (HAE) is a rare, life-threatening disease that imposes a significant burden on affected patients. 17α-alkylated androgens (anabolic androgens) decrease attack frequency and severity but carry the risk of potentially serious dose-related adverse effects. Despite the emergence of targeted therapies for HAE, continued anabolic androgen use has been driven in part by their low cost. To examine the hidden cost of anabolic androgen use related to the risk of developing non-HAE comorbidities. Patients with HAE were identified in the Southern California Kaiser Permanente database using clinical and laboratory findings compatible with HAE. These patients were stratified into anabolic androgen exposed and nonexposed groups. Matched controls were selected from the Kaiser database who did not have HAE or anabolic androgen exposure. Using multivariate analysis, we determined the number of non-HAE comorbidities linked to anabolic androgen use. We next determined the association between dosing and increasing exposure to anabolic androgens and the likelihood of having various comorbidities. Patients with HAE exposed to anabolic androgens had a 28% increase (P = .04) in non-HAE comorbidities when compared with their matched (nonexposed) controls. With each gram per month increase in exposure, a 12% increase in non-HAE comorbidities is observed (P < .01). The most commonly occurring non-HAE comorbidities were psychiatric, muscle cramps, obesity, and hyperlipidemia. Our data suggest that long-term anabolic androgen use enhances the risk of developing comorbid health conditions, thus amplifying the cost of care. Our report provides additional support for the preferred use of newer, targeted therapies for the management of HAE. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Mapping the Rainforest of the Sea: Global Coral Reef Maps for Global Conservation

NASA Technical Reports Server (NTRS)

Robinson, Julie A.

2006-01-01

Coral reefs are the center of marine biodiversity, yet are under threat with an estimated 60% of coral reef habitats considered at risk by the World Resources Institute. The location and extent of coral reefs in the world are the basic information required for resource management and as a baseline for monitoring change. A NASA sponsored partnership between remote sensing scientists, international agencies and NGOs, has developed a new generation of global reef maps based on data collected by satellites. The effort, dubbed the Millennium Coral Reef Map aims to develop new methods for wide distribution of voluminous satellite data of use to the conservation and management communities. We discuss the tradeoffs between remote sensing data sources, mapping objectives, and the needs for conservation and resource management. SeaWiFS data were used to produce a composite global shallow bathymetry map at 1 km resolution. Landsat 7/ETM+ data acquisition plans were modified to collect global reefs and new operational methods were designed to generate the firstever global coral reef geomorphology map. We discuss the challenges encountered to build these databases and in implementing the geospatial data distribution strategies. Conservation applications include a new assessment of the distribution of the world s marine protected areas (UNEPWCMC), improved spatial resolution in the Reefs at Risk analysis for the Caribbean (WRI), and a global basemap for the Census of Marine Life's OBIS database. The Millennium Coral Reef map and digital image archive will pay significant dividends for local and regional conservation projects around the globe. Complete details of the project are available at http://eol.jsc.nasa.gov/reefs.

[Establishement for regional pelvic trauma database in Hunan Province].

PubMed

Cheng, Liang; Zhu, Yong; Long, Haitao; Yang, Junxiao; Sun, Buhua; Li, Kanghua

2017-04-28

To establish a database for pelvic trauma in Hunan Province, and to start the work of multicenter pelvic trauma registry.
 Methods: To establish the database, literatures relevant to pelvic trauma were screened, the experiences from the established trauma database in China and abroad were learned, and the actual situations for pelvic trauma rescue in Hunan Province were considered. The database for pelvic trauma was established based on the PostgreSQL and the advanced programming language Java 1.6.
 Results: The complex procedure for pelvic trauma rescue was described structurally. The contents for the database included general patient information, injurious condition, prehospital rescue, conditions in admission, treatment in hospital, status on discharge, diagnosis, classification, complication, trauma scoring and therapeutic effect. The database can be accessed through the internet by browser/servicer. The functions for the database include patient information management, data export, history query, progress report, video-image management and personal information management.
 Conclusion: The database with whole life cycle pelvic trauma is successfully established for the first time in China. It is scientific, functional, practical, and user-friendly.

Contaminant exposure and effects--terrestrial vertebrates database: Trends and data gaps for Atlantic Coast estuaries

USGS Publications Warehouse

Rattner, B.A.; Pearson, J.L.; Golden, N.H.; Cohen, J.B.; Erwin, R.M.; Ottinger, M.A.

2000-01-01

In order to examine the condition of biota in Atlantic coast estuaries, a ?Contaminant Exposure and Effects--Terrestrial Vertebrates? database (CEE-TV) has been compiled through computerized search of published literature, review of existing databases, and solicitation of unpublished reports from conservation agencies, private groups, and universities. Summary information has been entered into the database, including species, collection date (1965-present), site coordinates, estuary name, hydrologic unit catalogue code, sample matrix, contaminant concentrations, biomarker and bioindicator responses, and reference source, utilizing a 98-field character and numeric format. Currently, the CEE-TV database contains 3699 georeferenced records representing 190 vertebrate species and >145,000 individuals residing in estuaries from Maine through Florida. This relational database can be directly queried, imported into a Geographic Information System to examine spatial patterns, identify data gaps and areas of concern, generate hypotheses, and focus ecotoxicological field assessments. Information on birds made up the vast majority (83%) of the database, with only a modicum of data on amphibians (75,000 chemical compounds in commerce, only 118 commonly measured environmental contaminants were quantified in tissues of terrestrial vertebrates. There were no CEE-TV data records in 15 of the 67 estuaries located along the Atlantic coast and Florida Gulf coast. The CEE-TV database has a number of potential applications including focusing biomonitoring efforts to generate critically needed ecotoxicological data in the numerous ?gaps? along the coast, reducing uncertainty about contaminant risk, identifying areas for mitigation, restoration or special management, and ranking ecological conditions of estuaries.

Regulatory administrative databases in FDA's Center for Biologics Evaluation and Research: convergence toward a unified database.

PubMed

Smith, Jeffrey K

2013-04-01

Regulatory administrative database systems within the Food and Drug Administration's (FDA) Center for Biologics Evaluation and Research (CBER) are essential to supporting its core mission, as a regulatory agency. Such systems are used within FDA to manage information and processes surrounding the processing, review, and tracking of investigational and marketed product submissions. This is an area of increasing interest in the pharmaceutical industry and has been a topic at trade association conferences (Buckley 2012). Such databases in CBER are complex, not for the type or relevance of the data to any particular scientific discipline but because of the variety of regulatory submission types and processes the systems support using the data. Commonalities among different data domains of CBER's regulatory administrative databases are discussed. These commonalities have evolved enough to constitute real database convergence and provide a valuable asset for business process intelligence. Balancing review workload across staff, exploring areas of risk in review capacity, process improvement, and presenting a clear and comprehensive landscape of review obligations are just some of the opportunities of such intelligence. This convergence has been occurring in the presence of usual forces that tend to drive information technology (IT) systems development toward separate stovepipes and data silos. CBER has achieved a significant level of convergence through a gradual process, using a clear goal, agreed upon development practices, and transparency of database objects, rather than through a single, discrete project or IT vendor solution. This approach offers a path forward for FDA systems toward a unified database.

Database on Demand: insight how to build your own DBaaS

NASA Astrophysics Data System (ADS)

Gaspar Aparicio, Ruben; Coterillo Coz, Ignacio

2015-12-01

At CERN, a number of key database applications are running on user-managed MySQL, PostgreSQL and Oracle database services. The Database on Demand (DBoD) project was born out of an idea to provide CERN user community with an environment to develop and run database services as a complement to the central Oracle based database service. The Database on Demand empowers the user to perform certain actions that had been traditionally done by database administrators, providing an enterprise platform for database applications. It also allows the CERN user community to run different database engines, e.g. presently three major RDBMS (relational database management system) vendors are offered. In this article we show the actual status of the service after almost three years of operations, some insight of our new redesign software engineering and near future evolution.

Space flight risk data collection and analysis project: Risk and reliability database

NASA Technical Reports Server (NTRS)

1994-01-01

The focus of the NASA 'Space Flight Risk Data Collection and Analysis' project was to acquire and evaluate space flight data with the express purpose of establishing a database containing measurements of specific risk assessment - reliability - availability - maintainability - supportability (RRAMS) parameters. The developed comprehensive RRAMS database will support the performance of future NASA and aerospace industry risk and reliability studies. One of the primary goals has been to acquire unprocessed information relating to the reliability and availability of launch vehicles and the subsystems and components thereof from the 45th Space Wing (formerly Eastern Space and Missile Command -ESMC) at Patrick Air Force Base. After evaluating and analyzing this information, it was encoded in terms of parameters pertinent to ascertaining reliability and availability statistics, and then assembled into an appropriate database structure.

Economic aspects of hydro geological risk mitigation measures management in Italy: the ReNDiS project experience

NASA Astrophysics Data System (ADS)

Spizzichino, D.; Campobasso, C.; Gallozzi, P. L.; Dessi', B.; Traversa, F.

2009-04-01

ReNDiS project is a useful tool for monitoring, analysis and management of information data on mitigation measures and restoration works of soil protection at national scale. The main scope of the project, and related monitoring activities, is to improve the knowledge about the use of national funds and efforts against floods and landslides risk and, as a consequence, to better address the preventive policies in future. Since 1999 after the disastrous mudflow event occurred in Sarno in 1998, which caused the loss of 160 human lives, an extraordinary effort was conducted by the Italian Government in order to promote preventive measures against the hydro geological risk over the entire Italian territory. The Italian Ministry for the Environment promoted several and annual soil protection programmes. The ReNDiS project (Repertory of mitigation measures for National Soil Protection) is carried out by ISPRA - Institute for Environmental protection and Research, with the aim of improving the knowledge about the results of preventive policies against floods and landslides in order to better address national funds as requested by the Minister itself. The repertory is composed by a main archive and two secondary interface, the first for direct data management (ReNDiS-ist) and the latter (ReNDiS-web) for the on-line access and public consultation. At present, ReNDiS database contains about 3000 records concerning those programmes, focused on restoration works but including also information on landslide typologies and processes. The monitoring project is developed taking into account all the information about each step of every mitigation measure from the initial funding phase until the end of the work. During present work, we have statistically analyzed the ReNDiS database in order to highlight the conformity between the characteristic and type of the hazard (identified in a specific area) and the corresponding mitigation measures adopted for risk reduction. Through specific queries, we have grouped engineering works in several categories that have been related to the characteristics and type of hazards Vs cost-benefit analysis and timing of each work. Implementing a statistical analysis of the ReNDiS database, it has been possible to attempt a first spatial and temporal comparison between zoning of risk and distribution of preventive measures with relative cost at national level. In synthesis, this study has shown that although the total amount of resources devoted to preventive measures are not enough to remove the risk over the entire territory, the response of Italian institutions is in general well calibrated on the characteristic and type of hazard, but still very complex. Further efforts are necessary in order to improve the knowledge on landslides and flood prone areas, also in the perspective of adaptation to climate changes and to better address the public investments where the hydro geological risk is more critical. The importance of this monitoring activities is mainly due to limited financial resources of the Italian public sector in soil protection. Data collection, monitoring activities and statistical analysis like the ones carried out in ReNDiS experience is one of the best way in order to optimise the allocation of financial resources for the mitigation of natural hazard and risk.

Insertion algorithms for network model database management systems

NASA Astrophysics Data System (ADS)

Mamadolimov, Abdurashid; Khikmat, Saburov

2017-12-01

The network model is a database model conceived as a flexible way of representing objects and their relationships. Its distinguishing feature is that the schema, viewed as a graph in which object types are nodes and relationship types are arcs, forms partial order. When a database is large and a query comparison is expensive then the efficiency requirement of managing algorithms is minimizing the number of query comparisons. We consider updating operation for network model database management systems. We develop a new sequantial algorithm for updating operation. Also we suggest a distributed version of the algorithm.

Identifying job characteristics related to employed women's breastfeeding behaviors.

PubMed

Spitzmueller, Christiane; Zhang, Jing; Thomas, Candice L; Wang, Zhuxi; Fisher, Gwenith G; Matthews, Russell A; Strathearn, Lane

2018-05-14

For employed mothers of infants, reconciliation of work demands and breastfeeding constitutes a significant challenge. The discontinuation of breastfeeding has the potential to result in negative outcomes for the mother (e.g., higher likelihood of obesity), her employer (e.g., increased absenteeism), and her infant (e.g., increased risk of infection). Given previous research findings identifying return to work as a major risk factor for breastfeeding cessation, we investigate what types of job characteristics relate to women's intentions to breastfeed shortly after giving birth and women's actual breastfeeding initiation and duration. Using job titles and job descriptors contained in a large Australian longitudinal cohort data set (N = 809), we coded job titles using the U.S. Department of Labor (DOL)'s Occupational Information Network (O*NET) database and extracted job characteristics. Hazardous working conditions and job autonomy were identified as significant determinants of women's breastfeeding intentions, their initiation of breastfeeding, and ultimately their breastfeeding continuation. Hence, we recommend that human resource professionals, managers, and public health initiatives provide breastfeeding-supportive resources to women who, based on their job characteristics, are at high risk to prematurely discontinue breastfeeding to ensure these mothers have equal opportunity to reap the benefits of breastfeeding. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Use of employer administrative databases to identify systematic causes of injury in aluminum manufacturing.

PubMed

Pollack, Keshia M; Agnew, Jacqueline; Slade, Martin D; Cantley, Linda; Taiwo, Oyebode; Vegso, Sally; Sircar, Kanta; Cullen, Mark R

2007-09-01

Employer administrative files are an underutilized source of data in epidemiologic studies of occupational injuries. Personnel files, occupational health surveillance data, industrial hygiene data, and a real-time incident and injury management system from a large multi-site aluminum manufacturer were linked deterministically. An ecological-level measure of physical job demand was also linked. This method successfully created a database containing over 100 variables for 9,101 hourly employees from eight geographically dispersed U.S. plants. Between 2002 and 2004, there were 3,563 traumatic injuries to 2,495 employees. The most common injuries were sprain/strains (32%), contusions (24%), and lacerations (14%). A multivariable logistic regression model revealed that physical job demand was the strongest predictor of injury risk, in a dose dependent fashion. Other strong predictors of injury included female gender, young age, short company tenure and short time on current job. Employer administrative files are a useful source of data, as they permit the exploration of risk factors and potential confounders that are not included in many population-based surveys. The ability to link employer administrative files with injury surveillance data is a valuable analysis strategy for comprehensively studying workplace injuries, identifying salient risk factors, and targeting workforce populations disproportionately affected. (c) 2007 Wiley-Liss, Inc.

The effect of cupping therapy for low back pain: A meta-analysis based on existing randomized controlled trials.

PubMed

Wang, Yun-Ting; Qi, Yong; Tang, Fu-Yong; Li, Fei-Meng; Li, Qi-Huo; Xu, Chang-Peng; Xie, Guo-Ping; Sun, Hong-Tao

2017-11-06

LBP is one of the most common symptoms with high prevalence throughout the world. Conflicting conclusions exist in RCTs on cupping for LBP. To assess the effects and safety of cupping for the patients with LBP. Pubmed, Cochrane Library databases, and Embase database were electronically researched. RCTs reporting the cupping for the patients with LBP were included. The meta-analysis was conducted using Review Manager software (version 5.3, Nordic Cochrane Centre). The primary outcome was VAS scores. The secondary outcomes included ODI scores, MPPI scores and complications. Six RCTs were included in this synthesized analysis. The results showed that cupping therapy was superior to the control management with respect to VAS scores (SMD: -0.73, [95% CI: -1.42 to -0.04]; P= 0.04), and ODI scores (SMD: -3.64, [95% CI: -5.85 to -1.42]; P= 0.001). There was no statistical significant difference as regard to MPPI scores. No serious adverse event was reported in the included studies. Cupping therapy can significantly decrease the VAS scores and ODI scores for patients with LBP compared to the control management. High heterogeneity and risk of bias existing in studies limit the authenticity of the findings.

A New Database Dedicated to Volcanic Hazards and Risks: The atlas of Merapi Volcano, Indonesia

NASA Astrophysics Data System (ADS)

Lavigne, Franck; Surono, Dr; Mei, Estuning; de Belizal, Edouard; Cholik, Noer; Picquout, Adrien; Komorowski, Jean-Christophe; Morin, Julie; sri Hadmoko, Danang

2014-05-01

Merapi volcano is one of the most active volcanoes worldwide. Approximately 1.3 million people live within a radius 20 km from the summit. In the framework of both, the FP7 MIA VITA Project, and the SEDIMER Project funded by AXA Research Fund, we have built a database at the village scale, which includes the elements at risk and the local resources. This unique geospatial database was used to build a series of maps at the scale of the volcano, providing the core of the Merapi atlas. Designed by the French Laboratory of Physical Geography in Meudon (France) and the Center of Volcanology and Geological Hazards Mitigation in Bandung (Indonesia), this atlas provides a state of the art synthesis of knowledge on Merapi, from the reconstruction of past eruptions and assessment of volcanic hazards to the quantification of vulnerability and capacities. It is pertinent to a broad audience ranging from volcanologists to the Indonesian population interested to learn about their sacred volcano. The primary goal of this Atlas is to provide an essential blueprint for planners and public officials involved in long-term development as well as risk and crisis management. The atlas contains 63 color plates gathered in 6 chapters: the introduction summarises the geological context as well as the environmental and human context of Merapi volcano. The second chapter pertains to the geology, the past activity, and the volcanic hazards at Merapi. The third chapter is dedicated to the resources offered by the volcano, including agriculture, livestock, and sand mining activities. The fourth chapter focuses on vulnerability and capacities. The fifth chapter provides a reconstruction of the 2010 VEI 4 eruption of Merapi and its environmental consequences. The sixth chapter summarises the socio-economical impact of the eruption, including mapping of casualties, evacuation, building damage, and an assessment of air traffic disturbance. The seventh chapter focuses on rain-triggered lahar activity following the 2010 eruption, and the associated impact at the local scale. In the conclusion, we show how the 2010 eruption of Merapi improved volcanic risk management, through an updated volcanic hazard map, the establishment of a new high-tech monitoring system, as well as the development of community-based disaster reduction measures. Extensive use of colour in maps at various scales, graphics, and photos, provides a visually appealing synthesis of the hazards and risks at Merapi volcano, one of the most dangerous in the world. This atlas is available online in free access.

Using Statistics for Database Management in an Academic Library.

ERIC Educational Resources Information Center

Hyland, Peter; Wright, Lynne

1996-01-01

Collecting statistical data about database usage by library patrons aids in the management of CD-ROM and database offerings, collection development, and evaluation of training programs. Two approaches to data collection are presented which should be used together: an automated or nonintrusive method which monitors search sessions while the…

Database Software Selection for the Egyptian National STI Network.

ERIC Educational Resources Information Center

Slamecka, Vladimir

The evaluation and selection of information/data management system software for the Egyptian National Scientific and Technical (STI) Network are described. An overview of the state-of-the-art of database technology elaborates on the differences between information retrieval and database management systems (DBMS). The desirable characteristics of…

Teaching Database Management System Use in a Library School Curriculum.

ERIC Educational Resources Information Center

Cooper, Michael D.

1985-01-01

Description of database management systems course being taught to students at School of Library and Information Studies, University of California, Berkeley, notes course structure, assignments, and course evaluation. Approaches to teaching concepts of three types of database systems are discussed and systems used by students in the course are…

Trends in Radical Prostatectomy Risk Group Distribution in a European Multicenter Analysis of 28 572 Patients: Towards Tailored Treatment.

