Mayo Clinic experience with modified Vecchietti procedure for vaginal agenesis: it is easy, safe, and effective.

PubMed

Nahas, Samar; Yi, Johnny; Magrina, Javier

2013-01-01

To evaluate the surgical outcome and the anatomic and sexual function in 10 women with Rokitansky syndrome who underwent the laparoscopic Vecchietti procedure at our center. Retrospective analysis. Data were analyzed on the basis of short-term and long-term surgical outcome and sexual function. All patients underwent clinical follow-up at 1, 2, and 6 months after surgery. In all 10 patients, the procedure produced anatomic and functional success. The laparoscopic Vecchietti technique is safe, simple, and effective for treatment of vaginal agenesis. Results are comparable to those of all European studies, and the procedure should gain more popularity in North America. Copyright © 2013 AAGL. All rights reserved.

29 CFR 1919.29 - Limitations on safe working loads and proof loads.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) GEAR CERTIFICATION Certification of Vessels: Tests and Proof... pertinent limitations based on stability and/or on structural competence at particular radii. Safe working...

29 CFR 1919.29 - Limitations on safe working loads and proof loads.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) GEAR CERTIFICATION Certification of Vessels: Tests and Proof... pertinent limitations based on stability and/or on structural competence at particular radii. Safe working...

29 CFR 1919.29 - Limitations on safe working loads and proof loads.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) GEAR CERTIFICATION Certification of Vessels: Tests and Proof... pertinent limitations based on stability and/or on structural competence at particular radii. Safe working...

29 CFR 1919.29 - Limitations on safe working loads and proof loads.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) GEAR CERTIFICATION Certification of Vessels: Tests and Proof... pertinent limitations based on stability and/or on structural competence at particular radii. Safe working...

29 CFR 1919.29 - Limitations on safe working loads and proof loads.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) GEAR CERTIFICATION Certification of Vessels: Tests and Proof... pertinent limitations based on stability and/or on structural competence at particular radii. Safe working...

Exploring varieties of knowledge in safe work practices - an ethnographic study of surgical teams

PubMed Central

2011-01-01

Background Within existing research in health and medicine, the nature of knowledge on how teams conduct safe work practices has yet to be properly explored. Methods We address this concern by exploring the varieties in which knowledge is expressed during interdisciplinary surgical operations. Specifically, the study was conducted in a surgical section of a Norwegian regional general hospital, between January and April of 2010, by means of an ethnographic design combining detailed non-participant observations, conversations and semi-structured interviews. Results Based on an analysis of the gathered data, we identify three particular themes in how knowledge is expressed by operating room personnel: (i) the ability and variety individuals demonstrate in handling multiple sources of information, before reaching a particular decision, (ii) the variety of ways awareness or anticipation of future events is expressed, and (iii) the different ways sudden and unexpected situations are handled by the individual team members. Conclusions We conclude that these facets of knowledge bring different insights into how safe work practices are achieved at an individual and team level in surgical operations, thus adding to the existing understanding of the nature of knowledge in safe work practices in surgical operations. Future research should focus on exploring and documenting the relationships between various elements of knowledge and safe work practices, in different surgical settings and countries. PMID:21914183

Working, declarative and procedural memory in specific language impairment

PubMed Central

Lum, Jarrad A.G.; Conti-Ramsden, Gina; Page, Debra; Ullman, Michael T.

2012-01-01

According to the Procedural Deficit Hypothesis (PDH), abnormalities of brain structures underlying procedural memory largely explain the language deficits in children with specific language impairment (SLI). These abnormalities are posited to result in core deficits of procedural memory, which in turn explain the grammar problems in the disorder. The abnormalities are also likely to lead to problems with other, non-procedural functions, such as working memory, that rely at least partly on the affected brain structures. In contrast, declarative memory is expected to remain largely intact, and should play an important compensatory role for grammar. These claims were tested by examining measures of working, declarative and procedural memory in 51 children with SLI and 51 matched typically-developing (TD) children (mean age 10). Working memory was assessed with the Working Memory Test Battery for Children, declarative memory with the Children’s Memory Scale, and procedural memory with a visuo-spatial Serial Reaction Time task. As compared to the TD children, the children with SLI were impaired at procedural memory, even when holding working memory constant. In contrast, they were spared at declarative memory for visual information, and at declarative memory in the verbal domain after controlling for working memory and language. Visuo-spatial short-term memory was intact, whereas verbal working memory was impaired, even when language deficits were held constant. Correlation analyses showed neither visuo-spatial nor verbal working memory was associated with either lexical or grammatical abilities in either the SLI or TD children. Declarative memory correlated with lexical abilities in both groups of children. Finally, grammatical abilities were associated with procedural memory in the TD children, but with declarative memory in the children with SLI. These findings replicate and extend previous studies of working, declarative and procedural memory in SLI. Overall, we

Working safely with H5N1 viruses.

PubMed

García-Sastre, Adolfo

2012-01-01

Research on H5N1 influenza viruses has received much attention recently due to the possible dangers associated with newly developed avian H5N1 viruses that were derived from highly pathogenic avian viruses and are now transmissible among ferrets via respiratory droplets. An appropriate discussion, based on scientific facts about the risks that such viruses pose and on the biocontainment facilities and practices necessary for working safely with these viruses, is needed. Selecting the right level of biocontainment is critical for minimizing the risks associated with H5N1 research while simultaneously allowing an appropriately fast pace of discovery. Rational countermeasures for preventing the spread of influenza can be developed only by gaining a thorough knowledge of the molecular mechanisms at work in host specificity and transmission.

Examining procedural working memory processing in obsessive-compulsive disorder.

PubMed

Shahar, Nitzan; Teodorescu, Andrei R; Anholt, Gideon E; Karmon-Presser, Anat; Meiran, Nachshon

2017-07-01

Previous research has suggested that a deficit in working memory might underlie the difficulty of obsessive-compulsive disorder (OCD) patients to control their thoughts and actions. However, a recent meta-analyses found only small effect sizes for working memory deficits in OCD. Recently, a distinction has been made between declarative and procedural working memory. Working memory in OCD was tested mostly using declarative measurements. However, OCD symptoms typically concerns actions, making procedural working-memory more relevant. Here, we tested the operation of procedural working memory in OCD. Participants with OCD and healthy controls performed a battery of choice reaction tasks under high and low procedural working memory demands. Reaction-times (RT) were estimated using ex-Gaussian distribution fitting, revealing no group differences in the size of the RT distribution tail (i.e., τ parameter), known to be sensitive to procedural working memory manipulations. Group differences, unrelated to working memory manipulations, were found in the leading-edge of the RT distribution and analyzed using a two-stage evidence accumulation model. Modeling results suggested that perceptual difficulties might underlie the current group differences. In conclusion, our results suggest that procedural working-memory processing is most likely intact in OCD, and raise a novel, yet untested assumption regarding perceptual deficits in OCD. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

SUNRAYCE 1993: Working safely with lead-acid batteries and photovoltaic power systems

NASA Astrophysics Data System (ADS)

Dephillips, M. P.; Moskowitz, P. D.; Fthenakis, V. M.

1992-11-01

The US Department of Energy (DOE) is sponsoring SUNRAYCE 93 to advance tile technology and use of photovoltaics and electric vehicles. Participants will use cars powered by photovoltaic modules and lead-acid storage batteries. This brochure, prepared for students and faculty participating in this race, outlines the health hazards presented by these electrical systems and gives guidance on strategies for their safe usage. At the outset, it should be noted that working with photovoltaic systems and batteries requires electric vehicle drivers and technicians to have 'hands-on' contact with the car on a daily basis. It is important that no one work near a photovoltaic energy system or battery, either in a vehicle or on the bench, unless they familiarize themselves with the components in use and know and observe safe work practices including the safety precautions described in the manuals provided by the various equipment vendors and this document.

Sociotechnical attributes of safe and unsafe work systems.

PubMed

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

2015-01-01

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

Sociotechnical attributes of safe and unsafe work systems

PubMed Central

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

2015-01-01

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

Colorectal endoscopic submucosal dissection: Recent technical advances for safe and successful procedures

PubMed Central

Yamamoto, Katsumi; Michida, Tomoki; Nishida, Tsutomu; Hayashi, Shiro; Naito, Masafumi; Ito, Toshifumi

2015-01-01

Endoscopic submucosal dissection (ESD) is very useful in en bloc resection of large superficial colorectal tumors but is a technically difficult procedure because the colonic wall is thin and endoscopic maneuverability is poor because of colonic flexure and extensibility. A high risk of perforation has been reported in colorectal ESD. To prevent complications such as perforation and unexpected bleeding, it is crucial to ensure good visualization of the submucosal layer by creating a mucosal flap, which is an exfoliated mucosa for inserting the tip of the endoscope under it. The creation of a mucosal flap is often technically difficult; however, various types of equipment, appropriate strategy, and novel procedures including our clip-flap method, appear to facilitate mucosal flap creation, improving the safety and success rate of ESD. Favorable treatment outcomes with colorectal ESD have already been reported in many advanced institutions, and appropriate understanding of techniques and development of training systems are required for world-wide standardization of colorectal ESD. Here, we describe recent technical advances for safe and successful colorectal ESD. PMID:26468335

[Rural work and health risks: a review into de "safe use" of pesticides in Brazil].

PubMed

de Abreu, Pedro Henrique Barbosa; Alonzo, Herling Gregorio Aguilar

2014-10-01

The paradigm of the "safe use" of pesticides is based on measures to control risks in the handling of these products. However, studies carried out in various regions of Brazil reveal a situation of widespread exposure and health damages among rural workers, revealing the ineffectiveness of this paradigm. This work presents a critical review of the "safe use" approach for pesticides in scientific papers published in Brazil in the past 15 years. Results indicate that these studies do not address, simultaneously, all the work activities that involve exposure and risk of intoxication (acquisition, transportation, storage, preparation and application, final disposal of empty containers and sanitization of contaminated clothes/ PPEs), nor do they comprehensively address the "safe use" measures recommended in safety manuals, which are mandatory for each activity. A total of 25 studies were selected and analyzed, revealing a high number of results and analyses regarding activities of preparation and application and final disposal of empty containers. The range of the approaches was seen to be timely in the six work activities. For future studies, a broader approach of the "safe use" of pesticides is recommended, seeking to reveal the complete infeasibility of this safety paradigm.

Resection and primary anastomosis without diverting ileostomy for left colon emergencies: is it a safe procedure?

PubMed

Jiménez Fuertes, Montiel; Costa Navarro, David

2012-05-01

Large-bowel obstruction and perforation are still frequently occurring entities for the acute care surgeon. In these cases, Hartmann's procedure is the most commonly used surgical technique. However, recent papers demonstrate that colon resection and primary anastomosis (RPA) in the emergency setting is a safe and feasible procedure. We present our series of left colon resection and primary anastomosis procedures from Torrevieja Hospital (Alicante, Spain), performed without bowel irrigation or a diverting ileostomy. Thirty-two RPA procedures were performed in emergency settings for perforation or obstruction, or both, during an 18-month period. The following data were prospectively collected: age, gender, nationality, diagnoses, ASA score, body mass index (BMI), POSSUM score (Physiological and Operative Severity Score for the enumeration of Mortality and morbidity), and the score according to the Hinchey classification. Furthermore, duration of the operation, length of postoperative hospital stay, and mortality and morbidity data were recorded. Sixteen of these patients were diagnosed with acute diverticulitis, 14 patients with neoplasm (of which 9 cases had obstruction, 2 cases had perforation, and 3 cases had both), and foreign body perforation in the remaining 2 cases. The mean hospital stay was 7.8 (range, 4-10) days. The physiological POSSUM score was 24.4 (range, 15-39), and the surgical POSSUM score was 19.8 (range, 16-24). None of the patients died (0% mortality). Seven patients developed some kind of complication (21.9%), all of which were managed conservatively. The results of this study suggest that RPA for left colon obstruction and perforation in emergency settings can be safely performed in certain surgical conditions.

Proposal for an Evaluation Method for the Performance of Work Procedures.

PubMed

Mohammed, Mouda; Mébarek, Djebabra; Wafa, Boulagouas; Makhlouf, Chati

2016-12-01

Noncompliance of operators with work procedures is a recurrent problem. This human behavior has been said to be situational and studied by many different approaches (ergonomic and others), which consider the noncompliance with work procedures to be obvious and seek to analyze its causes as well as consequences. The object of the proposed method is to solve this problem by focusing on the performance of work procedures and ensuring improved performance on a continuous basis. This study has multiple results: (1) assessment of the work procedures' performance by a multicriteria approach; (2) the use of a continuous improvement approach as a framework for the sustainability of the assessment method of work procedures' performance; and (3) adaptation of the Stop-Card as a facilitator support for continuous improvement of work procedures. The proposed method emphasizes to put in value the inputs of continuous improvement of the work procedures in relation with the conventional approaches which adopt the obvious evidence of the noncompliance to the working procedures and seek to analyze the cause-effect relationships related to this unacceptable phenomenon, especially in strategic industry.

DroidSafe

DTIC Science & Technology

2016-12-01

branches of our work . 3.1 Understanding Sensitive API Call and API Information Usage Android applications are written in a type- safe language (Java...directly invoke resolved targets. Because DroidSafe works with a comprehensive model of the Android environment , it supports precise resolution of...STATEMENT. FOR THE CHIEF ENGINEER: / S / / S / MARK K. WILLIAMS WARREN H. DEBANY, JR. Work Unit Manager

Safe Schools, Safe Communities.

ERIC Educational Resources Information Center

Lewis, Julie E.; Pickett, Dean; Pulliam, Janet L.; Schwartz, Richard A.; St. Germaine, Anne-Marie; Underwood, Julie; Worona, Jay

Schools must work together with agencies, groups, and individuals to eliminate the forces leading children to violence. Chapter 1, "School Safety: Working Together to Keep Schools Safe," stresses the importance of community collaboration in violence prevention. Effective prevention requires sharing information about students, consistent…

Safe and secure at work?: findings from the 2002 Workplace Risk Supplement.

PubMed

Jenkins, E Lynn; Fisher, Bonnie S; Hartley, Dan

2012-01-01

To examine employee's perception of safety and related workplace safety and prevention issues, including their use of self-protection measures and victimization experience. The Workplace Risk Supplement (WRS) to the National Crime Victimization Survey (NCVS) was administered to 55,158 employed respondents who were 16 years or older. Trained U.S. Census Bureau interviewers administered the WRS in all households selected for the NCVS during the 6-month reference period from January through June 2002. Responses from the 55,158 WRS respondents were weighted to obtain national estimates, resulting in 142,410,858 cases. The demographic distribution of WRS respondents is very similar to that of the U.S. labor force. Seven percent of respondents reported that they worried about someone in their workplace attacking them, while nearly 4% experienced victimization. The majority indicated that they felt that their workplace, the neighborhood around their workplace, and places they traveled to as part of their job were either "Very Safe" or "Somewhat Safe" from crime. Six percent carried some type of self protection while at work although this varied by occupation. Employees largely feel safe from violence while working. Differences in victimization by occupation bolster efforts to focus workplace violence prevention in high-risk occupations.

Lessons Learned "Establishing an Electrically Safe Work Condition" Specifically related to Racking Electrical Breakers

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

Martinez, Tommy Robert; Romero, Philbert Roland; Garcia, Samuel Anthony

During low voltage electrical equipment maintenance, a bad breaker was identified. The breaker was racked out from the substation cubicle without following the hazardous energy control process identified in the Integrated Work Document (IWD). The IWD required the substation to be in an electrically safe work condition prior to racking the breaker. Per NFPA 70E requirements, electrical equipment shall be put into an electrically safe work condition before an employee performs work on or interacts with equipment in a manner that increases the likelihood of creating an arc flash. Racking in or out a breaker on an energized bus maymore » increase the likelihood of creating an arc flash dependent on equipment conditions. A thorough risk assessment must be performed prior to performing such a task. The risk assessment determines the risk control measures to be put in place prior to performing the work. Electrical Safety Officers (ESO) can assist in performing risk assessments and incorporating risk control measures.« less

Safe working hours--doctors in training a best practice issue.

PubMed

Lewis, Andrew

2002-01-01

In 1995, the Australian Medical Association launched its Safe Working Hours campaign. By 1998, this had been developed into a National Code of Conduct that continues to resonate in the Australian public health system. However, and particularly in respect of Doctors in Training (DITs) who continue to work long hours, there are levels of resistance to proposals that seek to re-organise work or change prevailing professional and cultural expectations. Long working hours have substantial impacts on a DIT's capacity to consistently deliver high quality patient care, dilute the effectiveness of their training regime and have negative consequences on their health, social life and family responsibilities. While public hospitals often maintain the view that minimal budget flexibility restricts their capacity to affect change in a positive way, in fact devisable productivity and efficiency gains can be achieved by reducing working hours. Further, the medical profession needs to consider whether long hours provide an optimal environment for quality learning and performance.

SOME PROBLEMS OF "SAFE DOSE" ESTIMATION

EPA Science Inventory

In environmental carcinogenic risk assessment, the usually defined "safe doses" appear subjective in some sense. n this paper a method of standardizing "safe doses" based on some objective parameters is introduced and a procedure of estimating safe doses under the competing risks...

29 CFR 1919.75 - Determination of crane or derrick safe working loads and limitations in absence of manufacturer's...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 7 2011-07-01 2011-07-01 false Determination of crane or derrick safe working loads and limitations in absence of manufacturer's data. 1919.75 Section 1919.75 Labor Regulations Relating to Labor... Certification of Shore-Based Material Handling Devices § 1919.75 Determination of crane or derrick safe working...

29 CFR 1919.75 - Determination of crane or derrick safe working loads and limitations in absence of manufacturer's...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 7 2010-07-01 2010-07-01 false Determination of crane or derrick safe working loads and limitations in absence of manufacturer's data. 1919.75 Section 1919.75 Labor Regulations Relating to Labor... Certification of Shore-Based Material Handling Devices § 1919.75 Determination of crane or derrick safe working...

How Safe Are Kid-Safe Search Engines?

ERIC Educational Resources Information Center

Masterson-Krum, Hope

2001-01-01

Examines search tools available to elementary and secondary school students, both human-compiled and crawler-based, to help direct them to age-appropriate Web sites; analyzes the procedures of search engines labeled family-friendly or kid safe that use filters; and tests the effectiveness of these services to students in school libraries. (LRW)

Safe procedure development to manage hazardous drugs in the workplace.

PubMed

Gaspar Carreño, Marisa; Achau Muñoz, Rubén; Torrico Martín, Fátima; Agún Gonzalez, Juan José; Sanchez Santos, Jose Cristobal; Cercos Lletí, Ana Cristina; Ramos Orozco, Pedro

2017-03-01

To develop a safety working procedure for the employees in the Intermutual Hospital de Levante (HIL) in those areas of activity that deal with the handling of hazardous drugs (MP). The procedure was developed in six phases: 1) hazard definition; 2) definition and identification of processes and development of general correct work practices about hazardous drugs' selection and special handling; 3) detection, selection and set of specific recommendations to handle with hazardous drugs during the processes of preparation and administration included in the hospital GFT; 4) categorization of risk during the preparation/administration and development of an identification system; 5) information and training of professionals; 6) implementation of the identification measures and prevention guidelines. Six processes were detected handling HD. During those processes, thirty HD were identified included in the hospital GFT and a safer alternative was found for 6 of them. The HD were classified into 4 risk categories based on those measures to be taken during the preparation and administration of each of them. The development and implementation of specific safety-work processes dealing with medication handling, allows hospital managers to accomplish effectively with their legal obligations about the area of prevention and provides healthcare professional staff with the adequate techniques and safety equipment to avoid possible dangers and risks of some drugs. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Safe procedure in endoscopic submucosal dissection for colorectal tumors focused on preventing complications

PubMed Central

Yoshida, Naohisa; Yagi, Nobuaki; Naito, Yuji; Yoshikawa, Toshikazu

2010-01-01

Endoscopic submucosal dissection (ESD) is efficient for en bloc resection of large colorectal tumors. However, it has several technical difficulties, because the wall of the colon is thin and due to the winding nature of the colon. The main complications of ESD comprise postoperative perforation and hemorrhage, similar to endoscopic mucosal resection (EMR). In particular, the rate of perforation in ESD is higher than that in EMR. Perforation of the colon can cause fatal peritonitis. Endoscopic clipping is reported to be an efficient therapy for perforation. Most cases with perforation are treated conservatively without urgent surgical intervention. However, the rate of postoperative hemorrhage in ESD is similar to that in EMR. Endoscopic therapy including endoscopic clipping is performed and most of the cases are treated conservatively without blood transfusion. In blood examination, some degree of inflammation is detected after ESD. For the standardization of ESD, it is most important to decrease the rate of perforation. Adopting a safe strategy for ESD and a suitable choice of knife are both important ways of preventing perforation. Moreover, appropriate training and increasing experience can improve the endoscopic technique and can decrease the rate of perforation. In this review, we describe safe procedures in ESD to prevent complications, the complications of ESD and their management. PMID:20379999

Are the surgeons safe during UV-A radiation exposure in collagen cross-linking procedure?

PubMed

Shetty, Rashmi; Shetty, Rohit; Mahendradas, Padmamalini; Shetty, Bhujang K

2012-02-01

To quantify the effect of scattered UV-A radiation used in the collagen cross-linking (CXL) procedure and the amount of radiation reaching the surgeon and the surrounding area and to estimate the dampening effect by various protective devices. In this case series, 3 patients [aged 25-30 (±2.5) years] with keratoconus underwent a CXL procedure with UV-A light and riboflavin. Irradiance was measured using a spectrometer (Model USB2000; Ocean Optics, Inc) for various distances from the source, at various angles, and for different durations of radiation. The spectrometer was also used to measure the dampening effect produced by gown, latex gloves, and UV-protective glasses. Maximum UV-A radiation (1.4 × 10(-9) mW/cm(2)) was measured at 2 cm from the limbus, when the probe was held at a 45-degree angle to the floor. UV-A radiation reaching the surgeon's eye and the abdomen was 3.403 × 10(-11) and 2.36 × 10(-11) mW/cm(2), respectively. Gown, latex gloves, and UV-protective glasses showed dampening effects of 99.58%, 95.01%, and 99.73%, respectively. CXL appears to be a safe procedure with respect to UV-A radiation exposure to the surgeon. Further safety can be ensured by UV-protective devices.

Laparoscopy is safe among patients with congestive heart failure undergoing general surgery procedures.

PubMed

Speicher, Paul J; Ganapathi, Asvin M; Englum, Brian R; Vaslef, Steven N

2014-08-01

Over the past 2 decades, laparoscopy has been established as a superior technique in many general surgery procedures. Few studies, however, have examined the impact of the use of a laparoscopic approach in patients with symptomatic congestive heart failure (CHF). Because pneumoperitoneum has known effects on cardiopulmonary physiology, patients with CHF may be at increased risk. This study examines current trends in approaches to patients with CHF and effects on perioperative outcomes. The 2005-2011 National Surgical Quality Improvement Program Participant User File was used to identify patients who underwent the following general surgery procedures: Appendectomy, segmental colectomy, small bowel resection, ventral hernia repair, and splenectomy. Included for analysis were those with newly diagnosed CHF or chronic CHF with new signs or symptoms. Trends of use of laparoscopy were assessed across procedure types. The primary endpoint was 30-day mortality. The independent effect of laparoscopy in CHF was estimated with a multiple logistic regression model. A total of 265,198 patients were included for analysis, of whom 2,219 were identified as having new or recently worsened CHF. Of these patients, there were 1,300 (58.6%) colectomies, 486 (21.9%) small bowel resections, 216 (9.7%) ventral hernia repairs, 141 (6.4%) appendectomies, and 76 (3.4%) splenectomies. Laparoscopy was used less frequently in patients with CHF compared with their non-CHF counterparts, particularly for nonelective procedures. Baseline characteristics were similar for laparoscopy versus open procedures with the notable exception of urgent/emergent case status (36.4% vs 71.3%; P < .001). After multivariable adjustment, laparoscopy seemed to have a protective effect against mortality (adjusted odds ratio, 0.45; P = .04), but no differences in other secondary endpoints. For patients with CHF, an open operative approach seems to be utilized more frequently in general surgery procedures, particularly

Laparoscopy is safe among patients with congestive heart failure undergoing general surgery procedures

PubMed Central

Speicher, Paul J.; Ganapathi, Asvin M.; Englum, Brian R.; Vaslef, Steven N.

2015-01-01

general surgery procedures, particularly in urgent/emergent cases. Despite these patterns and apparent preferences, laparoscopy seems to offer a safe alternative in appropriately selected patients. Because morbidity and mortality were considerable regardless of approach, further understanding of appropriate management in this population is necessary. PMID:24947641

Procedures and Standards Handbook. Version 3.0. What Works Clearinghouse

ERIC Educational Resources Information Center

What Works Clearinghouse, 2014

2014-01-01

This "What Works Clearinghouse Procedures and Standards Handbook (Version 3.0)" provides a detailed description of the standards and procedures of the What Works Clearinghouse (WWC). The remaining chapters of this Handbook are organized to take the reader through the basic steps that the WWC uses to develop a review protocol, identify…

Procedure-Authoring Tool Improves Safety on Oil Rigs

NASA Technical Reports Server (NTRS)

2014-01-01

Dark, cold, and dangerous environments are plentiful in space and on Earth. To ensure safe operations in difficult surroundings, NASA relies heavily on procedures written well ahead of time. Houston-based TRACLabs Inc. worked with Ames Research Center through the SBIR program to create an electronic procedure authoring tool, now used by NASA and companies in the oil and gas industry.

The safe home project.

PubMed

Arphorn, Sara; Jiraniratisai, Sopaphan; Rungtakul, Rungsri; Phutta, Nikom

2011-12-01

The Thai Health Promotion Foundation supported the Improvement of Quality of Life of Informal Workers project in Ban Luang District, Amphur Photaram, Ratchaburi Province. There were many informal workers in Ban Luang District. Sweet-crispy fish producers in Ban Luang were the largest group among the sweet-crispy fish producers in Thailand. This project was aimed at improving living and working conditions of informal workers, with a focus on the sweet-crispy fish group. Good practices of improved living and working conditions were used to help informal workers build safe, healthy and productive work environments. These informal workers often worked in substandard conditions and were exposed to various hazards in the working area. These hazards included risk of exposure to hot work environment, ergonomics-related injuries, chemical hazards, electrical hazards etc. Ergonomics problems were commonly in the sweet-crispy fish group. Unnatural postures such as prolonged sitting were performed dominantly. One hundred and fifty informal workers participated in this project. Occupational health volunteers were selected to encourage occupational health and safety in four groups of informal workers in 2009. The occupational health volunteers trained in 2008 were farmers, beauty salon workers and doll makers. The occupational health and safety knowledge is extended to a new informal worker group: sweet-crispy fish producer, in 2009. The occupational health and safety training for sweet-crispy fish group is conducted by occupational health volunteers. The occupational health volunteers increased their skills and knowledge assist in to make safe home and safe community through participatory oriented training. The improvement of living and working condition is conducted by using a modified WISH, Work Improvement for Safe Home, checklist. The plans of improvement were recorded. The informal workers showed improvement mostly on material handling and storage. The safe uses and safe

Safe Hazmat Storage Tips.

ERIC Educational Resources Information Center

Neville, Angela

1996-01-01

Provides a list of recommendations for safely managing hazardous waste containers. Encourages training of employees on the hazards of the wastes they handle and the correct procedures for managing containers. (DDR)

Picture Me Safe

ERIC Educational Resources Information Center

Irvin, Daniel W.

1977-01-01

The validity of well-written articles can be destroyed by poor illustration, especially when the pictures show unsafe practices. The responsibility lies with the author to provide clear printable pictures showing safe working environments and safe practices. (Editor)

23 CFR 630.1106 - Policy and procedures for work zone safety management.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false Policy and procedures for work zone safety management... Policy and procedures for work zone safety management. (a) Each agency's policy and processes, procedures... established in accordance with 23 CFR 630.1006, shall include the consideration and management of road user...

Open lung biopsy performed in idiopathic pulmonary fibrosis is a safe procedure

PubMed Central

Halman, Joanna; Taniewska, Sonia; Burzyńska, Natalia; Piekarska, Anna; Sawicka, Wioletta

2017-01-01

Introduction Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease with a fatal prognosis. The diagnosis is made on the basis of high-resolution computed tomography and histological examination in selected cases. Aim To determine the risk of complications of open lung biopsy performed in patients with IPF. Material and methods We performed a retrospective analysis of 51 patients who underwent diagnostic excision of pulmonary parenchyma due to IPF in the period 1995–2014. We assessed the complication rate, length of drainage, postoperative period and 30-day mortality. We compared the results of treatment in the groups of patients operated on with thoracotomy and videothoracoscopy. Results The mean age of patients was 58 (47% female, 53% male) forced vital capacity (FVC) was 81%, forced expiratory volume in 1 s (FEV1) was 80% and body mass index (BMI) was 27 kg/m2. Thoracotomies (lateral, muscle sparing or anterior) were performed in 20 patients between 1995 and 2012 and videothoracoscopy in 31 patients operated on in the years 2009–2014. Patients in study groups did not differ considering age (p = 0.40), gender (p = 0.81), FVC (p = 0.08), FEV1 (p = 0.13) or BMI (p = 0.75). Postoperative complications occurred in 3.9% of patients (atrial arrhythmia 1.9% and recurrent pneumothorax 1.9%) with equal incidence in both study groups (p = 0.75). Median stay after thoracotomy was 4 days while after videothoracoscopy it was 3 days (p = 0.04). Conclusions Open lung biopsy performed on patients with IPF is a safe procedure. Open lung biopsy performed through thoracotomy could be as safe as through VATS, however is characterized by longer postoperative stay. PMID:29354175

Chapter 8. Medical procedures. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Zimmerman, Janice L; Sprung, Charles L

2010-04-01

To provide recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza pandemic or mass disaster with a specific focus on ensuring that adequate resources are available and appropriate protocols are developed to safely perform procedures in patients with and without influenza illness. Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including performing medical procedures. Key recommendations include: (1) specify high-risk procedures (aerosol generating-procedures); (2) determine if certain procedures will not be performed during a pandemic; (3) develop protocols for safe performance of high-risk procedures that include appropriateness, qualifications of personnel, site, personal protection equipment, safe technique and equipment needs; (4) ensure adequate training of personnel in high-risk procedures; (5) procedures should be performed at the bedside whenever possible; (6) ensure safe respiratory therapy practices to avoid aerosols; (7) provide safe respiratory equipment; and (8) determine criteria for cancelling and/or altering elective procedures. Judicious planning and adoption of protocols for safe performance of medical procedures are necessary to optimize outcomes during a pandemic.

Safe Disposal of Highly Reactive Chemicals.

ERIC Educational Resources Information Center

Lunn, George; Sansone, Eric B.

1994-01-01

Provides specific procedures for the disposal of a variety of highly reactive chemicals and reports the results of a study of their safe disposal. Disposal of some problematic sulfur-containing compounds are included. Procedures are based on a combination of literature review and author development. (LZ)

Safe Manual Jettison

NASA Technical Reports Server (NTRS)

Barton, Jay

2008-01-01

In space, the controlled release of certain cargoes is no less useful than the maritime jettisons from which they take their name but is also much more dangerous. Experience has shown that jettisons can be performed safely, but the process is complicated with the path to performing a jettison taking months or even years. In the background, time is also required to write procedures, train the crew, configure the vehicle, and many other activities. This paper outlines the current process used by the National Aeronautics and Space Administration (NASA) for manual jettisons, detailing the methods used to assure that the jettisons and the jettisoned objects are as safe as achievable and that the crew is adequately trained to be able to affect the safe jettison. The goal of this paper is not only to capture what it takes to perform safe jettisons in the near Earth environment but to extrapolate this knowledge to future space exploration scenarios that will likely have Extravehicular Activity (EVA) and International Partner (IP) interfaces.

Transfascial vaginal tape (TFT): a simple, safe and cost-effective procedure for stress urinary incontinence. A preliminary study.

PubMed

Foglia, Giovanni; Mistrangelo, Emanuela; Lijoi, Davide; Alessandri, Franco; Ragni, Nicola

2007-07-01

To analyse prospectively the effectiveness of a new simple, minimally invasive, and cost-effective technique for the treatment of female urinary stress incontinence: the transfascial vaginal tape (TFT). In a prospective study, we enrolled 45 women undergoing TFT with or without hysterectomy and/or another pelvic reconstructive procedure between 1st December 2003 and 31st December. TFT consists of a tension-free urethrosuspension using a sling located at the mid-urethral level and placed laterally in the endopelvic fascia previously perforated. Follow-up evaluations were established at 3 and 6 months and at 1 year after the operation. During each follow-up, women underwent cough stress test and they answered to the "Incontinence quality of life questionnaire" (I-QOL), to the Patient Global Impression of Severity (PGI-S) and of Improvement (PGI-I) questions. Thirty-nine patients (88.9%) had a follow-up examination 1 year after surgery. Of these, 30 (76.9%) were defined cured, 6 (15.4%) improved and 3 (7.7%) failed. TFT procedure can be considered a simple, safe and cost-effective procedure for the treatment of stress urinary incontinence and can be an alternative to tension-free vaginal tape or transobturator route for sub-urethral tape procedures.

Office-based endovascular suite is safe for most procedures.

PubMed

Jain, Krishna; Munn, John; Rummel, Mark C; Johnston, Dan; Longton, Chris

2014-01-01

This study was conducted to identify the safety of endovascular procedures in the office endovascular suite and to assess patient satisfaction in this setting. Between May 22, 2007, and December 31, 2012, 2822 patients underwent 6458 percutaneous procedures in an office-based endovascular suite. Demographics of the patients, complications, hospital transfers, and 30-day mortality were documented in a prospective manner. Follow-up calls were made, and a satisfaction survey was conducted. Almost all dialysis procedures were done under local anesthesia and peripheral arterial procedures under conscious sedation. All patients, except those undergoing catheter removals, received hydrocodone and acetaminophen (5/325 mg), diazepam (5-10 mg), and one dose of an oral antibiotic preprocedure and three doses postprocedure. Patients who required conscious sedation received fentanyl and midazolam. Conscious sedation was used almost exclusively in patients having an arterial procedure. Measurements of blood urea nitrogen, creatinine, international normalized ratio, and partial thromboplastin time were performed before peripheral arteriograms. All other patients had no preoperative laboratory tests. Patients considered high risk (American Society of Anesthesiologists Physical Status Classification 4), those who could not tolerate the procedure with mild to moderate conscious sedation, patients with a previous bad experience, or patients who weighed >400 pounds were not candidates for office based procedures. There were 54 total complications (0.8%): venous, 2.2%; aortogram without interventions, 1%; aortogram with interventions, 2.7%; fistulogram, 0.5%; catheters, 0.3%; and venous filter-related, 2%. Twenty-six patients required hospital transfer from the office. Ten patients needed an operative intervention because of a complication. No procedure-related deaths occurred. There were 18 deaths in a 30-day period. Of patients surveyed, 99% indicated that they would come back to the

Adoption of Sun Safe Work Place Practices by Local Governments

PubMed Central

Wallis, Allan; Andersen, Peter A.; Buller, David B.; Walkosz, Barbara; Lui, Lucia; Buller, Mary; Scott, Michael D.; Jenkins, Rob

2014-01-01

Context Outdoor workers are especially susceptible to skin cancer, the most common, but also one of the most preventable, forms of cancer. Colorado, the location of the study, has the second highest rate of skin cancer deaths in the nation. Objective Local government managers in Colorado—in municipalities, counties and special districts—were surveyed in order to ascertain the extent to which they engage in formal (written) and informal practices to protect their outdoor workers against excessive exposure to sun. Design The survey consisted of 51 question assessing awareness of formal or informal practices for sun protection of outdoor workers. An index of practices--the study's dependent variable--was created that was comprised or practices such as providing employees free or reduced-cost sunscreen, wide-brimmed hats, sunglasses, long-sleeved work shirts, long work pants, and temporary or permanent outdoor shade shelters. Proscriptive policies, such as restricting the use of broad brimmed hats, were subtracted from the index. Surveys were completed by 825 administrators representing 98 jurisdictions. Responses from administrators in the same jurisdiction were averaged. Results Over 40 percent of responding jurisdictions indicated that they engaged in informal sun safety practices. Tests conducted to determine what variables might account for the adoption of these sun protection practices found that the degree to which a community could be regarded as cosmopolite and as having an individualistic political culture were significant predictors. Type of government was also significant. Although, higher community income was a significant predictor, neither local government budget nor size was significant. Conclusions The adoption of sun safe practices bears low costs with potentially high returns. Findings from this study suggest that awareness campaigns might most effectively target cosmopolite communities, but that the greatest impact might be achieved by targeting

Asymptotically safe standard model extensions?

NASA Astrophysics Data System (ADS)

Pelaggi, Giulio Maria; Plascencia, Alexis D.; Salvio, Alberto; Sannino, Francesco; Smirnov, Juri; Strumia, Alessandro

2018-05-01

We consider theories with a large number NF of charged fermions and compute the renormalization group equations for the gauge, Yukawa and quartic couplings resummed at leading order in 1 /NF. We construct extensions of the standard model where SU(2) and/or SU(3) are asymptotically safe. When the same procedure is applied to the Abelian U(1) factor, we find that the Higgs quartic can not be made asymptotically safe and stay perturbative at the same time.

Supporting the future nuclear workforce with computer-based procedures

DOE PAGES

Oxstrand, Johanna; Le Blanc, Katya

2016-05-01

Here we see that computer-based tools have dramatically increased ease and efficiency of everyday tasks. Gone are the days of paging through a paper catalog, transcribing product numbers, and calculating totals. Today, a consumer can find a product online with a simple search engine, and then purchase it in a matter of a few clicks. Paper catalogs have their place, but it is hard to imagine life without on-line shopping sites. All tasks conducted in a nuclear power plant are guided by procedures, which helps ensure safe and reliable operation of the plants. One prominent goal of the nuclear industrymore » is to minimize the risk of human errors. To achieve this goal one has to ensure tasks are correctly and consistently executed. This is partly achieved by training and by a structured approach to task execution, which is provided by procedures and work instructions. Procedures are used in the nuclear industry to direct workers' actions in a proper sequence. The governing idea is to minimize the reliance on memory and choices made in the field. However, the procedure document may not contain sufficient information to successfully complete the task. Therefore, the worker might have to carry additional documents such as turnover sheets, operation experience, drawings, and other procedures to the work site. The nuclear industry is operated with paper procedures like paper catalogs of the past. A field worker may carry a large stack of documents needed to complete a task to the field. Even though the paper process has helped keep the industry safe for decades, there are limitations to using paper. Paper procedures are static (i.e., the content does not change after the document is printed), difficult to search, and rely heavily on the field worker’s situational awareness and ability to consistently meet the high expectation of human performance excellence. With computer-based procedures (CBPs) that stack of papers may be reduced to the size of a small tablet or even

Supporting the future nuclear workforce with computer-based procedures

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

Oxstrand, Johanna; Le Blanc, Katya

Here we see that computer-based tools have dramatically increased ease and efficiency of everyday tasks. Gone are the days of paging through a paper catalog, transcribing product numbers, and calculating totals. Today, a consumer can find a product online with a simple search engine, and then purchase it in a matter of a few clicks. Paper catalogs have their place, but it is hard to imagine life without on-line shopping sites. All tasks conducted in a nuclear power plant are guided by procedures, which helps ensure safe and reliable operation of the plants. One prominent goal of the nuclear industrymore » is to minimize the risk of human errors. To achieve this goal one has to ensure tasks are correctly and consistently executed. This is partly achieved by training and by a structured approach to task execution, which is provided by procedures and work instructions. Procedures are used in the nuclear industry to direct workers' actions in a proper sequence. The governing idea is to minimize the reliance on memory and choices made in the field. However, the procedure document may not contain sufficient information to successfully complete the task. Therefore, the worker might have to carry additional documents such as turnover sheets, operation experience, drawings, and other procedures to the work site. The nuclear industry is operated with paper procedures like paper catalogs of the past. A field worker may carry a large stack of documents needed to complete a task to the field. Even though the paper process has helped keep the industry safe for decades, there are limitations to using paper. Paper procedures are static (i.e., the content does not change after the document is printed), difficult to search, and rely heavily on the field worker’s situational awareness and ability to consistently meet the high expectation of human performance excellence. With computer-based procedures (CBPs) that stack of papers may be reduced to the size of a small tablet or even

Oral Surgical Procedures Performed Safely in Patients With Head and Neck Arteriovenous Malformations: A Retrospective Case Series of 12 Patients.

PubMed

Karim, Abdul Basit; Lindsey, Sean; Bovino, Brian; Berenstein, Alejandro

2016-02-01

This case series describes patients with head and neck arteriovenous malformations who underwent oral and maxillofacial surgical procedures combined with interventional radiology techniques to minimize blood loss. Twelve patients underwent femoral cerebral angiography to visualize the extent of vascular malformation. Before the surgical procedures, surgical sites were devascularized by direct injection of hemostatic or embolic agents. Direct puncture sclerotherapy at the base of surgical sites was performed using Surgiflo or n-butylcyanoacrylate glue. Surgical procedures were carried out in routine fashion. A hemostatic packing of FloSeal, Gelfoam, and Avitene was adapted to the surgical sites. Direct puncture sclerotherapy with Surgiflo or n-butylcyanoacrylate glue resulted in minimal blood loss intraoperatively. Local application of the FloSeal, Gelfoam, and Avitene packing sustained hemostasis and produced excellent healing postoperatively. Patients with arteriovenous malformations can safely undergo routine oral and maxillofacial surgical procedures with minimal blood loss when appropriate endovascular techniques and local hemostatic measures are used by the interventional radiologist and oral and maxillofacial surgeon. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Safe working practices and HIV infection: knowledge, attitudes, perception of risk, and policy in hospital.

PubMed Central

Davidson, G; Gillies, P

1993-01-01

OBJECTIVES--To assess the knowledge, attitudes, and perceptions of risk of occupational HIV transmission in hospital in relation to existing guidelines. DESIGN--Cross sectional anonymous questionnaire survey of all occupational groups. SETTING--One large inner city teaching hospital. SUBJECTS--All 1530 staff working in the hospital in October 1991 and 22 managers. MAIN MEASURES--Knowledge of safe working practices and hospital guidelines; attitudes towards patients with AIDS; perception of risk of occupational transmission of HIV; availability of guidelines. RESULTS--The response rate in the questionnaire survey was 63% (958/1530). Although staff across all occupational groups knew of the potential risk of infection from needlestick injury (98%, 904/922), significantly more non-clinical staff (ambulance, catering, and domestic staff) than clinical staff (doctors, nurses, and paramedics) thought HIV could be transmitted by giving blood (38%, 153/404 v 12%, 40/346; chi 2 = 66.1 p < 0.001); one in ten clinical staff believed this. Except for midwives, half of staff in most occupational groups and 19% (17/91) of doctors and 22% (28/125) of nurses thought gloves should be worn in all contacts with people with AIDS. Most staff (62%, 593/958), including 38% (36/94) of doctors and 52% (67/128) of nurses thought patients should be routinely tested on admission, 17% of doctors and 19% of nurses thought they should be isolated in hospital. One in three staff perceived themselves at risk of HIV. Midwives, nurses, and theatre technicians were most aware of guidelines for safe working compared with only half of doctors, ambulance, and paramedical staff and no incinerator staff. CONCLUSIONS--Policy guidelines for safe working practices for patients with HIV infection and AIDS need to be disseminated across all occupational groups to reduce negative staff attitudes, improve knowledge of occupational transmission, establish an appropriate perception of risk, and create a supportive

National CPS Certification | A Program of Safe Kids Worldwide

Science.gov Websites

the Tech! ABOUT THE PROGRAM National CPS Certification Training is a program of Safe Kids Worldwide ; E-Vouchers FAQS/HELP FAQs Fees Forms Policies & Procedures Who We Are NHTSA Safe Kids CPS-board State Farm Follow us on Facebook Copyright © 2017 by Safe Kids Worldwide - Child Passenger Safety

[Safe school].

PubMed

Liberal, Edson Ferreira; Aires, Roberto Tschoepke; Aires, Mariana Tschoepke; Osório, Ana Carla de Albuquerque

2005-11-01

To review the strategies to make school a safe environment. The paper first addresses the social context of accidents and violence in the school environment, and makes recommendations, based on the literature data, for the implementation of safe schools. Articles published between 1993 and 2005 in the MEDLINE database. Brazilian epidemiological and literature data have also been searched. There is growing evidence that intervention has multiple components, focusing on health education practices, with the participation of the whole community. The aim of those interventions is to help students and community members to adopt healthy and safe behaviors. Schools are taking on an increasing role in health promotion, disease prevention, and injury prevention. In the context of prevention of external causes of morbidity and mortality, it is important to recognize a risky environment, places, and risk behaviors as favorable to injury and violence, as well as the concept of accident as something one can avoid. Implementation of safe schools represents a promising new direction for school-based preventive work. It is important to note that a safe school should intervene not only in its physical structure, but it should also make it as safe as possible by gathering the school community through health education, and mainly encouraging healthy behavior.

Safe and accurate midcervical pedicle screw insertion procedure with the patient-specific screw guide template system.

PubMed

Kaneyama, Shuichi; Sugawara, Taku; Sumi, Masatoshi

2015-03-15

Clinical trial for midcervical pedicle screw insertion using a novel patient-specific intraoperative screw guiding device. To evaluate the availability of the "Screw Guide Template" (SGT) system for insertion of midcervical pedicle screws. Despite many efforts for accurate midcervical pedicle screw insertion, there still remain unacceptable rate of screw malpositioning that might cause neurovascular injuries. We developed patient-specific SGT system for safe and accurate intraoperative screw navigation tool and have reported its availability for the screw insertion to C2 vertebra and thoracic spine. Preoperatively, the bone image on computed tomography was analyzed and the trajectories of the screws were designed in 3-dimensional format. Three types of templates were created for each lamina: location template, drill guide template, and screw guide template. During the operations, after engaging the templates directly with the laminae, drilling, tapping, and screwing were performed with each template. We placed 80 midcervical pedicle screws for 20 patients. The accuracy and safety of the screw insertion by SGT system were evaluated using postoperative computed tomographic scan by calculation of screw deviation from the preplanned trajectory and evaluation of screw breach of pedicle wall. All templates fitted the laminae and screw navigation procedures proceeded uneventfully. All screws were inserted accurately with the mean screw deviation from planned trajectory of 0.29 ± 0.31 mm and no neurovascular complication was experienced. We demonstrated that our SGT system could support the precise screw insertion in midcervical pedicle. SGT prescribes the safe screw trajectory in a 3-dimensional manner and the templates fit and lock directly to the target laminae, which prevents screwing error along with the change of spinal alignment during the surgery. These advantages of the SGT system guarantee the high accuracy in screw insertion, which allowed surgeons to insert

Laparoscopic appendicectomy: safe and useful for training.

PubMed Central

Duff, S. E.; Dixon, A. R.

2000-01-01

Debate exists about the benefits of laparoscopic appendicectomy when compared to a conventional open procedure. The majority of appendices are removed by the open route in the UK. We report a series of 132 cases of suspected appendicitis managed laparoscopically: 112 (85%) of the patients had acute appendicitis, the remaining 20 (15%) had non-appendiceal pathology. The median operative time was 30 min and there were no conversions to an open operative procedure. The median postoperative stay was two days. Complications were seen in two patients. The published evidence comparing laparoscopic and open appendicectomy is contradictory. Our series shows that laparoscopic appendicectomy is a safe procedure with low morbidity; it is also an excellent training tool in laparoscopic technique and, with sufficient experience, takes no longer than an open procedure. Negative appendicocecotomies are most common in women of fertile age and can be associated with significant morbidity; therefore, laparoscopy should be used to make the diagnosis and, if appendicitis is the cause, the appendix could safely be removed laparoscopically. However, the choice between open and laparoscopic procedure is a subjective decision for the patient and their surgeon. Laparoscopic appendicectomy cannot be regarded as the gold standard. PMID:11103154

Cerebellar contribution to spatial event processing: involvement in procedural and working memory components.

PubMed

Mandolesi, L; Leggio, M G; Graziano, A; Neri, P; Petrosini, L

2001-12-01

Spatial function is one of the cognitive functions altered in the presence of cerebellar lesions. We investigated the cerebellar contribution to the acquisition of spatial procedural and working memory components by means of a radial maze. To establish whether a cerebellar lesion would cause a deficit in solving the radial maze, a first experiment was carried out by using a full-baited maze procedure in different experimental groups, with or without cerebellar lesion and with or without pretraining. Non-pretrained hemicerebellectomized (HCbed) animals exhibited impaired performances in all (motor, spatial and procedural) task aspects. Pre-trained HCbed animals performed similarly to control animals in the task aspects linked to the processing of spatial and procedural factors. To distinguish procedural from working memory components, a forced-choice paradigm of the radial maze was used in the second experiment. Non-pretrained HCbed rats continued to make a lot of errors and show severe perseverative tendencies, already observed in the first experiment, supporting a specific cerebellar role in acquiring new behaviours and in modifying them in relation to the context. Interestingly, hindered from putting the acquired explorative patterns into action and compelled to use only working memory abilities, the pretrained HCbed group exhibited a dramatic worsening of performance. In conclusion, the present findings demonstrate that cerebellar damage induces a specific behaviour in radial maze tasks, characterized by an inflexible use of the procedures (if indeed any procedure was acquired before the lesion) and by a severe impairment in working memory processes.

Organizing Safe Transitions from Intensive Care

PubMed Central

Häggström, Marie; Bäckström, Britt

2014-01-01

Background. Organizing and performing patient transfers in the continuum of care is part of the work of nurses and other staff of a multiprofessional healthcare team. An understanding of discharge practices is needed in order to ultimate patients' transfers from high technological intensive care units (ICU) to general wards. Aim. To describe, as experienced by intensive care and general ward staff, what strategies could be used when organizing patient's care before, during, and after transfer from intensive care. Method. Interviews of 15 participants were conducted, audio-taped, transcribed verbatim, and analyzed using qualitative content analysis. Results. The results showed that the categories secure, encourage, and collaborate are strategies used in the three phases of the ICU transitional care process. The main category; a safe, interactive rehabilitation process, illustrated how all strategies were characterized by an intention to create and maintain safety during the process. A three-way interaction was described: between staff and patient/families, between team members and involved units, and between patient/family and environment. Discussion/Conclusions. The findings highlight that ICU transitional care implies critical care rehabilitation. Discharge procedures need to be safe and structured and involve collaboration, encouraging support, optimal timing, early mobilization, and a multidiscipline approach. PMID:24782924

Is Office-Based Surgery Safe? Comparing Outcomes of 183,914 Aesthetic Surgical Procedures Across Different Types of Accredited Facilities.

PubMed

Gupta, Varun; Parikh, Rikesh; Nguyen, Lyly; Afshari, Ashkan; Shack, R Bruce; Grotting, James C; Higdon, K Kye

2017-02-01

There has been a dramatic rise in office-based surgery. However, due to wide variations in regulatory standards, the safety of office-based aesthetic surgery has been questioned. This study compares complication rates of cosmetic surgery performed at office-based surgical suites (OBSS) to ambulatory surgery centers (ASCs) and hospitals. A prospective cohort of patients undergoing cosmetic surgery between 2008 and 2013 were identified from the CosmetAssure database (Birmingham, AL). Patients were grouped by type of accredited facility where the surgery was performed: OBSS, ASC, or hospital. The primary outcome was the incidence of major complication(s) requiring emergency room visit, hospital admission, or reoperation within 30 days postoperatively. Potential risk factors including age, gender, body mass index (BMI), smoking, diabetes, type of procedure, and combined procedures were reviewed. Of the 129,007 patients (183,914 procedures) in the dataset, the majority underwent the procedure at ASCs (57.4%), followed by hospitals (26.7%) and OBSS (15.9%). Patients operated in OBSS were less likely to undergo combined procedures (30.3%) compared to ASCs (31.8%) and hospitals (35.3%, P < .01). Complication rates in OBSS, ASCs, and hospitals were 1.3%, 1.9%, and 2.4%, respectively. On multivariate analysis, there was a lower risk of developing a complication in an OBSS compared to an ASC (RR 0.67, 95% CI 0.59-0.77, P < .01) or a hospital (RR 0.59, 95% CI 0.52-0.68, P < .01). Accredited OBSS appear to be a safe alternative to ASCs and hospitals for cosmetic procedures. Plastic surgeons should continue to triage their patients carefully based on other significant comorbidities that were not measured in this present study. LEVEL OF EVIDENCE 3. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

The Lead-Safe Certified Guide to Renovate Right

MedlinePlus

... for information about courses and resources on lead-safe work practices. 1 RENOVAT ING, REPA IRING, OR PA ... child care facility or school. • Always use lead-safe work practices when renovation or repair will disturb painted ...

Outpatient radioiodine therapy for thyroid cancer: a safe nuclear medicine procedure.

PubMed

Willegaignon, José; Sapienza, Marcelo; Ono, Carla; Watanabe, Tomoco; Guimarães, Maria Inês; Gutterres, Ricardo; Marechal, Maria Helena; Buchpiguel, Carlos

2011-06-01

To evaluate the dosimetric effect of outpatient radioiodine therapy for thyroid cancer in members of a patient's family and their living environment, when using iodine-131 doses reaching 7.4 GBq. The following parameters were thus defined: (a) whole-body radiation doses to caregivers, (b) the production of contaminated solid waste, and (c) radiation potential and surface contamination within patients' living quarters. In total, 100 patients were treated on an outpatient basis, taking into consideration their acceptable living conditions, interests, and willingness to comply with medical and radiation safety guidelines. Both the caregivers and the radiation dose potentiality inside patients' residences were monitored by using thermoluminescent dosimeters. Surface contamination and contaminated solid wastes were identified and measured with a Geiger-Müller detector. A total of 90 monitored individuals received a mean dose of 0.27 (±0.28) mSv, and the maximum dose registered was 1.6 mSv. The mean value for the potential dose within all living quarters was 0.31 (±0.34) mSv, and the mean value per monitored surface was 5.58 Bq/cm(2) for all the 1659 points measured. The overall production of contaminated solid wastes was at a low level, being about 3 times less than the exemption level indicated by the International Atomic Energy Agency. This study indicates that the treatment of thyroid cancer by applying radioiodine activities up to 7.4 GBq, on an outpatient basis, is a safe procedure, especially when supervised by qualified professionals. This alternative therapy should be a topic for careful discussion considering the high potential for reducing costs in healthcare and improving patient acceptance.

A qualitative assessment of safe work practices in logging in the southern United States.

PubMed

Conway, Sadie H; Pompeii, Lisa A; Casanova, Vanessa; Douphrate, David I

2017-01-01

The logging industry is recognized as one of the most dangerous professions in the U.S., but little is known about safety management practices on remote logging sites. A total of six focus group sessions were held among logging supervisors and front line crew members in Arkansas, Louisiana, and Texas (N = 27 participants). Participants perceived that logging was a dangerous profession, but its risks had been mitigated in several ways, most notably through mechanization of timber harvesting. Log trucking-related incidents were widely identified as the primary source of risk for injury and death on logging work sites. Human error, in general, and being out of the machinery on the work site were highlighted as additional sources of risk. Participants indicated high levels of personal motivation to work in a safe manner but tended to underestimate workplace hazards and expressed widely varying levels of co-worker trust. Am. J. Ind. Med. 60:58-68, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

The moderating influence of procedural fairness on the relationship between work-life conflict and organizational commitment.

PubMed

Siegel, Phyllis A; Post, Corinne; Brockner, Joel; Fishman, Ariel Y; Garden, Charlee

2005-01-01

To help employees better manage work-life conflict, organizations have introduced various initiatives, which have met with mixed results. The present studies examined the utility of a procedurally based approach to understanding employees' reactions to work-life conflict. The authors examined whether the fairness of procedures used by organizational authorities to plan and implement decisions moderates the (inverse) relationship between work-life conflict and employees' organizational commitment. Three studies using different methodologies showed support for the moderating role played by procedural fairness. That is, the tendency for greater work-life conflict to lead to lower commitment was significantly less pronounced when procedural fairness was high rather than low. Theoretical contributions to the work-life conflict and organizational justice literatures are discussed, as are practical implications.