PubMed

van den Bergh, Roderick; Gandaglia, Giorgio; Tilki, Derya; Borgmann, Hendrik; Ost, Piet; Surcel, Christian; Valerio, Massimo; Sooriakumaran, Prasanna; Salomon, Laurent; Briganti, Alberto; Graefen, Markus; van der Poel, Henk; de la Taille, Alexandre; Montorsi, Francesco; Ploussard, Guillaume

2017-08-08

Active surveillance (AS) has been increasingly proposed as the preferential initial management strategy for low-risk prostate cancer (PC), while in high-risk PC the indication for surgery has widened. To evaluate the development of risk group distribution of patients undergoing radical prostatectomy (RP). Retrospective database review of combined RP databases (2000-2015) of four large European centers (Créteil, Paris; San Rafaele, Milan; Martini Klinik, Hamburg; NKI, AvL, Amsterdam). Clinical and pathological characteristics per year of surgery. Eligibility for AS was defined according to Prostate Cancer Research International Active Surveillance criteria: cT≤2c, cN0/X, cM0/X, PSA ≤10ng/ml, prostate-specific antigen density <0.2ng/ml/ml, one to two positive biopsies, and Gleason score ≤6, high-risk disease as: cT≥3, c N1, cM1, PSA >20ng/ml, and/or Gleason ≥8. In total, 28572 patients had complete clinical and 24790 complete pathological data available. The absolute number of RPs increased: 401, 975, 2344, and 2504 in 2000, 2005, 2010, and 2015, respectively. The proportion of cases considered suitable for AS decreased: 31%, 32%, 18%, and 5%, while the cases considered high risk increased: 10%, 8%, 16%, and 30%. The percentage of patients having only localized Gleason 6 disease after RP decreased: 46%, 34%, 14%, and 8% for all patients (p<0.01), as well as for AS-suitable patients: 70%, 54%, 41%, and 38% (p<0.01). Comparisons between centers were outside the scope of this article. Developments in diagnostics may have impacted on results. This European analysis confirmed the risk profile of patients undergoing RP shifting away of the most favorable disease spectrum. Patients with PC clinically considered suitable for AS and men having only localized Gleason 6 disease pathologically comprised a decreasing share of all RP performed. High-risk disease comprised an increasing share of all RPs. The databases of four large European centers of prostate cancer surgery were analyzed. In recent years, the risk profile of patients shifted away of low-risk cancer, while high-risk cancer comprised a larger part of cases. This confirms the introduction of active surveillance for low-risk prostate cancer and increase in potentially curative options for high-risk disease. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Evaluating the Impact of Database Heterogeneity on Observational Study Results

PubMed Central

Madigan, David; Ryan, Patrick B.; Schuemie, Martijn; Stang, Paul E.; Overhage, J. Marc; Hartzema, Abraham G.; Suchard, Marc A.; DuMouchel, William; Berlin, Jesse A.

2013-01-01

Clinical studies that use observational databases to evaluate the effects of medical products have become commonplace. Such studies begin by selecting a particular database, a decision that published papers invariably report but do not discuss. Studies of the same issue in different databases, however, can and do generate different results, sometimes with strikingly different clinical implications. In this paper, we systematically study heterogeneity among databases, holding other study methods constant, by exploring relative risk estimates for 53 drug-outcome pairs and 2 widely used study designs (cohort studies and self-controlled case series) across 10 observational databases. When holding the study design constant, our analysis shows that estimated relative risks range from a statistically significant decreased risk to a statistically significant increased risk in 11 of 53 (21%) of drug-outcome pairs that use a cohort design and 19 of 53 (36%) of drug-outcome pairs that use a self-controlled case series design. This exceeds the proportion of pairs that were consistent across databases in both direction and statistical significance, which was 9 of 53 (17%) for cohort studies and 5 of 53 (9%) for self-controlled case series. Our findings show that clinical studies that use observational databases can be sensitive to the choice of database. More attention is needed to consider how the choice of data source may be affecting results. PMID:23648805

The land management and operations database (LMOD)

USDA-ARS?s Scientific Manuscript database

This paper presents the design, implementation, deployment, and application of the Land Management and Operations Database (LMOD). LMOD is the single authoritative source for reference land management and operation reference data within the USDA enterprise data warehouse. LMOD supports modeling appl...

Development of bilateral data transferability in the Virginia Department of Transportation's Geotechnical Database Management System Framework.

DOT National Transportation Integrated Search

2006-01-01

An Internet-based, spatiotemporal Geotechnical Database Management System (GDBMS) Framework was designed, developed, and implemented at the Virginia Department of Transportation (VDOT) in 2002 to retrieve, manage, archive, and analyze geotechnical da...

Development of Hydrometeorological Monitoring and Forecasting as AN Essential Component of the Early Flood Warning System:

NASA Astrophysics Data System (ADS)

Manukalo, V.

2012-12-01

Defining issue The river inundations are the most common and destructive natural hazards in Ukraine. Among non-structural flood management and protection measures a creation of the Early Flood Warning System is extremely important to be able to timely recognize dangerous situations in the flood-prone areas. Hydrometeorological information and forecasts are a core importance in this system. The primary factors affecting reliability and a lead - time of forecasts include: accuracy, speed and reliability with which real - time data are collected. The existing individual conception of monitoring and forecasting resulted in a need in reconsideration of the concept of integrated monitoring and forecasting approach - from "sensors to database and forecasters". Result presentation The Project: "Development of Flood Monitoring and Forecasting in the Ukrainian part of the Dniester River Basin" is presented. The project is developed by the Ukrainian Hydrometeorological Service in a conjunction with the Water Management Agency and the Energy Company "Ukrhydroenergo". The implementation of the Project is funded by the Ukrainian Government and the World Bank. The author is nominated as the responsible person for coordination of activity of organizations involved in the Project. The term of the Project implementation: 2012 - 2014. The principal objectives of the Project are: a) designing integrated automatic hydrometeorological measurement network (including using remote sensing technologies); b) hydrometeorological GIS database construction and coupling with electronic maps for flood risk assessment; c) interface-construction classic numerical database -GIS and with satellite images, and radar data collection; d) providing the real-time data dissemination from observation points to forecasting centers; e) developing hydrometeoroogical forecasting methods; f) providing a flood hazards risk assessment for different temporal and spatial scales; g) providing a dissemination of current information, forecasts and warnings to consumers automatically. Besides scientific and technical issues the implementation of these objectives requires solution of a number of organizational issues. Thus, as a result of the increased complexity of types of hydrometeorological data and in order to develop forecasting methods, a reconsideration of meteorological and hydrological measurement networks should be carried out. The "optimal density of measuring networks" is proposed taking into account principal terms: a) minimizing an uncertainty in characterizing the spacial distribution of hydrometeorological parameters; b) minimizing the Total Life Cycle Cost of creation and maintenance of measurement networks. Much attention will be given to training Ukrainian disaster management authorities from the Ministry of Emergencies and the Water Management Agency to identify the flood hazard risk level and to indicate the best protection measures on the basis of continuous monitoring and forecasts of evolution of meteorological and hydrological conditions in the river basin.

Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society.

PubMed

Wild, Robert A; Carmina, Enrico; Diamanti-Kandarakis, Evanthia; Dokras, Anuja; Escobar-Morreale, Hector F; Futterweit, Walter; Lobo, Rogerio; Norman, Robert J; Talbott, Evelyn; Dumesic, Daniel A

2010-05-01

Women with polycystic ovary syndrome (PCOS) often have cardiovascular disease (CVD) risk factors. The Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society created a panel to provide evidence-based reviews of studies assessing PCOS-CVD risk relationships and to develop guidelines for preventing CVD. An expert panel in PCOS and CVD reviewed literature and presented recommendations. Only studies comparing PCOS with control patients were included. All electronic databases were searched; reviews included individual studies/databases, systematic reviews, abstracts, and expert data. Articles were excluded if other hyperandrogenic disorders were not excluded, PCOS diagnosis was unclear, controls were not described, or methodology precluded evaluation. Inclusion/exclusion criteria were confirmed by at least two reviewers and arbitrated by a third. Systematic reviews of CVD risk factors were compiled and submitted for approval to the AE-PCOS Society Board. Women with PCOS with obesity, cigarette smoking, dyslipidemia, hypertension, impaired glucose tolerance, and subclinical vascular disease are at risk, whereas those with metabolic syndrome and/or type 2 diabetes mellitus are at high risk for CVD. Body mass index, waist circumference, serum lipid/glucose, and blood pressure determinations are recommended for all women with PCOS, as is oral glucose tolerance testing in those with obesity, advanced age, personal history of gestational diabetes, or family history of type 2 diabetes mellitus. Mood disorder assessment is suggested in all PCOS patients. Lifestyle management is recommended for primary CVD prevention, targeting low-density and non-high-density lipoprotein cholesterol and adding insulin-sensitizing and other drugs if dyslipidemia or other risk factors persist.

Inter-Rater Agreement of Pressure Ulcer Risk and Prevention Measures in the National Database of Nursing Quality Indicators(®) (NDNQI).

PubMed

Waugh, Shirley Moore; Bergquist-Beringer, Sandra

2016-06-01

In this descriptive multi-site study, we examined inter-rater agreement on 11 National Database of Nursing Quality Indicators(®) (NDNQI(®) ) pressure ulcer (PrU) risk and prevention measures. One hundred twenty raters at 36 hospitals captured data from 1,637 patient records. At each hospital, agreement between the most experienced rater and each other team rater was calculated for each measure. In the ratings studied, 528 patients were rated as "at risk" for PrU and, therefore, were included in calculations of agreement for the prevention measures. Prevalence-adjusted kappa (PAK) was used to interpret inter-rater agreement because prevalence of single responses was high. The PAK values for eight measures indicated "substantial" to "near perfect" agreement between most experienced and other team raters: Skin assessment on admission (.977, 95% CI [.966-.989]), PrU risk assessment on admission (.978, 95% CI [.964-.993]), Time since last risk assessment (.790, 95% CI [.729-.852]), Risk assessment method (.997, 95% CI [.991-1.0]), Risk status (.877, 95% CI [.838-.917]), Any prevention (.856, 95% CI [.76-.943]), Skin assessment (.956, 95% CI [.904-1.0]), and Pressure-redistribution surface use (.839, 95% CI [.763-.916]). For three intervention measures, PAK values fell below the recommended value of ≥.610: Routine repositioning (.577, 95% CI [.494-.661]), Nutritional support (.500, 95% CI [.418-.581]), and Moisture management (.556, 95% CI [.469-.643]). Areas of disagreement were identified. Findings provide support for the reliability of 8 of the 11 measures. Further clarification of data collection procedures is needed to improve reliability for the less reliable measures. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Assessment of risk of peripheral vascular disease and vascular care capacity in low- and middle-income countries.

PubMed

Gyedu, A; Stewart, B T; Nakua, E; Quansah, R; Donkor, P; Mock, C; Hardy, M; Yangni-Angate, K H

2016-01-01

This study aimed to describe national peripheral vascular disease (PVD) risk and health burden, and vascular care capacity in Ghana. The gap between PVD burden and vascular care capacity in low- and middle-income countries was defined, and capacity improvement priorities were identified. Data to estimate PVD risk factor burden were obtained from the World Health Organization Study on Global Ageing and Adult Health (SAGE), Ghana, and the Institute of Health Metrics and Evaluation Global Burden of Disease (IHME GBD) database. In addition, a novel nationwide assessment of vascular care capacity was performed, with 20 vascular care items assessed at 40 hospitals in Ghana. Factors contributing to specific item deficiency were described. From the SAGE database, there were 4305 respondents aged at least 50 years with data to estimate PVD risk. Of these, 57·4 per cent were at moderate to risk high of PVD with at least three risk factors; extrapolating nationally, the estimate was 1 654 557 people. Based on IHME GBD data, the estimated disability-adjusted life-years incurred from PVD increased fivefold from 1990 to 2010 (from 6·3 to 31·7 per 100 000 persons respectively). Vascular care capacity assessment demonstrated marked deficiencies in items for diagnosis, and in perioperative and vascular surgical care. Deficiencies were most often due to absence of equipment, lack of training and technology breakage. Risk factor reduction and management as well as optimization of current resources are paramount to avoid the large burden of PVD falling on healthcare systems in low- and middle-income countries. These countries are not well equipped to handle vascular surgical care, and rapid development of such capacity would be difficult and expensive. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

Comparing Readmissions and Infectious Complications of Blunt Splenic Injuries Using a Statewide Database.

PubMed

Olufajo, Olubode A; Rios-Diaz, Arturo; Peetz, Allan B; Williams, Katherine J; Havens, Joaquim M; Cooper, Zara R; Gates, Jonathan D; Haider, Adil H; Salim, Ali; Askari, Reza

2016-04-01

Although non-operative management of blunt splenic injury (BSI) is increasingly common, the long-term infectious complications after adjunct splenic artery embolization (SAE) are not well described. Patients aged 18-64 y with BSI were identified in the California State Inpatient Database (2007-2011) and categorized as receiving either non-operative management (NOM) without SAE, NOM with SAE, or operative management (OM). The cumulative incidence of infections (surgical site infections [SSI], pneumonia, urinary tract infections, and sepsis) requiring readmission at different times up to one y after injury were calculated. Patient and treatment factors associated with infectious readmissions were determined using multivariable logistic regression models. Of the 4,360 patients with BSI, 61.6% had NOM without SAE, 5.8% had NOM with SAE, and 32.6% had OM. The cumulative incidences of infectious complications after each of the management modes were 1.27%, 1.59%, and 1.76%, respectively, during admission (p = 0.446); 2.16%, 5.18%, and 4.85%, respectively, at 30 d after injury (p < 0.001); and 4.69%, 9.16%, and 8.85%, respectively, at one y after injury (p < 0.001). Risk factors for infection-associated readmissions within one y after injury were Charlson score ≥2 (adjusted odds ratio [AOR] 3.9; 95% confidence interval [CI] 2.61-6.02), length of stay >seven d (AOR 2.47; 95% CI 1.58-3.85), NOM with SAE (AOR 2.00; 95% CI 1.19-3.34), and OM (AOR 1.47; 95% CI 1.05-2.07). The long-term risk of infectious complications in patients with BSI who have NOM with SAE is similar to that in patients who are treated with OM, indicating the need for pro-active strategies to reduce long-term infectious complications after SAE.

[Bibliografic resources on chemical risk administration and prevention].

PubMed

Calera Rubio, Alfonso A; Juan Quilis, Verónica; López Samaniego, Luz M; Caballero Pérez, Pablo; Ronda Pérez, Elena

2005-01-01

The documentation produced by public and private institutions in relation to the chemical risk constitutes an essential tool for prevention. The objective of this research is to locate and to revise the documents related to the management of the prevention of chemical risk focus to PYMES in Spain from 1995 to 2004. The methodology carried out for the selection of the bibliographical materials has been the consultation of automated databases and Web pages. 812 documents have been identified. Most corresponds to grey literature. The thematic more frequent has been the security and the most frequent objective of the papers has been the prevention. Most of the documents go to the technical sector. The results suggest that although that there is a great diversity of documents in Spain dedicated to the prevention of chemical risk it seems convenient: 1) to increase their diffusion, 2) to pay attention to the communication of the risks, 3) to investigate and to translate the research in good practice.

Kristin Munch | NREL

Science.gov Websites

Information Management System, Materials Research Society Fall Meeting (2013) Photovoltaics Informatics scientific data management, database and data systems design, database clusters, storage systems integration , and distributed data analytics. She has used her experience in laboratory data management systems, lab

Development of the interconnectivity and enhancement (ICE) module in the Virginia Department of Transportation's Geotechnical Database Management System Framework.

DOT National Transportation Integrated Search

2007-01-01

An Internet-based, spatiotemporal Geotechnical Database Management System (GDBMS) Framework was implemented at the Virginia Department of Transportation (VDOT) in 2002 to manage geotechnical data using a distributed Geographical Information System (G...

23 CFR 973.204 - Management systems requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL LANDS HIGHWAYS MANAGEMENT... system; (2) A process to operate and maintain the management systems and their associated databases; (3... systems shall use databases with a common or coordinated reference system that can be used to geolocate...

23 CFR 973.204 - Management systems requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL LANDS HIGHWAYS MANAGEMENT... system; (2) A process to operate and maintain the management systems and their associated databases; (3... systems shall use databases with a common or coordinated reference system that can be used to geolocate...

Korean Ministry of Environment's web-based visual consumer product exposure and risk assessment system (COPER).

PubMed

Lee, Hunjoo; Lee, Kiyoung; Park, Ji Young; Min, Sung-Gi

2017-05-01

With support from the Korean Ministry of the Environment (ME), our interdisciplinary research staff developed the COnsumer Product Exposure and Risk assessment system (COPER). This system includes various databases and features that enable the calculation of exposure and determination of risk caused by consumer products use. COPER is divided into three tiers: the integrated database layer (IDL), the domain specific service layer (DSSL), and the exposure and risk assessment layer (ERAL). IDL is organized by the form of the raw data (mostly non-aggregated data) and includes four sub-databases: a toxicity profile, an inventory of Korean consumer products, the weight fractions of chemical substances in the consumer products determined by chemical analysis and national representative exposure factors. DSSL provides web-based information services corresponding to each database within IDL. Finally, ERAL enables risk assessors to perform various exposure and risk assessments, including exposure scenario design via either inhalation or dermal contact by using or organizing each database in an intuitive manner. This paper outlines the overall architecture of the system and highlights some of the unique features of COPER based on visual and dynamic rendering engine for exposure assessment model on web.

Socioeconomic inequalities in mortality, morbidity and diabetes management for adults with type 1 diabetes: A systematic review

PubMed Central

Chambers, Duncan; Goyder, Elizabeth; O’Cathain, Alicia

2017-01-01

Aims To systematically review the evidence of socioeconomic inequalities for adults with type 1 diabetes in relation to mortality, morbidity and diabetes management. Methods We carried out a systematic search across six relevant databases and included all studies reporting associations between socioeconomic indicators and mortality, morbidity, or diabetes management for adults with type 1 diabetes. Data extraction and quality assessment was undertaken for all included studies. A narrative synthesis was conducted. Results A total of 33 studies were identified. Twelve cohort, 19 cross sectional and 2 case control studies met the inclusion criteria. Regardless of healthcare system, low socioeconomic status was associated with poorer outcomes. Following adjustments for other risk factors, socioeconomic status was a statistically significant independent predictor of mortality in 9/10 studies and morbidity in 8/10 studies for adults with type 1 diabetes. There appeared to be an association between low socioeconomic status and some aspects of diabetes management. Although only 3 of 16 studies made adjustments for confounders and other risk factors, poor diabetes management was associated with lower socioeconomic status in 3/3 of these studies. Conclusions Low socioeconomic status is associated with higher levels of mortality and morbidity for adults with type 1 diabetes even amongst those with access to a universal healthcare system. The association between low socioeconomic status and diabetes management requires further research given the paucity of evidence and the potential for diabetes management to mitigate the adverse effects of low socioeconomic status. PMID:28489876

Management of cervical esophageal and hypopharyngeal perforations.

PubMed

Zenga, Joseph; Kreisel, Daniel; Kushnir, Vladimir M; Rich, Jason T

2015-01-01

Evidence is limited for outcomes of surgical versus conservative management for patients with cervical esophageal or hypopharyngeal perforations. Patients with cervical esophageal or hypopharyngeal perforations treated between 1994 and 2014 were identified using an institutional database. Outcomes were compared between patients who underwent operative drainage and those who had conservative management with broad-spectrum antibiotics and withholding oral intake. Twenty-eight patients were identified with hypopharyngeal or cervical esophageal perforations, mostly due to iatrogenic (nasogastric tube placement, endoscopy, endotracheal intubation) injuries (68%). Fourteen were treated initially with conservative management and 14 with initial surgery. Six patients failed conservative treatment and two patients failed surgical treatment. Patients managed conservatively who had eaten between injury and diagnosis (p=0.003), those who had 24 hours or more between the time of injury and diagnosis (p=0.026), and those who showed signs of systemic toxicity (p=0.001) were significantly more likely to fail conservative treatment and require surgery. No variables were significant for treatment failure in the surgical group. Of the 20 patients who ultimately underwent a surgical procedure, two required a second procedure. Patients who have eaten between the time of perforation and diagnosis, have 24 hours or more between injury and diagnosis, and those that show signs of systemic toxicity are at higher risk of failing conservative management and surgical drainage should be considered. For patients without these risk factors, a trial of conservative management can be attempted. Copyright © 2015 Elsevier Inc. All rights reserved.

RECALMIN: The association between management of Spanish National Health Service Internal Medical Units and health outcomes.