Stay Safe at Work

MedlinePlus

... Back injuries are the most common type of workplace injury. You are at risk of getting hurt at ... To learn more, check out this list of workplace safety and health topics . Next section Arrange Your Work ...

Handling small arbovirus vectors safely during biosafety level 3 containment: Culicoides variipennis sonorensis (Diptera:Ceratopogonidae) and exotic bluetongue viruses.

PubMed

Hunt, G J; Tabachnick, W J

1996-05-01

Equipment and procedures are described for biosafety level 3 (BL-3) containment work with small, zoophilic arthropods. BL-3 classified pathogens always must be manipulated in biological safety cabinets. Procedures, including physical barriers and handling methods, that prevent the escape of potentially virus-infected insects are discussed, and the use of a monitoring system for insect security is explained. The inability to recover escaped minute, flying insects poses a major difference from similar work with larger insects, such as mosquitoes. Methods were developed for the safe and secure handling of Culicoides variipennis sonorensis Wirth & Jones infected with exotic bluetongue viruses during BL-3 containment.

Safe Grid

NASA Technical Reports Server (NTRS)

Chow, Edward T.; Stewart, Helen; Korsmeyer, David (Technical Monitor)

2003-01-01

The biggest users of GRID technologies came from the science and technology communities. These consist of government, industry and academia (national and international). The NASA GRID is moving into a higher technology readiness level (TRL) today; and as a joint effort among these leaders within government, academia, and industry, the NASA GRID plans to extend availability to enable scientists and engineers across these geographical boundaries collaborate to solve important problems facing the world in the 21 st century. In order to enable NASA programs and missions to use IPG resources for program and mission design, the IPG capabilities needs to be accessible from inside the NASA center networks. However, because different NASA centers maintain different security domains, the GRID penetration across different firewalls is a concern for center security people. This is the reason why some IPG resources are been separated from the NASA center network. Also, because of the center network security and ITAR concerns, the NASA IPG resource owner may not have full control over who can access remotely from outside the NASA center. In order to obtain organizational approval for secured remote access, the IPG infrastructure needs to be adapted to work with the NASA business process. Improvements need to be made before the IPG can be used for NASA program and mission development. The Secured Advanced Federated Environment (SAFE) technology is designed to provide federated security across NASA center and NASA partner's security domains. Instead of one giant center firewall which can be difficult to modify for different GRID applications, the SAFE "micro security domain" provide large number of professionally managed "micro firewalls" that can allow NASA centers to accept remote IPG access without the worry of damaging other center resources. The SAFE policy-driven capability-based federated security mechanism can enable joint organizational and resource owner approved remote

Driving simulator validation of driver behavior with limited safe vantage points for data collection in work zones.

PubMed

Bham, Ghulam H; Leu, Ming C; Vallati, Manoj; Mathur, Durga R

2014-06-01

This study is aimed at validating a driving simulator (DS) for the study of driver behavior in work zones. A validation study requires field data collection. For studies conducted in highway work zones, the availability of safe vantage points for data collection at critical locations can be a significant challenge. A validation framework is therefore proposed in this paper, demonstrated using a fixed-based DS that addresses the issue by using a global positioning system (GPS). The validation of the DS was conducted using objective and subjective evaluations. The objective validation was divided into qualitative and quantitative evaluations. The DS was validated by comparing the results of simulation with the field data, which were collected using a GPS along the highway and video recordings at specific locations in a work zone. The constructed work zone scenario in the DS was subjectively evaluated with 46 participants. The objective evaluation established the absolute and relative validity of the DS. The mean speeds from the DS data showed excellent agreement with the field data. The subjective evaluation indicated realistic driving experience by the participants. The use of GPS showed that continuous data collected along the highway can overcome the challenges of unavailability of safe vantage points especially at critical locations. Further, a validated DS can be used for examining driver behavior in complex situations by replicating realistic scenarios. Copyright © 2014 Elsevier Ltd. All rights reserved.

Experience with fluorine and its safe use as a propellant

NASA Technical Reports Server (NTRS)

Bond, D. L.; Guenther, M. E.; Stimpson, L. D.; Toth, L. R.; Young, D. L.

1979-01-01

The industrial and the propulsion experience with fluorine and its derivatives is surveyed. The hazardous qualities of fluorine and safe handling procedures for the substance are emphasized. Procedures which fulfill the safety requirements during ground operations for handling fluorinated propulsion systems are discussed. Procedures to be implemented for use onboard the Space Transportation System are included.

28 CFR 42.530 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND... Section 504 of the Rehabilitation Act of 1973 Procedures § 42.530 Procedures. (a) The procedural... section 803(a) of title I of the Omnibus Crime Control and Safe Streets Act, as amended by the Justice...

28 CFR 42.530 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND... Section 504 of the Rehabilitation Act of 1973 Procedures § 42.530 Procedures. (a) The procedural... section 803(a) of title I of the Omnibus Crime Control and Safe Streets Act, as amended by the Justice...

28 CFR 42.530 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND... Section 504 of the Rehabilitation Act of 1973 Procedures § 42.530 Procedures. (a) The procedural... section 803(a) of title I of the Omnibus Crime Control and Safe Streets Act, as amended by the Justice...

28 CFR 42.530 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND... Section 504 of the Rehabilitation Act of 1973 Procedures § 42.530 Procedures. (a) The procedural... section 803(a) of title I of the Omnibus Crime Control and Safe Streets Act, as amended by the Justice...

28 CFR 42.530 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND... Section 504 of the Rehabilitation Act of 1973 Procedures § 42.530 Procedures. (a) The procedural... section 803(a) of title I of the Omnibus Crime Control and Safe Streets Act, as amended by the Justice...

Safe Spaces, Support, Social Capital: A Critical Analysis of Artists Working with Vulnerable Young People in Educational Contexts

ERIC Educational Resources Information Center

Sellman, Edward

2015-01-01

This article provides a critical and thematic analysis of three research projects involving artists working with vulnerable young people in educational contexts. It argues that artists create safe spaces in contrast to traditional educational activities but it will also raise questions about what constitutes such a space for participants. It will…

Safe percutaneous suprapubic catheterisation.

PubMed

Goyal, N K; Goel, A; Sankhwar, S N

2012-11-01

We describe our technique of percutaneous suprapubic catheter insertion with special reference to steps that help to avoid common complications of haematuria and catheter misplacement. The procedure is performed using a stainless steel reusable trocar under local infiltrative anaesthesia, usually at the bedside. After clinical confirmation of a full bladder, the trocar is advanced into the bladder through a skin incision. Once the bladder is entered, the obturator is removed and the assistant inserts a Foley catheter followed by rapid balloon inflation. Slight traction is applied to the catheter for about five minutes. Patients with previous lower abdominal surgery, an inadequately distended bladder or acute pelvic trauma do not undergo suprapubic catheterisation using this method. The procedure was performed in 72 men (mean age: 42.4 years, range: 18-78 years) with urinary retention with a palpable bladder. The average duration of the procedure was less than five minutes. No complications were noted in any of the patients. Trocar suprapubic catheter insertion is a safe and effective bedside procedure for emergency bladder drainage and can be performed by resident surgeons. The common complications associated with the procedure can be avoided with a few careful steps.

78 FR 32088 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-29

...This rule establishes, amends, suspends, or revokes Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures for operations at certain airports. These regulatory actions are needed because of the adoption of new or revised criteria, or because of changes occurring in the National Airspace System, such as the commissioning of new navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide safe and efficient use of the navigable airspace and to promote safe flight operations under instrument flight rules at the affected airports.

75 FR 69331 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-12

...This establishes, amends, suspends, or revokes Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures for operations at certain airports. These regulatory actions are needed because of the adoption of new or revised criteria, or because of changes occurring in the National Airspace System, such as the commissioning of new navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide safe and efficient use of the navigable airspace and to promote safe flight operations under instrument flight rules at the affected airports.

77 FR 12454 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

...This rule establishes, amends, suspends, or revokes Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures for operations at certain airports. These regulatory actions are needed because of the adoption of new or revised criteria, or because of changes occurring in the National Airspace System, such as the commissioning of new navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide safe and efficient use of the navigable airspace and to promote safe flight operations under instrument flight rules at the affected airports.

Safe and efficacious use of procedural sedation and analgesia by nonanesthesiologists in a pediatric emergency department.

PubMed

Pitetti, Raymond D; Singh, Sonia; Pierce, Mary Clyde

2003-11-01

(23.6%); and intramuscular ketamine, midazolam, and atropine in 82 (6.6%). Procedural sedation and analgesia was successfully provided in 1177 (98.6%) of 1194 sedation events. Complications occurred in 207 (17.8%) of 1161 events. The most common complication was hypoxia (79.1% of patients), followed by vomiting (6.2% of patients). No patient required intubation. One patient had an oral airway placed, 3 patients received flumazenil, 3 patients received naloxone hydrochloride, and 1 patient received naloxone and bag-valve-mask ventilation. Seventy (9.8%) of 717 patients, following discharge from the ED, reported minor complications related to PSA. The most common complication was vomiting (76.7% of patients), followed by persistent dizziness (6.8% of patients). Patients who received IV fentanyl and midazolam were significantly more likely to experience a complication during PSA (P<.001), while patients sedated using IV ketamine, midazolam, and atropine (P =.006) or IV midazolam alone (P =.005) were less likely. No difference in success of sedation or incidence of complications at follow-up was found between the types of PSA provided. Complications related to PSA occurred in 17.9% of patients, but most commonly consisted of hypoxia that was easily treated. Sedation was successful in 98.6% of patients. Procedural sedation and analgesia can be safely and effectively provided by nonanesthesiologists in a pediatric ED.

The Food-Safe Schools Action Guide

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2007

2007-01-01

"The Food-Safe School Needs Assessment and Planning Guide" is a tool that can help schools assess their food safety policies, procedures, and programs and develop plans for improvement. This tool includes a simple, straightforward questionnaire, score card, and planning guide that give administrators, school staff, families, and students a chance…

Production Line Materials. Youth Training Scheme. Core Exemplar Work Based Project.

ERIC Educational Resources Information Center

Further Education Staff Coll., Blagdon (England).

This trainer's guide is intended to assist supervisors of work-based career training projects in helping students understand the operation of an assembly line, including safe working procedures. The guide is one in a series of core curriculum modules that is intended for use in combination on- and off-the-job programs to familiarize youth with the…

Safe abortion: WHO technical and policy guidance.

PubMed

Cook, R J; Dickens, B M; Horga, M

2004-07-01

In 2003, the World Health Organization published its well referenced handbook Safe Abortion: Technical and Policy Guidance for Health Systems to address the estimated almost 20 million induced abortions each year that are unsafe, imposing a burden of approximately 67 thousand deaths annually. It is a global injustice that 95% of unsafe abortions occur in developing countries. The focus of guidance is on abortion procedures that are lawful within the countries in which they occur, noting that in almost all countries, the law permits abortion to save a woman's life. The guidance treats unsafe abortion as a public health challenge, and responds to the problem through strategies concerning improved clinical care for women undergoing procedures, and the appropriate placement of necessary services. Legal and policy considerations are explored, and annexes present guidance to further reading, international consensus documents on safe abortion, and on manual vacuum aspiration and post-abortion contraception.

Rapid and Efficient Filtration-Based Procedure for Separation and Safe Analysis of CBRN Mixed Samples

PubMed Central

Bentahir, Mostafa; Laduron, Frederic; Irenge, Leonid; Ambroise, Jérôme; Gala, Jean-Luc

2014-01-01

Separating CBRN mixed samples that contain both chemical and biological warfare agents (CB mixed sample) in liquid and solid matrices remains a very challenging issue. Parameters were set up to assess the performance of a simple filtration-based method first optimized on separate C- and B-agents, and then assessed on a model of CB mixed sample. In this model, MS2 bacteriophage, Autographa californica nuclear polyhedrosis baculovirus (AcNPV), Bacillus atrophaeus and Bacillus subtilis spores were used as biological agent simulants whereas ethyl methylphosphonic acid (EMPA) and pinacolyl methylphophonic acid (PMPA) were used as VX and soman (GD) nerve agent surrogates, respectively. Nanoseparation centrifugal devices with various pore size cut-off (30 kD up to 0.45 µm) and three RNA extraction methods (Invisorb, EZ1 and Nuclisens) were compared. RNA (MS2) and DNA (AcNPV) quantification was carried out by means of specific and sensitive quantitative real-time PCRs (qPCR). Liquid chromatography coupled to time-of-flight mass spectrometry (LC/TOFMS) methods was used for quantifying EMPA and PMPA. Culture methods and qPCR demonstrated that membranes with a 30 kD cut-off retain more than 99.99% of biological agents (MS2, AcNPV, Bacillus Atrophaeus and Bacillus subtilis spores) tested separately. A rapid and reliable separation of CB mixed sample models (MS2/PEG-400 and MS2/EMPA/PMPA) contained in simple liquid or complex matrices such as sand and soil was also successfully achieved on a 30 kD filter with more than 99.99% retention of MS2 on the filter membrane, and up to 99% of PEG-400, EMPA and PMPA recovery in the filtrate. The whole separation process turnaround-time (TAT) was less than 10 minutes. The filtration method appears to be rapid, versatile and extremely efficient. The separation method developed in this work constitutes therefore a useful model for further evaluating and comparing additional separation alternative procedures for a safe handling and

Safe handling of cytotoxic compounds in a biopharmaceutical environment.

PubMed

Hensgen, Miriam I; Stump, Bernhard

2013-01-01

Handling cytotoxic drugs such as antibody-drug conjugates (ADCs) in a biopharmaceutical environment represents a challenge based on the potency of the compounds. These derivatives are dangerous to humans if they accidentally get in contact with the skin, are inhaled, or are ingested, either as pure compounds in their solid state or as a solution dissolved in a co-solvent. Any contamination of people involved in the manufacturing process has to be avoided. On the other hand, biopharmaceuticals need to be protected simultaneously against any contamination from the manufacturing personnel. Therefore, a tailor-made work environment is mandatory in order to manufacture ADCs. This asks for appropriate technical equipment to keep potential hazardous substances contained. In addition, clearly defined working procedures based on risk assessments as well as proper training for all personnel involved in the manufacturing process are needed to safely handle these highly potent pharmaceuticals.

A review of evidence for safe abortion care.

PubMed

Kapp, Nathalie; Whyte, Patti; Tang, Jennifer; Jackson, Emily; Brahmi, Dalia

2013-09-01

The provision of safe abortion services to women who need them has the potential to drastically reduce or eliminate maternal deaths due to unsafe abortion. The World Health Organization recently updated its evidence-based guidance for safe and effective clinical practices using data from systematic reviews of the literature. Systematic reviews pertaining to the evidence for safe abortion services, from pre-abortion care, medical and surgical methods of abortion and post-abortion care were evaluated for relevant outcomes, primarily those relating to safety, effectiveness and women's preference. Sixteen systematic reviews were identified and evaluated. The available evidence does not support the use of pre-abortion ultrasound to increase safety. Routine use of cervical preparation with osmotic dilators, mifepristone or misoprostol after 14 weeks gestation reduces complications; at early gestational ages, surgical abortions have very few complications. Prophylactic antibiotics result in lower rates of post-surgical abortion infection. Pain medication such as non-steroidal anti-inflammatories should be offered to women undergoing abortion procedures; acetaminophen, however, is not effective in reducing pain. Women who are eligible should be offered a choice between surgical (vacuum aspiration or dilation and evacuation) and medical methods (mifepristone and misoprostol) of abortion when possible. Modern methods of contraception can be safely initiated immediately following abortion procedures. Evidence-based guidelines assist health care providers and policymakers to utilize the best data available to provide safe abortion care and prevent the millions of deaths and disabilities that result from unsafe abortion. Copyright © 2013 Elsevier Inc. All rights reserved.

Standard operating procedures for serum and plasma collection: early detection research network consensus statement standard operating procedure integration working group.

PubMed

Tuck, Melissa K; Chan, Daniel W; Chia, David; Godwin, Andrew K; Grizzle, William E; Krueger, Karl E; Rom, William; Sanda, Martin; Sorbara, Lynn; Stass, Sanford; Wang, Wendy; Brenner, Dean E

2009-01-01

Specimen collection is an integral component of clinical research. Specimens from subjects with various stages of cancers or other conditions, as well as those without disease, are critical tools in the hunt for biomarkers, predictors, or tests that will detect serious diseases earlier or more readily than currently possible. Analytic methodologies evolve quickly. Access to high-quality specimens, collected and handled in standardized ways that minimize potential bias or confounding factors, is key to the "bench to bedside" aim of translational research. It is essential that standard operating procedures, "the how" of creating the repositories, be defined prospectively when designing clinical trials. Small differences in the processing or handling of a specimen can have dramatic effects in analytical reliability and reproducibility, especially when multiplex methods are used. A representative working group, Standard Operating Procedures Internal Working Group (SOPIWG), comprised of members from across Early Detection Research Network (EDRN) was formed to develop standard operating procedures (SOPs) for various types of specimens collected and managed for our biomarker discovery and validation work. This report presents our consensus on SOPs for the collection, processing, handling, and storage of serum and plasma for biomarker discovery and validation.

Guidewire retention following central venous catheterisation: a human factors and safe design investigation.

PubMed

Horberry, Tim; Teng, Yi-Chun; Ward, James; Patil, Vishal; Clarkson, P John

2014-01-01

Central Venous Catheterisation (CVC) has occasionally been associated with cases of retained guidewires in patients after surgery. In theory, this is a completely avoidable complication; however, as with any human procedure, operator error leading to guidewires being occasionally retained cannot be fully eliminated. The work described here investigated the issue in an attempt to better understand it both from an operator and a systems perspective, and to ultimately recommend appropriate safe design solutions that reduce guidewire retention errors. Nine distinct methods were used: observations of the procedure, a literature review, interviewing CVC end-users, task analysis construction, CVC procedural audits, two human reliability assessments, usability heuristics and a comprehensive solution survey with CVC end-users. The three solutions that operators rated most highly, in terms of both practicality and effectiveness, were: making trainees better aware of the potential guidewire complications and strongly emphasising guidewire removal in CVC training, actively checking that the guidewire is present in the waste tray for disposal, and standardising purchase of central line sets so that differences that may affect chances of guidewire loss is minimised. Further work to eliminate/engineer out the possibility of guidewires being retained is proposed.

Putting Safety in the Frame: Nurses' Sensemaking at Work.

PubMed

O'Keeffe, Valerie Jean; Thompson, Kirrilly Rebecca; Tuckey, Michelle Rae; Blewett, Verna Lesley

2015-01-01

Current patient safety policy focuses nursing on patient care goals, often overriding nurses' safety. Without understanding how nurses construct work health and safety (WHS), patient and nurse safety cannot be reconciled. Using ethnography, we examine social contexts of safety, studying 72 nurses across five Australian hospitals making decisions during patient encounters. In enacting safe practice, nurses used "frames" built from their contextual experiences to guide their behavior. Frames are produced by nurses, and they structure how nurses make sense of their work. Using thematic analysis, we identify four frames that inform nurses' decisions about WHS: (a) communicating builds knowledge, (b) experiencing situations guides decisions, (c) adapting procedures streamlines work, and (d) team working promotes safe working. Nurses' frames question current policy and practice by challenging how nurses' safety is positioned relative to patient safety. Recognizing these frames can assist the design and implementation of effective WHS management.

Safe places for pedestrians: using cognitive work analysis to consider the relationships between the engineering and urban design of footpaths.

PubMed

Stevens, Nicholas; Salmon, Paul

2014-11-01

Footpaths provide an integral component of our urban environments and have the potential to act as safe places for people and the focus for community life. Despite this, the approach to designing footpaths that are safe while providing this sense of place often occurs in silos. There is often very little consideration given to how designing for sense of place impacts safety and vice versa. The aim of this study was to use a systems analysis and design framework to develop a design template for an 'ideal' footpath system that embodies both safety and sense of place. This was achieved through using the first phase of the Cognitive Work Analysis framework, Work Domain Analysis, to specify a model of footpaths as safe places for pedestrians. This model was subsequently used to assess two existing footpath environments to determine the extent to which they meet the design requirements specified. The findings show instances where the existing footpaths both meet and fail to meet the design requirements specified. Through utilising a systems approach for footpaths, this paper has provided a novel design template that can inform new footpath design efforts or be used to evaluate the extent to which existing footpaths achieve their safety and sense of place requirements. Copyright © 2014 Elsevier Ltd. All rights reserved.

A 2-microm continuous-wave laser system for safe and high-precision dissection during NOTES procedures.

PubMed

Dray, Xavier; Donatelli, Gianfranco; Krishnamurty, Devi Mukkai; Dubcenco, Elena; Wroblewski, Ronald J; Assumpcao, Lia; Giday, Samuel A; Buscaglia, Jonathan M; Shin, Eun J; Magno, Priscilla; Pipitone, Laurie J; Marohn, Michael R; Kantsevoy, Sergey V; Kalloo, Anthony N

2010-09-01

Lasers 2-microm in wavelength offer efficient tissue cutting with limited thermal damage in biological tissue. To evaluate the dissection capabilities of a 2-microm continuous-wave laser for NOTES procedures. We conducted 18 acute animal experiments. Group 1 (three animals): transcolonic access to the peritoneal cavity (15-W transcolonic laser puncture, balloon dilation over the laser probe). Group 2 (six animals): transcolonic access with needle-knife puncture and balloon dilation. Group 3 (three animals): transgastric access to the peritoneal cavity (similar technique as group 1) followed by laser-assisted dissection of the kidney. In one animal of group 3, a therapeutic target (hematoma) was created by percutaneous puncture of the kidney. Group 4 (six animals): transgastric access (similar to the technique of group 2). Translumenal access to the peritoneal cavity was achieved in 2-3 min in group 1 (significantly shorter than with the needle-knife-assisted technique, 4-5 min, p=0.02) and in 7-10 min in group 3 (compared to 6-17 min in group 4, p=0.88). In group 3, laser dissection of the parietal peritoneum and of perinephric connective tissue allowed access to the retroperitoneum with complete removal of a blood collection in the animal with puncture trauma. Laser dissection demonstrated good maneuverability, clean and rapid cutting, and excellent hemostasis. Peritoneoscopy and necropsy showed no damage of targeted tissue and surrounding organs. The 2-microm continuous-wave laser system showed promising capabilities for highly precise and safe dissection during NOTES procedures.

Ketamine. A solution to procedural pain in burned children.

PubMed

Groeneveld, A; Inkson, T

1992-09-01

Our experience has shown ketamine to be a safe and effective method of providing pain relief during specific procedures in burned children. It renders high doses of narcotics unnecessary and offers children the benefit of general anesthesia without the requirement of endotracheal intubation and a trip to the operating room. The response of parents and staff to the use of ketamine has been positive. Parents often experience feelings of guilt following injury to a child and are eager to employ methods that reduce their child's pain. So far, no parent has refused the administration of ketamine; some have even asked that it be used during subsequent procedures on their child. With adequate pre-procedure teaching, parents are prepared for the possible occurrence of emergent reactions and can assist in reorienting the child during recovery. Staff have found that the stress of doing painful procedures on children is reduced when ketamine is used. The procedures tend to be quicker and the predicament of working on a screaming, agitated child is eliminated. At the same time, nursing staff have had to get used to the nystagmic gaze of the children and accept that these patients are truly anesthetized even though they might move and talk. Despite the success we and others have had with ketamine, several questions about its use in burn patients remain unanswered. The literature does not answer such questions as: Which nursing measures reduce the incidence of emergent reactions? How many ketamine anesthetics can safely be administered to one individual? How does the frequency of administration relate to tolerance in a burn patient? Are there detrimental effects of frequent or long-term use? Clearly, an understanding of these questions is necessary to determine the safe boundaries of ketamine use in burn patients. Ketamine is not a panacea for the problem of pain in burned children. But it is one means of managing procedural pain, which is, after all, a significant clinical

Safe percutaneous suprapubic catheterisation

PubMed Central

Goyal, NK; Goel, A; Sankhwar, SN

2012-01-01

INTRODUCTION We describe our technique of percutaneous suprapubic catheter insertion with special reference to steps that help to avoid common complications of haematuria and catheter misplacement. METHODS The procedure is performed using a stainless steel reusable trocar under local infiltrative anaesthesia, usually at the bedside. After clinical confirmation of a full bladder, the trocar is advanced into the bladder through a skin incision. Once the bladder is entered, the obturator is removed and the assistant inserts a Foley catheter followed by rapid balloon inflation. Slight traction is applied to the catheter for about five minutes. Patients with previous lower abdominal surgery, an inadequately distended bladder or acute pelvic trauma do not undergo suprapubic catheterisation using this method. RESULTS The procedure was performed in 72 men (mean age: 42.4 years, range: 18–78 years) with urinary retention with a palpable bladder. The average duration of the procedure was less than five minutes. No complications were noted in any of the patients. CONCLUSIONS Trocar suprapubic catheter insertion is a safe and effective bedside procedure for emergency bladder drainage and can be performed by resident surgeons. The common complications associated with the procedure can be avoided with a few careful steps. PMID:23131233

Cross-national research on contractor evaluation procedures in public works procurement

NASA Astrophysics Data System (ADS)

Kinoshita, Seiya; Sato, Naoyoshi; Matsumoto, Naoya

Contractor evaluation methods in Japan's public works procurement, beginning with construction business licensure, going through biennial preliminary firm rating, up to project-by-project prequalification and comprehensive point rating, were developed during the period when public works were mostly procured through designated competitive bidding. It is essential to focus attention on contractor evaluation methods for introducing different types of procurement procedures which enhance the use of technological capabilities held by private businesses. An overall review of contractor evaluation procedures should be conducted in view of the present situation, where the open competitive bidding has become mainly used in combination with comprehensive evaluation, as well as to allow for further diversification of procurement methods. In Western countries, improvements have been made for the past several years in contractor evaluation procedures with more emphasis on "Value for Money." Advanced efforts made by these countries will be useful as a reference for overhauling Japan's contractor evaluation system. This study conducts a comparative review of contractor evaluation procedures for public procurement in Western countries such as the United States, the United Kingdom and France by identifying similarities and differences between those of Japan and the above mentioned countries. This reveals that a contractor's technical or professional ability is looked at separately from its economic and financial standing in those countries studied, and there is no case like Japan in which those two factors are integrated into one for evaluation.

Surgical resident involvement is safe for common elective general surgery procedures.

PubMed

Tseng, Warren H; Jin, Leah; Canter, Robert J; Martinez, Steve R; Khatri, Vijay P; Gauvin, Jeffrey; Bold, Richard J; Wisner, David; Taylor, Sandra; Chen, Steven L

2011-07-01

Outcomes of surgical resident training are under scrutiny with the changing milieu of surgical education. Few have investigated the effect of surgical resident involvement (SRI) on operative parameters. Examining 7 common general surgery procedures, we evaluated the effect of SRI on perioperative morbidity and mortality and operative time (OpT). The American College of Surgeons National Surgical Quality Improvement Program database (2005 to 2007) was used to identify 7 cases of nonemergent operations. Cases with simultaneous procedures were excluded. Logistic regression was performed across all procedures and within each procedure incorporating SRI, OpT, and risk-stratifying American College of Surgery National Surgical Quality Improvement Program morbidity and mortality probability scores, which incorporate multiple prognostic individual patient factors. Procedure-specific, SRI-stratified OpTs were compared using Wilcoxon rank-sum tests. A total of 71.3% of the 37,907 cases had SRI. Absolute 30-day morbidity for all cases with SRI and without SRI were 3.0% and 1.0%, respectively (p < 0.001); absolute 30-day mortality for all cases with SRI and without SRI were 0.1% and 0.08%, respectively (p < 0.001). After multivariate analysis by specific procedure, SRI was not associated with increased morbidity but was associated with decreased mortality during open right colectomy (odds ratio 0.32; p = 0.01). Across all procedures, SRI was associated with increased morbidity (odds ratio 1.14; p = 0.048) but decreased mortality (odds ratio 0.42; p < 0.001). Mean OpT for all procedures was consistently lower for cases without SRI. SRI has a measurable impact on both 30-day morbidity and mortality and OpT. These data have implications to the impact associated with surgical graduate medical education. Further studies to identify causes of patient morbidity and prevention strategies in surgical teaching environments are warranted. Copyright © 2011 American College of Surgeons

Adherence to national recommendations for safe methotrexate dispensing in community pharmacies.

PubMed

Koster, Ellen S; Walgers, Joelle C D; van Grinsven, Mariska C J; Winters, Nina A; Bouvy, Marcel L

2014-02-01

The number of patients using methotrexate (MTX) has increased during the last decade. Because of the narrow therapeutic range and potential risks of incorrect use, vigilance is required when dispensing MTX. In 2009, the Royal Dutch Pharmacists Society, in accordance with the Dutch Health Care Inspectorate, published safe MTX dispensing recommendations for community pharmacies. To examine adherence to recommendations aimed at safe 
MTX dispensing. This study was conducted within a convenience sample of 78 community pharmacies belonging to the Utrecht Pharmacy Practice Network for Education and Research (UPPER). Data were collected in May 2011. 95 pharmacists and 337 pharmacy technicians were interviewed to assess self-reported adherence with dispensing recommendations. In addition, medication records for patients using MTX were extracted in 52 pharmacies in order to objectively assess adoption of recommendations. More than 75% of the pharmacists and pharmacy technicians reported to be adherent to 6 of the 11 recommendations. There are variations in reported adherence between team members working in 1 pharmacy; higher adherence rates ( greater than 75%) for the pharmacy team as a whole were only shown for 2 recommendations (recording of day of intake on the label and moment of authorization by the pharmacist). The medication records showed that adherence with working procedures significantly increased: The number of dispensed records with notification of the day of intake on the medication label increased from 9.9% of the records per pharmacy in 2008 to 77.1% in 2010 (P  less than  0.001). Dutch community pharmacies seem to be adherent to most safe dispensing recommendations. However, inconsistencies exist between team members that emphasize the importance of addressing this issue and discussing recommendations within the team, as there is still room for improvement to ensure safe dispensing.

Interprofessional and interdisciplinary simulation-based training leads to safe sedation procedures in the emergency department.

PubMed

Sauter, Thomas C; Hautz, Wolf E; Hostettler, Simone; Brodmann-Maeder, Monika; Martinolli, Luca; Lehmann, Beat; Exadaktylos, Aristomenis K; Haider, Dominik G

2016-08-02

, there is a significant increase in self-efficacy and knowledge with high effect size (d z  = 1.8). The learning is independent of profession and experience level. In the clinical evaluation after implementation, we found no major complications among the sedations performed. Time to procedure significantly improved after the introduction of the training (d = 0.88). Learning is independent of previous working experience and equally effective in raising the self-efficacy and knowledge in all professional groups. Clinical outcome evaluation confirms the concepts safety and feasibility. An interprofessional and interdisciplinary simulation-based sedation training is an efficient way to implement a conscious sedation concept in an ED.

A reliability-based cost effective fail-safe design procedure

NASA Technical Reports Server (NTRS)

Hanagud, S.; Uppaluri, B.

1976-01-01

The authors have developed a methodology for cost-effective fatigue design of structures subject to random fatigue loading. A stochastic model for fatigue crack propagation under random loading has been discussed. Fracture mechanics is then used to estimate the parameters of the model and the residual strength of structures with cracks. The stochastic model and residual strength variations have been used to develop procedures for estimating the probability of failure and its changes with inspection frequency. This information on reliability is then used to construct an objective function in terms of either a total weight function or cost function. A procedure for selecting the design variables, subject to constraints, by optimizing the objective function has been illustrated by examples. In particular, optimum design of stiffened panel has been discussed.

Insight, working through, and practice: the role of procedural knowledge.

PubMed

Rosenblatt, Allan

2004-01-01

A conception of insight is proposed, based on a systems and information-processing framework and using current neuroscience concepts, as an integration of information that results in a new symbolization of experience with a significant change in self-image and a transformation of non-declarative procedural knowledge into declarative knowledge. Since procedural memory and knowledge, seen to include emotional and relationship issues, is slow to change, durable emotional and behavioral change often requires repeated practice, a need not explicitly addressed in standard psychoanalytic technique. Working through is thus seen as also encompassing nondynamic factors. The application of these ideas to therapeutic technique suggests possible therapeutic interventions beyond interpretation. An illustrative clinical vignette is presented.

Integrated Work Management: Overview, Course 31881

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

Simpson, Lewis Edward

Integrated work management (IWM) is the process used for formally implementing the five-step process associated with integrated safety management (ISM) and integrated safeguards and security management (ISSM) at Los Alamos National Laboratory (LANL). IWM also directly supports the LANL Environmental Management System (EMS). IWM helps all workers and managers perform work safely and securely and in a manner that protects people, the environment, property, and the security of the nation. The IWM process applies to all work activities at LANL, from working in the office to designing experiments to assembling and detonating explosives. The primary LANL document that establishes andmore » describes IWM requirements is Procedure (P) 300, Integrated Work Management.« less

Registered nurse-administered sedation for gastrointestinal endoscopic procedure

PubMed Central

Amornyotin, Somchai

2015-01-01

The rising use of nonanesthesiologist-administered sedation for gastrointestinal endoscopy has clinical significances. Most endoscopic patients require some forms of sedation and/or anesthesia. The goals of this sedation are to guard the patient’s safety, minimize physical discomfort, to control behavior and to diminish psychological responses. Generally, moderate sedation for these procedures has been offered by the non-anesthesiologist by using benzodiazepines and/or opioids. Anesthesiologists and non-anesthesiologist personnel will need to work together for these challenges and for safety of the patients. The sedation training courses including clinical skills and knowledge are necessary for the registered nurses to facilitate the patient safety and the successful procedure. However, appropriate patient selection and preparation, adequate monitoring and regular training will ensure that the use of nurse-administered sedation is a feasible and safe technique for gastrointestinal endoscopic procedures. PMID:26191341

From Barrier Free to Safe Environments: The New Zealand Experience. Monograph #44.

ERIC Educational Resources Information Center

Wrightson, William; Pope, Campbell

Intrinsically safe design is presented as a logical extension of the principles of barrier free design, and as a higher level design strategy for effecting widespread implementation of the basic accessibility requirements for people with disabilities. Two fundamental planning procedures are proposed: including principles of safe and accessible…

Impact of a Safe Resident Handling Program in Nursing Homes on Return-to-Work and Re-injury Outcomes Following Work Injury.

PubMed

Kurowski, Alicia; Pransky, Glenn; Punnett, Laura

2018-05-21

Purpose This study examined the impact of a Safe Resident Handling Program (SRHP) on length of disability and re-injury, following work-related injuries of nursing home workers. Resident handling-related injuries and back injuries were of particular interest. Methods A large national nursing home corporation introduced a SRHP followed by three years of training for 136 centers. Lost-time workers' compensation claims (3 years pre-SRHP and 6 years post-SRHP) were evaluated. For each claim, length of first episode of disability and recurrence of disabling injury were evaluated over time. Differences were assessed using Chi square analyses and a generalized linear model, and "avoided" costs were projected. Results The SRHP had no impact on length of disability, but did appear to significantly reduce the rate of recurrence among resident handling-related injuries. As indemnity and medical costs were three times higher for claimants with recurrent disabling injuries, the SRHP resulted in significant "avoided" costs due to "avoided" recurrence. Conclusions In addition to reducing overall injury rates, SRHPs appear to improve long-term return-to-work success by reducing the rate of recurrent disabling injuries resulting in work disability. In this study, the impact was sustained over years, even after a formal training and implementation program ended. Since back pain is inherently a recurrent condition, results suggest that SRHPs help workers remain at work and return-to-work.

Beth Reis and the Safe Schools Coalition

ERIC Educational Resources Information Center

Vaught, Sabina E.

2007-01-01

This article chronicles the formation and organization of the Safe Schools Coalition (SCC) through the experiences of Beth Reis, co-founder and co-Chair. The article suggests ways in which the SCC can serve as a model for both collective and individual work in promoting safe schools.

SAFE DRINKING WATER FROM SMALL SYSTEMS: TREATMENT OPTIONS

EPA Science Inventory

Bringing small water systems into compliance with the ever-increasing number of regulations will require flexibility in terms of technology application and institional procedures. his article looks at the means by which small systems can provide safe drinking water, focusing on t...

Distributive justice, procedural justice, and psychological distress: the moderating effect of coworker support and work autonomy.

PubMed

Rousseau, Vincent; Salek, Salwa; Aubé, Caroline; Morin, Estelle M

2009-07-01

Recent research has demonstrated that the perception of injustice at work may increase psychological health-related problems. The purpose of this study is to examine the moderating effect of coworker support and work autonomy on the relationships between both distributive and procedural justice and psychological distress. Results, on the basis of responses to questionnaires given to 248 prison employees, show that coworker support moderates the relationships between both forms of justice and psychological distress. Specifically, these relationships are weakened when employees benefit from a high level of coworker support. Furthermore, work autonomy moderates the relationship between procedural justice and psychological distress but not the relationship between distributive justice and psychological distress. Thus, procedural injustice is less likely to increase psychological distress when the level of work autonomy is high. (c) 2009 APA, all rights reserved.

A Strategy to Safely Live and Work in the Space Radiation Environment

NASA Technical Reports Server (NTRS)

Corbin, Barbara J.; Sulzman, Frank M.; Krenek, Sam

2006-01-01

The goal of the National Aeronautics and Space Agency and the Space Radiation Project is to ensure that astronauts can safely live and work in the space radiation environment. The space radiation environment poses both acute and chronic risks to crew health and safety, but unlike some other aspects of space travel, space radiation exposure has clinically relevant implications for the lifetime of the crew. The term safely means that risks are sufficiently understood such that acceptable limits on mission, post-mission and multi-mission consequences (for example, excess lifetime fatal cancer risk) can be defined. The Space Radiation Project strategy has several elements. The first element is to use a peer-reviewed research program to increase our mechanistic knowledge and genetic capabilities to develop tools for individual risk projection, thereby reducing our dependency on epidemiological data and population-based risk assessment. The second element is to use the NASA Space Radiation Laboratory to provide a ground-based facility to study the understanding of health effects/mechanisms of damage from space radiation exposure and the development and validation of biological models of risk, as well as methods for extrapolation to human risk. The third element is a risk modeling effort that integrates the results from research efforts into models of human risk to reduce uncertainties in predicting risk of carcinogenesis, central nervous system damage, degenerative tissue disease, and acute radiation effects. To understand the biological basis for risk, we must also understand the physical aspects of the crew environment. Thus the fourth element develops computer codes to predict radiation transport properties, evaluate integrated shielding technologies and provide design optimization recommendations for the design of human space systems. Understanding the risks and determining methods to mitigate the risks are keys to a successful radiation protection strategy.

NASA Strategy to Safely Live and Work in the Space Radiation Environment

NASA Technical Reports Server (NTRS)

Cucinotta, Francis A.; Wu, Honglu; Corbin, Barbara J.; Sulzman, Frank M.; Krenek, Sam

2007-01-01

In space, astronauts are constantly bombarded with energetic particles. The goal of the National Aeronautics and Space Agency and the NASA Space Radiation Project is to ensure that astronauts can safely live and work in the space radiation environment. The space radiation environment poses both acute and chronic risks to crew health and safety, but unlike some other aspects of space travel, space radiation exposure has clinically relevant implications for the lifetime of the crew. Among the identified radiation risks are cancer, acute and late CNS damage, chronic and degenerative tissue decease, and acute radiation syndrome. The term "safely" means that risks are sufficiently understood such that acceptable limits on mission, post-mission and multi-mission consequences can be defined. The NASA Space Radiation Project strategy has several elements. The first element is to use a peer-reviewed research program to increase our mechanistic knowledge and genetic capabilities to develop tools for individual risk projection, thereby reducing our dependency on epidemiological data and population-based risk assessment. The second element is to use the NASA Space Radiation Laboratory to provide a ground-based facility to study the health effects/mechanisms of damage from space radiation exposure and the development and validation of biological models of risk, as well as methods for extrapolation to human risk. The third element is a risk modeling effort that integrates the results from research efforts into models of human risk to reduce uncertainties in predicting the identified radiation risks. To understand the biological basis for risk, we must also understand the physical aspects of the crew environment. Thus, the fourth element develops computer algorithms to predict radiation transport properties, evaluate integrated shielding technologies and provide design optimization recommendations for the design of human space systems. Understanding the risks and determining

40 CFR 68.52 - Operating procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 2 Prevention Program § 68.52 Operating procedures. (a) The... for safely conducting activities associated with each covered process consistent with the safety information for that process. Operating procedures or instructions provided by equipment manufacturers or...

Hallways Paved with Good Intentions: Analyzing Rules and Procedures in Non-Classroom Middle School Spaces

ERIC Educational Resources Information Center

Wellenreiter, Benjamin R.

2018-01-01

Non-classroom school spaces such as cafeterias, hallways, and locker rooms have complex structures that require analysis to maintain or improve school climate. Middle level educators are encouraged to observe, question, and evaluate rules and procedures to ensure these spaces are safe and socially just. Educators should work to view these spaces…

Write Procedures That Work.

ERIC Educational Resources Information Center

Cubberley, Carol W.

1991-01-01

Discusses written procedures that explain library tasks and describes methods for writing them clearly and coherently. The use of appropriate terminology and vocabulary is discussed; the value of illustrations, typography, and format to enhance the visual effect is explained; the intended audience is considered; and examples are given. (seven…

Developing standard operating procedures for gene drive research in disease vector mosquitoes.

PubMed

Adelman, Zach N; Pledger, David; Myles, Kevin M

2017-12-01

Numerous arthropod species represent potential targets for gene-drive-based population suppression or replacement, including those that transmit diseases, damage crops, or act as deleterious invasive species. Containment measures for gene drive research in arthropods have been discussed in the literature, but the importance of developing safe and effective standard operating procedures (SOPs) for these types of experiments has not been adequately addressed. Concisely written SOPs link safe work practices, containment measures, institutional training, and research-specific protocols. Here we discuss information to be considered by principal investigators, biosafety officers, and institutional biosafety committees as they work together to develop SOPs for experiments involving gene drive in arthropods, and describe various courses of action that can be used to maintain the effectiveness of SOPs through evaluation and revision. The information provided herein will be especially useful to investigators and regulatory personnel who may lack extensive experience working with arthropods under containment conditions.

Promoting job safety for workers with intellectual disabilities: the staying safe at work training curriculum.

PubMed

Dewey, Robin

2011-01-01

In the United States, approximately 125,000 people with disabilities are employed through Community Rehabilitation Programs in manufacturing, assembly, and service jobs. These jobs have significant hazards and, consequently, the workers are at risk of injury. Training that empowers workers to participate in prevention efforts can help reduce work-related injuries. In general this kind of health and safety training in the United States is limited. It is even more so for workers with intellectual disabilities, in part because there have not been programs for teaching individuals with cognitive challenges health and safety skills, adapted to their learning needs. This paper describes the development and promotion of the Staying Safe at Work curriculum of UC Berkeley's Labor Occupational Health Program, which is designed for use by support agencies and employers of workers with intellectual disabilities. The goal of this program is to teach these workers essential occupational safety and health skills in a manner they can understand.

Safe sex

MedlinePlus

... sex; Sexually transmitted - safe sex; GC - safe sex; Gonorrhea - safe sex; Herpes - safe sex; HIV - safe sex; ... contact. STIs include: Chlamydia Genital herpes Genital warts Gonorrhea Hepatitis HIV HPV Syphilis STIs are also called ...

Working safely with robot workers: Recommendations for the new workplace.

PubMed

Murashov, Vladimir; Hearl, Frank; Howard, John

2016-01-01

The increasing use of robots in performing tasks alongside or together with human co-workers raises novel occupational safety and health issues. The new 21st century workplace will be one in which occupational robotics plays an increasing role. This article describes the increasing complexity of robots and proposes a number of recommendations for the practice of safe occupational robotics.

Working Safely with Robot Workers: Recommendations for the New Workplace

PubMed Central

Murashov, Vladimir; Hearl, Frank; Howard, John

2016-01-01

The increasing use of robots in performing tasks alongside or together with human coworkers raises novel occupational safety and health issues. The new 21st century workplace will be one in which occupational robotics plays an increasing role. This paper describes the increasing complexity of robots and proposes a number of recommendations for the practice of safe occupational robotics. PMID:26554511

Reprint of "Safe places for pedestrians: using cognitive work analysis to consider the relationships between the engineering and urban design of footpaths".

PubMed

Stevens, Nicholas; Salmon, Paul

2015-01-01

Footpaths provide an integral component of our urban environments and have the potential to act as safe places for people and the focus for community life. Despite this, the approach to designing footpaths that are safe while providing this sense of place often occurs in silos. There is often very little consideration given to how designing for sense of place impacts safety and vice versa. The aim of this study was to use a systems analysis and design framework to develop a design template for an 'ideal' footpath system that embodies both safety and sense of place. This was achieved through using the first phase of the Cognitive Work Analysis framework, Work Domain Analysis, to specify a model of footpaths as safe places for pedestrians. This model was subsequently used to assess two existing footpath environments to determine the extent to which they meet the design requirements specified. The findings show instances where the existing footpaths both meet and fail to meet the design requirements specified. Through utilising a systems approach for footpaths, this paper has provided a novel design template that can inform new footpath design efforts or be used to evaluate the extent to which existing footpaths achieve their safety and sense of place requirements. Copyright © 2014 Elsevier Ltd. All rights reserved.

A safe, effective, and facility compatible cleaning in place procedure for affinity resin in large-scale monoclonal antibody purification.

PubMed

Wang, Lu; Dembecki, Jill; Jaffe, Neil E; O'Mara, Brian W; Cai, Hui; Sparks, Colleen N; Zhang, Jian; Laino, Sarah G; Russell, Reb J; Wang, Michelle

2013-09-20

Cleaning-in-place (CIP) for column chromatography plays an important role in therapeutic protein production. A robust and efficient CIP procedure ensures product quality, improves column life time and reduces the cost of the purification processes, particularly for those using expensive affinity resins, such as MabSelect protein A resin. Cleaning efficiency, resin compatibility, and facility compatibility are the three major aspects to consider in CIP process design. Cleaning MabSelect resin with 50mM sodium hydroxide (NaOH) along with 1M sodium chloride is one of the most popular cleaning procedures used in biopharmaceutical industries. However, high concentration sodium chloride is a leading cause of corrosion in the stainless steel containers used in large scale manufacture. Corroded containers may potentially introduce metal contaminants into purified drug products. Therefore, it is challenging to apply this cleaning procedure into commercial manufacturing due to facility compatibility and drug safety concerns. This paper reports a safe, effective and environmental and facility-friendly cleaning procedure that is suitable for large scale affinity chromatography. An alternative salt (sodium sulfate) is used to prevent the stainless steel corrosion caused by sodium chloride. Sodium hydroxide and salt concentrations were optimized using a high throughput screening approach to achieve the best combination of facility compatibility, cleaning efficiency and resin stability. Additionally, benzyl alcohol is applied to achieve more effective microbial control. Based on the findings, the recommended optimum cleaning strategy is cleaning MabSelect resin with 25 mM NaOH, 0.25 M Na2SO4 and 1% benzyl alcohol solution every cycle, followed by a more stringent cleaning using 50 mM NaOH with 0.25 M Na2SO4 and 1% benzyl alcohol at the end of each manufacturing campaign. A resin life cycle study using the MabSelect affinity resin demonstrates that the new cleaning strategy

Pain and nurses' emotion work in a paediatric clinic: treatment procedures and nurse-child alignments.

PubMed

Rindstedt, Camilla

2013-01-01

In the treatment of cancer in children, treatment procedures have been reported to be one of the most feared elements, as more painful than the illness as such. This study draws on a video ethnography of routine needle procedure events, as part of fieldwork at a paediatric oncology clinic documenting everyday treatment negotiations between nurses and young children. On the basis of detailed transcriptions of verbal and nonverbal staff-child interaction, the analyses focus on ways in which pain and anxiety can be seen as phenomena that are partly contingent on nurses' emotion work. The school-age children did not display fear. In the preschool group, though, pain and fear seemed to be phenomena that were greatly reduced through nurses' emotion work. This study focuses on three preschoolers facing potentially painful treatment, showing how the nurses engaged in massive emotion work with the children, through online commentaries, interactive formats (delegation of tasks, consent sequences, collaborative 'we'-formats), as well as solidarity-oriented moves (such as praise and endearment terms). Even a young toddler would handle the distress of needle procedures, when interacting with an inventive nurse who mobilized child participation through skilful emotion work.

Safety Precautions and Operating Procedures in an (A)BSL-4 Laboratory: 2. General Practices.

PubMed

Mazur, Steven; Holbrook, Michael R; Burdette, Tracey; Joselyn, Nicole; Barr, Jason; Pusl, Daniela; Bollinger, Laura; Coe, Linda; Jahrling, Peter B; Lackemeyer, Matthew G; Wada, Jiro; Kuhn, Jens H; Janosko, Krisztina

2016-10-03

Work in a biosafety level 4 (BSL-4) containment laboratory requires time and great attention to detail. The same work that is done in a BSL-2 laboratory with non-high-consequence pathogens will take significantly longer in a BSL-4 setting. This increased time requirement is due to a multitude of factors that are aimed at protecting the researcher from laboratory-acquired infections, the work environment from potential contamination and the local community from possible release of high-consequence pathogens. Inside the laboratory, movement is restricted due to air hoses attached to the mandatory full-body safety suits. In addition, disinfection of every item that is removed from Class II biosafety cabinets (BSCs) is required. Laboratory specialists must be trained in the practices of the BSL-4 laboratory and must show high proficiency in the skills they are performing. The focus of this article is to outline proper procedures and techniques to ensure laboratory biosafety and experimental accuracy using a standard viral plaque assay as an example procedure. In particular, proper techniques to work safely in a BSL-4 environment when performing an experiment will be visually emphasized. These techniques include: setting up a Class II BSC for experiments, proper cleaning of the Class II BSC when finished working, waste management and safe disposal of waste generated inside a BSL-4 laboratory, and the removal of inactivated samples from inside a BSL-4 laboratory to the BSL-2 laboratory.

Alternative antimicrobial commercial egg washing procedures

USDA-ARS?s Scientific Manuscript database

Commercial table eggs are washed prior to packaging. Standard wash procedures use an alkaline pH and warm water. If a cool water method could be developed that would still provide a microbiologically safe egg, the industry may save energy costs associated with water heating. Four wash procedures ...

Implementing AORN recommended practices for a safe environment of care.

PubMed

Hughes, Antonia B

2013-08-01

Providing a safe environment for every patient undergoing a surgical or other invasive procedure is imperative. AORN's "Recommended practices for a safe environment of care" provides guidance on a wide range of topics related to the safety of perioperative patients and health care personnel. The recommendations are intended to provide guidance for establishing best practices and implementing safety measures in all perioperative practice settings. Perioperative nurses should be aware of risks related to musculoskeletal injuries, fire, equipment, latex, and chemicals, among others, and understand strategies for reducing the risks. Evidence-based recommendations can give practitioners the tools to guide safe practice. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Computer Based Procedures for Field Workers - FY16 Research Activities

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

Oxstrand, Johanna; Bly, Aaron

The Computer-Based Procedure (CBP) research effort is a part of the Light-Water Reactor Sustainability (LWRS) Program, which provides the technical foundations for licensing and managing the long-term, safe, and economical operation of current nuclear power plants. One of the primary missions of the LWRS program is to help the U.S. nuclear industry adopt new technologies and engineering solutions that facilitate the continued safe operation of the plants and extension of the current operating licenses. One area that could yield tremendous savings in increased efficiency and safety is in improving procedure use. A CBP provides the opportunity to incorporate context-driven jobmore » aids, such as drawings, photos, and just-in-time training. The presentation of information in CBPs can be much more flexible and tailored to the task, actual plant condition, and operation mode. The dynamic presentation of the procedure will guide the user down the path of relevant steps, thus minimizing time spent by the field worker to evaluate plant conditions and decisions related to the applicability of each step. This dynamic presentation of the procedure also minimizes the risk of conducting steps out of order and/or incorrectly assessed applicability of steps. This report provides a summary of the main research activities conducted in the Computer-Based Procedures for Field Workers effort since 2012. The main focus of the report is on the research activities conducted in fiscal year 2016. The activities discussed are the Nuclear Electronic Work Packages – Enterprise Requirements initiative, the development of a design guidance for CBPs (which compiles all insights gained through the years of CBP research), the facilitation of vendor studies at the Idaho National Laboratory (INL) Advanced Test Reactor (ATR), a pilot study for how to enhance the plant design modification work process, the collection of feedback from a field evaluation study at Plant Vogtle, and path forward to

Working safely in summertime heat

Treesearch

Robert B. Rummer

1997-01-01

As logging operations continue in the hotter months of he year, the safety hazard of heat stress appears. Loggers are particularly at risk, because the combination of hard physical work and outdoor conditions puts high demands on the body. While loggers rarely die from heat stress, they may suffer heat illness symptoms ranging from the discomfort of heat rash to nausea...

Embracing Safe Ground Test Facility Operations and Maintenance

NASA Technical Reports Server (NTRS)

Dunn, Steven C.; Green, Donald R.

2010-01-01

Conducting integrated operations and maintenance in wind tunnel ground test facilities requires a balance of meeting due dates, efficient operation, responsiveness to the test customer, data quality, effective maintenance (relating to readiness and reliability), and personnel and facility safety. Safety is non-negotiable, so the balance must be an "and" with other requirements and needs. Pressure to deliver services faster at increasing levels of quality in under-maintained facilities is typical. A challenge for management is to balance the "need for speed" with safety and quality. It s especially important to communicate this balance across the organization - workers, with a desire to perform, can be tempted to cut corners on defined processes to increase speed. Having a lean staff can extend the time required for pre-test preparations, so providing a safe work environment for facility personnel and providing good stewardship for expensive National capabilities can be put at risk by one well-intending person using at-risk behavior. This paper documents a specific, though typical, operational environment and cites management and worker safety initiatives and tools used to provide a safe work environment. Results are presented and clearly show that the work environment is a relatively safe one, though still not good enough to keep from preventing injury. So, the journey to a zero injury work environment - both in measured reality and in the minds of each employee - continues. The intent of this paper is to provide a benchmark for others with operational environments and stimulate additional sharing and discussion on having and keeping a safe work environment.

SafeNet: a methodology for integrating general-purpose unsafe devices in safe-robot rehabilitation systems.

PubMed

Vicentini, Federico; Pedrocchi, Nicola; Malosio, Matteo; Molinari Tosatti, Lorenzo

2014-09-01

Robot-assisted neurorehabilitation often involves networked systems of sensors ("sensory rooms") and powerful devices in physical interaction with weak users. Safety is unquestionably a primary concern. Some lightweight robot platforms and devices designed on purpose include safety properties using redundant sensors or intrinsic safety design (e.g. compliance and backdrivability, limited exchange of energy). Nonetheless, the entire "sensory room" shall be required to be fail-safe and safely monitored as a system at large. Yet, sensor capabilities and control algorithms used in functional therapies require, in general, frequent updates or re-configurations, making a safety-grade release of such devices hardly sustainable in cost-effectiveness and development time. As such, promising integrated platforms for human-in-the-loop therapies could not find clinical application and manufacturing support because of lacking in the maintenance of global fail-safe properties. Under the general context of cross-machinery safety standards, the paper presents a methodology called SafeNet for helping in extending the safety rate of Human Robot Interaction (HRI) systems using unsafe components, including sensors and controllers. SafeNet considers, in fact, the robotic system as a device at large and applies the principles of functional safety (as in ISO 13489-1) through a set of architectural procedures and implementation rules. The enabled capability of monitoring a network of unsafe devices through redundant computational nodes, allows the usage of any custom sensors and algorithms, usually planned and assembled at therapy planning-time rather than at platform design-time. A case study is presented with an actual implementation of the proposed methodology. A specific architectural solution is applied to an example of robot-assisted upper-limb rehabilitation with online motion tracking. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The 'Whip-Stow' procedure: an innovative modification to the whipple procedure in the management of premalignant and malignant pancreatic head disease.