PubMed

Zapatero-Gaviria, Antonio; Javier Elola-Somoza, Francisco; Casariego-Vales, Emilio; Fernandez-Perez, Cristina; Gomez-Huelgas, Ricardo; Bernal, José Luis; Barba-Martín, Raquel

2017-08-01

To investigate the association between management of Internal Medical Units (IMUs) with outcomes (mortality and length of stay) within the Spanish National Health Service. Data on management were obtained from a descriptive transversal study performed among IMUs of the acute hospitals. Outcome indicators were taken from an administrative database of all hospital discharges from the IMUs. Spanish National Health Service. One hundred and twenty-four acute general hospitals with available data of management and outcomes (401 424 discharges). IMU risk standardized mortality rates were calculated using a multilevel model adjusted by Charlson Index. Risk standardized myocardial infarction and heart failure mortality rates were calculated using specific multilevel models. Length of stay was adjusted by complexity. Greater hospital complexity was associated with longer average length of stays (r: 0.42; P < 0.001). Crude in-hospital mortality rates were higher at larger hospitals, but no significant differences were found when mortality was risk adjusted. There was an association between nurse workload with mortality rate for selected conditions (r: 0.25; P = 0.009). Safety committee and multidisciplinary ward rounds were also associated with outcomes. We have not found any association between complexity and intra-hospital mortality. There is an association between some management indicators with intra-hospital mortality and the length of stay. Better disease-specific outcomes adjustments and a larger number of IMUs in the sample may provide more insights about the association between management of IMUs with healthcare outcomes. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Weight management during pregnancy: a systematic review of qualitative evidence.

PubMed

Johnson, Maxine; Campbell, Fiona; Messina, Josie; Preston, Louise; Buckley Woods, Helen; Goyder, Elizabeth

2013-12-01

increasing overweight and obesity rates in pregnant women present health risks to mother and unborn infant. to identify barriers and facilitators to implementing and carrying out maternal weight management interventions. searches were carried out in medical, midwifery and nursing databases, augmented by hand searching of midwifery journals. articles were included that were published in the UK after 1990, with a focus on women's and health professional's views about weight management during pregnancy. from 6423 citations, 126 full text papers were retrieved. Of these, 18 (reporting 17 studies) fulfilled the inclusion criteria. Included papers were assessed for quality. Reported findings were analysed and synthesised using thematic analysis. a major theme was access to relevant and appropriate information; advice was reported as vague or inadequate. Overweight or obese women reported feelings of stigmatisation during routine examinations. Health professionals reported a reluctance to discuss weight with larger women. Perceived risk to the fetus as well as changes in women's physiological responses to pregnancy, were reported barriers to optimal physical activity and dietary intake. Perceptions of control were related to women's feelings about their body image. evidence suggests that the complexity of interactions with advice sources, bodily changes, feelings of control, as well as perceived risks may explain the relative ineffectiveness of weight management interventions during pregnancy. Focusing on healthy diet and physical activity levels may be more useful and less stigmatising than focusing on weight. Copyright © 2012 Elsevier Ltd. All rights reserved.

Empirical performance of the self-controlled case series design: lessons for developing a risk identification and analysis system.

PubMed

Suchard, Marc A; Zorych, Ivan; Simpson, Shawn E; Schuemie, Martijn J; Ryan, Patrick B; Madigan, David

2013-10-01

The self-controlled case series (SCCS) offers potential as an statistical method for risk identification involving medical products from large-scale observational healthcare data. However, analytic design choices remain in encoding the longitudinal health records into the SCCS framework and its risk identification performance across real-world databases is unknown. To evaluate the performance of SCCS and its design choices as a tool for risk identification in observational healthcare data. We examined the risk identification performance of SCCS across five design choices using 399 drug-health outcome pairs in five real observational databases (four administrative claims and one electronic health records). In these databases, the pairs involve 165 positive controls and 234 negative controls. We also consider several synthetic databases with known relative risks between drug-outcome pairs. We evaluate risk identification performance through estimating the area under the receiver-operator characteristics curve (AUC) and bias and coverage probability in the synthetic examples. The SCCS achieves strong predictive performance. Twelve of the twenty health outcome-database scenarios return AUCs >0.75 across all drugs. Including all adverse events instead of just the first per patient and applying a multivariate adjustment for concomitant drug use are the most important design choices. However, the SCCS as applied here returns relative risk point-estimates biased towards the null value of 1 with low coverage probability. The SCCS recently extended to apply a multivariate adjustment for concomitant drug use offers promise as a statistical tool for risk identification in large-scale observational healthcare databases. Poor estimator calibration dampens enthusiasm, but on-going work should correct this short-coming.

The Brazilian consensus for the clinical approach and treatment of subclinical hypothyroidism in adults: recommendations of the thyroid Department of the Brazilian Society of Endocrinology and Metabolism.

PubMed

Sgarbi, Jose A; Teixeira, Patrícia F S; Maciel, Lea M Z; Mazeto, Glaucia M F S; Vaisman, Mario; Montenegro Junior, Renan M; Ward, Laura S

2013-04-01

Subclinical hypothyroidism (SCH), defined as elevated concentrations of thyroid stimulating hormone (TSH) despite normal levels of thyroid hormones, is highly prevalent in Brazil, especially among women and the elderly. Although an increasing number of studies have related SCH to an increased risk of coronary artery disease and mortality, there have been no randomized clinical trials verifying the benefit of levothyroxine treatment in reducing these risks, and the treatment remains controversial. This consensus, sponsored by the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism and developed by Brazilian experts with extensive clinical experience with thyroid diseases, presents these recommendations based on evidence for the clinical management of SCH patients in Brazil. After structuring the clinical questions, the search for evidence in the literature was initially performed in the MedLine-PubMed database and later in the Embase and SciELO - Lilacs databases. The strength of evidence was evaluated according to the Oxford classification system and established based on the experimental design used, considering the best available evidence for each question and the Brazilian experience. The topics covered included SCH definition and diagnosis, natural history, clinical significance, treatment and pregnancy, and the consensus issued 29 recommendations for the clinical management of adult patients with SCH. Treatment with levothyroxine was recommended for all patients with persistent SCH with serum TSH values > 10 mU/L and for certain patient subgroups.

Salary Management System for Small and Medium-sized Enterprises

NASA Astrophysics Data System (ADS)

Hao, Zhang; Guangli, Xu; Yuhuan, Zhang; Yilong, Lei

Small and Medium-sized Enterprises (SMEs) in the process of wage entry, calculation, the total number are needed to be done manually in the past, the data volume is quite large, processing speed is low, and it is easy to make error, which is resulting in low efficiency. The main purpose of writing this paper is to present the basis of salary management system, establish a scientific database, the computer payroll system, using the computer instead of a lot of past manual work in order to reduce duplication of staff labor, it will improve working efficiency.This system combines the actual needs of SMEs, through in-depth study and practice of the C/S mode, PowerBuilder10.0 development tools, databases and SQL language, Completed a payroll system needs analysis, database design, application design and development work. Wages, departments, units and personnel database file are included in this system, and have data management, department management, personnel management and other functions, through the control and management of the database query, add, delete, modify, and other functions can be realized. This system is reasonable design, a more complete function, stable operation has been tested to meet the basic needs of the work.

High-performance Negative Database for Massive Data Management System of The Mingantu Spectral Radioheliograph

NASA Astrophysics Data System (ADS)

Shi, Congming; Wang, Feng; Deng, Hui; Liu, Yingbo; Liu, Cuiyin; Wei, Shoulin

2017-08-01

As a dedicated synthetic aperture radio interferometer in China, the MingantU SpEctral Radioheliograph (MUSER), initially known as the Chinese Spectral RadioHeliograph (CSRH), has entered the stage of routine observation. More than 23 million data records per day need to be effectively managed to provide high-performance data query and retrieval for scientific data reduction. In light of these massive amounts of data generated by the MUSER, in this paper, a novel data management technique called the negative database (ND) is proposed and used to implement a data management system for the MUSER. Based on the key-value database, the ND technique makes complete utilization of the complement set of observational data to derive the requisite information. Experimental results showed that the proposed ND can significantly reduce storage volume in comparison with a relational database management system (RDBMS). Even when considering the time needed to derive records that were absent, its overall performance, including querying and deriving the data of the ND, is comparable with that of a relational database management system (RDBMS). The ND technique effectively solves the problem of massive data storage for the MUSER and is a valuable reference for the massive data management required in next-generation telescopes.

Landslide databases for applied landslide impact research: the example of the landslide database for the Federal Republic of Germany

NASA Astrophysics Data System (ADS)

Damm, Bodo; Klose, Martin

2014-05-01

This contribution presents an initiative to develop a national landslide database for the Federal Republic of Germany. It highlights structure and contents of the landslide database and outlines its major data sources and the strategy of information retrieval. Furthermore, the contribution exemplifies the database potentials in applied landslide impact research, including statistics of landslide damage, repair, and mitigation. The landslide database offers due to systematic regional data compilation a differentiated data pool of more than 5,000 data sets and over 13,000 single data files. It dates back to 1137 AD and covers landslide sites throughout Germany. In seven main data blocks, the landslide database stores besides information on landslide types, dimensions, and processes, additional data on soil and bedrock properties, geomorphometry, and climatic or other major triggering events. A peculiarity of this landslide database is its storage of data sets on land use effects, damage impacts, hazard mitigation, and landslide costs. Compilation of landslide data is based on a two-tier strategy of data collection. The first step of information retrieval includes systematic web content mining and exploration of online archives of emergency agencies, fire and police departments, and news organizations. Using web and RSS feeds and soon also a focused web crawler, this enables effective nationwide data collection for recent landslides. On the basis of this information, in-depth data mining is performed to deepen and diversify the data pool in key landslide areas. This enables to gather detailed landslide information from, amongst others, agency records, geotechnical reports, climate statistics, maps, and satellite imagery. Landslide data is extracted from these information sources using a mix of methods, including statistical techniques, imagery analysis, and qualitative text interpretation. The landslide database is currently migrated to a spatial database system running on PostgreSQL/PostGIS. This provides advanced functionality for spatial data analysis and forms the basis for future data provision and visualization using a WebGIS application. Analysis of landslide database contents shows that in most parts of Germany landslides primarily affect transportation infrastructures. Although with distinct lower frequency, recent landslides are also recorded to cause serious damage to hydraulic facilities and waterways, supply and disposal infrastructures, sites of cultural heritage, as well as forest, agricultural, and mining areas. The main types of landslide damage are failure of cut and fill slopes, destruction of retaining walls, street lights, and forest stocks, burial of roads, backyards, and garden areas, as well as crack formation in foundations, sewer lines, and building walls. Landslide repair and mitigation at transportation infrastructures is dominated by simple solutions such as catch barriers or rock fall drapery. These solutions are often undersized and fail under stress. The use of costly slope stabilization or protection systems is proven to reduce these risks effectively over longer maintenance cycles. The right balancing of landslide mitigation is thus a crucial problem in managing landslide risks. Development and analysis of such landslide databases helps to support decision-makers in finding efficient solutions to minimize landslide risks for human beings, infrastructures, and financial assets.

48 CFR 52.232-33 - Payment by Electronic Funds Transfer-System for Award Management.

Code of Federal Regulations, 2013 CFR

2013-10-01

... contained in the System for Award Management (SAM) database. In the event that the EFT information changes, the Contractor shall be responsible for providing the updated information to the SAM database. (c... 210. (d) Suspension of payment. If the Contractor's EFT information in the SAM database is incorrect...

48 CFR 52.232-33 - Payment by Electronic Funds Transfer-System for Award Management.

Code of Federal Regulations, 2014 CFR

2014-10-01

... contained in the System for Award Management (SAM) database. In the event that the EFT information changes, the Contractor shall be responsible for providing the updated information to the SAM database. (c... 210. (d) Suspension of payment. If the Contractor's EFT information in the SAM database is incorrect...

Microcomputer-Based Access to Machine-Readable Numeric Databases.

ERIC Educational Resources Information Center

Wenzel, Patrick

1988-01-01

Describes the use of microcomputers and relational database management systems to improve access to numeric databases by the Data and Program Library Service at the University of Wisconsin. The internal records management system, in-house reference tools, and plans to extend these tools to the entire campus are discussed. (3 references) (CLB)

How Database Management Systems Can Be Used To Evaluate Program Effectiveness in Small School Districts.

ERIC Educational Resources Information Center

Hoffman, Tony

Sophisticated database management systems (DBMS) for microcomputers are becoming increasingly easy to use, allowing small school districts to develop their own autonomous databases for tracking enrollment and student progress in special education. DBMS applications can be designed for maintenance by district personnel with little technical…

47 CFR 101.1523 - Sharing and coordination among non-government licensees and between non-government and government...

Code of Federal Regulations, 2014 CFR

2014-10-01

... Wireless Telecommunications Bureau announces by public notice the implementation of a third-party database...) Provide an electronic copy of an interference analysis to the third-party database manager which...-party database managers shall receive and retain the interference analyses electronically and make them...

47 CFR 101.1523 - Sharing and coordination among non-government licensees and between non-government and government...

Code of Federal Regulations, 2012 CFR

2012-10-01

... Wireless Telecommunications Bureau announces by public notice the implementation of a third-party database...) Provide an electronic copy of an interference analysis to the third-party database manager which...-party database managers shall receive and retain the interference analyses electronically and make them...

47 CFR 101.1523 - Sharing and coordination among non-government licensees and between non-government and government...

Code of Federal Regulations, 2010 CFR

2010-10-01

... Wireless Telecommunications Bureau announces by public notice the implementation of a third-party database...) Provide an electronic copy of an interference analysis to the third-party database manager which...-party database managers shall receive and retain the interference analyses electronically and make them...

47 CFR 101.1523 - Sharing and coordination among non-government licensees and between non-government and government...

Code of Federal Regulations, 2013 CFR

2013-10-01

... Wireless Telecommunications Bureau announces by public notice the implementation of a third-party database...) Provide an electronic copy of an interference analysis to the third-party database manager which...-party database managers shall receive and retain the interference analyses electronically and make them...

47 CFR 101.1523 - Sharing and coordination among non-government licensees and between non-government and government...

Code of Federal Regulations, 2011 CFR

2011-10-01

... Wireless Telecommunications Bureau announces by public notice the implementation of a third-party database...) Provide an electronic copy of an interference analysis to the third-party database manager which...-party database managers shall receive and retain the interference analyses electronically and make them...

A Database Design and Development Case: NanoTEK Networks

ERIC Educational Resources Information Center

Ballenger, Robert M.

2010-01-01

This case provides a real-world project-oriented case study for students enrolled in a management information systems, database management, or systems analysis and design course in which database design and development are taught. The case consists of a business scenario to provide background information and details of the unique operating…

Database Access Systems.

ERIC Educational Resources Information Center

Dalrymple, Prudence W.; Roderer, Nancy K.

1994-01-01

Highlights the changes that have occurred from 1987-93 in database access systems. Topics addressed include types of databases, including CD-ROMs; enduser interface; database selection; database access management, including library instruction and use of primary literature; economic issues; database users; the search process; and improving…

BoreholeAR: A mobile tablet application for effective borehole database visualization using an augmented reality technology

NASA Astrophysics Data System (ADS)

Lee, Sangho; Suh, Jangwon; Park, Hyeong-Dong

2015-03-01

Boring logs are widely used in geological field studies since the data describes various attributes of underground and surface environments. However, it is difficult to manage multiple boring logs in the field as the conventional management and visualization methods are not suitable for integrating and combining large data sets. We developed an iPad application to enable its user to search the boring log rapidly and visualize them using the augmented reality (AR) technique. For the development of the application, a standard borehole database appropriate for a mobile-based borehole database management system was designed. The application consists of three modules: an AR module, a map module, and a database module. The AR module superimposes borehole data on camera imagery as viewed by the user and provides intuitive visualization of borehole locations. The map module shows the locations of corresponding borehole data on a 2D map with additional map layers. The database module provides data management functions for large borehole databases for other modules. Field survey was also carried out using more than 100,000 borehole data.

Facilitating quality control for spectra assignments of small organic molecules: nmrshiftdb2--a free in-house NMR database with integrated LIMS for academic service laboratories.

PubMed

Kuhn, Stefan; Schlörer, Nils E

2015-08-01

nmrshiftdb2 supports with its laboratory information management system the integration of an electronic lab administration and management into academic NMR facilities. Also, it offers the setup of a local database, while full access to nmrshiftdb2's World Wide Web database is granted. This freely available system allows on the one hand the submission of orders for measurement, transfers recorded data automatically or manually, and enables download of spectra via web interface, as well as the integrated access to prediction, search, and assignment tools of the NMR database for lab users. On the other hand, for the staff and lab administration, flow of all orders can be supervised; administrative tools also include user and hardware management, a statistic functionality for accounting purposes, and a 'QuickCheck' function for assignment control, to facilitate quality control of assignments submitted to the (local) database. Laboratory information management system and database are based on a web interface as front end and are therefore independent of the operating system in use. Copyright © 2015 John Wiley & Sons, Ltd.

Emerging use of combination therapies for the management of type 2 diabetes – focus on saxagliptin and dapagliflozin

PubMed Central

Yu, Huan; Woo, Vincent C

2017-01-01

Aims The aim of this article is to review the safety and efficacy data of dapagliflozin, saxagliptin, and their combination in the management of patients with type 2 diabetes. Evidence for the use of the single-tablet combination formulation is also presented. Methods A nonsystematic literature review was performed using the Ovid, PubMed, and Google Scholar databases. Results The addition of dapagliflozin/saxagliptin to metformin can lower mean hemoglobin A1c by as much as 1.47% and lead to weight loss of 0.5–2.0 kg. The risk of genital infections with combination therapy is lower than observed with dapagliflozin alone, suggestive of a protective effect. Adverse event risk at 52-week follow-up was not increased beyond that seen with either monotherapy. Conclusion Dapagliflozin/saxagliptin combination is generally well tolerated and is an effective tool in helping patients with diabetes improve glycemic control. PMID:28769579

Defining an at-risk population for obstetric anal sphincter laceration.

PubMed

Minaglia, Steven M; Kimata, Chieko; Soules, Karen A; Pappas, Tamara; Oyama, Ian A

2009-11-01

The purpose of this study was to calculate the number of cesarean deliveries needed to prevent 1 case of obstetric anal sphincter laceration associated with operative vaginal delivery in an at-risk cohort. An institutional, computerized database was used to analyze women with obstructed labor who could have been managed by either operative vaginal or cesarean delivery from September 2006 to March 2008. Women with 1 or more of the following diagnoses comprised the cohort: cephalopelvic disproportion (CPD), arrest of descent, maternal exhaustion, and fetal distress. Fifty (23.9%) out of a total of 209 women managed by operative vaginal delivery experienced an anal sphincter laceration compared to none of 254 women in the cesarean delivery group (P < .0001). The ARR therefore was 23.9% (95% confidence interval, 18.1-29.7) and the NNT was 4.2 (95% confidence interval, 3.4-5.5). Five cesarean deliveries are needed to prevent 1 anal sphincter laceration associated with operative vaginal delivery in this cohort.

From tsunami hazard assessment to risk management in Guadeloupe (F.W.I.)

NASA Astrophysics Data System (ADS)

Zahibo, Narcisse; Dudon, Bernard; Krien, Yann; Arnaud, Gaël; Mercado, Aurelio; Roger, Jean

2017-04-01

The Caribbean region is prone to numerous natural hazards such as earthquakes, landslides, storm surges, tsunamis, coastal erosion or hurricanes. All these threats may cause great human and economic losses and are thus of prime interest for applied research. One of the main challenges for the scientific community is to conduct state-of-the-art research to assess hazards and share the results with coastal planners and decision makers so that they can regulate land use and develop mitigation strategies. We present here the results of a scientific collaborative project between Guadeloupe and Porto Rico which aimed at bringing a decision-making support to the authorities regarding tsunami hazards. This project led us to build a database of potential extreme events, and to study their impacts on Guadeloupe to investigate storm surge and tsunami hazards. The results were used by local authorities to develop safeguarding and mitigation measures in coastal areas. This project is thus a good example to demonstrate the benefit of inter Caribbean scientific collaboration for natural risks management.