PubMed

Jeyarajah, D Rohan; Khithani, Amit; Curtis, David; Galanopoulos, Christos A

2010-01-01

Pancreaticoduodenectomy (PD) is the standard of care in the treatment of premalignant and malignant diseases of the head of the pancreas. Variability exists in anastomosis with the pancreatic remnant. This work describes a safe and easy modification for the pancreatic anastomosis after PD. Ten patients underwent the "Whip-Stow" procedure for the management of the pancreatic remnant. PD combined with a Puestow (lateral pancreaticojejunostomy [LPJ]) was completed using a running single-layer, 4-0 Prolene obeying a duct-to-mucosa technique. LPJ and pancreaticogastrostomy (PG) historical leak rates are reported to be 13.9 and 15.8 per cent, respectively. Mortality, leak, and postoperative bleeding rates were 0 per cent in all patients. The Whip-Stow was completed without loops or microscope with a 4-0 single-layer suture decreasing the time and complexity of the anastomosis. Average time was 12 minutes as compared with the 50 minutes of a 5 or 6-0 interrupted, multilayered duct-mucosa anastomosis. Benefits included a long-segment LPJ. In this study, the Whip-Stow procedure has proven to be a safe and simple approach to pancreatic anastomosis in selected patients. This new technique provides the benefit of technical ease while obeying the age old principles of obtaining a wide duct to mucosa anastomosis.

When procedures meet practice in community pharmacies: qualitative insights from pharmacists and pharmacy support staff

PubMed Central

Ashcroft, Darren M

2016-01-01

Objectives Our aim was to explore how members of community pharmacy staff perceive and experience the role of procedures within the workplace in community pharmacies. Setting Community pharmacies in England and Wales. Participants 24 community pharmacy staff including pharmacists and pharmacy support staff were interviewed regarding their view of procedures in community pharmacy. Transcripts were analysed using thematic analysis. Results 3 main themes were identified. According to the ‘dissemination and creation of standard operating procedures’ theme, community pharmacy staff were required to follow a large amount of procedures as part of their work. At times, complying with all procedures was not possible. According to the ‘complying with procedures’ theme, there are several factors that influenced compliance with procedures, including work demands, the high workload and the social norm within the pharmacy. Lack of staff, pressure to hit targets and poor communication also affected how able staff felt to follow procedures. The third theme ‘procedural compliance versus using professional judgement’ highlighted tensions between the standardisation of practice and the professional autonomy of pharmacists. Pharmacists feared being unsupported by their employer for working outside of procedures, even when acting for patient benefit. Some support staff believed that strictly following procedures would keep patients and themselves safe. Dispensers described following the guidance of the pharmacist which sometimes meant working outside of procedures, but occasionally felt unable to voice concerns about not working to rule. Conclusions Organisational resilience in community pharmacy was apparent and findings from this study should help to inform policymakers and practitioners regarding factors likely to influence the implementation of procedures in community pharmacy settings. Future research should focus on exploring community pharmacy employees' intentions

Strategies and challenges for safe injection practice in developing countries.

PubMed

Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kumar, Kc Vikash

2013-01-01

Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the early twentieth century but has not received adequate attention in developing countries. The establishment of "Safe Injection Global Network (SIGN)" was an milestone towards safe injection practice globally. In developing countries, people perceive injection as a powerful healing tool and do not hesitate to pay more for injections. Unsafe disposal and reuse of contaminated syringe is common. Ensuring safe injection practice is one of the greatest challenges for healthcare system in developing countries. To address the problem, interventions with active involvement of a number of stakeholders is essential. A combination of educational, managerial and regulatory strategies is found to be effective and economically viable. Rational and safe use of injections can save many lives but unsafe practice threatens life. Safe injection practice is crucial in developing countries. Evidence based interventions, with honest commitment and participation from the service provider, recipient and community with aid of policy makers are required to ensure safe injection practice.

Strategies and challenges for safe injection practice in developing countries

PubMed Central

Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kumar, KC Vikash

2013-01-01

Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the early twentieth century but has not received adequate attention in developing countries. The establishment of “Safe Injection Global Network (SIGN)” was an milestone towards safe injection practice globally. In developing countries, people perceive injection as a powerful healing tool and do not hesitate to pay more for injections. Unsafe disposal and reuse of contaminated syringe is common. Ensuring safe injection practice is one of the greatest challenges for healthcare system in developing countries. To address the problem, interventions with active involvement of a number of stakeholders is essential. A combination of educational, managerial and regulatory strategies is found to be effective and economically viable. Rational and safe use of injections can save many lives but unsafe practice threatens life. Safe injection practice is crucial in developing countries. Evidence based interventions, with honest commitment and participation from the service provider, recipient and community with aid of policy makers are required to ensure safe injection practice. PMID:23662018

Assessing the 'system' in safe systems-based road designs: using cognitive work analysis to evaluate intersection designs.

PubMed

Cornelissen, M; Salmon, P M; Stanton, N A; McClure, R

2015-01-01

While a safe systems approach has long been acknowledged as the underlying philosophy of contemporary road safety strategies, systemic applications are sparse. This article argues that systems-based methods from the discipline of Ergonomics have a key role to play in road transport design and evaluation. To demonstrate, the Cognitive Work Analysis framework was used to evaluate two road designs - a traditional Melbourne intersection and a cut-through design for future intersections based on road safety safe systems principles. The results demonstrate that, although the cut-through intersection appears different in layout from the traditional intersection, system constraints are not markedly different. Furthermore, the analyses demonstrated that redistribution of constraints in the cut-through intersection resulted in emergent behaviour, which was not anticipated and could prove problematic. Further, based on the lack of understanding of emergent behaviour, similar design induced problems are apparent across both intersections. Specifically, incompatibilities between infrastructure, vehicles and different road users were not dealt with by the proposed design changes. The importance of applying systems methods in the design and evaluation of road transport systems is discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

Safe endobag morcellation in a single-port laparoscopy subtotal hysterectomy.

PubMed

Angioni, Stefano; Pontis, Alessandro; Multinu, Angelo; Melis, Gianbenedetto

2016-01-01

Recently, the American Food and Drug Administration (FDA) published an alert about the risks of uterine tissue morcellation during laparoscopic procedures. In particular, the possible risk of spreading an undiagnosed malignant tumor was emphasized. From then on, a fervent debate in the media has led major scientific societies to express their position on the matter. We present a safe endobag abdominal morcellation in a single port-access laparoscopy subtotal hysterectomy. The endobag abdominal morcellation is feasible and safe; consequently, the development of devices dedicated to intracavitary morcellation in a closed system has been encouraged.

Safety on the Job. Some Guidelines for Working Safely. Instructor's Edition.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

This teacher's guide was developed to help teachers (especially in Oklahoma) promote safe practices on the job. As a supplement to existing programs in the requirements for job safety, this book can also promote same basic safety attitudes and help support basic safety concepts, with an emphasis on accident prevention. The guide contains eight…

Working Safely at Some Times and Unsafely at Others: A Typology and Within-Person Process Model of Safety-Related Work Behaviors.

PubMed

Beus, Jeremy M; Taylor, William D

2017-06-22

Why do individuals choose to work safely in some instances and unsafely in others? Though this inherently within-person question is straightforward, the preponderance of between-person theory and research in the workplace safety literature is not equipped to answer it. Additionally, the limited way in which safety-related behaviors tend to be conceptualized further restricts understanding of why individuals vary in their safety-related actions. We use a goal-focused approach to conceptually address this question of behavioral variability and contribute to workplace safety research in 2 key ways. First, we establish an updated typology of safety-related behaviors that differentiates behaviors based on goal choice (i.e., safe vs. unsafe behaviors), goal-directedness (i.e., intentional vs. unintentional behaviors), and the means of goal pursuit (i.e., commission vs. omission and promotion vs. prevention-focused behaviors). Second, using an expectancy-value theoretical framework to explain variance in goal choice, we establish within-person propositions stating that safety-related goal choice and subsequent behaviors are a function of the target of safety-related behaviors, the instrumentality and resource requirement of behaviors, and the perceived severity, likelihood, and immediacy of the threats associated with behaviors. Taken together, we define what safety-related behaviors are, explain how they differ, and offer propositions concerning when and why they may vary within-persons. We explore potential between-person moderators of our theoretical propositions and discuss the practical implications of our typology and process model of safety-related behavior. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Inexpensive and Safe DNA Gel Electrophoresis Using Household Materials

ERIC Educational Resources Information Center

Ens, S.; Olson, A. B.; Dudley, C.; Ross, N. D., III; Siddiqi, A. A.; Umoh, K. M.; Schneegurt, M. A.

2012-01-01

Gel electrophoresis is the single most important molecular biology technique and it is central to life sciences research, but it is often too expensive for the secondary science classroom or homeschoolers. A simple safe low-cost procedure is described here that uses household materials to construct and run DNA gel electrophoresis. Plastic…

Old and New Techniques as a Safe Hybrid Approach for Carotid Tandem Lesions.

PubMed

Barillà, David; Massara, Mafalda; Alberti, Antonino; Volpe, Alberto; Cutrupi, Andrea; Versace, Paolo; Volpe, Pietro

2016-04-01

Carotid revascularization is performed to prevent stroke. Carotid tandem lesions represent a challenge for treatment, and a hybrid approach may result effective. A high-risk 65-year-old woman presented with a "tandem lesion" of left common and internal carotid artery. She was deemed unfit for "simple" standard carotid endarterectomy (CEA). A "single-step" safe hybrid procedure was scheduled for the patient. A "Cormier" carotid vein graft bypass with a retrograde stenting was performed under local anesthesia. The "safe hybrid procedure" for tandem lesions of the common and internal carotid artery is effective and suitable in high-risk patients in a high-volume centers. Copyright © 2016 Elsevier Inc. All rights reserved.

Practical Tips for the Safe Handling of Micro-organisms in Schools

ERIC Educational Resources Information Center

Holt, G.

1974-01-01

Outlines safe laboratory procedures for the handling of micro-organisms including aseptic technique, manipulation of cultures, and treatment of contaminated equipment. Identifies the principal hazard as the microbial aerosol, explains its possible effects, and describes the appropriate precautions. (GS)

Young Children Can Be Key to Fire-Safe Families

ERIC Educational Resources Information Center

Kourofsky, Carolyn E.; Cole, Robert E.

2010-01-01

For more than 15 years, preschool programs nationwide have worked with Fireproof Children/Prevention First, an international center for injury prevention research and education, to bring fire safety education to young children and their families. The "play safe! be safe!"[R] curriculum includes lessons that young children can learn and understand,…

Acute normovolemic hemodilution is safe in neurosurgery.

PubMed

Oppitz, Paulo P; Stefani, Marco A

2013-01-01

To determine the safety of acute normovolemic hemodilution (ANH) for patients undergoing neurosurgical procedures. A group of 100 patients undergoing neurosurgical procedures was assigned prospectively to receive ANH. A group of 47 patients who underwent craniotomy for aneurysm clipping and standard anesthetic management was used as a control. Procedures conducted under ANH were performed without significant variations in physiologic parameters. Compared with controls, intraoperative blood loss, operative time, incidence and grade of complications, and length of hospital stay were similar between the two groups. Although the ANH group showed a difference in prothrombin levels before and after hemodilution procedures, the levels were still considered within physiologic parameters. Platelet counts and partial thromboplastin time (PTT) levels indicated no significant variations in either group. During the ANH procedure, a considerable reduction of brain oxygen extraction was observed in individuals with worse preoperative neurologic status (P < 0.05), indicating potential benefit. Among patients with cerebral aneurysm, patients with good initial clinical grades had better clinical results as indicated by Glasgow Outcome Scale scores (P < 0.02). ANH is a safe procedure for patients undergoing neurosurgical procedures. Further studies are necessary to confirm the improvement in brain oxygen extraction and the clinical impact. Nonetheless, patients undergoing aneurysm clipping with good clinical grades seem to profit from ANH. Copyright © 2013 Elsevier Inc. All rights reserved.

Understanding procedural violations using Safety-I and Safety-II: The case of community pharmacies.

PubMed

Jones, Christian E L; Phipps, Denham L; Ashcroft, Darren M

2018-06-01

Procedural violations are known to occur in a range of work settings, and are an important topic of interest with regard to safety management. A Safety-I perspective sees violations as undesirable digressions from standardised procedures, while a Safety-II perspective sees violations as adaptations to a complex work system. This study aimed to apply both perspectives to the examination of violations in community pharmacies. Twenty-four participants (13 pharmacists and 11 pharmacy support staff) were purposively sampled to participate in semi-structured interviews using the critical incident technique. Participants described violations they made during the course of their work. Interviews were digitally recorded, transcribed verbatim and analysed using template analysis. Community pharmacies located in England and Wales. 31 procedural violations were described during the interviews revealing multiple reasons for violations in this setting. Our findings suggest that from a Safety-II perspective, staff violated to adapt to situations and to manage safety. However, participants also violated procedures in order to maintain productivity which was found to increase risk in some, but not all situations. Procedural violations often relied on the context in which staff were working, resulting in the violation being deemed rational to the individual making the violation, yet the behaviour may be difficult to justify from an outside perspective. Combining Safety-I and Safety-II perspectives provided a detailed understanding of the underlying reasons for procedural violations. Our findings identify aspects of practice that could benefit from targeted interventions to help support staff in providing safe patient care.

Task-shifting of orthopaedic surgery to non-physician clinicians in Malawi: effective and safe?

PubMed

Wilhelm, Torsten J; Dzimbiri, Kondwani; Sembereka, Victoria; Gumeni, Martin; Bach, Olaf; Mothes, Henning

2017-10-01

There is a shortage of orthopaedic surgeons in Malawi. Orthopaedic clinical officers (OCOs) treat trauma patients and occasionally perform major orthopaedic surgery. No studies have assessed the efficacy and safety of their work. The aim of this study was to evaluate their contribution to major orthopaedic surgery at Zomba Central Hospital. Data about orthopaedic procedures during 2006-2010 were collected from theatre books. We selected major amputations and open reductions and plating for outcome analysis and collected details from files. We compared patients operated by OCOs alone ('OCOs alone' group) and by surgeons or OCOs assisted by surgeons ('Surgeon present' group). OCOs performed 463/1010 major (45.8%) and 1600/1765 minor operations (90.7%) alone. There was no difference in perioperative outcome between both groups. OCOs carry out a large proportion of orthopaedic procedures with good clinical results. Shifting of clinical tasks including major orthopaedic surgery can be safe. Further prospective studies are recommended.

75 FR 21151 - Proposed Collection; Comment Request for Revenue Procedure 2004-18

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-22

... Revenue Procedure 2004- 18 AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice and request... comments concerning Revenue Procedure 2004-18, Average Area Purchase Price Safe Harbors and Nationwide.... OMB Number: 1545-1877. Revenue Procedure Number: Revenue Procedure 2004-18. Abstract: Revenue...

Safe use of chemicals for sterilization in healthcare.

PubMed

Warburton, P Richard

2012-01-01

Chemical sterilization is necessary for temperature sensitive items that cannot be sterilized with steam. These chemical sterilants are by their nature hazardous; otherwise, they would not function well. Modern sterilizers and associated equipment are designed so that these chemicals can be used safely. Whether through mechanical failure, wear and tear, or user error, leaks do sometimes occur. The maximum chemical exposure is determined by OSHA permissible exposure limits, if available, and if not available, employers should use recognized standards. Employers have a duty to ensure safe work environment and take appropriate action to mitigate potential risks. Employers should therefore assess the hazards of the chemicals used, the potential modes for leakage, means for identifying leaks and the risk of exposure of employees. Ideally, work practices should be developed by healthcare facilities so that sterile processing employees know what to do in case of a chemical leak or spill, and how to safely use these chemicals to ensure their own, and patient safety.

Challenges of safe medication practice in paediatric care--a nursing perspective.

PubMed

Star, Kristina; Nordin, Karin; Pöder, Ulrika; Edwards, I Ralph

2013-05-01

To explore nurses' experiences of handling medications in paediatric clinical practice, with a focus on factors that hinder and facilitate safe medication practices. Twenty nurses (registered nurses) from four paediatric wards at two hospitals in Sweden were interviewed in focus groups. The interviews were analysed using content analysis. Six themes emerged from the analysed interviews: the complexity specific for nurses working on paediatric wards is a hindrance to safe medication practices; nurses' concerns about medication errors cause a considerable psychological burden; the individual nurse works hard for safe medication practices and values support from other nurse colleagues; circumstances out of the ordinary are perceived as critical challenges for maintaining patient safety; nurses value clear instructions, guidelines and routines, but these are often missing, variable or changeable; management, other medical professionals, the pharmacy, the pharmaceutical industry and informatics support need to respond to the requirements of the nurses' working situations to improve safe medication practices. Weaknesses were apparent in the long chain of the medication-delivery process. A joint effort by different professions involved in that delivery process, and a nationwide collaboration between hospitals is recommended to increase safe medication practices in paediatric care. ©2013 Foundation Acta Paediatrica. Published by Blackwell Publishing Ltd.

Working from the Inside Out: A Case Study of Mackay Safe Community

ERIC Educational Resources Information Center

Hanson, Dale; Gunning, Colleen; Rose, Judy; McFarlane, Kathryn; Franklin, Richard C.

2015-01-01

Mackay Whitsunday Safe Community (MWSC) was established in 2000 in response to high rates of injury observed in the region. MWSC assumed an ecological perspective, incorporating targeted safety promotion campaigns reinforced by supportive environments and policy. By involving the community in finding its own solutions, MWSC attempted to catalyze…

Interdisciplinary Development of an Improved Emergency Department Procedural Work Surface Through Iterative Design and Use Testing in Simulated and Clinical Environments.

PubMed

Zhang, Xiao C; Bermudez, Ana M; Reddy, Pranav M; Sarpatwari, Ravi R; Chheng, Darin B; Mezoian, Taylor J; Schwartz, Victoria R; Simmons, Quinneil J; Jay, Gregory D; Kobayashi, Leo

2017-03-01

A stable and readily accessible work surface for bedside medical procedures represents a valuable tool for acute care providers. In emergency department (ED) settings, the design and implementation of traditional Mayo stands and related surface devices often limit their availability, portability, and usability, which can lead to suboptimal clinical practice conditions that may affect the safe and effective performance of medical procedures and delivery of patient care. We designed and built a novel, open-source, portable, bedside procedural surface through an iterative development process with use testing in simulated and live clinical environments. The procedural surface development project was conducted between October 2014 and June 2016 at an academic referral hospital and its affiliated simulation facility. An interdisciplinary team of emergency physicians, mechanical engineers, medical students, and design students sought to construct a prototype bedside procedural surface out of off-the-shelf hardware during a collaborative university course on health care design. After determination of end-user needs and core design requirements, multiple prototypes were fabricated and iteratively modified, with early variants featuring undermattress stabilizing supports or ratcheting clamp mechanisms. Versions 1 through 4 underwent 2 hands-on usability-testing simulation sessions; version 5 was presented at a design critique held jointly by a panel of clinical and industrial design faculty for expert feedback. Responding to select feedback elements over several surface versions, investigators arrived at a near-final prototype design for fabrication and use testing in a live clinical setting. This experimental procedural surface (version 8) was constructed and then deployed for controlled usability testing against the standard Mayo stands in use at the study site ED. Clinical providers working in the ED who opted to participate in the study were provided with the prototype

Analogous Mechanisms of Selection and Updating in Declarative and Procedural Working Memory: Experiments and a Computational Model

ERIC Educational Resources Information Center

Oberauer, Klaus; Souza, Alessandra S.; Druey, Michel D.; Gade, Miriam

2013-01-01

The article investigates the mechanisms of selecting and updating representations in declarative and procedural working memory (WM). Declarative WM holds the objects of thought available, whereas procedural WM holds representations of what to do with these objects. Both systems consist of three embedded components: activated long-term memory, a…

Safe motherhood partners -- the International Children's Centre.

PubMed

1994-01-01

The International Children's Centre (ICC) works worldwide to improve child health in the least developed countries. In its training and research projects the agency contributes to the Safe Motherhood Initiative to improve the health of mothers and infants. ICC is based in Paris, it was established in 1949, and the agency has cooperated with governments, nongovernmental organizations and international bodies like the World Health Organization (WHO) in child care. ICC's activities reflect concern for the health of women before and during pregnancy and the rest of their lives. The center's work comprises training, research, local projects, and information and documentation. Following the 1987 Nairobi conference on safe motherhood, ICC organized a seminar in Paris on maternal mortality in Sub-Saharan francophone Africa, which led to participation in the Safe Motherhood Initiative with a variety of training and research programs. ICC training is integrated, community-based, and multidisciplinary. Anthropology, psychology, economics and management have played a role in ICC training courses. The center runs an international course on maternal and child health from January to April each year and also organizes distance training courses on problem solving in health care. ICC training programs have taken place in Laos, Senegal, and Vietnam to strengthen the work of maternal and child health training centers there. A 4-week course on economic evaluation of health programs is held in Paris each July. In 1989 and 1990, ICC organized in collaboration with WHO safe motherhood workshops on research methodology in Benin and in Burkina Faso with participants from 6 francophone African countries. One research project in Benin is on risk factors for maternal and perinatal mortality and morbidity, and the other in Cameroon on improving surveillance of pregnancy, delivery, and the postnatal period. ICC focuses on long-term planning and action for the benefit of mothers and children.

Co-creating Emotionally Safe Environments at Camp: Training Staff To Facilitate Adventure Activities.

ERIC Educational Resources Information Center

Brownlee, Matt; Yerkes, Rita

2003-01-01

An emotionally safe environment helps campers participate in adventure activities. Staff development tips for creating a safe environment include using cooperative goal setting; using parallel training processes; developing working lesson plans that outline facilitation techniques for creating emotionally safe environments; and using co-created…

Cool and Safe: Multiplicity in Safe Innovation at Unilever

ERIC Educational Resources Information Center

Penders, Bart

2011-01-01

This article presents the making of a safe innovation: the application of ice structuring protein (ISP) in edible ices. It argues that safety is not the absence of risk but is an active accomplishment; innovations are not "made safe afterward" but "safe innovations are made". Furthermore, there are multiple safeties to be accomplished in the…

Feeling safe during an inpatient hospitalization: a concept analysis.

PubMed

Mollon, Deene

2014-08-01

This paper aims to explore the critical attributes of the concept feeling safe. The safe delivery of care is a high priority; however; it is not really known what it means to the patient to 'feel safe' during an inpatient hospitalization. This analysis explores the topic of safety from the patient's perspective. Concept analysis. The data bases of CINAHL, Medline, PsychInfo and Google Scholar for the years 1995-2012 were searched using the terms safe and feeling safe. The eight-step concept analysis method of Walker and Avant was used to analyse the concept of feeling safe. Uses and defining attributes, as well as identified antecedents, consequences and empirical referents, are presented. Case examples are provided to assist in the understanding of defining attributes. Feeling safe is defined as an emotional state where perceptions of care contribute to a sense of security and freedom from harm. Four attributes were identified: trust, cared for, presence and knowledge. Relationship, environment and suffering are the antecedents of feeling safe, while control, hope and relaxed or calm are the consequences. Empirical referents and early development of a theory of feeling safe are explored. This analysis begins the work of synthesizing qualitative research already completed around the concept of feeling safe by defining the key attributes of the concept. Support for the importance of developing patient-centred models of care and creating positive environments where patients receive high-quality care and feel safe is provided. © 2014 John Wiley & Sons Ltd.

Safe Sleep Practices of Kansas Birthing Hospitals

PubMed Central

Ahlers-Schmidt, Carolyn R.; Schunn, Christy; Sage, Cherie; Engel, Matthew; Benton, Mary

2018-01-01

Background Sleep-related death is tied with congenital anomalies as the leading cause of infant mortality in Kansas, and external risk factors are present in 83% of these deaths. Hospitals can impact caregiver intentions to follow risk-reduction strategies. This project assessed the current practices and policies of Kansas hospitals with regard to safe sleep. Methods A cross-sectional survey of existing safe sleep practices and policies in Kansas hospitals was performed. Hospitals were categorized based on reported delivery volume and data were compared across hospital sizes. Results Thirty-one of 73 (42%) contacted hospitals responded. Individual survey respondents represented various hospital departments including newborn/well-baby (68%), neonatal intensive care unit (3%) and other non-nursery departments or administration (29%). Fifty-eight percent of respondents reported staff were trained on infant safe sleep; 44% of these held trainings annually. High volume hospitals tended to have more annual training than low or mid volume birth hospitals. Thirty-nine percent reported a safe sleep policy, though most of these (67%) reported never auditing compliance. The top barrier to safe sleep education, regardless of delivery volume, was conflicting patient and family member beliefs. Conclusions Hospital promotion of infant safe sleep is being conducted in Kansas to varying degrees. High and mid volume birth hospitals may need to work more on formal auditing of safe sleep practices, while low volume hospitals may need more staff training. Low volume hospitals also may benefit from access to additional caregiver education materials. Finally, it is important to note hospitals should not be solely responsible for safe sleep education. PMID:29844848

Do procedural skills workshops during family practice residency work?

PubMed Central

MacKenzie, Mark S.; Berkowitz, Jonathan

2010-01-01

ABSTRACT OBJECTIVE To determine if participation in a procedural skills workshop during family practice residency affects future use of these skills in postgraduate clinical practice. DESIGN Survey involving self-assessment of procedural skills experience and competence. SETTING British Columbia. PARTICIPANTS Former University of British Columbia family practice residents who trained in Vancouver, BC, including residents who participated in a procedural skills workshop in 2001 or 2003 and residents graduating in 2000 and 2002 who did not participate in the procedural skills workshop. MAIN OUTCOME MEASURES Self-assessed experience and competence in the 6 office-based procedural skills that were taught during the procedural skills workshops in 2001 and 2003. RESULTS Participation in a procedural skills workshop had no positive effect on future use of these skills in clinical practice. Participation in the workshop was associated with less reported experience (P = .091) in injection of lateral epicondylitis. As with previous Canadian studies, more women than men reported experience and competence in gynecologic procedures. More women than men reported experience (P = .001) and competence (P = .004) in intrauterine device insertion and experience (P = .091) in endometrial aspiration biopsy. More men than women reported competence (P = .052) in injection of trochanteric bursae. A third year of emergency training was correlated with an increase in reported experience (P = .021) in shoulder injection. CONCLUSION Participation in a procedural skills workshop during family practice residency did not produce a significant increase in the performance of these skills on the part of participants once they were in clinical practice. The benefit of a skills workshop might be lost when there is no opportunity to practise and perfect these skills. Sex bias in the case of some procedures might represent a needs-based acquisition of skills on the part of practising physicians. Short

Do procedural skills workshops during family practice residency work?

PubMed

MacKenzie, Mark S; Berkowitz, Jonathan

2010-08-01

To determine if participation in a procedural skills workshop during family practice residency affects future use of these skills in postgraduate clinical practice. Survey involving self-assessment of procedural skills experience and competence. British Columbia. Former University of British Columbia family practice residents who trained in Vancouver, BC, including residents who participated in a procedural skills workshop in 2001 or 2003 and residents graduating in 2000 and 2002 who did not participate in the procedural skills workshop. Self-assessed experience and competence in the 6 office-based procedural skills that were taught during the procedural skills workshops in 2001 and 2003. Participation in a procedural skills workshop had no positive effect on future use of these skills in clinical practice. Participation in the workshop was associated with less reported experience (P = .091) in injection of lateral epicondylitis. As with previous Canadian studies, more women than men reported experience and competence in gynecologic procedures. More women than men reported experience (P = .001) and competence (P = .004) in intrauterine device insertion and experience (P = .091) in endometrial aspiration biopsy. More men than women reported competence (P = .052) in injection of trochanteric bursae. A third year of emergency training was correlated with an increase in reported experience (P = .021) in shoulder injection. Participation in a procedural skills workshop during family practice residency did not produce a significant increase in the performance of these skills on the part of participants once they were in clinical practice. The benefit of a skills workshop might be lost when there is no opportunity to practise and perfect these skills. Sex bias in the case of some procedures might represent a needs-based acquisition of skills on the part of practising physicians. Short procedural skills workshops might be better suited to graduated physicians with more

Effect of episodic and working memory impairments on semantic and cognitive procedural learning at alcohol treatment entry.