Influence of the Angelina Jolie Announcement and Insurance Reimbursement on Practice Patterns for Hereditary Breast Cancer

PubMed Central

Lee, Jihyoun; Kang, Eunyoung; Park, Suyeon; Kim, Zisun; Lee, Min Hyuk

2017-01-01

Lack of awareness, the stigma of carrying a genetic mutation, and economic factors are barriers to acceptance of BRCA genetic testing or appropriate risk management. We aimed to investigate the influence of Angelina Jolie's announcement of her medical experience and also health insurance reimbursement for BRCA gene testing on practice patterns for hereditary breast and ovarian cancer (HBOC). A survey regarding changes in practice patterns for HBOC before and after the announcement was conducted online. The rate of BRCA gene testing was obtained from the National Health Insurance Review and Assessment Service database. From May to August 2016, 70 physicians responded to the survey. Genetic testing recommendations and prophylactic management were increased after the announcement. Risk-reducing salpingo-oophorectomy and contralateral prophylactic mastectomy was significantly increased in BRCA carriers with breast cancer. The BRCA testing rate increased annually. Health insurance and a celebrity announcement were associated with increased genetic testing. PMID:28690658

A global, open-source database of flood protection standards

NASA Astrophysics Data System (ADS)

Scussolini, Paolo; Aerts, Jeroen; Jongman, Brenden; Bouwer, Laurens; Winsemius, Hessel; de Moel, Hans; Ward, Philip

2016-04-01

Accurate flood risk estimation is pivotal in that it enables risk-informed policies in disaster risk reduction, as emphasized in the recent Sendai framework for Disaster Risk Reduction. To improve our understanding of flood risk, models are now capable to provide actionable risk information on the (sub)global scale. Still the accuracy of their results is greatly limited by the lack of information on standards of protection to flood that are actually in place; and researchers thus take large assumptions on the extent of protection. With our work we propose a first global, open-source database of FLOod PROtection Standards, FLOPROS, covering a range of spatial scales. FLOPROS is structured in three layers of information, and merges them into one consistent database: 1) the Design layer contains empirical information about the standard of protection presently in place; 2) the Policy layer contains intended protection standards from normative documents; 3) the Model layer uses a validated numerical approach to calculate protection standards for areas not covered in the other layers. The FLOPROS database can be used for more accurate risk assessment exercises across scales. As the database should be continually updated to reflect new interventions, we invite researchers and practitioners to contribute information. Further, we look for partners within the risk community to participate in additional strategies to implement the amount and accuracy of information contained in this first version of FLOPROS.

Resources for global risk assessment: the International Toxicity Estimates for Risk (ITER) and Risk Information Exchange (RiskIE) databases.

PubMed

Wullenweber, Andrea; Kroner, Oliver; Kohrman, Melissa; Maier, Andrew; Dourson, Michael; Rak, Andrew; Wexler, Philip; Tomljanovic, Chuck

2008-11-15

The rate of chemical synthesis and use has outpaced the development of risk values and the resolution of risk assessment methodology questions. In addition, available risk values derived by different organizations may vary due to scientific judgments, mission of the organization, or use of more recently published data. Further, each organization derives values for a unique chemical list so it can be challenging to locate data on a given chemical. Two Internet resources are available to address these issues. First, the International Toxicity Estimates for Risk (ITER) database (www.tera.org/iter) provides chronic human health risk assessment data from a variety of organizations worldwide in a side-by-side format, explains differences in risk values derived by different organizations, and links directly to each organization's website for more detailed information. It is also the only database that includes risk information from independent parties whose risk values have undergone independent peer review. Second, the Risk Information Exchange (RiskIE) is a database of in progress chemical risk assessment work, and includes non-chemical information related to human health risk assessment, such as training modules, white papers and risk documents. RiskIE is available at http://www.allianceforrisk.org/RiskIE.htm, and will join ITER on National Library of Medicine's TOXNET (http://toxnet.nlm.nih.gov/). Together, ITER and RiskIE provide risk assessors essential tools for easily identifying and comparing available risk data, for sharing in progress assessments, and for enhancing interaction among risk assessment groups to decrease duplication of effort and to harmonize risk assessment procedures across organizations.

Network Configuration of Oracle and Database Programming Using SQL

NASA Technical Reports Server (NTRS)

Davis, Melton; Abdurrashid, Jibril; Diaz, Philip; Harris, W. C.

2000-01-01

A database can be defined as a collection of information organized in such a way that it can be retrieved and used. A database management system (DBMS) can further be defined as the tool that enables us to manage and interact with the database. The Oracle 8 Server is a state-of-the-art information management environment. It is a repository for very large amounts of data, and gives users rapid access to that data. The Oracle 8 Server allows for sharing of data between applications; the information is stored in one place and used by many systems. My research will focus primarily on SQL (Structured Query Language) programming. SQL is the way you define and manipulate data in Oracle's relational database. SQL is the industry standard adopted by all database vendors. When programming with SQL, you work on sets of data (i.e., information is not processed one record at a time).

A geospatial database model for the management of remote sensing datasets at multiple spectral, spatial, and temporal scales

NASA Astrophysics Data System (ADS)

Ifimov, Gabriela; Pigeau, Grace; Arroyo-Mora, J. Pablo; Soffer, Raymond; Leblanc, George

2017-10-01

In this study the development and implementation of a geospatial database model for the management of multiscale datasets encompassing airborne imagery and associated metadata is presented. To develop the multi-source geospatial database we have used a Relational Database Management System (RDBMS) on a Structure Query Language (SQL) server which was then integrated into ArcGIS and implemented as a geodatabase. The acquired datasets were compiled, standardized, and integrated into the RDBMS, where logical associations between different types of information were linked (e.g. location, date, and instrument). Airborne data, at different processing levels (digital numbers through geocorrected reflectance), were implemented in the geospatial database where the datasets are linked spatially and temporally. An example dataset consisting of airborne hyperspectral imagery, collected for inter and intra-annual vegetation characterization and detection of potential hydrocarbon seepage events over pipeline areas, is presented. Our work provides a model for the management of airborne imagery, which is a challenging aspect of data management in remote sensing, especially when large volumes of data are collected.

How I do it: a practical database management system to assist clinical research teams with data collection, organization, and reporting.

PubMed

Lee, Howard; Chapiro, Julius; Schernthaner, Rüdiger; Duran, Rafael; Wang, Zhijun; Gorodetski, Boris; Geschwind, Jean-François; Lin, MingDe

2015-04-01

The objective of this study was to demonstrate that an intra-arterial liver therapy clinical research database system is a more workflow efficient and robust tool for clinical research than a spreadsheet storage system. The database system could be used to generate clinical research study populations easily with custom search and retrieval criteria. A questionnaire was designed and distributed to 21 board-certified radiologists to assess current data storage problems and clinician reception to a database management system. Based on the questionnaire findings, a customized database and user interface system were created to perform automatic calculations of clinical scores including staging systems such as the Child-Pugh and Barcelona Clinic Liver Cancer, and facilitates data input and output. Questionnaire participants were favorable to a database system. The interface retrieved study-relevant data accurately and effectively. The database effectively produced easy-to-read study-specific patient populations with custom-defined inclusion/exclusion criteria. The database management system is workflow efficient and robust in retrieving, storing, and analyzing data. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

Universal Index System

NASA Technical Reports Server (NTRS)

Kelley, Steve; Roussopoulos, Nick; Sellis, Timos; Wallace, Sarah

1993-01-01

The Universal Index System (UIS) is an index management system that uses a uniform interface to solve the heterogeneity problem among database management systems. UIS provides an easy-to-use common interface to access all underlying data, but also allows different underlying database management systems, storage representations, and access methods.

Maintaining Research Documents with Database Management Software.

ERIC Educational Resources Information Center

Harrington, Stuart A.

1999-01-01

Discusses taking notes for research projects and organizing them into card files; reviews the literature on personal filing systems; introduces the basic process of database management; and offers a plan for managing research notes. Describes field groups and field definitions, data entry, and creating reports. (LRW)

76 FR 15953 - Agency Information Collection Activities; Announcement of Office of Management and Budget...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-22

... CONSUMER PRODUCT SAFETY COMMISSION Agency Information Collection Activities; Announcement of Office of Management and Budget Approval; Publicly Available Consumer Product Safety Information Database... Product Safety Information Database has been approved by the Office of Management and Budget (OMB) under...

The Design of Data Disaster Recovery of National Fundamental Geographic Information System

NASA Astrophysics Data System (ADS)

Zhai, Y.; Chen, J.; Liu, L.; Liu, J.

2014-04-01

With the development of information technology, data security of information system is facing more and more challenges. The geographic information of surveying and mapping is fundamental and strategic resource, which is applied in all areas of national economic, defence and social development. It is especially vital to national and social interests when such classified geographic information is directly concerning Chinese sovereignty. Several urgent problems that needs to be resolved for surveying and mapping are how to do well in mass data storage and backup, establishing and improving the disaster backup system especially after sudden natural calamity accident, and ensuring all sectors rapidly restored on information system will operate correctly. For overcoming various disaster risks, protect the security of data and reduce the impact of the disaster, it's no doubt the effective way is to analysis and research on the features of storage and management and security requirements, as well as to ensure that the design of data disaster recovery system suitable for the surveying and mapping. This article analyses the features of fundamental geographic information data and the requirements of storage management, three site disaster recovery system of DBMS plan based on the popular network, storage and backup, data replication and remote switch of application technologies. In LAN that synchronous replication between database management servers and the local storage of backup management systems, simultaneously, remote asynchronous data replication between local storage backup management systems and remote database management servers. The core of the system is resolving local disaster in the remote site, ensuring data security and business continuity of local site. This article focuses on the following points: background, the necessity of disaster recovery system, the analysis of the data achievements and data disaster recovery plan. Features of this program is to use a hardware-based data hot backup, and remote online disaster recovery support for Oracle database system. The achievement of this paper is in summarizing and analysing the common characteristics of disaster of surveying and mapping business system requirements, while based on the actual situation of the industry, designed the basic GIS disaster recovery solutions, and we also give the conclusions about key technologies of RTO and RPO.

Risk assessment and the prevention of radicalization from nonviolence into terrorism.

PubMed

Sarma, Kiran M

2017-04-01

This article considers the challenges associated with completing risk assessments in countering violent extremism. In particular, it is concerned with risk assessment of those who come to the attention of government and nongovernment organizations as being potentially on a trajectory toward terrorism and where there is an obligation to consider the potential future risk that they may pose. Risk assessment in this context is fraught with difficulty, primarily due to the variable nature of terrorism, the low base-rate problem, and the dearth of strong evidence on relevant risk and resilience factors. Statistically, this will lead to poor predictive value. Ethically, it can lead to the labeling of an individual who is not on a trajectory toward violence as being "at risk" of engaging in terrorism and the imposing of unnecessary risk management actions. The article argues that actuarial approaches to risk assessment in this context cannot work. However, it further argues that approaches that help assessors to process and synthesize information in a structured way are of value and are in line with good practice in the broader field of violence risk assessment. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Design of Student Information Management Database Application System for Office and Departmental Target Responsibility System

NASA Astrophysics Data System (ADS)

Zhou, Hui

It is the inevitable outcome of higher education reform to carry out office and departmental target responsibility system, in which statistical processing of student's information is an important part of student's performance review. On the basis of the analysis of the student's evaluation, the student information management database application system is designed by using relational database management system software in this paper. In order to implement the function of student information management, the functional requirement, overall structure, data sheets and fields, data sheet Association and software codes are designed in details.

Risk factors for work-related stress and health in head teachers.

PubMed

Phillips, Samantha J; Sen, Dil; McNamee, Roseanne

2008-12-01

Work-related stress (WRS) is known to cause ill-health and decreased productivity. Work in the education sector is thought to be particularly stressful. Few studies have considered risk factors for WRS and health in head teachers. To investigate health in head teachers in West Sussex. To determine personal risk factors most likely to predict cases of WRS and of poor health in head teachers. A cross-sectional study, in a population of 290 head teachers and principals of colleges of further education, using a validated questionnaire, 'a short stress evaluation tool' (ASSET) and additional questions derived from earlier studies. Results were compared with the ASSET database 'norm' groups: a general population of workers (GPN) group and a group of managers and professionals (MPN). 'Caseness' was defined as respondents who felt work was 'very or extremely stressful'. Head teachers had poor physical and mental health compared to the GPN group. Psychological well-being, particularly of females and primary head teachers was worse than a comparative group of managers and professionals. Teaching<5 h/week was a significant predictor of caseness and being female was the main risk factor for poor psychological well-being. Prevalence of self-reported stress in head teachers in West Sussex is high. Female head teachers had worse health outcomes. Our study identified possible personal risk factors predicting WRS and/or poor health in head teachers.

Development of the ageing management database of PUSPATI TRIGA reactor

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

Ramli, Nurhayati, E-mail: nurhayati@nm.gov.my; Tom, Phongsakorn Prak; Husain, Nurfazila

Since its first criticality in 1982, PUSPATI TRIGA Reactor (RTP) has been operated for more than 30 years. As RTP become older, ageing problems have been seen to be the prominent issues. In addressing the ageing issues, an Ageing Management (AgeM) database for managing related ageing matters was systematically developed. This paper presents the development of AgeM database taking into account all RTP major Systems, Structures and Components (SSCs) and ageing mechanism of these SSCs through the system surveillance program.

The Design and Implementation of a Relational to Network Query Translator for a Distributed Database Management System.

DTIC Science & Technology

1985-12-01

RELATIONAL TO NETWORK QUERY TRANSLATOR FOR A DISTRIBUTED DATABASE MANAGEMENT SYSTEM TH ESI S .L Kevin H. Mahoney -- Captain, USAF AFIT/GCS/ENG/85D-7...NETWORK QUERY TRANSLATOR FOR A DISTRIBUTED DATABASE MANAGEMENT SYSTEM - THESIS Presented to the Faculty of the School of Engineering of the Air Force...Institute of Technology Air University In Partial Fulfillment of the Requirements for the Degree of Master of Science in Computer Systems - Kevin H. Mahoney

Business Management System Support Analysis

NASA Technical Reports Server (NTRS)

Parikh, Jay

2008-01-01

The purpose of this research project was to develop a searchable database compiled with internal and external audit findings/observations. The data will correspond to the findings and observations from the date of Center-wide implementation of the ISO 9001-2000 standard to the present (2003-2008). It was derived and extracted from several sources and was in multiple formats. Once extracted, categorization of the findings/observations would be possible. The final data was mapped to the ISO 9001-2000 standard with the understanding that it will be displayed graphically. The data will be used to verify trends, associate risks, and establish timelines to identify strengths and weaknesses to determine areas of improvement in the Kennedy Space Center Business Management System Internal Audit Program.

Tautomerism in chemical information management systems

NASA Astrophysics Data System (ADS)

Warr, Wendy A.

2010-06-01

Tautomerism has an impact on many of the processes in chemical information management systems including novelty checking during registration into chemical structure databases; storage of structures; exact and substructure searching in chemical structure databases; and depiction of structures retrieved by a search. The approaches taken by 27 different software vendors and database producers are compared. It is hoped that this comparison will act as a discussion document that could ultimately improve databases and software for researchers in the future.

Phynx: an open source software solution supporting data management and web-based patient-level data review for drug safety studies in the general practice research database and other health care databases.

PubMed

Egbring, Marco; Kullak-Ublick, Gerd A; Russmann, Stefan

2010-01-01

To develop a software solution that supports management and clinical review of patient data from electronic medical records databases or claims databases for pharmacoepidemiological drug safety studies. We used open source software to build a data management system and an internet application with a Flex client on a Java application server with a MySQL database backend. The application is hosted on Amazon Elastic Compute Cloud. This solution named Phynx supports data management, Web-based display of electronic patient information, and interactive review of patient-level information in the individual clinical context. This system was applied to a dataset from the UK General Practice Research Database (GPRD). Our solution can be setup and customized with limited programming resources, and there is almost no extra cost for software. Access times are short, the displayed information is structured in chronological order and visually attractive, and selected information such as drug exposure can be blinded. External experts can review patient profiles and save evaluations and comments via a common Web browser. Phynx provides a flexible and economical solution for patient-level review of electronic medical information from databases considering the individual clinical context. It can therefore make an important contribution to an efficient validation of outcome assessment in drug safety database studies.

A hierarchical spatial framework and database for the national river fish habitat condition assessment

USGS Publications Warehouse

Wang, L.; Infante, D.; Esselman, P.; Cooper, A.; Wu, D.; Taylor, W.; Beard, D.; Whelan, G.; Ostroff, A.

2011-01-01

Fisheries management programs, such as the National Fish Habitat Action Plan (NFHAP), urgently need a nationwide spatial framework and database for health assessment and policy development to protect and improve riverine systems. To meet this need, we developed a spatial framework and database using National Hydrography Dataset Plus (I-.100,000-scale); http://www.horizon-systems.com/nhdplus). This framework uses interconfluence river reaches and their local and network catchments as fundamental spatial river units and a series of ecological and political spatial descriptors as hierarchy structures to allow users to extract or analyze information at spatial scales that they define. This database consists of variables describing channel characteristics, network position/connectivity, climate, elevation, gradient, and size. It contains a series of catchment-natural and human-induced factors that are known to influence river characteristics. Our framework and database assembles all river reaches and their descriptors in one place for the first time for the conterminous United States. This framework and database provides users with the capability of adding data, conducting analyses, developing management scenarios and regulation, and tracking management progresses at a variety of spatial scales. This database provides the essential data needs for achieving the objectives of NFHAP and other management programs. The downloadable beta version database is available at http://ec2-184-73-40-15.compute-1.amazonaws.com/nfhap/main/.

Web Application Software for Ground Operations Planning Database (GOPDb) Management

NASA Technical Reports Server (NTRS)

Lanham, Clifton; Kallner, Shawn; Gernand, Jeffrey

2013-01-01

A Web application facilitates collaborative development of the ground operations planning document. This will reduce costs and development time for new programs by incorporating the data governance, access control, and revision tracking of the ground operations planning data. Ground Operations Planning requires the creation and maintenance of detailed timelines and documentation. The GOPDb Web application was created using state-of-the-art Web 2.0 technologies, and was deployed as SaaS (Software as a Service), with an emphasis on data governance and security needs. Application access is managed using two-factor authentication, with data write permissions tied to user roles and responsibilities. Multiple instances of the application can be deployed on a Web server to meet the robust needs for multiple, future programs with minimal additional cost. This innovation features high availability and scalability, with no additional software that needs to be bought or installed. For data governance and security (data quality, management, business process management, and risk management for data handling), the software uses NAMS. No local copy/cloning of data is permitted. Data change log/tracking is addressed, as well as collaboration, work flow, and process standardization. The software provides on-line documentation and detailed Web-based help. There are multiple ways that this software can be deployed on a Web server to meet ground operations planning needs for future programs. The software could be used to support commercial crew ground operations planning, as well as commercial payload/satellite ground operations planning. The application source code and database schema are owned by NASA.

Common Database Interface for Heterogeneous Software Engineering Tools.

DTIC Science & Technology

1987-12-01

SUB-GROUP Database Management Systems ;Programming(Comuters); 1e 05 Computer Files;Information Transfer;Interfaces; 19. ABSTRACT (Continue on reverse...Air Force Institute of Technology Air University In Partial Fulfillment of the Requirements for the Degree of Master of Science in Information Systems ...Literature ..... 8 System 690 Configuration ......... 8 Database Functionis ............ 14 Software Engineering Environments ... 14 Data Manager

Improving data management and dissemination in web based information systems by semantic enrichment of descriptive data aspects

NASA Astrophysics Data System (ADS)

Gebhardt, Steffen; Wehrmann, Thilo; Klinger, Verena; Schettler, Ingo; Huth, Juliane; Künzer, Claudia; Dech, Stefan

2010-10-01

The German-Vietnamese water-related information system for the Mekong Delta (WISDOM) project supports business processes in Integrated Water Resources Management in Vietnam. Multiple disciplines bring together earth and ground based observation themes, such as environmental monitoring, water management, demographics, economy, information technology, and infrastructural systems. This paper introduces the components of the web-based WISDOM system including data, logic and presentation tier. It focuses on the data models upon which the database management system is built, including techniques for tagging or linking metadata with the stored information. The model also uses ordered groupings of spatial, thematic and temporal reference objects to semantically tag datasets to enable fast data retrieval, such as finding all data in a specific administrative unit belonging to a specific theme. A spatial database extension is employed by the PostgreSQL database. This object-oriented database was chosen over a relational database to tag spatial objects to tabular data, improving the retrieval of census and observational data at regional, provincial, and local areas. While the spatial database hinders processing raster data, a "work-around" was built into WISDOM to permit efficient management of both raster and vector data. The data model also incorporates styling aspects of the spatial datasets through styled layer descriptions (SLD) and web mapping service (WMS) layer specifications, allowing retrieval of rendered maps. Metadata elements of the spatial data are based on the ISO19115 standard. XML structured information of the SLD and metadata are stored in an XML database. The data models and the data management system are robust for managing the large quantity of spatial objects, sensor observations, census and document data. The operational WISDOM information system prototype contains modules for data management, automatic data integration, and web services for data retrieval, analysis, and distribution. The graphical user interfaces facilitate metadata cataloguing, data warehousing, web sensor data analysis and thematic mapping.

Design and deployment of a large brain-image database for clinical and nonclinical research

NASA Astrophysics Data System (ADS)

Yang, Guo Liang; Lim, Choie Cheio Tchoyoson; Banukumar, Narayanaswami; Aziz, Aamer; Hui, Francis; Nowinski, Wieslaw L.

2004-04-01

An efficient database is an essential component of organizing diverse information on image metadata and patient information for research in medical imaging. This paper describes the design, development and deployment of a large database system serving as a brain image repository that can be used across different platforms in various medical researches. It forms the infrastructure that links hospitals and institutions together and shares data among them. The database contains patient-, pathology-, image-, research- and management-specific data. The functionalities of the database system include image uploading, storage, indexing, downloading and sharing as well as database querying and management with security and data anonymization concerns well taken care of. The structure of database is multi-tier client-server architecture with Relational Database Management System, Security Layer, Application Layer and User Interface. Image source adapter has been developed to handle most of the popular image formats. The database has a user interface based on web browsers and is easy to handle. We have used Java programming language for its platform independency and vast function libraries. The brain image database can sort data according to clinically relevant information. This can be effectively used in research from the clinicians" points of view. The database is suitable for validation of algorithms on large population of cases. Medical images for processing could be identified and organized based on information in image metadata. Clinical research in various pathologies can thus be performed with greater efficiency and large image repositories can be managed more effectively. The prototype of the system has been installed in a few hospitals and is working to the satisfaction of the clinicians.

Documentation of a spatial data-base management system for monitoring pesticide application in Washington

USGS Publications Warehouse

Schurr, K.M.; Cox, S.E.

1994-01-01

The Pesticide-Application Data-Base Management System was created as a demonstration project and was tested with data submitted to the Washington State Department of Agriculture by pesticide applicators from a small geographic area. These data were entered into the Department's relational data-base system and uploaded into the system's ARC/INFO files. Locations for pesticide applica- tions are assigned within the Public Land Survey System grids, and ARC/INFO programs in the Pesticide-Application Data-Base Management System can subdivide each survey section into sixteen idealized quarter-quarter sections for display map grids. The system provides data retrieval and geographic information system plotting capabilities from a menu of seven basic retrieval options. Additionally, ARC/INFO coverages can be created from the retrieved data when required for particular applications. The Pesticide-Application Data-Base Management System, or the general principles used in the system, could be adapted to other applica- tions or to other states.

READY: a web-based geographical information system for enhanced flood resilience through raising awareness in citizens

NASA Astrophysics Data System (ADS)

Albano, R.; Sole, A.; Adamowski, J.

2015-02-01

As evidenced by the EU Floods Directive (2007/60/EC), flood management strategies in Europe have undergone a shift in focus in recent years. The goal of flood prevention using structural measures has been replaced by an emphasis on the management of flood risks using non-structural measures. One implication of this is that it is no longer public authorities alone who take responsibility for flood management. A broader range of stakeholders, who may experience the negative effects of flooding, also take on responsibility to protect themselves. Therefore, it is vital that information concerning flood risks are conveyed to those who may be affected in order to facilitate the self-protection of citizens. Experience shows that even where efforts have been made to communicate flood risks, problems persist. There is a need for the development of new tools, which are able to rapidly disseminate flood risk information to the general public. To be useful, these tools must be able to present information relevant to the location of the user. Moreover, the content and design of the tool need to be adjusted to laypeople's needs. Dissemination and communication influences both people's access to and understanding of natural risk information. Such a tool could be a useful aid to effective management of flood risks. To address this gap, a Web-based Geographical Information System, (WebGIS), has been developed through the collaborative efforts of a group of scientists, hazard and risk analysts and managers, GIS analysts, system developers and communication designers. This tool, called "READY: Risk, Extreme Events, Adaptation, Defend Yourself", aims to enhance the general public knowledge of flood risk, making them more capable of responding appropriately during a flood event. The READY WebGIS has allowed for the visualization and easy querying of a complex hazard and risk database thanks to a high degree of interactivity and its easily readable maps. In this way, READY has enabled fast exploration of alternative flood scenarios or past calamitous events. Combined also with a system of graphic symbols designed ad hoc for communication of self-protection behaviors, it is believed READY could lead to an increase in citizen participation, informed discussion and consensus building. The platform has been developed for a site-specific application, i.e. the Basilicata Region, Italy, has been selected as pilot application area. The goal of the prototype is to raise citizen awareness of flood risks, and to build social capacity and enhanced resilience to flood events.

READY: a web-based geographical information system for enhanced flood resilience through raising awareness in citizens

NASA Astrophysics Data System (ADS)

Albano, R.; Sole, A.; Adamowski, J.

2015-07-01

As evidenced by the EU Floods Directive (2007/60/EC), flood management strategies in Europe have undergone a shift in focus in recent years. The goal of flood prevention using structural measures has been replaced by an emphasis on the management of flood risks using non-structural measures. One implication of this is that public authorities alone not only take responsibility for flood management. A broader range of stakeholders, who may personally experience the negative effects of flooding, also take on responsibility for protecting themselves. Therefore, it is vital that information concerning flood risks is conveyed to those who may be affected in order to facilitate the self-protection of citizens. Experience shows that problems persist even where efforts have been made to communicate flood risks. There is a need for the development of new tools that are able to rapidly disseminate flood-risk information to the general public. To be useful these tools must be able to present information relevant to the location of the user. Moreover, the content and design of the tool need to be adjusted to laypeople's needs. Dissemination and communication influence both people's access to and understanding of natural risk information. Such a tool could be a useful aid to effective management of flood risks. To address this gap, a web-based geographical information system (WebGIS) has been developed through the collaborative efforts of a group of scientists, hazard and risk analysts and managers, GIS analysts, system developers and communication designers. This tool, called "READY: Risk, Extreme Events, Adaptation, Defend Yourself", aims to enhance the general public knowledge of flood risk, making citizens more capable of responding appropriately during a flood event. The READY WebGIS has allowed for the visualization and easy querying of a complex hazard and risk database thanks to a high degree of interactivity and easily read maps. In this way, READY has enabled fast exploration of alternative flood scenarios or past calamitous events. Combined also with a system of graphic symbols designed ad hoc for communication of self-protection behaviours, it is believed READY could lead to an increase in citizen participation, informed discussion and consensus building. The platform has been developed for a site-specific application: the Basilicata region, Italy, has been selected as pilot application area. The goal of the prototype is to raise citizen awareness of flood risks and to build social capacity and enhanced resilience to flood events.

Cancer incidence among HIV-positive women in British Columbia, Canada: Heightened risk of virus-related malignancies.

PubMed

Salters, K A; Cescon, A; Zhang, W; Ogilvie, G; Murray, M C M; Coldman, A; Hamm, J; Chiu, C G; Montaner, J S G; Wiseman, S M; Money, D; Pick, N; Hogg, R S

2016-03-01

We used population-based data to identify incident cancer cases and correlates of cancer among women living with HIV/AIDS in British Columbia (BC), Canada between 1994 and 2008. Data were obtained from a retrospective population-based cohort created from linkage of two province-wide databases: (1) the database of the BC Cancer Agency, a province-wide population-based cancer registry, and (2) a database managed by the BC Centre for Excellence in HIV/AIDS, which contains data on all persons treated with antiretroviral therapy in BC. This analysis included women (≥ 19 years old) living with HIV in BC, Canada. Incident cancer diagnoses that occurred after highly active antiretroviral therapy (HAART) initiation were included. We obtained a general population comparison of cancer incidence among women from the BC Cancer Agency. Bivariate analysis (Pearson χ(2) , Fisher's exact or Wilcoxon rank-sum test) compared women with and without incident cancer across relevant clinical and sociodemographic variables. Standardized incidence ratios (SIRs) were calculated for selected cancers compared with the general population sample. We identified 2211 women with 12 529 person-years (PY) of follow-up who were at risk of developing cancer after HAART initiation. A total of 77 incident cancers (615/100 000 PY) were identified between 1994 and 2008. HIV-positive women with cancer, in comparison to the general population sample, were more likely to be diagnosed with invasive cervical cancer, Hodgkin's lymphoma, non-Hodgkin's lymphoma and Kaposi's sarcoma and less likely to be diagnosed with cancers of the digestive system. This study observed elevated rates of cancer among HIV-positive women compared to a general population sample. HIV-positive women may have an increased risk for cancers of viral-related pathogenesis. © 2015 British HIV Association.

A database to manage flood risk in Catalonia

NASA Astrophysics Data System (ADS)

Echeverria, S.; Toldrà, R.; Verdaguer, I.

2009-09-01

We call priority action spots those local sites where heavy rain, increased river flow, sea storms and other flooding phenomena can cause human casualties or severe damage to property. Some examples are campsites, car parks, roads, chemical factories… In order to keep to a minimum the risk of these spots, both a prevention programme and an emergency response programme are required. The flood emergency plan of Catalonia (INUNCAT) prepared in 2005 included already a listing of priority action spots compiled by the Catalan Water Agency (ACA), which was elaborated taking into account past experience, hydraulic studies and information available by several knowledgeable sources. However, since land use evolves with time this listing of priority action spots has become outdated and incomplete. A new database is being built. Not only does this new database update and expand the previous listing, but adds to each entry information regarding prevention measures and emergency response: which spots are the most hazardous, under which weather conditions problems arise, which ones should have their access closed as soon as these conditions are forecast or actually given, which ones should be evacuated, who is in charge of the preventive actions or emergency response and so on. Carrying out this programme has to be done with the help and collaboration of all the organizations involved, foremost with the local authorities in the areas at risk. In order to achieve this goal a suitable geographical information system is necessary which can be easily used by all actors involved in this project. The best option has turned out to be the Spatial Data Infrastructure of Catalonia (IDEC), a platform to share spatial data on the Internet involving the Generalitat de Catalunya, Localret (a consortium of local authorities that promotes information technology) and other institutions.

Review of the Complications Associated with Treatment of Oropharyngeal Cancer: A Guide to the Dental Practitioner

PubMed Central

Turner, Lena; Mupparapu, Muralidhar; Akintoye, Sunday O

2013-01-01

Objectives Oropharyngeal cancer (OPC) is the 6th most common cancer worldwide. Focus on risk factors, improved diagnostic methods and effective management strategies have made it possible to successfully treat OPC. However, the 5-year survival rate has not improved for several years due to multiple treatment complications, tissue morbidity, loss of function and diminished quality of life. Survivors are faced with complications like oral mucositis, hyposalivation, osteoradionecrosis; tissue fibrosis, morbidity from jaw resection; disfigurement and loss of function that further diminish quality of life. The aim of this review is to highlight major complications associated with treatment of OPC via a literature search and review of available options for identification and management of these complications. Data Sources Relevant publications on oral complications of OPC therapy were thoroughly reviewed from the literature published between the years 1988 and 2012. Material and Method We evaluated reported incidence, prevalence and risk factors for oral complications of chemotherapy and radiotherapy for OPC. The authors conducted electronic search using English language databases namely PubMed Plus, Medline (Pre-Medline and Medline), Cochrane Database of systematic reviews (evidence-based medicine), Dentistry & Oral sciences source, AccessScience, Embase, Evidence-Based Medicine Reviews Multifile, Google Scholar, ISI Journal Citation Reports, Ovid Multi-Database. Conclusion We identified the most common complications associated with the treatment of oral cancers. Based on the information gathered, there is evidence that survival of OPC extends beyond eradication of the diseased tissue. Understanding the potential treatment complications and utilizing available resources to prevent and minimize them are important. Caring for OPC survivors should be a multidisciplinary team approach involving the dentist, oncologist, internist and social worker to improve the currently stagnant 5-year survival rate of OPC. More emphasis on improved quality of life after elimination of the cancer will ultimately improve OPC survivorship. PMID:23444208

The measurement of quality of care in the Veterans Health Administration.

PubMed

Halpern, J

1996-03-01

The Veterans Health Administration (VHA) is committed to continual refinement of its system of quality measurement. The VHA organizational structure for quality measurement has three levels. At the national level, the Associate Chief Medical Director for Quality Management provides leadership, sets policy, furnishes measurement tools, develops and distributes measures of quality, and delivers educational programs. At the intermediate level, VHA has four regional offices with staff responsible for reviewing risk management data, investigating quality problems, and ensuring compliance with accreditation requirements. At the hospital level, staff reporting directly to the chief of staff or the hospital director are responsible for implementing VHA quality management policy. The Veterans Health Administration's philosophy of quality measurement recognizes the agency's moral imperative to provide America's veterans with care that meets accepted standards. Because the repair of faulty systems is more efficient than the identification of poor performers, VHA has integrated the techniques of total quality into a multifaceted improvement program that also includes the accreditation program and traditional quality assurance activities. VHA monitors its performance by maintaining adverse incident databases, conducting patient satisfaction surveys, contracting for external peer review of 50,000 records per year, and comparing process and outcome rates internally and when possible with external benchmarks. The near-term objectives of VHA include providing medical centers with a quality matrix that will permit local development of quality indicators, construction of a report card for VHA's customers, and implementing the Malcolm W. Baldrige system for quality improvement as the road map for systemwide continuous improvement. Other goals include providing greater access to data, creating a patient-centered database, providing real-time clinical decision support, and expanding the databases.

Diagnosing and managing common food allergies: a systematic review.

PubMed

Chafen, Jennifer J Schneider; Newberry, Sydne J; Riedl, Marc A; Bravata, Dena M; Maglione, Margaret; Suttorp, Marika J; Sundaram, Vandana; Paige, Neil M; Towfigh, Ali; Hulley, Benjamin J; Shekelle, Paul G

2010-05-12

There is heightened interest in food allergies but no clear consensus exists regarding the prevalence or most effective diagnostic and management approaches to food allergies. To perform a systematic review of the available evidence on the prevalence, diagnosis, management, and prevention of food allergies. Electronic searches of PubMed, Cochrane Database of Systematic Reviews, Cochrane Database of Abstracts of Reviews of Effects, and Cochrane Central Register of Controlled Trials. Searches were limited to English-language articles indexed between January 1988 and September 2009. Diagnostic tests were included if they had a prospective, defined study population, used food challenge as a criterion standard, and reported sufficient data to calculate sensitivity and specificity. Systematic reviews and randomized controlled trials (RCTs) for management and prevention outcomes were also used. For foods where anaphylaxis is common, cohort studies with a sample size of more than 100 participants were included. Two investigators independently reviewed all titles and abstracts to identify potentially relevant articles and resolved discrepancies by repeated review and discussion. Quality of systematic reviews and meta-analyses was assessed using the AMSTAR criteria, the quality of diagnostic studies using the QUADAS criteria most relevant to food allergy, and the quality of RCTs using the Jadad criteria. A total of 12,378 citations were identified and 72 citations were included. Food allergy affects more than 1% to 2% but less than 10% of the population. It is unclear if the prevalence of food allergies is increasing. Summary receiver operating characteristic curves comparing skin prick tests (area under the curve [AUC], 0.87; 95% confidence interval [CI], 0.81-0.93) and serum food-specific IgE (AUC, 0.84; 95% CI, 0.78-0.91) to food challenge showed no statistical superiority for either test. Elimination diets are the mainstay of therapy but have been rarely studied. Immunotherapy is promising but data are insufficient to recommend use. In high-risk infants, hydrolyzed formulas may prevent cow's milk allergy but standardized definitions of high risk and hydrolyzed formula do not exist. The evidence for the prevalence and management of food allergy is greatly limited by a lack of uniformity for criteria for making a diagnosis.

Informatics in radiology: use of CouchDB for document-based storage of DICOM objects.

PubMed

Rascovsky, Simón J; Delgado, Jorge A; Sanz, Alexander; Calvo, Víctor D; Castrillón, Gabriel

2012-01-01

Picture archiving and communication systems traditionally have depended on schema-based Structured Query Language (SQL) databases for imaging data management. To optimize database size and performance, many such systems store a reduced set of Digital Imaging and Communications in Medicine (DICOM) metadata, discarding informational content that might be needed in the future. As an alternative to traditional database systems, document-based key-value stores recently have gained popularity. These systems store documents containing key-value pairs that facilitate data searches without predefined schemas. Document-based key-value stores are especially suited to archive DICOM objects because DICOM metadata are highly heterogeneous collections of tag-value pairs conveying specific information about imaging modalities, acquisition protocols, and vendor-supported postprocessing options. The authors used an open-source document-based database management system (Apache CouchDB) to create and test two such databases; CouchDB was selected for its overall ease of use, capability for managing attachments, and reliance on HTTP and Representational State Transfer standards for accessing and retrieving data. A large database was created first in which the DICOM metadata from 5880 anonymized magnetic resonance imaging studies (1,949,753 images) were loaded by using a Ruby script. To provide the usual DICOM query functionality, several predefined "views" (standard queries) were created by using JavaScript. For performance comparison, the same queries were executed in both the CouchDB database and a SQL-based DICOM archive. The capabilities of CouchDB for attachment management and database replication were separately assessed in tests of a similar, smaller database. Results showed that CouchDB allowed efficient storage and interrogation of all DICOM objects; with the use of information retrieval algorithms such as map-reduce, all the DICOM metadata stored in the large database were searchable with only a minimal increase in retrieval time over that with the traditional database management system. Results also indicated possible uses for document-based databases in data mining applications such as dose monitoring, quality assurance, and protocol optimization. RSNA, 2012

Kingfisher: a system for remote sensing image database management

NASA Astrophysics Data System (ADS)

Bruzzo, Michele; Giordano, Ferdinando; Dellepiane, Silvana G.

2003-04-01

At present retrieval methods in remote sensing image database are mainly based on spatial-temporal information. The increasing amount of images to be collected by the ground station of earth observing systems emphasizes the need for database management with intelligent data retrieval capabilities. The purpose of the proposed method is to realize a new content based retrieval system for remote sensing images database with an innovative search tool based on image similarity. This methodology is quite innovative for this application, at present many systems exist for photographic images, as for example QBIC and IKONA, but they are not able to extract and describe properly remote image content. The target database is set by an archive of images originated from an X-SAR sensor (spaceborne mission, 1994). The best content descriptors, mainly texture parameters, guarantees high retrieval performances and can be extracted without losses independently of image resolution. The latter property allows DBMS (Database Management System) to process low amount of information, as in the case of quick-look images, improving time performance and memory access without reducing retrieval accuracy. The matching technique has been designed to enable image management (database population and retrieval) independently of dimensions (width and height). Local and global content descriptors are compared, during retrieval phase, with the query image and results seem to be very encouraging.

Apical/Retrograde Periimplantitis/Implant Periapical Lesion: Etiology, Risk Factors, and Treatment Options: A Systematic Review.

PubMed

Ramanauskaite, Ausra; Juodzbalys, Gintaras; Tözüm, Tolga F

2016-10-01

To review the literature on retrograde periimplantitis symptoms, risk factors, and treatment methods and to propose a decision-making tree of retrograde periimplantitis management. An electronic literature search was conducted on the MEDLINE and EMBASE databases for articles published between 1990 and 2015. Clinical human studies in the English language were included. The search resulted in 44 case reports published by 27 authors. The average time of the diagnosis of the pathology was found to be 26.07 weeks after implant placement (SD ± 39.7). Fistula formation was found to be the most common clinical symptom, statistically significantly more often occurring in the maxilla (P = 0.04). A negative correlation was found between pain and the adjacent tooth with incomplete endodontic treatment/endodontic pathology (r = -0.4; P = 0.009) and a positive correlation between the later risk factor and implant removal (r = 0.3; P = 0.028). Regenerative treatment (45.2% of the cases) or implant removal (35.7% of the cases) was the most common treatment techniques used. A decision-making tree of retrograde periimplantitis management is suggested. The etiology of retrograde periimplantitis is most often infectious. A decision-making tree aimed at managing patients with retrograde periimplantitis according to the possible etiology and symptoms of the disease can be a useful tool in the treatment of the pathology.