PubMed

Pitel, Anne Lise; Witkowski, Thomas; Vabret, François; Guillery-Girard, Bérengère; Desgranges, Béatrice; Eustache, Francis; Beaunieux, Hélène

2007-02-01

Chronic alcoholism is known to impair the functioning of episodic and working memory, which may consequently reduce the ability to learn complex novel information. Nevertheless, semantic and cognitive procedural learning have not been properly explored at alcohol treatment entry, despite its potential clinical relevance. The goal of the present study was therefore to determine whether alcoholic patients, immediately after the weaning phase, are cognitively able to acquire complex new knowledge, given their episodic and working memory deficits. Twenty alcoholic inpatients with episodic memory and working memory deficits at alcohol treatment entry and a control group of 20 healthy subjects underwent a protocol of semantic acquisition and cognitive procedural learning. The semantic learning task consisted of the acquisition of 10 novel concepts, while subjects were administered the Tower of Toronto task to measure cognitive procedural learning. Analyses showed that although alcoholic subjects were able to acquire the category and features of the semantic concepts, albeit slowly, they presented impaired label learning. In the control group, executive functions and episodic memory predicted semantic learning in the first and second halves of the protocol, respectively. In addition to the cognitive processes involved in the learning strategies invoked by controls, alcoholic subjects seem to attempt to compensate for their impaired cognitive functions, invoking capacities of short-term passive storage. Regarding cognitive procedural learning, although the patients eventually achieved the same results as the controls, they failed to automate the procedure. Contrary to the control group, the alcoholic groups' learning performance was predicted by controlled cognitive functions throughout the protocol. At alcohol treatment entry, alcoholic patients with neuropsychological deficits have difficulty acquiring novel semantic and cognitive procedural knowledge. Compared with

Sexual harassment at work place: are you safe?

PubMed

Naveed, Anila; Tharani, Ambreen; Alwani, Nasreen

2010-01-01

In today's world women are increasingly participating in the realm of work force, yet they are facing many obstacles in their way. Sexual harassment is one of those obstacles. Sexual harassment at work place is prevalent in every society. It could happen to anyone but women are the targeted victims. Sexual harassment is considered as a traumatic event and the victim may end up in having physical and mental sufferings that hinders a person to work effectively. At an organisational level this may result in decrease work effectiveness, decreased work productivity, high absenteeism, high turnover, and low staff morale. Hence there is a need that, organisations and government should look seriously into this matter. Proper education and training programs should be developed to deal with these issues. The goal must be both to deal with sexual harassment incidents effectively and to prevent the occurrence of future incidents.

Microbial ecology laboratory procedures manual NASA/MSFC

NASA Technical Reports Server (NTRS)

Huff, Timothy L.

1990-01-01

An essential part of the efficient operation of any microbiology laboratory involved in sample analysis is a standard procedures manual. The purpose of this manual is to provide concise and well defined instructions on routine technical procedures involving sample analysis and methods for monitoring and maintaining quality control within the laboratory. Of equal importance is the safe operation of the laboratory. This manual outlines detailed procedures to be followed in the microbial ecology laboratory to assure safety, analytical control, and validity of results.

EPA Reaches Settlement with Two N.H. Companies for Failure to Disclose Lead Paint Information or Follow Lead-Safe Work Practices at Residential Property in Manchester

EPA Pesticide Factsheets

The U.S. EPA finalized a settlement agreement with two N.H. companies for their alleged failure to follow lead-safe work practices and provide proper lead paint disclosure to tenants at a residential property in Manchester, N.H.

Effective Work Procedure design Using Discomfort and Effort Factor in Brick stacking operation-A case study

NASA Astrophysics Data System (ADS)

Rout, Biswaranjan; Dash, R. R.; Dhupal, D.

2018-02-01

In this work a typical planning of movement of limbs and torso of the worker to be well design to reduce fatigue and energy of the worker. A simulation model is generated to suit the procedure and comply with the constraints in the workspace. It requires verifying the capability of human postures and movements in different working conditions for the evaluation of effectiveness of the new design. In this article a simple human performance measure is introduce that enable the mathematical model for evaluation of a cost function. The basic scheme is to evaluate the performance in the form of several cost factors using AI techniques. Here two main cost factors taken in to consideration are discomfort factor and effort factor in limb movements. Discomfort factor measures the level of discomfort from the most neutral position of a given limb to the position of the corresponding limb after movement and effort factor is a measure of the displacement of the corresponding limbs from the original position. The basic aim is to optimize the movement of the limbs with the above mentioned cost functions. The effectiveness of the procedure is tested with an example of working procedure of workers used for stacking of fly ash bricks in a local fly ash bricks manufacturing unit. The objective is to find out the optimised movement of the limbs to reduce discomfort level and effort required of workers. The effectiveness of the procedure in this case study illustrated with the obtained results.

Multilevel models in the explanation of the relationship between safety climate and safe behavior.

PubMed

Cheyne, Alistair; Tomás, José M; Oliver, Amparo

2013-01-01

This study examines the relationships between components of organizational safety climate, including employee attitudes to organizational safety issues; perceptions of the physical working environment, and evaluations of worker engagement with safety issues; and relates these to self-reported levels of safety behavior. It attempts to explore the relationships between these variables in 1189 workers across 78 work groups in a large transportation organization. Evaluations of safety climate, the working environment and worker engagement, as well as safe behaviors, were collected using a self report questionnaire. The multilevel analysis showed that both levels of evaluation (the work group and the individual), and some cross-level interactions, were significant in explaining safe behaviors. Analyses revealed that a number of variables, at both levels, were associated with worker engagement and safe behaviors. The results suggest that, while individual evaluations of safety issues are important, there is also a role for the fostering of collective safety climates in encouraging safe behaviors and therefore reducing accidents.

Work history and radioprotection practices in relation to cancer incidence and mortality in US radiologic technologists performing nuclear medicine procedures.

PubMed

Bernier, Marie Odile; Doody, Michele M; Van Dyke, Miriam E; Villoing, Daphné; Alexander, Bruce H; Linet, Martha S; Kitahara, Cari M

2018-05-02

Technologists working in nuclear medicine (NM) are exposed to higher radiation doses than most other occupationally exposed populations. The aim of this study was to estimate the risk of cancer in NM technologists in relation to work history, procedures performed and radioprotection practices. From the US Radiologic Technologists cohort study, 72 755 radiologic technologists who completed a 2003-2005 questionnaire were followed for cancer mortality through 31 December 2012 and for cancer incidence through completion of a questionnaire in 2012-2013. Multivariable-adjusted models were used to estimate HRs for total cancer incidence and mortality by history of ever performing NM procedures and frequency of performing specific diagnostic or therapeutic NM procedures and associated radiation protection measures by decade. During follow-up (mean=7.5 years), 960 incident cancers and 425 cancer deaths were reported among the 22 360 technologists who worked with NM procedures. We observed no increased risk of cancer incidence (HR 0.96, 95% CI 0.89 to 1.04) or death (HR 1.05, 95% CI 0.93 to 1.19) among workers who ever performed NM procedures. HRs for cancer incidence but not mortality were higher for technologists who began performing therapeutic procedures in 1960 and later compared with the 1950s. Frequency of performing diagnostic or therapeutic NM procedures and use of radioprotection measures were not consistently associated with cancer risk. No clear associations were observed for specific cancers, but results were based on small numbers. Cancer incidence and mortality were not associated with NM work history practices, including greater frequency of procedures performed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Immediate Titanium Mesh Implantation for Patients with Postcraniotomy Neurosurgical Site Infections: Safe and Aesthetic Alternative Procedure?

PubMed

Ehrlich, Gregory; Kindling, Stefanie; Wenz, Holger; Hänggi, Daniel; Schulte, Dirk Michael; Schmiedek, Peter; Seiz-Rosenhagen, Marcel

2017-03-01

Surgical site infection (SSI) is one of the main complications after craniotomy. The incidence is up to 11% in the literature. The established procedure is debridement, removal of the bone flap, and delayed cranioplasty. Delayed cranioplasty has several disadvantages. A promising approach is the immediate titanium mesh implantation at the time of wound revision. We report our experience with this technique regarding outcome measured by reinfection rates and patient satisfaction. Patients treated in our department from January 2013 to October 2014 with SSI after craniotomy for brain tumor, trauma, or vascular pathologies were prospectively collected. In all these patients, immediate titanium mesh implantation after bone flap removal was performed. Primary outcome parameters were the reinfection rate and patient satisfaction via self-designed questionnaires in a follow-up period >3 months. Twenty-four patients were included within the study period. Main risk factors causing SSI were previous steroid medication (62.5%), cranial radiation therapy (42%), cerebrospinal fluid fistula after initial surgery (12.5%), and diabetes mellitus (25%). The follow-up was >3 months after titanium mesh cranioplasty (mean 4.6 months; range 3-6 months). No recurrent infection was detected in the study group. In 2 cases, reoperation was necessary. The returning questionnaires showed a high satisfaction rate with the cosmetic result. Our small series seems to confirm that immediate titanium mesh implantation for patients with postcraniotomy SSI is a cost-effective, safe, and cosmetically suitable alternative to delayed cranioplasty in selected patients without hydrocephalus or persistent cerebrospinal fluid fistula. Copyright © 2016 Elsevier Inc. All rights reserved.

29 CFR 1915.15 - Maintenance of safe conditions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Enclosed Spaces and Other Dangerous Atmospheres in Shipyard Employment § 1915.15 Maintenance of safe... within a tested confined or enclosed space or other dangerous atmosphere occurs, work in the affected...

29 CFR 1915.15 - Maintenance of safe conditions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Enclosed Spaces and Other Dangerous Atmospheres in Shipyard Employment § 1915.15 Maintenance of safe... within a tested confined or enclosed space or other dangerous atmosphere occurs, work in the affected...

29 CFR 1915.15 - Maintenance of safe conditions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Enclosed Spaces and Other Dangerous Atmospheres in Shipyard Employment § 1915.15 Maintenance of safe... within a tested confined or enclosed space or other dangerous atmosphere occurs, work in the affected...

Investigation of safe-life fail-safe criteria for the space shuttle

NASA Technical Reports Server (NTRS)

1972-01-01

An investigation was made to determine the effects of a safe-life design approach and a fail-safe design approach on the space shuttle booster vehicle structure, and to recommend any changes to the structural design criteria. Two configurations of the booster vehicle were considered, one incorporating a delta wing (B-9U configuration) and the other a swept wing (B-16B configuration). Several major structural components of the booster were studied to determine the fatigue life, safe-life, and fail-safe capabilities of the baseline design. Each component was investigated to determine the practicability of applying a safe-life or fail-safe design philosophy, the changes such design approaches might require, and the impact of these changes on weight, cost, development plans, and performance.

[The transrectus sheath preperitoneal procedure: a safe, effective and cheap surgical approach to inguinal hernia?].

PubMed

Prins, M W Wiesje; Voropai, D A Dasha; van Laarhoven, C J H M Kees; Akkersdijk, Willem L

2013-01-01

The main complication of surgery for inguinal hernia is chronic postoperative pain. This is often reported following the Lichtenstein procedure. A new, open surgical technique for the repair of inguinal hernia has been developed. This procedure is called the transrectus sheath preperitoneal procedure (TREPP). At TREPP a lightweight mesh with a ring made of memory metal is introduced into the preperitoneal space through the transrectus sheath. The first results of this operative technique are very promising: short operation time, short learning curve and not many patients with chronic postoperative pain. In a randomised, multi-centre study which will start mid-2013 (ISRCTN18591339), the TREPP procedure is compared with the transinguinal preperitoneal procedure. The primary outcome measure of this study is chronic postoperative pain.

Implementation of Safe-by-Design for Nanomaterial Development and Safe Innovation: Why We Need a Comprehensive Approach

PubMed Central

Kraegeloh, Annette; Suarez-Merino, Blanca; Sluijters, Teun; Micheletti, Christian

2018-01-01

Manufactured nanomaterials (MNMs) are regarded as key components of innovations in various fields with high potential impact (e.g., energy generation and storage, electronics, photonics, diagnostics, theranostics, or drug delivery agents). Widespread use of MNMs raises concerns about their safety for humans and the environment, possibly limiting the impact of the nanotechnology-based innovation. The development of safe MNMs and nanoproducts has to result in a safe as well as functional material or product. Its safe use, and disposal at the end of its life cycle must be taken into account too. However, not all MNMs are similarly useful for all applications, some might bear a higher hazard potential than others, and use scenarios could lead to different exposure probabilities. To improve both safety and efficacy of nanotechnology, we think that a new proactive approach is necessary, based on pre-regulatory safety assessment and dialogue between stakeholders. On the basis of the work carried out in different European Union (EU) initiatives, developing and integrating MNMs Safe-by-Design and Trusted Environments (NANoREG, ProSafe, and NanoReg2), we present our point of view here. This concept, when fully developed, will allow for cost effective industrial innovation, and an exchange of key information between regulators and innovators. Regulators are thus informed about incoming innovations in good time, supporting a proactive regulatory action. The final goal is to contribute to the nanotechnology governance, having faster, cheaper, effective, and safer nano-products on the market. PMID:29661997

Implementation of Safe-by-Design for Nanomaterial Development and Safe Innovation: Why We Need a Comprehensive Approach.

PubMed

Kraegeloh, Annette; Suarez-Merino, Blanca; Sluijters, Teun; Micheletti, Christian

2018-04-14

Manufactured nanomaterials (MNMs) are regarded as key components of innovations in various fields with high potential impact (e.g., energy generation and storage, electronics, photonics, diagnostics, theranostics, or drug delivery agents). Widespread use of MNMs raises concerns about their safety for humans and the environment, possibly limiting the impact of the nanotechnology-based innovation. The development of safe MNMs and nanoproducts has to result in a safe as well as functional material or product. Its safe use, and disposal at the end of its life cycle must be taken into account too. However, not all MNMs are similarly useful for all applications, some might bear a higher hazard potential than others, and use scenarios could lead to different exposure probabilities. To improve both safety and efficacy of nanotechnology, we think that a new proactive approach is necessary, based on pre-regulatory safety assessment and dialogue between stakeholders. On the basis of the work carried out in different European Union (EU) initiatives, developing and integrating MNMs Safe-by-Design and Trusted Environments (NANoREG, ProSafe, and NanoReg2), we present our point of view here. This concept, when fully developed, will allow for cost effective industrial innovation, and an exchange of key information between regulators and innovators. Regulators are thus informed about incoming innovations in good time, supporting a proactive regulatory action. The final goal is to contribute to the nanotechnology governance, having faster, cheaper, effective, and safer nano-products on the market.

Safety of propofol sedation for pediatric outpatient procedures.

PubMed

Larsen, Reagan; Galloway, David; Wadera, Sheetal; Kjar, Dean; Hardy, David; Mirkes, Curtis; Wick, Lori; Pohl, John F

2009-10-01

Propofol sedation is used more frequently in pediatric procedures because of its ability to provide varying sedation levels. The authors evaluated all outpatient pediatric procedures using propofol sedation over a 6-year period. All sedation was provided by pediatric intensivists at a single institution. In all, 4716 procedures were recorded during the study period; 15% of procedures were associated with minor complications, whereas only 0.1% of procedures were associated with major complications. Significantly more major complications associated with propofol occurred during bronchoscopy (P = .001). Propofol administered by a pediatric intensivist is a safe sedation technique in the pediatric outpatient setting.

Household's willingness to pay for arsenic safe drinking water in Bangladesh.

PubMed

Khan, Nasreen Islam; Brouwer, Roy; Yang, Hong

2014-10-01

This study examines willingness to pay (WTP) in Bangladesh for arsenic (As) safe drinking water across different As-risk zones, applying a double bound discrete choice value elicitation approach. The study aims to provide a robust estimate of the benefits of As safe drinking water supply, which is compared to the results from a similar study published almost 10 years ago using a single bound estimation procedure. Tests show that the double bound valuation design does not suffer from anchoring or incentive incompatibility effects. Health risk awareness levels are high and households are willing to pay on average about 5 percent of their disposable average annual household income for As safe drinking water. Important factors influencing WTP include the bid amount to construct communal deep tubewell for As safe water supply, the risk zone where respondents live, household income, water consumption, awareness of water source contamination, whether household members are affected by As contamination, and whether they already take mitigation measures. Copyright © 2014 Elsevier Ltd. All rights reserved.

Safe Space Oddity: Revisiting Critical Pedagogy

ERIC Educational Resources Information Center

Redmond, Melissa

2010-01-01

Inspired by an incident in a social work graduate classroom in which she was a teaching assistant, the author reflects on her commitment to constructivist teaching methods, critical theory, and critical pedagogy. Exploring the educational utility of notions such as public space and safe space, the author employs this personal experience to examine…

Safe Zones: Creating LGBT Safe Space Ally Programs

ERIC Educational Resources Information Center

Poynter, Kerry John; Tubbs, Nancy Jean

2008-01-01

This article discusses model LGBT Safe Space Ally programs. These programs, often called "Safe Zones," include self selected students, faculty, and employees who publicly show support by displaying stickers, signs, and other identifiable items. Issues covered in the article include history, development, training, membership, assessment, and…

Driving Procedures. A Resource Guide for Driver Education Teachers.

ERIC Educational Resources Information Center

Texas State Dept. of Public Safety, Austin.

Designed to provide instructors with resource materials for driver education, this book contains mainly materials on established safe driving procedures. An introduction defines a procedure as describing ways in which a driver can comply with the law to do something extra that will increase his/her safety and prevent congestion and collision.…

Hemodynamic stability during laryngeal electromyography procedures.

PubMed

Lu, Yi-An; Pei, Yu-Cheng; Wong, Alice Mk; Chiang, Hui-Chen; Fang, Tuan-Jen

2017-10-01

Laryngeal electromyography (LEMG) is accepted as safe, with minimal side effects. However, patient hemodynamic stability, during these procedures, has not been reported. This study aimed to investigate the hemodynamics in patients undergoing LEMG and determine the risk factors for hemodynamic changes. We recruited 89 consecutive patients who underwent LEMG. Baseline and postprocedural changes in vital signs were analyzed. Diastolic blood pressure (DBP) increased from 75.08 ± 11.54 mmHg preprocedure to 77.4 ± 11.91 mmHg postprocedure (p = .006); pulse rate (PR) increased from 78.1 ± 13.3 beats per minute preprocedure to 80.02 ± 13.69 postprocedure (p = .027). Systolic blood pressure (SBP) and oxygen saturation were unchanged after the procedure. However, about 17% of patients experienced profound changes in vital signs of >20% above baseline during LEMG. The hemodynamic changes did not differ between sexes or between surgical and non-surgical etiologies of vocal fold paralysis. Two patients experienced profound but reversible near-syncope during the procedure. LEMG is a safe procedure with few immediate complications, though it may affect the patient's hemodynamic status by increasing DBP and PR. The hemodynamic monitoring is recommended so that timely intervention can be applied in case any warning sign occurs.

Ensuring a Safe Technological Revolution

DTIC Science & Technology

2016-12-01

Defense AT&L: November-December 2016 14 Ensuring a Safe Technological Revolution William E. Frazier, Ph.D. n Elizabeth L. McMichael n Jennifer...for 5 years, working on nonferrous welding and AM and has an M.S. in Mechanical Engineering from the University of Maryland, Baltimore County. I n...has acceptable proper- ties. A “certified” part can perform properly in its operating environment . The conventional qualification/certification

A Safe School's Top 10 Needs

ERIC Educational Resources Information Center

Brunner, Judy; Lewis, Dennis

2005-01-01

An environment of safety in the school seldom comes down to any one particular component or plan; it is a combination of strategies and ideas that makes a school safe and secure for everyone. In this article, the authors provide practical information to educators who are already working to capacity in terms of time allocation and monetary…

Pelvic denervation procedures for dysmenorrhea.

PubMed

Ramirez, Christina; Donnellan, Nicole

2017-08-01

Chronic pelvic pain and dysmenorrhea are common conditions affecting reproductive-age women. Surgical pelvic denervation procedures may be a treatment option for women with midline dysmenorrhea, in which medical management is declined by the patient, ineffective at managing symptoms, or medically contraindicated. This review describes the surgical techniques and complications associated with pelvic denervation procedures as well as the current evidence for these procedures in women with primary dysmenorrhea and dysmenorrhea secondary to endometriosis. Presacral neurectomy is the preferred pelvic denervation procedure in patients with primary dysmenorrhea and midline chronic pelvic pain associated with endometriosis. In patients with endometriosis presacral neurectomy is a useful adjunct to excision or ablation of all endometrial lesions to improve postoperative pain relief. There is no additional patient benefit of performing combined presacral neurectomy and uterine nerve ablation procedures. Pelvic denervation procedures can be performed safely and quickly with a low risk of complication if the surgeon is knowledgeable and skilled in operating in the presacral space. Patients should be adequately counseled on expected success rates and potential complications associated with pelvic denervation procedures.

Student Discipline Rights and Procedures: A Guide for Advocates

ERIC Educational Resources Information Center

Boylan, Ellen

2004-01-01

To be both fair and effective, student discipline law and policy must balance two separate rights of students: the constitutional right to a public education, and the right to a safe and orderly learning environment. Procedures and laws to protect students from arbitrary and wrongful discipline are necessary, as are procedures and laws to allow…

Why don't humanitarian organizations provide safe abortion services?

PubMed

McGinn, Therese; Casey, Sara E

2016-01-01

Although sexual and reproductive health services have become more available in humanitarian settings over the last decade, safe abortion services are still rarely provided. The authors' observations suggest that four reasons are typically given for this gap: 'There's no need'; 'Abortion is too complicated to provide in crises'; 'Donors don't fund abortion services'; and 'Abortion is illegal'. However, each of these reasons is based on false premises. Unsafe abortion is a major cause of maternal mortality globally, and the collapse of health systems in crises suggests it likely increases in humanitarian settings. Abortion procedures can be safely performed in health centers by mid-level providers without sophisticated equipment or supplies. Although US government aid does not fund abortion-related activities, other donors, including many European governments, do fund abortion services. In most countries, covering 99 % of the world's population, abortion is permitted under some circumstances; it is illegal without exception in only six countries. International law supports improved access to safe abortion. As none of the reasons often cited for not providing these services is valid, it is the responsibility of humanitarian NGOs to decide where they stand regarding their commitment to humanitarian standards and women's right to high quality and non-discriminatory health services. Providing safe abortion to women who become pregnant as a result of rape in war may be a more comfortable place for organizations to begin the discussion. Making safe abortion available will improve women's health and human rights and save lives.

Development of an Ultra-Safe Rechargeable Lithium-Ion Battery.

DTIC Science & Technology

1994-11-15

34 DEVELOPMENT OF AN ULTRA-SAFE RECHARGEABLE LITHIUM - ION BATTERY DTIC \\ JANI 0 1995 19941221 079 Contract # N00014-94-C-0141 ARPA Order...DEVELOPMENT OF AN ULTRA-SAFE RECHARGEABLE LITHIUM - ION BATTERY R&D STATUS REPORT 1931-1001/0 ARPA Order No.: 9332004arp01/13APR1994/313ES Program Code...Title of Work: Lithium - ion Battery Development Reporting Period: August 15, 1994 to November 15, 1994 Description of Progress: The project activities had

Office procedures: practical and safety considerations.

PubMed

Erickson, Ty B

2012-09-01

Gynecologic invasive procedures have moved into the physician's office due to improved reimbursement and convenience. Creating a just and safe office culture has generated robust conversations in the medical literature. This article reviews the foundational principles relating to safe practices in the office including: checklists, drills, selecting a safety officer, achieving office certification, medication usage, and engaging the patient in the safety culture. Reduction of medical errors in the office will require open dialogue between the stake holders: providers, insurers, patients, state and federal agencies, and educational bodies such as the American College of Obstetricians and Gynecologists.

Transthoracic Adrenal Biopsy Procedure Using Artificial Carbon Dioxide Pneumothorax as Outpatient Procedure

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

Favelier, Sylvain; Guiu, Severine; Cherblanc, Violaine

2013-08-01

Many routes have been described for percutaneous adrenal gland biopsy. They require either a complex non-axial path or a long hydrodissection or even pass through an organ thereby increasing complications. We describe here an approach using an artificially-induced carbon dioxide (CO{sub 2}) pneumothorax, performed as an outpatient procedure in a 57-year-old woman. Under local anaesthesia, 200 ml of CO{sub 2} was injected in the pleural space through a Veress needle under computed tomography fluoroscopy, to clear the lung parenchyma from the biopsy route. Using this technique, transthoracic adrenal biopsy can be performed under simple local anaesthesia as an safely outpatientmore » procedure.« less

Flywheel Rotor Safe-Life Technology

NASA Technical Reports Server (NTRS)

Ratner, J. K. H.; Chang, J. B.; Christopher, D. A.; McLallin, Kerry L. (Technical Monitor)

2002-01-01

Since the 1960s, research has been conducted into the use of flywheels as energy storage systems. The-proposed applications include energy storage for hybrid and electric automobiles, attitude control and energy storage for satellites, and uninterruptible power supplies for hospitals and computer centers. For many years, however, the use of flywheels for space applications was restricted by the total weight of a system employing a metal rotor. With recent technological advances in the manufacturing of composite materials, however, lightweight composite rotors have begun to be proposed for such applications. Flywheels with composite rotors provide much higher power and energy storage capabilities than conventional chemical batteries. However, the failure of a high speed flywheel rotor could be a catastrophic event. For this reason, flywheel rotors are classified by the NASA Fracture Control Requirements Standard as fracture critical parts. Currently, there is no industry standard to certify a composite rotor for safe and reliable operation forth( required lifetime of the flywheel. Technical problems hindering the development of this standard include composite manufacturing inconsistencies, insufficient nondestructive evaluation (NDE) techniques for detecting defects and/or impact damage, lack of standard material test methods for characterizing composite rotor design allowables, and no unified proof (over-spin) test for flight rotors. As part of a flywheel rotor safe-life certification pro-ram funded b the government, a review of the state of the art in composite rotors is in progress. The goal of the review is to provide a clear picture of composite flywheel rotor technologies. The literature review has concentrated on the following topics concerning composites and composite rotors: durability (fatigue) and damage tolerance (safe-life) analysis/test methods, in-service NDE and health monitoring techniques, spin test methods/ procedures, and containment options

Safe delivery practices: experience from cross-sectional data of Bangladeshi women.

PubMed

Kabir, M A; Goh, Kim-Leng; Khan, M M H; Al-Amin, Abul Quasem; Azam, Mohammad Nurul

2015-03-01

This study examines the safe delivery practices of Bangladeshi women using data on 4905 ever-married women aged 15 to 49 years from the 2007 Bangladesh Demographic and Health Survey. Variables that included age, region of origin, education level of respondent and spouse, residence, working status, religion, involvement in NGOs, mass media exposure, and wealth index were analyzed to find correlates of safe delivery practices. More than 80% of the deliveries took place at home, and only 18% were under safe and hygienic conditions. The likelihood of safe deliveries was significantly lower among younger and older mothers than middle-aged mothers and higher among educated mothers and those living in urban areas. Economically better-off mothers and those with greater exposure to mass media had a significantly higher incidence of safe delivery practices. A significant association with religion and safe delivery practices was revealed. Demographic, socioeconomic, cultural, and programmatic factors that are strongly associated with safe delivery practices should be considered in the formulation of reproductive health policy. © 2012 APJPH.

Assessing Procedural Competence: Validity Considerations.

PubMed

Pugh, Debra M; Wood, Timothy J; Boulet, John R

2015-10-01

Simulation-based medical education (SBME) offers opportunities for trainees to learn how to perform procedures and to be assessed in a safe environment. However, SBME research studies often lack robust evidence to support the validity of the interpretation of the results obtained from tools used to assess trainees' skills. The purpose of this paper is to describe how a validity framework can be applied when reporting and interpreting the results of a simulation-based assessment of skills related to performing procedures. The authors discuss various sources of validity evidence because they relate to SBME. A case study is presented.

Diversity and Similarity of Anesthesia Procedures in the United States During and Among Regular Work Hours, Evenings, and Weekends.

PubMed

Dexter, Franklin; Epstein, Richard H; Dutton, Richard P; Kordylewski, Hubert; Ledolter, Johannes; Rosenberg, Henry; Hindman, Bradley J

2016-12-01

Anesthesiologists providing care during off hours (ie, weekends or holidays, or cases started during the evening or late afternoon) are more likely to care for patients at greater risk of sustaining major adverse events than when they work during regular hours (eg, Monday through Friday, from 7:00 AM to 2:59 PM). We consider the logical inconsistency of using subspecialty teams during regular hours but not during weekends or evenings. We analyzed data from the Anesthesia Quality Institute's National Anesthesia Clinical Outcomes Registry (NACOR). Among the hospitals in the United States, we estimated the average number of common types of anesthesia procedures (ie, diversity measured as inverse of Herfindahl index), and the average difference in the number of common procedures between 2 off-hours periods (regular hours versus weekends, and regular hours versus evenings). We also used NACOR data to estimate the average similarity in the distributions of procedures between regular hours and weekends and between regular hours and evenings in US facilities. Results are reported as mean ± standard error of the mean among 399 facilities nationwide with weekend cases. The distributions of common procedures were moderately similar (ie, not large, <.8) between regular hours and evenings (similarity index .59 ± .01) and between regular hours and weekends (similarity index, .55 ± .02). For most facilities, the number of common procedures differed by <5 procedures between regular hours and evenings (74.4% of facilities, P < .0001) and between regular hours and weekends (64.7% of facilities, P < .0001). The average number of common procedures was 13.59 ± .12 for regular hours, 13.12 ± .13 for evenings, and 9.43 ± .13 for weekends. The pairwise differences by facility were .13 ± .07 procedures (P = .090) between regular hours and evenings and 3.37 ± .12 procedures (P < .0001) between regular hours and weekends. In contrast, the differences were -5.18 ± .12 and 7.59 ± .13

Reactive, Safe Navigation for Lunar and Planetary Robots

NASA Technical Reports Server (NTRS)

Utz, Hans; Ruland, Thomas

2008-01-01

When humans return to the moon, Astronauts will be accompanied by robotic helpers. Enabling robots to safely operate near astronauts on the lunar surface has the potential to significantly improve the efficiency of crew surface operations. Safely operating robots in close proximity to astronauts on the lunar surface requires reactive obstacle avoidance capabilities not available on existing planetary robots. In this paper we present work on safe, reactive navigation using a stereo based high-speed terrain analysis and obstacle avoidance system. Advances in the design of the algorithms allow it to run terrain analysis and obstacle avoidance algorithms at full frame rate (30Hz) on off the shelf hardware. The results of this analysis are fed into a fast, reactive path selection module, enforcing the safety of the chosen actions. The key components of the system are discussed and test results are presented.

[Offshore work and the work of nurses on board: an integrative review].

PubMed

Antoniolli, Silvana Aline Cordeiro; Emmel, Suzel Vaz; Ferreira, Gímerson Erick; Paz, Potiguara de Oliveira; Kaiser, Dagmar Elaine

2015-08-01

To know the production of theoretical approaches on issues related to offshore work and the work of offshore nurses. Integrative literature review conducted in the databases of LILACS, BDENF, MEDLINE, SciELO and Index PSI. We selected 33 studies published in national and international journals between 1997 and 2014. The thematic analysis corpus resulted in four central themes: offshore work environment; amid work adversities, an escape; structuring of offshore health and safety services; in search of safe practices. This study contributes to the offshore work of nurses in relation to the nature of work, acting amid adversities and the restless search for safe practices in the open sea.

Time-saving and fail-safe dissection method for vestibulocochlear organs in gross anatomy classes.

PubMed

Suzuki, Ryoji; Konno, Naoaki; Ishizawa, Akimitsu; Kanatsu, Yoshinori; Funakoshi, Kodai; Akashi, Hideo; Zhou, Ming; Abe, Hiroshi

2017-09-01

Because the vestibulocochlear organs are tiny and complex, and are covered by the petrous part of the temporal bone, they are very difficult for medical students to dissect and visualize during gross anatomy classes. Here, we report a time-saving and fail-safe procedure we have devised, using a hand-held hobby router. Nine en bloc temporal bone samples from donated human cadavers were used as trial materials for devising an appropriate procedure for dissecting the vestibulocochlear organs. A hand-held hobby router was used to cut through the temporal bone. After trials, the most time-saving and fail-safe method was selected. The performance of the selected method was assessed by a survey of 242 sides of 121 cadavers during gross anatomy classes for vestibulocochlear dissection. The assessment was based on the observation ratio. The best procedure appeared to be removal of the external acoustic meatus roof and tympanic cavity roof together with removal of the internal acoustic meatus roof. The whole procedure was completed within two dissection classes, each lasting 4.5 hr. The ratio of surveillance for the chorda tympani and three semicircular canals by students was significantly improved during 2013 through 2016. In our dissection class, "removal of the external acoustic meatus roof and tympanic cavity roof together with removal of the internal acoustic meatus roof" was the best procedure for students in the limited time available. Clin. Anat. 30:703-710, 2017. © 2017Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Getting Home Safe and Sound: Occupational Safety and Health Administration at 38

PubMed Central

Silverstein, Michael

2008-01-01

The Occupational Safety and Health Act of 1970 (OSHAct) declared that every worker is entitled to safe and healthful working conditions, and that employers are responsible for work being free from all recognized hazards. Thirty-eight years after these assurances, however, it is difficult to find anyone who believes the promise of the OSHAct has been met. The persistence of preventable, life-threatening hazards at work is a failure to keep a national promise. I review the history of the Occupational Safety and Health Administration and propose measures to better ensure that those who go to work every day return home safe and sound. These measures fall into 6 areas: leverage and accountability, safety and health systems, employee rights, equal protection, framing, and infrastructure. PMID:18235060

Getting home safe and sound: occupational safety and health administration at 38.

PubMed

Silverstein, Michael

2008-03-01

The Occupational Safety and Health Act of 1970 (OSHAct) declared that every worker is entitled to safe and healthful working conditions, and that employers are responsible for work being free from all recognized hazards. Thirty-eight years after these assurances, however, it is difficult to find anyone who believes the promise of the OSHAct has been met. The persistence of preventable, life-threatening hazards at work is a failure to keep a national promise. I review the history of the Occupational Safety and Health Administration and propose measures to better ensure that those who go to work every day return home safe and sound. These measures fall into 6 areas: leverage and accountability, safety and health systems, employee rights, equal protection, framing, and infrastructure.

Marital Status and Return to Work After Living Kidney Donation.

PubMed

Frech, Adrianne; Natale, Ginny; Hayes, Don; Tumin, Dmitry

2018-01-01

Living kidney donation is safe and effective, but patients in need of a transplant continue to outnumber donors. Disincentives to living donation include lost income, risk of job loss, perioperative complications, and unreimbursed medical expenses. This study uses US registry and follow-up data on living kidney donors from 2013 to 2015 to identify social predictors of return to work across gender following living kidney donation. Using logistic regression, we find that predictors of return to work following living kidney donation differ for women and men. Among women, age, education, smoking status, and procedure type are associated with return to work. Among men, education, procedure type, and hospital readmission within 6 weeks postdonation are associated with return to work. Notably, single and divorced men are less likely to return to work compared to married men (odds ratio [OR] for single men 0.51, 95% confidence interval [CI], 0.37-0.69, P < .001; OR for divorced men 0.51, 95% CI, 0.34-0.75, P = .006). Marital status is not associated with return to work for women. Single and divorced men's greater odds of not returning to work are robust to controls for relevant pre- and postdonation characteristics. Single and divorced men's lack of social support may present an obstacle to work resumption following living kidney donation.

METHOD OF CONDUCTING A PERSON BETWEEN A SAFE REGION AND A DANGEROUS REGION

DOEpatents

Moulthrop, H.A.

1957-11-12

This invention relates to a method for conducting a person between a safe region and a dangerous or con taminated region so that he may work in the dangerous region without risk to himself or the hinderance of an attached tube, and without danger of contaminating the safe region. A safely suit in which a person is to work is connected by a thermoplastic tube, turned partially inside out, to a hole in the wall separating the dangerous region. The tube is sealed by pressure and separated into two parts at the seal, whereupon the person in the suit may move around freely in the dangerous area. When the person desires to exit the dangerous region, the parts of the tube are resealed, removing a portion of the tube at the seal, and the person leaves the hole whcre he entered, seals the tube to close the hole, and cuts his suit free from the tube. Bands of masking tape inside and outside of the tube at predetermined points simplify the pressure sealing of the tube at the desired points. This patent provides a simple, safe and economical method of freely working in a dangerous region.

The Safe Yield and Climatic Variability: Implications for Groundwater Management.

PubMed

Loáiciga, Hugo A

2017-05-01

Methods for calculating the safe yield are evaluated in this paper using a high-quality and long historical data set of groundwater recharge, discharge, extraction, and precipitation in a karst aquifer. Consideration is given to the role that climatic variability has on the determination of a climatically representative period with which to evaluate the safe yield. The methods employed to estimate the safe yield are consistent with its definition as a long-term average extraction rate that avoids adverse impacts on groundwater. The safe yield is a useful baseline for groundwater planning; yet, it is herein shown that it is not an operational rule that works well under all climatic conditions. This paper shows that due to the nature of dynamic groundwater processes it may be most appropriate to use an adaptive groundwater management strategy that links groundwater extraction rates to groundwater discharge rates, thus achieving a safe yield that represents an estimated long-term sustainable yield. An example of the calculation of the safe yield of the Edwards Aquifer (Texas) demonstrates that it is about one-half of the average annual recharge. © 2016, National Ground Water Association.

The relation between receptive grammar and procedural, declarative, and working memory in specific language impairment.

PubMed

Conti-Ramsden, Gina; Ullman, Michael T; Lum, Jarrad A G

2015-01-01

What memory systems underlie grammar in children, and do these differ between typically developing (TD) children and children with specific language impairment (SLI)? Whilst there is substantial evidence linking certain memory deficits to the language problems in children with SLI, few studies have investigated multiple memory systems simultaneously, examining not only possible memory deficits but also memory abilities that may play a compensatory role. This study examined the extent to which procedural, declarative, and working memory abilities predict receptive grammar in 45 primary school aged children with SLI (30 males, 15 females) and 46 TD children (30 males, 16 females), both on average 9;10 years of age. Regression analyses probed measures of all three memory systems simultaneously as potential predictors of receptive grammar. The model was significant, explaining 51.6% of the variance. There was a significant main effect of learning in procedural memory and a significant group × procedural learning interaction. Further investigation of the interaction revealed that procedural learning predicted grammar in TD but not in children with SLI. Indeed, procedural learning was the only predictor of grammar in TD. In contrast, only learning in declarative memory significantly predicted grammar in SLI. Thus, different memory systems are associated with receptive grammar abilities in children with SLI and their TD peers. This study is, to our knowledge, the first to demonstrate a significant group by memory system interaction in predicting grammar in children with SLI and their TD peers. In line with Ullman's Declarative/Procedural model of language and procedural deficit hypothesis of SLI, variability in understanding sentences of varying grammatical complexity appears to be associated with variability in procedural memory abilities in TD children, but with declarative memory, as an apparent compensatory mechanism, in children with SLI.

Is percutaneous nephrolithotomy in solitary kidneys safe?

PubMed

Wong, Kathie Alexina; Sahai, Arun; Patel, Amit; Thomas, Kay; Bultitude, Matthew; Glass, Jonathan

2013-11-01

To review our experience from a high volume stone center with a focus on efficacy, safety, and renal function. Stones requiring percutaneous nephrolithotomy (PCNL) in patients with solitary kidneys can pose significant anxiety to the urologist. Limited data are available in published reports in this setting. A comprehensive retrospective review of medical records was performed on patients who underwent PCNL and had a solitary kidney or a single functioning renal unit. Data were collected on patient demographics, stone burden, outcomes, complications, and renal function. Of 378 PCNLs performed between January 2003 and September 2011, 22 were performed in 17 patients with a single functioning kidney. Three procedures were performed in a transplanted kidney. In those with solitary calculus, the longest mean length and stone surface area were 37 mm and 825 mm(2), respectively. Stone-free rate was 59%. Auxiliary procedures were required in 6 cases, resulting in a stone-free rate of 77%. Median inpatient stay was 4 days. Serum creatinine values improved from 144 to 126 umol/L before and after the procedure and mean estimated glomerular filtration rate improved similarly from 51 to 59 mls/minute, respectively. Blood transfusion was required in 1 patient, sepsis developed in 3, and 2 patients required a stent for obstruction. PCNL in solitary kidneys is safe with an acceptable complication rate if performed in a high volume center. Outcomes are good, although auxiliary procedures may be necessary. Renal function remains stable or improves after procedure. Copyright © 2013 Elsevier Inc. All rights reserved.

Total laparoscopic reversal of Hartmann's procedure.

PubMed

Masoni, Luigi; Mari, Francesco Saverio; Nigri, Giuseppe; Favi, Francesco; Pindozzi, Fioralba; Dall'Oglio, Anna; Pancaldi, Alessandra; Brescia, Antonio

2013-01-01

Hartmann's procedure is still performed in those cases in which colorectal anastomosis might be unsafe. Reversal of Hartmann's procedure (HR) is considered a major surgical procedure with a high morbidity (55 to 60%) and mortality rate (0 to 4%). To decrease these rates, laparoscopic Hartmann's reversal procedure was successfully experienced. We report our totally laparoscopic Hartmann's reversal technique. Between 2004 and 2010 we performed 27 HRs with a totally laparoscopic approach. The efficacy and safety of this technique were demonstrated evaluating the operative data, postoperative complications, and the outcome of the patients. There were no open conversions or major intraoperative complications. Anastomotic leaking occurred in one patient requiring an ileostomy; one patient needed a blood transfusion and one had a nosocomial pneumonia. The mean postoperative hospitalization was 5.7 days. Laparoscopic HR is a feasible and safe procedure and can be considered a valid alternative to open HR.

A ‘Simple Anterior Fish Excluder’ (SAFE) for Mitigating Penaeid-Trawl Bycatch

PubMed Central

McHugh, Matthew J.; Broadhurst, Matt K.; Sterling, David J.; Millar, Russell B.

2015-01-01

Various plastic strips and sheets (termed ‘simple anterior fish excluders’−SAFEs) were positioned across the openings of penaeid trawls in attempts at reducing the unwanted bycatches of small teleosts. Initially, three SAFEs (a single wire without, and with small and large plastic panels) were compared against a control (no SAFE) on paired beam trawls. All SAFEs maintained targeted Metapenaeus macleayi catches, while the largest plastic SAFE significantly reduced total bycatch by 51% and the numbers of Pomatomus saltatrix, Mugil cephalus and Herklotsichthys castelnaui by up to 58%. A redesigned SAFE (‘continuous plastic’) was subsequently tested (against a control) on paired otter trawls, significantly reducing total bycatch by 28% and P. saltatrix and H. castelnaui by up to 42%. The continuous-plastic SAFE also significantly reduced M. macleayi catches by ~7%, but this was explained by ~5% less wing-end spread, and could be simply negated through otter-board refinement. Further work is required to refine the tested SAFEs, and to quantify species-specific escape mechanisms. Nevertheless, the SAFE concept might represent an effective approach for improving penaeid-trawl selectivity. PMID:25837892

Directors of Naturoptics for Safe Recovery of Vision, Inc. Release Patented Process to Awardees for their Personal Use and Mentored Teaching of the Process

NASA Astrophysics Data System (ADS)

Giordano, Paul J.; D., N.; C., D.; McLeod, Roger David

2008-05-01

The Board of Directors of Naturoptics for Safe Recovery of Vision, Inc., US Patent Office, trademark issued, patent issue date April 8, 2008, has granted ``The David Matthew Mc Leod Memorial Award,'' to named individuals. Naturoptics teaching earnings by recipients are to be disbursed according to agreed percentages to named academic entities and to the awardees. When awardees sign non-disclosure agreements, they are shown why the process is safe. They are also taught that no diagnostic or treatment techniques are used, necessary or allowed for the processes. This is an educational consultation that explains how Naturoptics inventor, Roger David Mc Leod, safely and rapidly recovered his vision. The now patented processes as taught is released for the use of those awardees that sign agreements that they were merely provided a teaching service, and will only be doing educational consulting for their clients. Such clients must follow similar procedures. Other equivalent work-study grants are named ``The Kaan Balam Matagamon Memorial Award,'' also in memory of DMM. The American Indians in Science and Engineering Society may also be participating.

30 CFR 77.803 - Fail safe ground check circuits on high-voltage resistance grounded systems.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Fail safe ground check circuits on high-voltage... WORK AREAS OF UNDERGROUND COAL MINES Surface High-Voltage Distribution § 77.803 Fail safe ground check..., resistance grounded systems shall include a fail safe ground check circuit or other no less effective device...

30 CFR 77.803 - Fail safe ground check circuits on high-voltage resistance grounded systems.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Fail safe ground check circuits on high-voltage... WORK AREAS OF UNDERGROUND COAL MINES Surface High-Voltage Distribution § 77.803 Fail safe ground check..., resistance grounded systems shall include a fail safe ground check circuit or other no less effective device...

30 CFR 77.803 - Fail safe ground check circuits on high-voltage resistance grounded systems.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Fail safe ground check circuits on high-voltage... WORK AREAS OF UNDERGROUND COAL MINES Surface High-Voltage Distribution § 77.803 Fail safe ground check..., resistance grounded systems shall include a fail safe ground check circuit or other no less effective device...

30 CFR 77.803 - Fail safe ground check circuits on high-voltage resistance grounded systems.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Fail safe ground check circuits on high-voltage... WORK AREAS OF UNDERGROUND COAL MINES Surface High-Voltage Distribution § 77.803 Fail safe ground check..., resistance grounded systems shall include a fail safe ground check circuit or other no less effective device...

Effectiveness of a Driving Intervention on Safe Community Mobility for Returning Combat Veterans

DTIC Science & Technology

2017-05-01

study is a follow-on to prior DOD funded work “Efficacy of a Driving Intervention Program on Safe Community Mobility for Combat Veterans”. Funding for...lack of control groups, suggest that a simu- lator-based OT-DI can provide a safe environment for testing and training of CV to reduce dangerous...AWARD NUMBER: W81XWH-15-1-0032 TITLE: Effectiveness of a Driving Intervention on Safe Community Mobility for Returning Combat Veterans

Safe sex self-efficacy and safe sex practice in a Southern United States College

PubMed Central

Addoh, Ovuokerie; Sng, Eveleen; Loprinzi, Paul D.

2017-01-01

Background: The purpose of this study was to assess the association between safe sex self-efficacy and safe-sex practice in a Southern college setting. Methods: Multivariable logistic regression models were used to examine the association between safe sex self-efficacy in four domains (mechanics, partner disapproval, assertiveness, intoxicants) and safe sex practice (outcome variable). Results: For every 1-unit increase in the composite condom use self-efficacy score, there was an 8% increase in the odds of being beyond the median safe-sex practice score (odds ration [OR]: 1.08, 95% CI: 1.02-1.15). Additionally, for every 1-unit increase in intoxicants self-efficacy score, there was a 31% increase in the odds of being beyond the median safe-sex practice score (OR: 1.31, 95% CI: 1.08-1.58). Conclusion: A greater degree of safe-sex self-efficacy is associated with increased odds of safe-sex practice. These findings are informative for the development of targeted approaches to foster safe-sex behavior in Southern US colleges. PMID:28326287

Advanced laparoscopic bariatric surgery Is safe in general surgery training.

PubMed

Kuckelman, John; Bingham, Jason; Barron, Morgan; Lallemand, Michael; Martin, Matthew; Sohn, Vance

2017-05-01

Bariatric surgery makes up an increasing percentage of general surgery training. The safety of resident involvement in these complex cases has been questioned. We evaluated patient outcomes in resident performed laparoscopic bariatric procedures. Retrospective review of patients undergoing a laparoscopic bariatric procedure over seven years at a tertiary care single center. Procedures were primarily performed by a general surgery resident and proctored by an attending surgeon. Primary outcomes included operative volume, operative time and leak rate with perioperative outcomes evaluated as secondary outcomes. A total of 1649 bariatric procedures were evaluated. Operations included laparoscopic bypass (690) and laparoscopic sleeve gastrectomy (959). Average operating time was 136 min. Eighteen leaks (0.67%) were identified. Graduating residents performed an average of 89 laparoscopic bariatric cases during their training. There were no significant differences between resident levels with concern to operative time or leak rate (p 0.97 and p = 0.54). General surgery residents can safely perform laparoscopic bariatric surgery. When proctored by a staff surgeon, a resident's level of training does not significantly impact leak rate. Published by Elsevier Inc.

A Safe Ride to School; A Safe Ride Home.

ERIC Educational Resources Information Center

Illinois State Board of Education, Springfield.

Text and illustrations are used to teach safe school bus riding practices. The guide begins with instructions to parents or guardians to set a good example of safe behavior, and to help children learn safety rules and be on time. Instructions to children concern obeying the bus driver, boarding the bus, riding the bus, crossing the road, and using…

Interventional MSK procedures: the hip.

PubMed

Dodré, Emilie; Lefebvre, Guillaume; Cockenpot, Eric; Chastanet, Patrick; Cotten, Anne

2016-01-01

Percutaneous musculoskeletal procedures are widely accepted as low invasive, highly effective, efficient and safe methods in a vast amount of hip pathologies either in diagnostic or in therapeutic management. Hip intra-articular injections are used for the symptomatic treatment of osteoarthritis. Peritendinous or intrabursal corticosteroid injections can be used for the symptomatic treatment of greater trochanteric pain syndrome and anterior iliopsoas impingement. In past decades, the role of interventional radiology has rapidly increased in metastatic disease, thanks to the development of many ablative techniques. Image-guided percutaneous ablation of skeletal metastases provides a minimally invasive treatment option that appears to be a safe and effective palliative treatment for localized painful lytic lesion. Methods of tumour destruction based on temperature, such as radiofrequency ablation (RFA) and cryotherapy, are performed for the management of musculoskeletal metastases. MR-guided focused ultrasound surgery provides a non-invasive alternative to these ablative methods. Cementoplasty is now widely used for pain management and consolidation of acetabular metastases and can be combined with RFA. RFA is also used to treat benign tumours, namely osteoid osteomas. New interventional procedures such as percutaneous screw fixation are also proposed to treat non-displaced or minimally displaced acetabular roof fractures.

'High profile health facilities can add to your trouble': Women, stigma and un/safe abortion in Kenya.

PubMed

Izugbara, Chimaraoke O; Egesa, Carolyne; Okelo, Rispah

2015-09-01

Public health discourses on safe abortion assume the term to be unambiguous. However, qualitative evidence elicited from Kenyan women treated for complications of unsafe abortion contrasted sharply with public health views of abortion safety. For these women, safe abortion implied pregnancy termination procedures and services that concealed their abortions, shielded them from the law, were cheap and identified through dependable social networks. Participants contested the notion that poor quality abortion procedures and providers are inherently dangerous, asserting them as key to women's preservation of a good self, management of stigma, and protection of their reputation, respect, social relationships, and livelihoods. Greater public health attention to the social dimensions of abortion safety is urgent. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Procedural justice, supervisor autonomy support, work satisfaction, organizational identification and job performance: the mediating role of need satisfaction and perceived organizational support.

PubMed

Gillet, Nicolas; Colombat, Philippe; Michinov, Estelle; Pronost, Anne-Marie; Fouquereau, Evelyne

2013-11-01

To test a model linking procedural justice, supervisor autonomy support, need satisfaction, organizational support, work satisfaction, organizational identification and job performance. Research in industrial and organizational psychology has shown that procedural justice and supervisor autonomy support lead to positive outcomes. However, very little research related to this subject has been conducted in healthcare settings. Moreover, few studies have examined mechanisms that could account for these positive relationships. A cross-sectional correlational design was used. Convenience sampling was used and a sample of 500 nurses working in haematology, oncology and haematology/oncology units in France was surveyed in 2011. The final sample consisted of 323 nurses (64.6% response rate). The hypothesized model was tested using structural equation modelling. Procedural justice and supervisor autonomy support significantly and positively influenced need satisfaction and perceived organizational support, which in turn positively predicted work satisfaction, organizational identification and job performance. Organizations could deliver training programmes for their managers aimed at enhancing the use of fair procedures in allocating outcomes and developing their autonomy-supportive behaviours to improve nurses' work satisfaction, organizational identification and job performance. © 2013 Blackwell Publishing Ltd.

Varying influences of motivation factors on employees' likelihood to perform safe food handling practices because of demographic differences.

PubMed

Ellis, Jason D; Arendt, Susan W; Strohbehn, Catherine H; Meyer, Janell; Paez, Paola

2010-11-01

Food safety training has been the primary avenue for ensuring food workers are performing proper food handling practices and thus, serving safe food. Yet, knowledge of safe food handling practices does not necessarily result in actual performance of these practices. This research identified participating food service employees' level of agreement with four factors of motivation (internal motivations, communication, reward-punishment, and resources) and determined if respondents with different demographic characteristics reported different motivating factors. Data were collected from 311 food service employees who did not have any supervisory responsibilities. Intrinsic motivation agreement scores were consistently the highest of all four motivational factors evaluated and did not differ across any of the demographic characteristics considered. In contrast, motivation agreement scores for communication, reward-punishment, and resources did differ based on respondents' gender, age, place of employment, job status, food service experience, completion of food handler course, or possession of a food safety certification. In general, respondents agreed that these motivation factors influenced their likelihood to perform various safe food handling procedures. This research begins to illustrate how employees' demographic characteristics influence their responses to various motivators, helping to clarify the complex situation of ensuring safe food in retail establishments. Future research into why employee willingness to perform varies more for extrinsic motivation than for intrinsic motivation could assist food service managers in structuring employee development programs and the work environment, in a manner that aids in improving external motivation (communication, reward-punishment, and resources) and capitalizing on internal motivation.

Proton beam irradiation: a safe procedure in post-equatorial extraocular extension from uveal melanoma.

PubMed

Seibel, Ira; Riechardt, Aline I; Erb-Eigner, Katharina; Böker, Alexander; Cordini, Dino; Heufelder, Jens; Joussen, Antonia M

2018-04-12

This study was performed to show long-term outcomes concerning metastasis rates and local recurrence rates after primary proton beam therapy in uveal melanoma with posterior extraocular extension (EOE) with the main focus on optic nerve invasion. Retrospective case series METHODS: All patients treated with primary proton beam therapy for choroidal or ciliary body melanoma with posterior EOE between July 1998 and August 2010 were included. EOE was either detected upon sonography at primary examination or during the surgical application of tantalum clips onto the sclera. Ultrasound was performed in each patient before surgery, and if EOE was detected, a magnetic resonance imaging (MRI) scan was performed to confirm EOE. All patients with tumors exceeding 6 mm in thickness or abutting the optic disc received a 1.5 Tesla MRI scan after clip surgery. To asses EOE during follow-up, either ultrasound examinations or-if initially detected only by MRI-MRI scans were performed during follow-up. A total of 27 patients underwent primary proton beam therapy. The EOE was separated into 3 growth types: Optic nerve infiltration in 10 patients, vortex vein infiltration in 9 patients, and transscleral growth post-equatorially in 8 patients. No local recurrences were found during the overall median follow-up of 80 months (11-168 months). Metastasis rates correlated with AJCC stages but not EOE volume. This study shows that posterior EOE can safely be treated by proton beam therapy, even if the optic nerve is infiltrated. MRI enables safe detection of optic nerve invasion. Copyright © 2018 Elsevier Inc. All rights reserved.

12 CFR 609.930 - Policies and procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Boards and Management § 609.930 Policies and procedures. The FCA supports E-commerce and wants to... delivery of safe and sound credit and closely related services. Through E-commerce, System institutions can... time, E-commerce presents challenges and risks that your board must carefully consider in advance...

12 CFR 609.930 - Policies and procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Boards and Management § 609.930 Policies and procedures. The FCA supports E-commerce and wants to... delivery of safe and sound credit and closely related services. Through E-commerce, System institutions can... time, E-commerce presents challenges and risks that your board must carefully consider in advance...