The ID Database: Managing the Instructional Development Process

ERIC Educational Resources Information Center

Piña, Anthony A.; Sanford, Barry K.

2017-01-01

Management is evolving as a foundational domain to the field of instructional design and technology. However, there are few tools dedicated to the management of instructional design and development projects and activities. In this article, we describe the development, features and implementation of an instructional design database--built from a…

Expansion of the MANAGE database with forest and drainage studies

USDA-ARS?s Scientific Manuscript database

The “Measured Annual Nutrient loads from AGricultural Environments” (MANAGE) database was published in 2006 to expand an early 1980’s compilation of nutrient export (load) data from agricultural land uses at the field or farm spatial scale. Then in 2008, MANAGE was updated with 15 additional studie...

76 FR 12617 - Airworthiness Directives; The Boeing Company Model 777-200 and -300 Series Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-08

... installing new operational software for the electrical load management system and configuration database... the electrical load management system operational software and configuration database software, in... Management, P.O. Box 3707, MC 2H-65, Seattle, Washington 98124-2207; telephone 206- 544-5000, extension 1...

[Risk management in health care systems: the new legislative orientations in medical civil responsibility].

PubMed

Tomassini, A; Signorelli, C; Colzani, E

2004-01-01

The recent radical change in the relationships between physicians and patients has increased the frequency of malpractice. Consequently, on one hand, many physicians got used to avoiding any possible risk of denunciation by applying the so called "defensive medicine", while on the other hand, the insurance companies raised the prices of their premiums for policies concerning civil responsibility of health operators. In order to avoid this "vicious circle", some health structures created Units for the Risk Management related to malpractice, while others took advantage of the collaboration of Associations for Patients' Rights to create database about the most frequent medical mistakes. The need for a legislative change has been accepted by the Parliament which expects with the proposal n.108 (approved in spring 2002 by the Commission for Hygiene and Health of the Senate) to attribute the civil responsibility of the physicians to the hospitals (both private and public) for which they work, to constitute a Register of experts and to accelerate the legal disputes. The problem is complex and still to be solved, but it seems that time for a strong intervention in order to improve the situation has to come.

Reinventing The Design Process: Teams and Models

NASA Technical Reports Server (NTRS)

Wall, Stephen D.

1999-01-01

The future of space mission designing will be dramatically different from the past. Formerly, performance-driven paradigms emphasized data return with cost and schedule being secondary issues. Now and in the future, costs are capped and schedules fixed-these two variables must be treated as independent in the design process. Accordingly, JPL has redesigned its design process. At the conceptual level, design times have been reduced by properly defining the required design depth, improving the linkages between tools, and managing team dynamics. In implementation-phase design, system requirements will be held in crosscutting models, linked to subsystem design tools through a central database that captures the design and supplies needed configuration management and control. Mission goals will then be captured in timelining software that drives the models, testing their capability to execute the goals. Metrics are used to measure and control both processes and to ensure that design parameters converge through the design process within schedule constraints. This methodology manages margins controlled by acceptable risk levels. Thus, teams can evolve risk tolerance (and cost) as they would any engineering parameter. This new approach allows more design freedom for a longer time, which tends to encourage revolutionary and unexpected improvements in design.

Solving Relational Database Problems with ORDBMS in an Advanced Database Course

ERIC Educational Resources Information Center

Wang, Ming

2011-01-01

This paper introduces how to use the object-relational database management system (ORDBMS) to solve relational database (RDB) problems in an advanced database course. The purpose of the paper is to provide a guideline for database instructors who desire to incorporate the ORDB technology in their traditional database courses. The paper presents…

Migration from relational to NoSQL database

NASA Astrophysics Data System (ADS)

Ghotiya, Sunita; Mandal, Juhi; Kandasamy, Saravanakumar

2017-11-01

Data generated by various real time applications, social networking sites and sensor devices is of very huge amount and unstructured, which makes it difficult for Relational database management systems to handle the data. Data is very precious component of any application and needs to be analysed after arranging it in some structure. Relational databases are only able to deal with structured data, so there is need of NoSQL Database management System which can deal with semi -structured data also. Relational database provides the easiest way to manage the data but as the use of NoSQL is increasing it is becoming necessary to migrate the data from Relational to NoSQL databases. Various frameworks has been proposed previously which provides mechanisms for migration of data stored at warehouses in SQL, middle layer solutions which can provide facility of data to be stored in NoSQL databases to handle data which is not structured. This paper provides a literature review of some of the recent approaches proposed by various researchers to migrate data from relational to NoSQL databases. Some researchers proposed mechanisms for the co-existence of NoSQL and Relational databases together. This paper provides a summary of mechanisms which can be used for mapping data stored in Relational databases to NoSQL databases. Various techniques for data transformation and middle layer solutions are summarised in the paper.

Filling Terrorism Gaps: VEOs, Evaluating Databases, and Applying Risk Terrain Modeling to Terrorism

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

Hagan, Ross F.

2016-08-29

This paper aims to address three issues: the lack of literature differentiating terrorism and violent extremist organizations (VEOs), terrorism incident databases, and the applicability of Risk Terrain Modeling (RTM) to terrorism. Current open source literature and publicly available government sources do not differentiate between terrorism and VEOs; furthermore, they fail to define them. Addressing the lack of a comprehensive comparison of existing terrorism data sources, a matrix comparing a dozen terrorism databases is constructed, providing insight toward the array of data available. RTM, a method for spatial risk analysis at a micro level, has some applicability to terrorism research, particularlymore » for studies looking at risk indicators of terrorism. Leveraging attack data from multiple databases, combined with RTM, offers one avenue for closing existing research gaps in terrorism literature.« less

Improving Risk Management and Resiliency: A Plan for a Proactive National Policy on Insurance Practices in FEMA’s Public Assistance Program

DTIC Science & Technology

2013-12-01

DisasterRecoveryExpenditure/Pag es/default.aspx, Canadian Disaster Database, and www.fema.gov) 116 Table 15. Comparison of declaration criteria and disasters for $30 million...the role of insurance in FEMA’s Public Assistance program. The guidance provided in the 44 CFR has not kept up with the industry since being...the nation. xxix THIS PAGE INTENTIONALLY LEFT BLANK I. INTRODUCTION Insurance is a complex industry , which is a large component of the U.S

Assessment and application of national environmental databases and mapping tools at the local level to two community case studies.

PubMed

Hammond, Davyda; Conlon, Kathryn; Barzyk, Timothy; Chahine, Teresa; Zartarian, Valerie; Schultz, Brad

2011-03-01

Communities are concerned over pollution levels and seek methods to systematically identify and prioritize the environmental stressors in their communities. Geographic information system (GIS) maps of environmental information can be useful tools for communities in their assessment of environmental-pollution-related risks. Databases and mapping tools that supply community-level estimates of ambient concentrations of hazardous pollutants, risk, and potential health impacts can provide relevant information for communities to understand, identify, and prioritize potential exposures and risk from multiple sources. An assessment of existing databases and mapping tools was conducted as part of this study to explore the utility of publicly available databases, and three of these databases were selected for use in a community-level GIS mapping application. Queried data from the U.S. EPA's National-Scale Air Toxics Assessment, Air Quality System, and National Emissions Inventory were mapped at the appropriate spatial and temporal resolutions for identifying risks of exposure to air pollutants in two communities. The maps combine monitored and model-simulated pollutant and health risk estimates, along with local survey results, to assist communities with the identification of potential exposure sources and pollution hot spots. Findings from this case study analysis will provide information to advance the development of new tools to assist communities with environmental risk assessments and hazard prioritization. © 2010 Society for Risk Analysis.

Risk segmentation in Chilean social health insurance.

PubMed

Hidalgo, Hector; Chipulu, Maxwell; Ojiako, Udechukwu

2013-01-01

The objective of this study is to identify how risk and social variables are likely to be impacted by an increase in private sector participation in health insurance provision. The study focuses on the Chilean health insurance industry, traditionally dominated by the public sector. Predictive risk modelling is conducted using a database containing over 250,000 health insurance policy records provided by the Superintendence of Health of Chile. Although perceived with suspicion in some circles, risk segmentation serves as a rational approach to risk management from a resource perspective. The variables that have considerable impact on insurance claims include the number of dependents, gender, wages and the duration a claimant has been a customer. As shown in the case study, to ensure that social benefits are realised, increased private sector participation in health insurance must be augmented by regulatory oversight and vigilance. As it is clear that a "community-rated" health insurance provision philosophy impacts on insurance firm's ability to charge "market" prices for insurance provision, the authors explore whether risk segmentation is a feasible means of predicting insurance claim behaviour in Chile's private health insurance industry.

Identification and Classification of Common Risks in Space Science Missions

NASA Technical Reports Server (NTRS)

Hihn, Jairus M.; Chattopadhyay, Debarati; Hanna, Robert A.; Port, Daniel; Eggleston, Sabrina

2010-01-01

Due to the highly constrained schedules and budgets that NASA missions must contend with, the identification and management of cost, schedule and risks in the earliest stages of the lifecycle is critical. At the Jet Propulsion Laboratory (JPL) it is the concurrent engineering teams that first address these items in a systematic manner. Foremost of these concurrent engineering teams is Team X. Started in 1995, Team X has carried out over 1000 studies, dramatically reducing the time and cost involved, and has been the model for other concurrent engineering teams both within NASA and throughout the larger aerospace community. The ability to do integrated risk identification and assessment was first introduced into Team X in 2001. Since that time the mission risks identified in each study have been kept in a database. In this paper we will describe how the Team X risk process is evolving highlighting the strengths and weaknesses of the different approaches. The paper will especially focus on the identification and classification of common risks that have arisen during Team X studies of space based science missions.

National Library of Medicine

MedlinePlus

... Disasters and Public Health Emergencies The NLM Disaster Information Management Research Center has tools, guides, and databases to ... Disasters and Public Health Emergencies The NLM Disaster Information Management Research Center has tools, guides, and databases to ...

Knowledge and confidence of Australian emergency department clinicians in managing patients with mental health-related presentations: findings from a national qualitative study

PubMed Central

2013-01-01

Background Mental health related presentations are common in Australian Emergency Departments (EDs). We sought to better understand ED staff knowledge and levels of confidence in treating people with mental health related problems using qualitative methods. Methods This was a qualitative learning needs analysis of Australian emergency doctors and nurses regarding the assessment and management of mental health presentations. Participants were selected for semi-structured telephone interview using criterion-based sampling. Recruitment was via the Australasian College for Emergency Medicine and College of Emergency Nursing Australasia membership databases. Interviews were audio-recorded and transcribed verbatim. Thematic framework analysis was used to identify perceived knowledge gaps and levels of confidence among participants in assessing and managing patients attending EDs with mental health presentations. Results Thirty-six staff comprising 20 doctors and 16 nurses consented to participate. Data saturation was achieved for four major areas where knowledge gaps were reported. These were: assessment (risk assessment and assessment of mental status), management (psychotherapeutic skills, ongoing management, medication management and behaviour management), training (curriculum and rotations), and application of mental health legislation. Participants’ confidence in assessing mental health patients was affected by environmental, staff, and patient related factors. Clinicians were keen to learn more about evidence based practice to provide better care for this patient group. Areas where clinicians felt the least confident were in the effective assessment and management of high risk behaviours, providing continuity of care, managing people with dual diagnosis, prescribing and effectively managing medications, assessing and managing child and adolescent mental health, and balancing the caseload in ED. Conclusion Participants were most concerned about knowledge gaps in risk assessment, particularly for self-harming patients, violent and aggressive patients and their management, and distinguishing psychiatric from physical illness. Staff confidence was enhanced by better availability of skilled psychiatric support staff to assist in clinical decision-making for complex cases and via the provision of a safe ED environment. Strategies to enhance the care of patients with mental health presentations in Australian emergency departments should address these gaps in knowledge and confidence. PMID:23317351

Design storm prediction and hydrologic modeling using a web-GIS approach on a free-software platform

NASA Astrophysics Data System (ADS)

Castrogiovanni, E. M.; La Loggia, G.; Noto, L. V.

2005-09-01

The aim of this work has been to implement a set of procedures useful to automatise the evaluation, the design storm prediction and the flood discharge associated with a selected risk level. For this purpose a Geographic Information System has been implemented using Grass 5.0. One of the main topics of such a system is a georeferenced database of the highest intensity rainfalls and their assigned duration recorded in Sicily. This database contains the main characteristics for more than 250 raingauges, as well as the values of intense rainfall events recorded by these raingauges. These data are managed through the combined use of the PostgreSQL and GRASS-GIS 5.0 databases. Some of the best-known probability distributions have been implemented within the Geographical Information System in order to determine the point and/or areal rain values once duration and return period have been defined. The system also includes a hydrological module necessary to compute the probable flow, for a selected risk level, at points chosen by the user. A peculiarity of the system is the possibility to querying the model using a web-interface. The assumption is that the rising needs of geographic information, and dealing with the rising importance of peoples participation in the decision process, requires new forms for the diffusion of territorial data. Furthermore, technicians as well as public administrators needs to get customized and specialist data to support planning, particularly in emergencies. In this perspective a Web-interface has been developed for the hydrologic system. The aim is to allow remote users to access a centralized database and processing-power to serve the needs of knowledge without complex hardware/software infrastructures.

Construction of In-house Databases in a Corporation

NASA Astrophysics Data System (ADS)

Dezaki, Kyoko; Saeki, Makoto

Rapid progress in advanced informationalization has increased need to enforce documentation activities in industries. Responding to it Tokin Corporation has been engaged in database construction for patent information, technical reports and so on accumulated inside the Company. Two results are obtained; One is TOPICS, inhouse patent information management system, the other is TOMATIS, management and technical information system by use of personal computers and all-purposed relational database software. These systems aim at compiling databases of patent and technological management information generated internally and externally by low labor efforts as well as low cost, and providing for comprehensive information company-wide. This paper introduces the outline of these systems and how they are actually used.

Countermeasure Evaluation and Validation Project (CEVP) Database Requirement Documentation

NASA Technical Reports Server (NTRS)

Shin, Sung Y.

2003-01-01

The initial focus of the project by the JSC laboratories will be to develop, test and implement a standardized complement of integrated physiological test (Integrated Testing Regimen, ITR) that will examine both system and intersystem function, and will be used to validate and certify candidate countermeasures. The ITR will consist of medical requirements (MRs) and non-MR core ITR tests, and countermeasure-specific testing. Non-MR and countermeasure-specific test data will be archived in a database specific to the CEVP. Development of a CEVP Database will be critical to documenting the progress of candidate countermeasures. The goal of this work is a fully functional software system that will integrate computer-based data collection and storage with secure, efficient, and practical distribution of that data over the Internet. This system will provide the foundation of a new level of interagency and international cooperation for scientific experimentation and research, providing intramural, international, and extramural collaboration through management and distribution of the CEVP data. The research performed this summer includes the first phase of the project. The first phase of the project is a requirements analysis. This analysis will identify the expected behavior of the system under normal conditions and abnormal conditions; that could affect the system's ability to produce this behavior; and the internal features in the system needed to reduce the risk of unexpected or unwanted behaviors. The second phase of this project have also performed in this summer. The second phase of project is the design of data entry screen and data retrieval screen for a working model of the Ground Data Database. The final report provided the requirements for the CEVP system in a variety of ways, so that both the development team and JSC technical management have a thorough understanding of how the system is expected to behave.

Management of the extravasation of anti-neoplastic agents.

PubMed

Boulanger, J; Ducharme, A; Dufour, A; Fortier, S; Almanric, K

2015-05-01

Extravasation is a potentially severe complication that can occur during the administration of chemotherapy. The scarcity of evidence available makes it difficult to develop an optimal management scheme. The purpose of this guideline is to review the relevant scientific literature on the prevention, management, and treatment of extravasation occurring during the administration of chemotherapy to cancer patients. A scientific literature review was conducted using the PubMed search tool. The period covered was from database inception to April 2014, inclusively. Since the literature on extravasation treatment is often empirical, anecdotal, and controversial, the review also identified clinical practice guidelines and expert consensuses published by relevant international organizations and cancer agencies. Identification of potential risk factors and preventive measures can reduce the risk of extravasation. Recognition and management of symptoms are crucial in patients with this complication. Provision of adequate instruction to personnel responsible for administering chemotherapy and to patients on recognizing symptoms, preventing, and managing extravasation is essential. Extravasation can be treated with dry warm or cold compresses and various antidotes such as dimethyl sulfoxide, dexrazoxane, hyaluronidase, or sodium thiosulfate, depending on the agent that has caused extravasation. Patient monitoring to assess the progression or regression of symptoms and to thus take the appropriate measures is necessary. Several strategies must be established to ensure that extravasation is recognized and properly managed. Given the evidence available at this time, the Comité de l'évolution des pratiques en oncologie (CEPO) has made recommendations for clinical practice in Quebec.

No abatement of steroid injections for tennis elbow in Australian General Practice: A 15-year observational study with random general practitioner sampling.

PubMed

Vicenzino, Bill; Britt, Helena; Pollack, Allan J; Hall, Michelle; Bennell, Kim L; Hunter, David J

2017-01-01

Evaluate general practitioner (GP) management of tennis elbow (TE) in Australia. Data about the management of TE by GPs from 2000 to 2015 were extracted from the Bettering the Evaluation of Care of Health program database. Patient and GP characteristics and encounter management data were classified by the International Classification of Primary Care, version 2, and reported using descriptive statistics with point estimates and 95% confidence intervals. TE was managed by GPs 242,000 times per year on average. Patients were mainly female (52.3%), aged between 35 and 64 years (mean: 49.3 yrs), had higher relative risks of concomitant disorders (e.g. carpal tunnel syndrome and other tendonitis) and their TE was 10 times more likely to be work related than problems managed for patients who did not have TE. Use of diagnostic tests was low, implying a clinical examination based diagnosis of TE. Management was by procedural treatments (36 per 100 TE problems), advice, education or counselling (25 per 100), and referral to other health care providers (14 per 100, mainly to physiotherapy). The rate of local injection did not change over the 15 years and was performed at similar rates as physiotherapy referral. The high risk of comorbidities and work relatedness and no abatement in the reasonably high rate of local injections (which is contrary to the evidence from clinical trials) provides support for the development and dissemination of TE clinical guidelines for GPs.

Treatment of olecranon bursitis: a systematic review.

PubMed

Sayegh, Eli T; Strauch, Robert J

2014-11-01

The optimal management of olecranon bursitis is ill-defined. The purposes of this review were to systematically evaluate clinical outcomes for aseptic versus septic bursitis, compare surgical versus nonsurgical management, and examine the roles of corticosteroid injection and aspiration in aseptic bursitis. The English-language literature was searched using PubMed, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, Allied and Complementary Medicine, and Cochrane Central Register of Controlled Trials. Analyses were performed for clinical resolution and complications after treatment of aseptic and/or septic olecranon bursitis. Twenty-nine studies containing 1278 patients were included. Compared with septic bursitis, aseptic bursitis was associated with a significantly higher overall complication rate (p = 0.0108). Surgical management was less likely to clinically resolve septic or aseptic bursitis (p = 0.0476), and demonstrated higher rates of overall complications (p = 0.0117), persistent drainage (p = 0.0194), and bursal infection (p = 0.0060) than nonsurgical management. Corticosteroid injection for aseptic bursitis was associated with increased overall complications (p = 0.0458) and skin atrophy (p = 0.0261). Aspiration did not increase the risk of bursal infection for aseptic bursitis. Based primarily on level IV evidence, nonsurgical management of olecranon bursitis is significantly more effective and safer than surgical management. The clinical course of aseptic bursitis appears to be more complicated than that of septic bursitis. Corticosteroid injection is associated with significant risks without improving the outcome of aseptic bursitis. Therapeutic IV.

Characteristics of effective self-management interventions in patients with COPD: individual patient data meta-analysis.

PubMed

Jonkman, Nini H; Westland, Heleen; Trappenburg, Jaap C A; Groenwold, Rolf H H; Bischoff, Erik W M A; Bourbeau, Jean; Bucknall, Christine E; Coultas, David; Effing, Tanja W; Epton, Michael; Gallefoss, Frode; Garcia-Aymerich, Judith; Lloyd, Suzanne M; Monninkhof, Evelyn M; Nguyen, Huong Q; van der Palen, Job; Rice, Kathryn L; Sedeno, Maria; Taylor, Stephanie J C; Troosters, Thierry; Zwar, Nicholas A; Hoes, Arno W; Schuurmans, Marieke J

2016-07-01

It is unknown whether heterogeneity in effects of self-management interventions in patients with chronic obstructive pulmonary disease (COPD) can be explained by differences in programme characteristics. This study aimed to identify which characteristics of COPD self-management interventions are most effective.Systematic search in electronic databases identified randomised trials on self-management interventions conducted between 1985 and 2013. Individual patient data were requested for meta-analysis by generalised mixed effects models.14 randomised trials were included (67% of eligible), representing 3282 patients (75% of eligible). Univariable analyses showed favourable effects on some outcomes for more planned contacts and longer duration of interventions, interventions with peer contact, without log keeping, without problem solving, and without support allocation. After adjusting for other programme characteristics in multivariable analyses, only the effects of duration on all-cause hospitalisation remained. Each month increase in intervention duration reduced risk of all-cause hospitalisation (time to event hazard ratios 0.98, 95% CI 0.97-0.99; risk ratio (RR) after 6 months follow-up 0.96, 95% CI 0.92-0.99; RR after 12 months follow-up 0.98, 95% CI 0.96-1.00).Our results showed that longer duration of self-management interventions conferred a reduction in all-cause hospitalisations in COPD patients. Other characteristics are not consistently associated with differential effects of self-management interventions across clinically relevant outcomes. The content of this work is not subject to copyright. Design and branding are copyright ©ERS 2016.

Waste management facility accident analysis (WASTE ACC) system: software for analysis of waste management alternatives

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

Kohout, E.F.; Folga, S.; Mueller, C.

1996-03-01

This paper describes the Waste Management Facility Accident Analysis (WASTE{underscore}ACC) software, which was developed at Argonne National Laboratory (ANL) to support the US Department of Energy`s (DOE`s) Waste Management (WM) Programmatic Environmental Impact Statement (PEIS). WASTE{underscore}ACC is a decision support and database system that is compatible with Microsoft{reg_sign} Windows{trademark}. It assesses potential atmospheric releases from accidents at waste management facilities. The software provides the user with an easy-to-use tool to determine the risk-dominant accident sequences for the many possible combinations of process technologies, waste and facility types, and alternative cases described in the WM PEIS. In addition, its structure willmore » allow additional alternative cases and assumptions to be tested as part of the future DOE programmatic decision-making process. The WASTE{underscore}ACC system demonstrates one approach to performing a generic, systemwide evaluation of accident risks at waste management facilities. The advantages of WASTE{underscore}ACC are threefold. First, the software gets waste volume and radiological profile data that were used to perform other WM PEIS-related analyses directly from the WASTE{underscore}MGMT system. Second, the system allows for a consistent analysis across all sites and waste streams, which enables decision makers to understand more fully the trade-offs among various policy options and scenarios. Third, the system is easy to operate; even complex scenario runs are completed within minutes.« less

The frequency of asthma exacerbations and healthcare utilization in patients with asthma from the UK and USA.

PubMed

Suruki, Robert Y; Daugherty, Jonas B; Boudiaf, Nada; Albers, Frank C

2017-04-27

Asthma exacerbations are frequent in patients with severe disease. This report describes results from two retrospective cohort studies describing exacerbation frequency and risk, emergency department (ED)/hospital re-admissions, and asthma-related costs by asthma severity in the US and UK. Patients with asthma in the US-based Clinformatics™ DataMart Multiplan IMPACT (2010-2011; WEUSKOP7048) and the UK-based Clinical Practice Research Datalink (2009-2011; WEUSKOP7092) databases were categorized by disease severity (Global Initiative for Asthma [GINA]; Step and exacerbation history) during the 12 months pre-asthma medical code (index date). Outcomes included: frequency of exacerbations (asthma-related ED visit, hospitalization, or oral corticosteroid use with an asthma medical code recorded within ±2 weeks) 12 months post-index, asthma-related ED visits/hospitalization, and asthma-related costs 30 days post-index. Risk of a subsequent exacerbation was determined by proportional hazard model. Of the 222,817 and 211,807 patients with asthma included from the US and UK databases, respectively, 12.5 and 8.4% experienced ≥1 exacerbation during the follow-up period. Exacerbation frequency increased with disease severity. Among the 5,167 and 2,904 patients with an asthma-related ED visit/hospitalization in the US and UK databases, respectively, 9.2 and 4.7% had asthma-related re-admissions within 30 days. Asthma-related re-admission rates and costs increased with disease severity, approximately doubling between GINA Step 1 and 5 and in patients with ≥2 versus <2 exacerbations in the previous year. Risk of a subsequent exacerbation increased 32-35% for an exacerbation requiring ED visit/hospitalization versus oral corticosteroids. Increased disease severity was associated with higher exacerbation frequency, ED/hospitalization re-admission, costs and risk of subsequent exacerbation, indicating that these patients require high-intensity post-exacerbation management.

An integrated photogrammetric and spatial database management system for producing fully structured data using aerial and remote sensing images.

PubMed

Ahmadi, Farshid Farnood; Ebadi, Hamid

2009-01-01

3D spatial data acquired from aerial and remote sensing images by photogrammetric techniques is one of the most accurate and economic data sources for GIS, map production, and spatial data updating. However, there are still many problems concerning storage, structuring and appropriate management of spatial data obtained using these techniques. According to the capabilities of spatial database management systems (SDBMSs); direct integration of photogrammetric and spatial database management systems can save time and cost of producing and updating digital maps. This integration is accomplished by replacing digital maps with a single spatial database. Applying spatial databases overcomes the problem of managing spatial and attributes data in a coupled approach. This management approach is one of the main problems in GISs for using map products of photogrammetric workstations. Also by the means of these integrated systems, providing structured spatial data, based on OGC (Open GIS Consortium) standards and topological relations between different feature classes, is possible at the time of feature digitizing process. In this paper, the integration of photogrammetric systems and SDBMSs is evaluated. Then, different levels of integration are described. Finally design, implementation and test of a software package called Integrated Photogrammetric and Oracle Spatial Systems (IPOSS) is presented.

Personal Database Management System I TRIAS

NASA Astrophysics Data System (ADS)

Yamamoto, Yoneo; Kashihara, Akihiro; Kawagishi, Keisuke

The current paper provides TRIAS (TRIple Associative System) which is a database management system for a personal use. In order to implement TRIAS, we have developed an associative database, whose format is (e,a,v) : e for entity, a for attribute, v for value. ML-TREE is used to construct (e,a,v). ML-TREE is a reversion of B+-tree that is multiway valanced tree. The paper focuses mainly on the usage of associative database, demonstrating how to use basic commands, primary functions and applcations.

The ADAMS interactive interpreter

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

Rietscha, E.R.

1990-12-17

The ADAMS (Advanced DAta Management System) project is exploring next generation database technology. Database management does not follow the usual programming paradigm. Instead, the database dictionary provides an additional name space environment that should be interactively created and tested before writing application code. This document describes the implementation and operation of the ADAMS Interpreter, an interactive interface to the ADAMS data dictionary and runtime system. The Interpreter executes individual statements of the ADAMS Interface Language, providing a fast, interactive mechanism to define and access persistent databases. 5 refs.

An Extensible "SCHEMA-LESS" Database Framework for Managing High-Throughput Semi-Structured Documents

NASA Technical Reports Server (NTRS)

Maluf, David A.; Tran, Peter B.

2003-01-01

Object-Relational database management system is an integrated hybrid cooperative approach to combine the best practices of both the relational model utilizing SQL queries and the object-oriented, semantic paradigm for supporting complex data creation. In this paper, a highly scalable, information on demand database framework, called NETMARK, is introduced. NETMARK takes advantages of the Oracle 8i object-relational database using physical addresses data types for very efficient keyword search of records spanning across both context and content. NETMARK was originally developed in early 2000 as a research and development prototype to solve the vast amounts of unstructured and semistructured documents existing within NASA enterprises. Today, NETMARK is a flexible, high-throughput open database framework for managing, storing, and searching unstructured or semi-structured arbitrary hierarchal models, such as XML and HTML.

An Extensible Schema-less Database Framework for Managing High-throughput Semi-Structured Documents

NASA Technical Reports Server (NTRS)

Maluf, David A.; Tran, Peter B.; La, Tracy; Clancy, Daniel (Technical Monitor)

2002-01-01

Object-Relational database management system is an integrated hybrid cooperative approach to combine the best practices of both the relational model utilizing SQL queries and the object oriented, semantic paradigm for supporting complex data creation. In this paper, a highly scalable, information on demand database framework, called NETMARK is introduced. NETMARK takes advantages of the Oracle 8i object-relational database using physical addresses data types for very efficient keyword searches of records for both context and content. NETMARK was originally developed in early 2000 as a research and development prototype to solve the vast amounts of unstructured and semi-structured documents existing within NASA enterprises. Today, NETMARK is a flexible, high throughput open database framework for managing, storing, and searching unstructured or semi structured arbitrary hierarchal models, XML and HTML.

NETMARK: A Schema-less Extension for Relational Databases for Managing Semi-structured Data Dynamically

NASA Technical Reports Server (NTRS)

Maluf, David A.; Tran, Peter B.

2003-01-01

Object-Relational database management system is an integrated hybrid cooperative approach to combine the best practices of both the relational model utilizing SQL queries and the object-oriented, semantic paradigm for supporting complex data creation. In this paper, a highly scalable, information on demand database framework, called NETMARK, is introduced. NETMARK takes advantages of the Oracle 8i object-relational database using physical addresses data types for very efficient keyword search of records spanning across both context and content. NETMARK was originally developed in early 2000 as a research and development prototype to solve the vast amounts of unstructured and semi-structured documents existing within NASA enterprises. Today, NETMARK is a flexible, high-throughput open database framework for managing, storing, and searching unstructured or semi-structured arbitrary hierarchal models, such as XML and HTML.

Novel statistical tools for management of public databases facilitate community-wide replicability and control of false discovery.

PubMed

Rosset, Saharon; Aharoni, Ehud; Neuvirth, Hani

2014-07-01

Issues of publication bias, lack of replicability, and false discovery have long plagued the genetics community. Proper utilization of public and shared data resources presents an opportunity to ameliorate these problems. We present an approach to public database management that we term Quality Preserving Database (QPD). It enables perpetual use of the database for testing statistical hypotheses while controlling false discovery and avoiding publication bias on the one hand, and maintaining testing power on the other hand. We demonstrate it on a use case of a replication server for GWAS findings, underlining its practical utility. We argue that a shift to using QPD in managing current and future biological databases will significantly enhance the community's ability to make efficient and statistically sound use of the available data resources. © 2014 WILEY PERIODICALS, INC.

VIEWCACHE: An incremental pointer-based access method for autonomous interoperable databases

NASA Technical Reports Server (NTRS)

Roussopoulos, N.; Sellis, Timos

1992-01-01

One of biggest problems facing NASA today is to provide scientists efficient access to a large number of distributed databases. Our pointer-based incremental database access method, VIEWCACHE, provides such an interface for accessing distributed data sets and directories. VIEWCACHE allows database browsing and search performing inter-database cross-referencing with no actual data movement between database sites. This organization and processing is especially suitable for managing Astrophysics databases which are physically distributed all over the world. Once the search is complete, the set of collected pointers pointing to the desired data are cached. VIEWCACHE includes spatial access methods for accessing image data sets, which provide much easier query formulation by referring directly to the image and very efficient search for objects contained within a two-dimensional window. We will develop and optimize a VIEWCACHE External Gateway Access to database management systems to facilitate distributed database search.

A case study for a digital seabed database: Bohai Sea engineering geology database

NASA Astrophysics Data System (ADS)

Tianyun, Su; Shikui, Zhai; Baohua, Liu; Ruicai, Liang; Yanpeng, Zheng; Yong, Wang

2006-07-01

This paper discusses the designing plan of ORACLE-based Bohai Sea engineering geology database structure from requisition analysis, conceptual structure analysis, logical structure analysis, physical structure analysis and security designing. In the study, we used the object-oriented Unified Modeling Language (UML) to model the conceptual structure of the database and used the powerful function of data management which the object-oriented and relational database ORACLE provides to organize and manage the storage space and improve its security performance. By this means, the database can provide rapid and highly effective performance in data storage, maintenance and query to satisfy the application requisition of the Bohai Sea Oilfield Paradigm Area Information System.

Geoscience research databases for coastal Alabama ecosystem management

USGS Publications Warehouse

Hummell, Richard L.

1995-01-01

Effective management of complex coastal ecosystems necessitates access to scientific knowledge that can be acquired through a multidisciplinary approach involving Federal and State scientists that take advantage of agency expertise and resources for the benefit of all participants working toward a set of common research and management goals. Cooperative geostatic investigations have led toward building databases of fundamental scientific knowledge that can be utilized to manage coastal Alabama's natural and future development. These databases have been used to assess the occurrence and economic potential of hard mineral resources in the Alabama EFZ, and to support oil spill contingency planning and environmental analysis for coastal Alabama.

Using Virtual Servers to Teach the Implementation of Enterprise-Level DBMSs: A Teaching Note

ERIC Educational Resources Information Center

Wagner, William P.; Pant, Vik

2010-01-01

One of the areas where demand has remained strong for MIS students is in the area of database management. Since the early days, this topic has been a mainstay in the MIS curriculum. Students of database management today typically learn about relational databases, SQL, normalization, and how to design and implement various kinds of database…

Towards G2G: Systems of Technology Database Systems

NASA Technical Reports Server (NTRS)

Maluf, David A.; Bell, David

2005-01-01

We present an approach and methodology for developing Government-to-Government (G2G) Systems of Technology Database Systems. G2G will deliver technologies for distributed and remote integration of technology data for internal use in analysis and planning as well as for external communications. G2G enables NASA managers, engineers, operational teams and information systems to "compose" technology roadmaps and plans by selecting, combining, extending, specializing and modifying components of technology database systems. G2G will interoperate information and knowledge that is distributed across organizational entities involved that is ideal for NASA future Exploration Enterprise. Key contributions of the G2G system will include the creation of an integrated approach to sustain effective management of technology investments that supports the ability of various technology database systems to be independently managed. The integration technology will comply with emerging open standards. Applications can thus be customized for local needs while enabling an integrated management of technology approach that serves the global needs of NASA. The G2G capabilities will use NASA s breakthrough in database "composition" and integration technology, will use and advance emerging open standards, and will use commercial information technologies to enable effective System of Technology Database systems.

Supporting the operational use of process based hydrological models and NASA Earth Observations for use in land management and post-fire remediation through a Rapid Response Erosion Database (RRED).

NASA Astrophysics Data System (ADS)

Miller, M. E.; Elliot, W.; Billmire, M.; Robichaud, P. R.; Banach, D. M.

2017-12-01

We have built a Rapid Response Erosion Database (RRED, http://rred.mtri.org/rred/) for the continental United States to allow land managers to access properly formatted spatial model inputs for the Water Erosion Prediction Project (WEPP). Spatially-explicit process-based models like WEPP require spatial inputs that include digital elevation models (DEMs), soil, climate and land cover. The online database delivers either a 10m or 30m USGS DEM, land cover derived from the Landfire project, and soil data derived from SSURGO and STATSGO datasets. The spatial layers are projected into UTM coordinates and pre-registered for modeling. WEPP soil parameter files are also created along with linkage files to match both spatial land cover and soils data with the appropriate WEPP parameter files. Our goal is to make process-based models more accessible by preparing spatial inputs ahead of time allowing modelers to focus on addressing scenarios of concern. The database provides comprehensive support for post-fire hydrological modeling by allowing users to upload spatial soil burn severity maps, and within moments returns spatial model inputs. Rapid response is critical following natural disasters. After moderate and high severity wildfires, flooding, erosion, and debris flows are a major threat to life, property and municipal water supplies. Mitigation measures must be rapidly implemented if they are to be effective, but they are expensive and cannot be applied everywhere. Fire, runoff, and erosion risks also are highly heterogeneous in space, creating an urgent need for rapid, spatially-explicit assessment. The database has been used to help assess and plan remediation on over a dozen wildfires in the Western US. Future plans include expanding spatial coverage, improving model input data and supporting additional models. Our goal is to facilitate the use of the best possible datasets and models to support the conservation of soil and water.

Fatal falls in the US construction industry, 1990 to 1999.

PubMed

Derr, J; Forst, L; Chen, H Y; Conroy, L

2001-10-01

The Occupational Safety and Health Administration's (OSHA's) Integrated Management Information System (IMIS) database allows for the detailed analysis of risk factors surrounding fatal occupational events. This study used IMIS data to (1) perform a risk factor analysis of fatal construction falls, and (2) assess the impact of the February 1995 29 CFR Part 1926 Subpart M OSHA fall protection regulations for construction by calculating trends in fatal fall rates. In addition, IMIS data on fatal construction falls were compared with data from other occupational fatality surveillance systems. For falls in construction, the study identified several demographic factors that may indicate increased risk. A statistically significant downward trend in fatal falls was evident in all construction and within several construction categories during the decade. Although the study failed to show a statistically significant intervention effect from the new OSHA regulations, it may have lacked the power to do so.

Does albendazole affect seizure remission and computed tomography response in children with neurocysticercosis? A Systematic review and meta-analysis.

PubMed

Mazumdar, Maitreyi; Pandharipande, Pari; Poduri, Annapurna

2007-02-01

A recent trial suggested that albendazole reduces seizures in adults with neurocysticercosis. There is still no consensus regarding optimal management of neurocysticercosis in children. The authors conducted a systematic review and meta-analysis to assess the efficacy of albendazole in children with neurocysticercosis, by searching the Cochrane Databases, MEDLINE, EMBASE, and LILACS. Three reviewers extracted data using an intent-to-treat analysis. Random effects models were used to estimate relative risks. Four randomized trials were selected for meta-analysis, and 10 observational studies were selected for qualitative review. The relative risk of seizure remission in treatment versus control was 1.26 (1.09, 1.46). The relative risk of improvement in computed tomography in these trials was 1.15 (0.97, 1.36). Review of observational studies showed conflicting results, likely owing to preferential administration of albendazole to sicker children.

Adopting a corporate perspective on databases. Improving support for research and decision making.

PubMed

Meistrell, M; Schlehuber, C

1996-03-01

The Veterans Health Administration (VHA) is at the forefront of designing and managing health care information systems that accommodate the needs of clinicians, researchers, and administrators at all levels. Rather than using one single-site, centralized corporate database VHA has constructed several large databases with different configurations to meet the needs of users with different perspectives. The largest VHA database is the Decentralized Hospital Computer Program (DHCP), a multisite, distributed data system that uses decoupled hospital databases. The centralization of DHCP policy has promoted data coherence, whereas the decentralization of DHCP management has permitted system development to be done with maximum relevance to the users'local practices. A more recently developed VHA data system, the Event Driven Reporting system (EDR), uses multiple, highly coupled databases to provide workload data at facility, regional, and national levels. The EDR automatically posts a subset of DHCP data to local and national VHA management. The development of the EDR illustrates how adoption of a corporate perspective can offer significant database improvements at reasonable cost and with modest impact on the legacy system.

Central venous catheter-related infections in hematology and oncology: 2012 updated guidelines on diagnosis, management and prevention by the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology.

PubMed

Hentrich, M; Schalk, E; Schmidt-Hieber, M; Chaberny, I; Mousset, S; Buchheidt, D; Ruhnke, M; Penack, O; Salwender, H; Wolf, H-H; Christopeit, M; Neumann, S; Maschmeyer, G; Karthaus, M

2014-05-01

Cancer patients are at increased risk for central venous catheter-related infections (CRIs). Thus, a comprehensive, practical and evidence-based guideline on CRI in patients with malignancies is warranted. A panel of experts by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO) has developed a guideline on CRI in cancer patients. Literature searches of the PubMed, Medline and Cochrane databases were carried out and consensus discussions were held. Recommendations on diagnosis, management and prevention of CRI in cancer patients are made, and the strength of the recommendation and the level of evidence are presented. This guideline is an evidence-based approach to the diagnosis, management and prevention of CRI in cancer patients.

Technical Aspects of Interfacing MUMPS to an External SQL Relational Database Management System

PubMed Central

Kuzmak, Peter M.; Walters, Richard F.; Penrod, Gail

1988-01-01

This paper describes an interface connecting InterSystems MUMPS (M/VX) to an external relational DBMS, the SYBASE Database Management System. The interface enables MUMPS to operate in a relational environment and gives the MUMPS language full access to a complete set of SQL commands. MUMPS generates SQL statements as ASCII text and sends them to the RDBMS. The RDBMS executes the statements and returns ASCII results to MUMPS. The interface suggests that the language features of MUMPS make it an attractive tool for use in the relational database environment. The approach described in this paper separates MUMPS from the relational database. Positioning the relational database outside of MUMPS promotes data sharing and permits a number of different options to be used for working with the data. Other languages like C, FORTRAN, and COBOL can access the RDBMS database. Advanced tools provided by the relational database vendor can also be used. SYBASE is an advanced high-performance transaction-oriented relational database management system for the VAX/VMS and UNIX operating systems. SYBASE is designed using a distributed open-systems architecture, and is relatively easy to interface with MUMPS.

Evaluation of nutritional care of hospitalized children in a tertiary pediatric hospital.

PubMed

De Longueville, Caroline; Robert, Martine; Debande, Marjorie; Podlubnai, Sylviane; Defourny, Sophie; Namane, Sid-Ali; Pace, Aude; Brans, Camille; Cayrol, Elodie; Goyens, Philippe; De Laet, Corinne

2018-06-01

Hospitalized children are at risk of malnutrition. The aim of the present study was to evaluate a clinical practice in a tertiary hospital. The nutritional team developed a specific software for screening of malnutrition and risk of malnutrition (Evalnut) that provides also recommendations for the nutritional management of the patient. The data recorded into this program and the tool itself were analyzed and optimizations are highlighted. A retrospective study analyzed the data collected in 2015 during 4931 consecutive hospitalizations (3984 children) at the University Children's Hospital Queen Fabiola. Pivot tables analysis (Excel) of the database of the screening tool was compared with the clinical practice of the dietitians. First data processing excluded records with abnormal or missing values. Impact of nutritional care analysis needs at least 2 evaluations and a positive patient's height trend. In case of height equality, only length of hospital stays less than 2 weeks were kept. This study highlighted inaccurate database records related to imperfections of the computer program, missing or erroneous measures and incomplete encoding. First analysis on 3219 valid hospitalizations showed statistical correlations. Prevalence of malnutrition on admission was 33%, split into 14,5% acute malnutrition, 15% chronic malnutrition and 3,5% mixed malnutrition. Overall, 30,3% of the children were categorized at risk of developing malnutrition during their stay. Positive impact of nutritional management on the resulting nutritional status was demonstrated on the second data selection (352 hospitalizations): WFH median (interquartile range) increased from 96,1% (87,1-106,4) on admission to 96,9% (89,1-106,1) (p < 0,01) on discharge. An optimization of the existing software was finally proposed. In our hospital, the dietitians are the most aware on the importance of nutritional assessment and management during hospitalization. Encouraging results are obtained. Inclusion of a nutritional program in the medical file is useful to raise interest amongst caregivers and is particularly valuable for the nutritional follow up of the patients by the nutrition team. Copyright © 2018 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Data base management system for lymphatic filariasis--a neglected tropical disease.

PubMed

Upadhyayula, Suryanaryana Murty; Mutheneni, Srinivasa Rao; Kadiri, Madhusudhan Rao; Kumaraswamy, Sriram; Nelaturu, Sarat Chandra Babu

2012-01-01

Researchers working in the area of Public Health are being confronted with large volumes of data on various aspects of entomology and epidemiology. To obtain the relevant information out of these data requires particular database management system. In this paper, we have described about the usages of our developed database on lymphatic filariasis. This database application is developed using Model View Controller (MVC) architecture, with MySQL as database and a web based interface. We have collected and incorporated the data on filariasis in the database from Karimnagar, Chittoor, East and West Godavari districts of Andhra Pradesh, India. The importance of this database is to store the collected data, retrieve the information and produce various combinational reports on filarial aspects which in turn will help the public health officials to understand the burden of disease in a particular locality. This information is likely to have an imperative role on decision making for effective control of filarial disease and integrated vector management operations.

Organizing, exploring, and analyzing antibody sequence data: the case for relational-database managers.

PubMed

Owens, John

2009-01-01

Technological advances in the acquisition of DNA and protein sequence information and the resulting onrush of data can quickly overwhelm the scientist unprepared for the volume of information that must be evaluated and carefully dissected to discover its significance. Few laboratories have the luxury of dedicated personnel to organize, analyze, or consistently record a mix of arriving sequence data. A methodology based on a modern relational-database manager is presented that is both a natural storage vessel for antibody sequence information and a conduit for organizing and exploring sequence data and accompanying annotation text. The expertise necessary to implement such a plan is equal to that required by electronic word processors or spreadsheet applications. Antibody sequence projects maintained as independent databases are selectively unified by the relational-database manager into larger database families that contribute to local analyses, reports, interactive HTML pages, or exported to facilities dedicated to sophisticated sequence analysis techniques. Database files are transposable among current versions of Microsoft, Macintosh, and UNIX operating systems.

[The therapeutic drug monitoring network server of tacrolimus for Chinese renal transplant patients].

PubMed

Deng, Chen-Hui; Zhang, Guan-Min; Bi, Shan-Shan; Zhou, Tian-Yan; Lu, Wei

2011-07-01

This study is to develop a therapeutic drug monitoring (TDM) network server of tacrolimus for Chinese renal transplant patients, which can facilitate doctor to manage patients' information and provide three levels of predictions. Database management system MySQL was employed to build and manage the database of patients and doctors' information, and hypertext mark-up language (HTML) and Java server pages (JSP) technology were employed to construct network server for database management. Based on the population pharmacokinetic model of tacrolimus for Chinese renal transplant patients, above program languages were used to construct the population prediction and subpopulation prediction modules. Based on Bayesian principle and maximization of the posterior probability function, an objective function was established, and minimized by an optimization algorithm to estimate patient's individual pharmacokinetic parameters. It is proved that the network server has the basic functions for database management and three levels of prediction to aid doctor to optimize the regimen of tacrolimus for Chinese renal transplant patients.

78 FR 43890 - Privacy Act of 1974; Department of Homeland Security, Federal Emergency Management Agency-006...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-22

... titled, ``Department of Homeland Security/Federal Emergency Management Agency--006 Citizen Corps Database...) authorities; (5) purpose; (6) routine uses of information; (7) system manager and address; (8) notification... Database'' and retitle it ``DHS/FEMA--006 Citizen Corps Program System of Records.'' FEMA administers the...

NREL: U.S. Life Cycle Inventory Database - Project Management Team

Science.gov Websites

Project Management Team Information about the U.S. Life Cycle Inventory (LCI) Database project management team is listed on this page. Additional project information is available about the U.S. LCI Mechanical Engineering, Colorado State University Professional History Michael has worked as a Senior

Development of a Relational Database for Learning Management Systems

ERIC Educational Resources Information Center

Deperlioglu, Omer; Sarpkaya, Yilmaz; Ergun, Ertugrul

2011-01-01

In today's world, Web-Based Distance Education Systems have a great importance. Web-based Distance Education Systems are usually known as Learning Management Systems (LMS). In this article, a database design, which was developed to create an educational institution as a Learning Management System, is described. In this sense, developed Learning…

An Overview of the Object Protocol Model (OPM) and the OPM Data Management Tools.

ERIC Educational Resources Information Center

Chen, I-Min A.; Markowitz, Victor M.

1995-01-01

Discussion of database management tools for scientific information focuses on the Object Protocol Model (OPM) and data management tools based on OPM. Topics include the need for new constructs for modeling scientific experiments, modeling object structures and experiments in OPM, queries and updates, and developing scientific database applications…

Risk management policy and black-box warnings: a qualitative analysis of US FDA proceedings.

PubMed

Cook, Daniel M; Gurugubelli, Rama K; Bero, Lisa A

2009-01-01

The US FDA increasingly applies risk management to drug safety policy. Little is known about the process by which the FDA approves labelling changes. Although advisory committees can recommend any of the risk management tools, including the use of 'black-box warnings', it is unknown whether they deliberate on these questions or how they apply the principles of risk minimization or management during their considerations of drug licensing. To examine the process by which risk management is considered by the FDA, including the role of FDA advisory committees. We also aimed to identify and describe drug labelling changes and additions, including the prevalence of black-box warnings. We electronically obtained publicly available information regarding drug approvals, drug revisions and advisory committee meetings over 3 years (2004-6) from the FDA. Data in the form of meeting transcripts and full histories of labelling changes were collected on drugs discussed by advisory committees. We then searched and qualitatively analysed the meeting transcripts to identify themes in the discussion. We also created a database of all prescription drug labelling changes for 3 years and examined which drugs have had the most changes. We describe the risk management consideration process and report the frequency and characteristics of labelling changes. Excerpts from the transcripts are selected to illustrate both typical and atypical features of the discussion. A total of 174 black-box changes were made in the 3-year period of our study, of which 77 were new black-box warnings and 97 were revisions in black-box warnings. Of 77 new black-box warning additions, only 11 drugs were discussed by the advisory committees. Of the 17 most frequently revised drug labels in these 3 years, two were discussed in the advisory committee meetings. Advisory meeting discussions revealed confusion about black-box warnings and emphasized potential consequences of the warnings rather than their content. The safety labelling of drugs on the market is changed often. Panels of advisors consider only a few drugs, rarely discuss the labelling requirements, and display confusion about applying black-box warnings. The creation and application of black-box warnings on prescription medications should receive closer attention from the FDA and its advisors.

As of 2012, what are the key predictive risk factors for pressure ulcers? Developing French guidelines for clinical practice.

PubMed

Michel, J-M; Willebois, S; Ribinik, P; Barrois, B; Colin, D; Passadori, Y

2012-10-01

An evaluation of predictive risk factors for pressure ulcers is essential in development of a preventive strategy on admission to hospitals and/or nursing homes. Identification of the predictive factors for pressure ulcers as of 2012. Systematic review of the literature querying the databases PASCAL Biomed, Cochrane Library and PubMed from 2000 through 2010. Immobility should be considered as a predictive risk factor for pressure ulcers (grade B). Undernutrition/malnutrition may also be a predictive risk factor for pressure ulcers (grade C). Even if the level of evidence is low, once these risk factors have been detected, management is essential. Sensitizing and mobilizing health care teams requires training in ways of tracking and screening. According to the experts, risk scales should be used. As decision aids, they should always be balanced and complemented by the clinical judgment of the treatment team. According to experts, it is important to know and predictively evaluate risk of pressure ulcers at the time of hospital admission. The predictive risk factors found in this study are identical to those highlighted at the 2001 consensus conference of which was PERSE was the promoter. Copyright © 2012. Published by Elsevier Masson SAS.

The risky business of being an entomologist: A systematic review.

PubMed

Stanhope, Jessica; Carver, Scott; Weinstein, Philip

2015-07-01

Adverse work-related health outcomes are a significant problem worldwide. Entomologists, including arthropod breeders, are a unique occupational group exposed to potentially harmful arthropods, pesticides, and other more generic hazards. These exposures may place them at risk of a range of adverse work-related health outcomes. To determine what adverse work-related health outcomes entomologists have experienced, the incidence/prevalence of these outcomes, and what occupational management strategies have been employed by entomologists, and their effectiveness. A systematic search of eight databases was undertaken to identify studies informing the review objectives. Data pertaining to country, year, design, work-exposure, adverse work-related health outcomes, incidence/prevalence of these outcomes, and occupational management strategies were extracted, and reported descriptively. Results showed entomologists experienced work-related allergies, venom reactions, infections, infestations and delusional parasitosis. These related to exposure to insects, arachnids, chilopods and entognathans, and non-arthropod exposures, e.g. arthropod feed. Few studies reported the incidence/prevalence of such conditions, or work-related management strategies utilised by entomologists. There were no studies that specifically investigated the effectiveness of potential management strategies for entomologists as a population. Indeed, critical appraisal analysis indicated poor research quality in this area, which is a significant research gap. Entomologists are a diverse, unique occupational group, at risk of a range of adverse work-related health outcomes. This study represents the first systematic review of their work-related health risks. Future studies investigating the prevalence of adverse work-related health outcomes for entomologists, and the effectiveness of management strategies are warranted to decrease the disease burden of this otherwise understudied group. Copyright © 2015 Elsevier Inc. All rights reserved.

Graphical user interfaces for symbol-oriented database visualization and interaction

NASA Astrophysics Data System (ADS)

Brinkschulte, Uwe; Siormanolakis, Marios; Vogelsang, Holger

1997-04-01

In this approach, two basic services designed for the engineering of computer based systems are combined: a symbol-oriented man-machine-service and a high speed database-service. The man-machine service is used to build graphical user interfaces (GUIs) for the database service; these interfaces are stored using the database service. The idea is to create a GUI-builder and a GUI-manager for the database service based upon the man-machine service using the concept of symbols. With user-definable and predefined symbols, database contents can be visualized and manipulated in a very flexible and intuitive way. Using the GUI-builder and GUI-manager, a user can build and operate its own graphical user interface for a given database according to its needs without writing a single line of code.

Data analyst technician: an innovative role for the pharmacy technician.

PubMed

Ervin, K C; Skledar, S; Hess, M M; Ryan, M

2001-10-01

The development of an innovative role for the pharmacy technician is described. The role of the pharmacy technician was based on a needs assessment and the expertise of the pharmacy technician selected. Initial responsibilities of the technician included chart reviews, benchmarking surveys, monthly financial impact analysis, initiative assessment, and quality improvement reporting. As the drug-use and disease-state management (DUDSM) program expanded, pharmacist activities increased, requiring the expansion of data analyst technician (DAT) duties. These new responsibilities included participation in patient assessment, data collection and interpretation, and formulary enforcement. Most recently, technicians' expanded duties include maintenance of a physician compliance profiling database, quality improvement reporting and graphing, active role in patient risk assessment and database management for adult vaccination, and support of financial impact monitoring for other institutions within the health system. This pharmacist-technician collaboration resulted a threefold increase in patient assessments completed per day. In addition, as the DUDSM program continues to expand across the health system, an increase in DAT resources from 0.5 to 1.0 full-time equivalent was obtained. The role of the DAT has increased the efficiency of the DUDSM program and has provided an innovative role for the pharmacy technician.

Comparison of local infiltration and epidural analgesia for postoperative pain control in total knee arthroplasty and total hip arthroplasty: A systematic review and meta-analysis

PubMed Central

Yan, Huan; Cang, Jing; Xue, Zhanggang; Lu, Jianfeng; Wang, Hao

2016-01-01

Pain management after total knee arthroplasty (TKA) and total hip arthroplasty should permit early mobilization with minimal pain. Local infiltration analgesia (LIA) is a new popular method for decreasing postoperative pain. The goal of this meta-analysis is to evaluate the efficacy of LIA in comparison with epidural analgesia. A literature search was performed in PubMed, EMBASE, the OVID database, Web of Science, and the Cochrane Library databases. The risk of bias was assessed using the Cochrane collaboration tool. Outcomes of interest included visual analog scale score, range of flexion, length of stay, and complications. Nine trials involving 537 patients met the inclusion criteria. LIA provides better pain relief and larger range of motion in TKA patients compared to epidural analgesia at the late postoperative period. No significant difference was observed in regard to the length of stay and complications. The current evidence shows that the use of local infiltration is effective for postoperative pain management in TKA patients. More high-quality randomized controlled trials with long-term follow-up are required for examining the long-term efficacy and safety of local infiltration. PMID:27209072

Comparison of local infiltration and epidural analgesia for postoperative pain control in total knee arthroplasty and total hip arthroplasty: A systematic review and meta-analysis.

PubMed

Yan, Huan; Cang, Jing; Xue, Zhanggang; Lu, Jianfeng; Wang, Hao

2016-11-10

Pain management after total knee arthroplasty (TKA) and total hip arthroplasty should permit early mobilization with minimal pain. Local infiltration analgesia (LIA) is a new popular method for decreasing postoperative pain. The goal of this meta-analysis is to evaluate the efficacy of LIA in comparison with epidural analgesia. A literature search was performed in PubMed, EMBASE, the OVID database, Web of Science, and the Cochrane Library databases. The risk of bias was assessed using the Cochrane collaboration tool. Outcomes of interest included visual analog scale score, range of flexion, length of stay, and complications. Nine trials involving 537 patients met the inclusion criteria. LIA provides better pain relief and larger range of motion in TKA patients compared to epidural analgesia at the late postoperative period. No significant difference was observed in regard to the length of stay and complications. The current evidence shows that the use of local infiltration is effective for postoperative pain management in TKA patients. More high-quality randomized controlled trials with long-term follow-up are required for examining the long-term efficacy and safety of local infiltration.

Distance education course on spatial multi-hazard risk assessment, using Open Source software

NASA Astrophysics Data System (ADS)

van Westen, C. J.; Frigerio, S.

2009-04-01

As part of the capacity building activities of the United Nations University - ITC School on Disaster Geo-Information Management (UNU-ITC DGIM) the International Institute for Geoinformation Science and Earth Observation (ITC) has developed a distance education course on the application of Geographic Information Systems for multi-hazard risk assessment. This course is designed for academic staff, as well as for professionals working in (non-) governmental organizations where knowledge of disaster risk management is essential. The course guides the participants through the entire process of risk assessment, on the basis of a case study of a city exposed to multiple hazards, in a developing country. The courses consists of eight modules, each with a guide book explaining the theoretical background, and guiding the participants through spatial data requirements for risk assessment, hazard assessment procedures, generation of elements at risk databases, vulnerability assessment, qualitative and quantitative risk assessment methods, risk evaluation and risk reduction. Linked to the theory is a large set of exercises, with exercise descriptions, answer sheets, demos and GIS data. The exercises deal with four different types of hazards: earthquakes, flooding, technological hazards, and landslides. One important consideration in designing the course is that people from developing countries should not be restricted in using it due to financial burdens for software acquisition. Therefore the aim was to use Open Source software as a basis. The GIS exercises are written for the ILWIS software. All exercises have also been integrated into a WebGIS, using the Open source software CartoWeb (based on GNU License). It is modular and customizable thanks to its object-oriented architecture and based on a hierarchical structure (to manage and organize every package of information of every step required in risk assessment). Different switches for every component of the risk assessment course have been defined and through various menus the user can define the options for every exercise. For every layer of information tools for querying, printing, searching and surface analysis are implemented, allowing the option to compare maps at different scale and for on-line interpretations.

Quantifying the Risk of Analgesic-Related Adverse Events After Knee Arthroscopy.

PubMed

Gonzales, Jeff; Lovald, Scott T; Lau, Edmund C; Ong, Kevin L

Opioids are frequently used as part of multimodal pain management protocols for knee arthroscopy; however, their use may be associated with opioid-related adverse events. The purpose of this study was to evaluate the risk of potential analgesic-related complications after knee arthroscopy using a nationally representative database. Using 2010\\endash 2012 Medicare claims data, patients undergoing knee arthroscopy procedures (including ligament repair, meniscectomy, and chondroplasty) were identified. The risk of complications related to typical modalities of analgesia, including opioids, within 90 days following surgery was assessed using multivariate Cox regression. Based on follow-up of 16,567 cases, respiratory complications (bradypnea, pulmonary insufficiency, asphyxia, and hypoxemia) were the most frequently diagnosed complications ( n = 418; 2.52%), followed by postoperative nausea and vomiting ( n = 174; 1.05%) and urinary retention complications ( n = 166; 1.00%). Risk factors including older age, male gender, lower socioeconomic status, and a high number of comorbidities were associated with development of postsurgical complications.