12 CFR 609.930 - Policies and procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Boards and Management § 609.930 Policies and procedures. The FCA supports E-commerce and wants to... delivery of safe and sound credit and closely related services. Through E-commerce, System institutions can... time, E-commerce presents challenges and risks that your board must carefully consider in advance...

12 CFR 609.930 - Policies and procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Boards and Management § 609.930 Policies and procedures. The FCA supports E-commerce and wants to... delivery of safe and sound credit and closely related services. Through E-commerce, System institutions can... time, E-commerce presents challenges and risks that your board must carefully consider in advance...

SafeConnect Solar - Final Scientific/Technical Report (Updated)

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

McNish, Zachary

2016-02-03

Final Scientific/Technical Report from Tier 0 SunShot Incubator award for hardware-based solution to reducing soft costs of installed solar. The primary objective of this project was for SafeConnect Solar (“SafeConnect”) to create working proof-of-concept hardware prototypes from its proprietary intellectual property and business concepts for a plug-and-play, safety-oriented hardware solution for photovoltaic solar systems. Specifically, SafeConnect sought to build prototypes of its “SmartBox” and related cabling and connectors, as well as the firmware needed to run the hardware. This hardware is designed to ensure a residential PV system installed with it can address all safety concerns that currently form themore » basis of AHJ electrical permitting and licensing requirements, thereby reducing the amount of permitting and specialized labor required on a residential PV system, and also opening up new sales channels and customer acquisition opportunities.« less

Use Medicines Safely

MedlinePlus

... Medicines Safely Print This Topic En español Use Medicines Safely Browse Sections The Basics Overview Prescription Medicines ... Medicines 1 of 7 sections The Basics: Prescription Medicines There are different types of medicine. The 2 ...

Mentored retroperitoneal laparoscopic renal surgery in children: a safe approach to learning.

PubMed

Farhat, W; Khoury, A; Bagli, D; McLorie, G; El-Ghoneimi, A

2003-10-01

To review the feasibility of introducing advanced retroperitoneal renal laparoscopic surgery (RRLS) to a paediatric urology division, using the mentorship-training model. Although the scope of practice in paediatric urology is currently adapting endoscopic surgery into daily practice, most paediatric urologists in North America have had no formal training in laparoscopic surgery. The study included four paediatric urologists with 3-25 years of practice; none had had any formal laparoscopic training or ever undertaken advanced RRLS. An experienced laparoscopic surgeon (the mentor) assisted the learning surgeons over a year. The initial phases of learning incorporated detailed lectures, visualization through videotapes and 'hands-on' demonstration by the expert in the technique of the standardized steps for each type of surgery. Over 10 months, ablative and reconstructive RRLS was undertaken jointly by the surgeons and the mentor. After this training the surgeons operated independently. To prevent lengthy operations, conversion to open surgery was planned if there was no significant progression after 2 h of laparoscopic surgery. Over the 10 months of mentorship, 36 RRLS procedures were undertaken in 31 patients (28 ablative and eight reconstructive). In all cases the mentored surgeons accomplished both retroperitoneal access and the creation of a working space within the cavity. The group was able to initiate ablative RRLS but the mentor undertook all the reconstructive procedures. After the mentorship period, over 10 months, 12 ablative procedures were undertaken independently, and five other attempts at RRLS failed. Although the mentored approach can successfully and safely initiate advanced RRLS in a paediatric urology division, assessing the laparoscopic practice pattern after mentorship in the same group of trainees is warranted. Ablative RRLS is easier to learn for the experienced surgeon, but reconstructive procedures, e.g. pyeloplasty, require a high degree

Hazard avoidance via descent images for safe landing

NASA Astrophysics Data System (ADS)

Yan, Ruicheng; Cao, Zhiguo; Zhu, Lei; Fang, Zhiwen

2013-10-01

In planetary or lunar landing missions, hazard avoidance is critical for landing safety. Therefore, it is very important to correctly detect hazards and effectively find a safe landing area during the last stage of descent. In this paper, we propose a passive sensing based HDA (hazard detection and avoidance) approach via descent images to lower the landing risk. In hazard detection stage, a statistical probability model on the basis of the hazard similarity is adopted to evaluate the image and detect hazardous areas, so that a binary hazard image can be generated. Afterwards, a safety coefficient, which jointly utilized the proportion of hazards in the local region and the inside hazard distribution, is proposed to find potential regions with less hazards in the binary hazard image. By using the safety coefficient in a coarse-to-fine procedure and combining it with the local ISD (intensity standard deviation) measure, the safe landing area is determined. The algorithm is evaluated and verified with many simulated descent downward looking images rendered from lunar orbital satellite images.

75 FR 38187 - Proposed Collection; Comment Request for Revenue Procedure 2007-48

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-01

... safe harbor method of accounting for rotable spare parts provided in the proposed revenue procedures... in Accounting Method. Current Actions: There are no changes being made to the revenue procedures at... OMB control number. Books or records relating to a collection of information must be retained as long...

Arkansas People Participating in Lead Education (APPLE): results of a lead-safe training program.

PubMed

Ferguson, Alesia; Bursac, Zoran; Kern, David F

2011-06-01

Lead is still seen as one of the most harmful environmental toxins for young children, with the predominant source being deteriorating lead-based paint. Those at continued risk include those living in homes built before 1978, renovators and remodelers, and especially those with limited access to proper healthcare and diets. Proper training on lead-safe work practices focused on preventing and reducing the spread of lead dust can help reduce lead exposure. Presented in this paper are experiences in delivering lead-safe work practices training in six Arkansas cities, and results from pre- and post- surveys delivered before and immediately after the training. Pre- and post-surveys assess strong and weak areas of training. Participants demonstrated positive shifts in attitude and behavior towards lead-safe work practices following training. However, our research found that more emphasis should be focused on clarifying current lead exposure sources and routes for children.

Saving our backs: safe patient handling and mobility for home care.

PubMed

Beauvais, Audrey; Frost, Lenore

2014-01-01

Predicted work-related injuries for nurses and home healthcare workers are on the rise given the many risk factors in the home environment and the escalating demands for home healthcare workers in the United States. Fortunately, safe patient handling and mobility programs can dramatically decrease injuries. Despite strides being made to promote safe patient handling and mobility programs in acute care, more can be done to establish such initiatives in the home care setting.

The use of collaboration to implement evidence-based safe practices.

PubMed

Clarke, John R

2013-12-01

The Pennsylvania Patient Safety Authority receives over 235,000 reports of medical error per year. Near miss and serious event reports of common and interesting problems are analysed to identify best practices for preventing harmful errors. Dissemination of this evidence-based information in the peer-reviewed Pennsylvania Patient Safety Advisory and presentations to medical staffs are not sufficient for adoption of best practices. Adoption of best practices has required working with institutions to identify local barriers to and incentives for adopting best practices and redesigning the delivery system to make desired behaviour easy and undesirable behaviour more difficult. Collaborations, where institutions can learn from the experiences of others, have show decreases in harmful events. The Pennsylvania Program to Prevent Wrong-Site Surgery is used as an example. Two collaborations to prevent wrong-site surgery have been completed, one with 30 institutions in eastern Pennsylvania and one with 19 in western Pennsylvania. The first collaboration achieved a 73% decrease in the rolling average of wrong-site events over 18 months. The second collaboration experienced no wrong-site operating room procedures over more than one year. Significance for public healthSince the Institute of Medicine's To Err is Human identified medical errors as a major cause of death, the public has been interested in the recommendations for reporting of medical errors and implementing safe systems for the delivery of healthcare. The Commonwealth of Pennsylvania has followed those recommendations and found that an essential intermediate step between analysing reports and implementing safe systems is collaborative learning among healthcare institutions. The experience in Pennsylvania should be useful to other public organizations wishing to improve safety.

Safe Schools/Safe Communities: A Directory of Resources for Pennsylvania.

ERIC Educational Resources Information Center

Pennsylvania State Dept. of Education, Harrisburg.

This document contains a directory of resources available in Pennsylvania to help achieve the goal of safe schools. Following a copy of the Safe Schools Act of 1993, nine sections list agencies that provide services and products under the headings of: conflict resolution/mediation, gangs, suicide, crisis response, family violence, diversity,…

Lessons Learned from Safe Kids/Safe Streets. Juvenile Justice Bulletin

ERIC Educational Resources Information Center

Cronin, Roberta; Gragg, Frances; Schultz, Dana; Eisen, Karla

2006-01-01

This bulletin reports results from an evaluation of six sites of the Safe Kids/Safe Streets (SK/SS) program, which applies a comprehensive, collaborative approach to the child maltreatment field. The bulletin provides insights into collaboration building, systems reform, service options, and other strategies. Among the findings were that the SK/SS…

Stop Disease: Diapering Procedures = Alto a las Enfermedades: Procedimientos para Cambiar Panales.

ERIC Educational Resources Information Center

California Child Care Health Program, Oakland.

In order to prevent the occurrence and spread of disease in California child care programs, this set of laminated procedure pages, in English and Spanish versions, details infant and child care procedures for safe diapering. The document delineates important rules about diapering, gives directions for making a disinfecting solution, and provides…

76 FR 12719 - Safe Schools/Healthy Students Program; Office of Safe and Drug-Free Schools; Safe Schools/Healthy...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-08

... official version of this document is the document published in the Federal Register. Free Internet access... DEPARTMENT OF EDUCATION Safe Schools/Healthy Students Program; Office of Safe and Drug- Free... telecommunications device for the deaf (TDD), call the Federal Relay Service (FRS), toll free, at 1-800-877-8339...

Safe teleradiology: information assurance as project planning methodology

NASA Astrophysics Data System (ADS)

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

2003-05-01

This project demonstrates use of OCTAVE, an information security risk assessment method, as an approach to the safe design and planning of a teleradiology system. By adopting this approach to project planning, we intended to provide evidence that including information security as an intrinsic component of project planning improves information assurance and that using information assurance as a planning tool produces and improves the general system management plan. Several considerations justify this approach to planning a safe teleradiology system. First, because OCTAVE was designed as a method for retrospectively assessing and proposing enhancements for the security of existing information management systems, it should function well as a guide to prospectively designing and deploying a secure information system such as teleradiology. Second, because OCTAVE provides assessment and planning tools for use primarily by interdisciplinary teams from user organizations, not consultants, it should enhance the ability of such teams at the local level to plan safe information systems. Third, from the perspective of sociological theory, OCTAVE explicitly attempts to enhance organizational conditions identified as necessary to safely manage complex technologies. Approaching information system design from the perspective of information security risk management proactively integrates health information assurance into a project"s core. This contrasts with typical approaches that perceive "security" as a secondary attribute to be "added" after designing the system and with approaches that identify information assurance only with security devices and user training. The perspective of health information assurance embraces so many dimensions of a computerized health information system"s design that one may successfully deploy a method for retrospectively assessing information security risk as a prospective planning tool. From a sociological perspective, this approach enhances the

Safe syringe disposal is related to safe syringe access among HIV-positive injection drug users.

PubMed

Coffin, Phillip O; Latka, Mary H; Latkin, Carl; Wu, Yingfeng; Purcell, David W; Metsch, Lisa; Gomez, Cynthia; Gourevitch, Marc N

2007-09-01

We evaluated the effect of syringe acquisition on syringe disposal among HIV-positive injection drug users (IDUs) in Baltimore, New York City, and San Francisco (N = 680; mean age 42 years, 62% male, 59% African-American, 21% Hispanic, 12% White). Independent predictors of safe disposal were acquiring syringes through a safe source and ever visiting a syringe exchange program. Weaker predictors included living in San Francisco, living in the area longer, less frequent binge drinking, injecting with an HIV+ partner, peer norms supporting safe injection, and self-empowerment. Independent predictors of safe "handling"-both acquiring and disposing of syringes safely-also included being from New York and being older. HIV-positive IDUs who obtain syringes from a safe source are more likely to safely dispose; peer norms contribute to both acquisition and disposal. Interventions to improve disposal should include expanding sites of safe syringe acquisition while enhancing disposal messages, alternatives, and convenience.

NASA Battery Working Group - 2007-2008: Battery Task Summary Report

NASA Technical Reports Server (NTRS)

Manzo, Michelle

2008-01-01

This presentation provides a summary of the 2007-2008 NASA Battery Working Group efforts completed in support of the NASA Engineering Safety Center (NESC). The effort covered a series of pro-active tasks that address the following: Binding Procurements -- guidelines related to requirements for the battery system that should be considered at the time of contract award Wet Life of Ni-H2 Batteries -- issues/strategies for effective storage and impact of long-term storage on performance and life Generic Guidelines for Lithium-ion Safety, Handling and Qualification -- Standardized approaches developed and risk assessments (1) Lithium-ion Performance Assessment -- survey of manufacturers and capabilities to meet mission needs. Guidelines document generated (2) Conditions Required for using Pouch Cells in Aerospace Missions -- focus on corrosion, thermal excursions and long-term performance issues. Document defining requirements to maintain performance and life (3) High Voltage Risk Assessment -- focus on safety and abuse tolerance of battery module assemblies. Recommendations of features required for safe implementation (4) Procedure for Determination of Safe Charge Rates -- evaluation of various cell chemistries and recommendation of safe operating regimes for specific cell designs

A simulation facility for testing Space Station assembly procedures

NASA Technical Reports Server (NTRS)

Hajare, Ankur R.; Wick, Daniel T.; Shehad, Nagy M.

1994-01-01

NASA plans to construct the Space Station Freedom (SSF) in one of the most hazardous environments known to mankind - space. It is of the utmost importance that the procedures to assemble and operate the SSF in orbit are both safe and effective. This paper describes a facility designed to test the integration of the telerobotic systems and to test assembly procedures using a real-world robotic arm grappling space hardware in a simulated microgravity environment.

Safe patient handling in diagnostic imaging.

PubMed

Murphey, Susan L

2010-01-01

Raising awareness of the risk to diagnostic imaging personnel from manually lifting, transferring, and repositioning patients is critical to improving workplace safety and staff utilization. The aging baby boomer generation and growing bariatric population exacerbate the problem. Also, legislative initiatives are increasing nationwide for hospitals to implement safe patient handling programs. A management process designed to improve working conditions through implementing ergonomic programs can reduce losses and improve productivity and patient care outcome measures for imaging departments.

Effectiveness of a Driving Intervention on Safe Community Mobility for Returning Combat Veterans

DTIC Science & Technology

2016-05-01

Simulator drive  development  underway.  Key personnel appointed  and  meet regularly to advance study aims.  Effectiveness of a Driving Intervention on  Safe ...AWARD NUMBER: W81XWH-15-1-0032 TITLE: Effectiveness of a Driving Intervention on Safe Community Mobility for Returning Combat Veterans...is a follow-on to prior DOD funded work “Efficacy of a Driving Intervention Program on Safe Community Mobility for Combat Veterans”. Funding for the

NASA trend analysis procedures

NASA Technical Reports Server (NTRS)

1993-01-01

This publication is primarily intended for use by NASA personnel engaged in managing or implementing trend analysis programs. 'Trend analysis' refers to the observation of current activity in the context of the past in order to infer the expected level of future activity. NASA trend analysis was divided into 5 categories: problem, performance, supportability, programmatic, and reliability. Problem trend analysis uncovers multiple occurrences of historical hardware or software problems or failures in order to focus future corrective action. Performance trend analysis observes changing levels of real-time or historical flight vehicle performance parameters such as temperatures, pressures, and flow rates as compared to specification or 'safe' limits. Supportability trend analysis assesses the adequacy of the spaceflight logistics system; example indicators are repair-turn-around time and parts stockage levels. Programmatic trend analysis uses quantitative indicators to evaluate the 'health' of NASA programs of all types. Finally, reliability trend analysis attempts to evaluate the growth of system reliability based on a decreasing rate of occurrence of hardware problems over time. Procedures for conducting all five types of trend analysis are provided in this publication, prepared through the joint efforts of the NASA Trend Analysis Working Group.

How Principals Can Help to Ensure Safe Science Study.

ERIC Educational Resources Information Center

Kaufman, James A.

1995-01-01

Most schools inadequately protect the health and safety of students involved in science study. Echoing industry standards (and safety records), schools should have safety policies and committees, develop safety orientation programs, make working safely an employment condition, reward good safety performance, inspect and correct, and supply…

Effect of bariatric surgery on future general surgical procedures.

PubMed

Kini, Subhash; Kannan, Umashankkar

2011-04-01

Bariatric surgery is now accepted as a safe and effective procedure for morbid obesity. The frequency of bariatric procedures is increasing with the adoption of the laparoscopic approach. The general surgeons will be facing many more of such patients presenting with common general surgical problems. Many of the general surgeons, faced with such situations, may not be aware of the changes in the gastrointestinal anatomy following bariatric procedures and management of these clinical situations will therefore present diagnostic and therapeutic challenges. We hereby present a review of management of few common general surgical problems in patients with a history of bariatric surgery.

Safe Reentry for False Aneurysm Operations in High-Risk Patients.

PubMed

Martinelli, Gian Luca; Cotroneo, Attilio; Caimmi, Philippe Primo; Musica, Gabriele; Barillà, David; Stelian, Edmond; Romano, Angelo; Novelli, Eugenio; Renzi, Luca; Diena, Marco

2017-06-01

In the absence of a standardized safe surgical reentry strategy for high-risk patients with large or anterior postoperative aortic false aneurysm (PAFA), we aimed to describe an effective and safe approach for such patients. We prospectively analyzed patients treated for PAFA between 2006 and 2015. According to the preoperative computed tomography scan examination, patients were divided into two groups according to the anatomy and extension of PAFA: in group A, high-risk PAFA (diameter ≥3 cm) developed in the anterior mediastinum; in group B, low-risk PAFA (diameter <3 cm) was situated posteriorly. For group A, a safe surgical strategy, including continuous cerebral, visceral, and coronary perfusion was adopted before resternotomy; group B patients underwent conventional surgery. We treated 27 patients (safe reentry, n = 13; standard approach, n = 14). Mean age was 60 years (range, 29 to 80); 17 patients were male. Mean interval between the first operation and the last procedure was 4.3 years. Overall 30-day mortality rate was 7.4% (1 patient in each group). No aorta-related mortality was observed at 1 and 5 years in either group. The Kaplan-Meier overall survival estimates at 1 and 5 years were, respectively, 92.3% ± 7.4% and 73.4% ± 13.4% in group A, and 92.9% ± 6.9% and 72.2% ± 13.9% in group B (log rank test, p = 0.830). Freedom from reoperation for recurrent aortic disease was 100% at 1 year and 88% at 5 years. The safe reentry technique with continuous cerebral, visceral, and coronary perfusion for high-risk patients resulted in early and midterm outcomes similar to those observed for low-risk patients undergoing conventional surgery. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Separation, Aspiration, and Fat Equalization: SAFE Liposuction Concepts for Comprehensive Body Contouring.

PubMed

Wall, Simeon H; Lee, Michael R

2016-12-01

Separation, aspiration, and fatty equilibration (SAFE) liposuction uses a process approach to body contouring and minimizes injury to surrounding structures. The multistep process allows for (1) fat separation, (2) lipoaspiration, and (3) fat equalization. The purpose of this study was to review both outcomes and complications of primary SAFE liposuction. Retrospective chart review was completed of patients undergoing SAFE liposuction from January of 2006 to January of 2011. Patient selection was limited to those undergoing liposuction alone with no adjuvant excisional procedures. Data were collected regarding demographics, body mass index, operative details, and outcomes. Seven hundred thirty-four patients were identified as having undergone SAFE liposuction. One hundred twenty-nine patients were found to have been treated with liposuction alone. Patient age ranged from 18 to 42 years and body mass index ranged from 18 to 42 kg/m (mean, 26.3 kg/m). Seven patients (5.4 percent) underwent treatment of the face and neck, six patients (4.7 percent) underwent treatment of upper extremities, 13 patients (10.1 percent) underwent treatment of the chest, 20 patients (15.5 percent) underwent treatment of lower extremities, 32 patients (24.8 percent) underwent treatment of the circumferential trunk, and 51 patients (39.5 percent) underwent treatment of circumferential trunk and additional area(s). No major complications occurred. Five of the 129 patients (3.87 percent) developed the minor complication of seroma formation. SAFE liposuction is a multistep process approach to body contouring consisting of (1) fat separation, (2) lipoaspiration, and (3) fat equalization. The results of this study show such technique to be safe and effective. Therapeutic, IV.

The Effect of Principle-Procedure and Procedure-Principle Sequencing on Learning Outcomes. IDD&E Working Paper No. 19.

ERIC Educational Resources Information Center

Lim-Quek, Muriel; And Others

This study tested the effects of two instructional sequences--principle-procedure and procedure-principle--on the application and transfer of learning. It was hypothesized that a principle-procedure sequence would result in better near-transfer and far-transfer and that students would prefer this sequence. The 38 freshmen enrolled in a business…

Technologies for safe births.

PubMed

1984-01-01

The basic elements of a safe birth are proper prenatal care, adequate preparation of the mother, health worker, and site, awareness of the progress of labor and safe delivery, recognition of danger signs, and appropriate follow-up care. Technologies are differentiated by determining 1) the needs of rural birth attendants, 2) the nature of delivery kits, 3) proper cleanliness of the hands and equipment, and appropriate use of 5) disinfecting equipment, 6) drugs and medications, 7) the vertical position, 8) specialized instruments, and 9) records and support materials. Alternatives for measuring time are indicated. Customized kits available from UNICEF are described; some of the problems with these kits are reported. The logistics, referral procedures, and training and supervision needed for appropriate program managements are discussed. Adapting technologies to the local environment requires assessing the practices of traditional birth attendants (TBAs), the provision of kits (cost, ease of use and maintenance, replacement, durability, availability), the training required for proper use of equipment, the logistics of kit use, side effects of technologies, community attitudes, and evaluation. The advantages and disadvantages of including or not including particular supplies in the kit are discussed, i.e., the container for boiling water would either be a local pot or the aluminum carrying case. In lieu of a fingernail brush, a twig may be used for nail cleaning. Hand washing where water shortages exist might entail using a tin with a hole plugged with a stick to let water trickle as needed. Antiseptic solutions such a Dettol or Savlon can be used where a severe shortage exists. Basic equipment includes: soap and water, a container for boiling, other sterile containers, a protective cover of delivery area, towels, swabs, an optional apron, cord ties, a cutting instrument, gauze, a receiving blanket, records, and a carrying case.

The SAFE strategy for the elimination of trachoma by 2020: will it work?

PubMed Central

Bailey, R.; Lietman, T.

2001-01-01

WHO has recently launched a programme (GET 2020) for the elimination of trachoma, the leading cause of preventable blindness. GET 2020 has adopted the SAFE strategy, a comprehensive set of control measures (Surgery for entropion/trichiasis; Antibiotics for infectious trachoma; Facial cleanliness to reduce transmission; Environmental improvements such as control of disease-spreading flies and access to clean water). The present article reviews the strengths and weaknesses of each component of the strategy. Although significant hurdles remain to be overcome there is every reason to hope that GET 2020 will be successful. PMID:11285668

Target Trailing With Safe Navigation With Colregs for Maritime Autonomous Surface Vehicles

NASA Technical Reports Server (NTRS)

Kuwata, Yoshiaki (Inventor); Aghazarian, Hrand (Inventor); Huntsberger, Terrance L. (Inventor); Howard, Andrew B. (Inventor); Wolf, Michael T. (Inventor); Zarzhitsky, Dimitri V. (Inventor)

2014-01-01

Systems and methods for operating autonomous waterborne vessels in a safe manner. The systems include hardware for identifying the locations and motions of other vessels, as well as the locations of stationary objects that represent navigation hazards. By applying a computational method that uses a maritime navigation algorithm for avoiding hazards and obeying COLREGS using Velocity Obstacles to the data obtained, the autonomous vessel computes a safe and effective path to be followed in order to accomplish a desired navigational end result, while operating in a manner so as to avoid hazards and to maintain compliance with standard navigational procedures defined by international agreement. The systems and methods have been successfully demonstrated on water with radar and stereo cameras as the perception sensors, and integrated with a higher level planner for trailing a maneuvering target.

How to Stop Steroid Medicines Safely

MedlinePlus

... Kids and Teens Pregnancy and Childbirth Women Men Seniors Your Health Resources Healthcare Management End-of-Life Issues Insurance & Bills Self Care Working With Your Doctor Drugs, Procedures & Devices Over-the- ...

Reliability based fatigue design and maintenance procedures

NASA Technical Reports Server (NTRS)

Hanagud, S.

1977-01-01

A stochastic model has been developed to describe a probability for fatigue process by assuming a varying hazard rate. This stochastic model can be used to obtain the desired probability of a crack of certain length at a given location after a certain number of cycles or time. Quantitative estimation of the developed model was also discussed. Application of the model to develop a procedure for reliability-based cost-effective fail-safe structural design is presented. This design procedure includes the reliability improvement due to inspection and repair. Methods of obtaining optimum inspection and maintenance schemes are treated.

Apollo Operations Handbook Lunar Module (LM 11 and Subsequent) Vol. 2 Operational Procedures

NASA Technical Reports Server (NTRS)

1971-01-01

The Apollo Operations Handbook (AOH) is the primary means of documenting LM descriptions and procedures. The AOH is published in two separately bound volumes. This information is useful in support of program management, engineering, test, flight simulation, and real time flight support efforts. This volume contains crew operational procedures: normal, backup, abort, malfunction, and emergency. These procedures define the sequence of actions necessary for safe and efficient subsystem operation.

23 CFR 630.1012 - Project-level procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1012 Project-level procedures. (a) This section provides guidance and establishes procedures for States to manage the work zone impacts of individual projects. (b) Transportation Management Plan (TMP). A TMP consists of strategies to manage the work zone...

23 CFR 630.1012 - Project-level procedures.

Code of Federal Regulations, 2013 CFR

2013-04-01

... PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1012 Project-level procedures. (a) This section provides guidance and establishes procedures for States to manage the work zone impacts of individual projects. (b) Transportation Management Plan (TMP). A TMP consists of strategies to manage the work zone...

23 CFR 630.1012 - Project-level procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1012 Project-level procedures. (a) This section provides guidance and establishes procedures for States to manage the work zone impacts of individual projects. (b) Transportation Management Plan (TMP). A TMP consists of strategies to manage the work zone...

23 CFR 630.1012 - Project-level procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1012 Project-level procedures. (a) This section provides guidance and establishes procedures for States to manage the work zone impacts of individual projects. (b) Transportation Management Plan (TMP). A TMP consists of strategies to manage the work zone...

Unmanned Aerial Systems Traffic Management (UTM): Safely Enabling UAS Operations in Low-Altitude Airspace

NASA Technical Reports Server (NTRS)

Rios, Joseph

2016-01-01

Currently, there is no established infrastructure to enable and safely manage the widespread use of low-altitude airspace and UAS flight operations. Given this, and understanding that the FAA faces a mandate to modernize the present air traffic management system through computer automation and significantly reduce the number of air traffic controllers by FY 2020, the FAA maintains that a comprehensive, yet fully automated UAS traffic management (UTM) system for low-altitude airspace is needed. The concept of UTM is to begin by leveraging concepts from the system of roads, lanes, stop signs, rules and lights that govern vehicles on the ground today. Building on its legacy of work in air traffic management (ATM), NASA is working with industry to develop prototype technologies for a UAS Traffic Management (UTM) system that would evolve airspace integration procedures for enabling safe, efficient low-altitude flight operations that autonomously manage UAS operating in an approved low-altitude airspace environment. UTM is a cloud-based system that will autonomously manage all traffic at low altitudes to include UASs being operated beyond visual line of sight of an operator. UTM would thus enable safe and efficient flight operations by providing fully integrated traffic management services such as airspace design, corridors, dynamic geofencing, severe weather and wind avoidance, congestion management, terrain avoidance, route planning re-routing, separation management, sequencing spacing, and contingency management. UTM removes the need for human operators to continuously monitor aircraft operating in approved areas. NASA envisions concepts for two types of UTM systems. The first would be a small portable system, which could be moved between geographical areas in support of operations such as precision agriculture and public safety. The second would be a Persistent system, which would support low-altitude operations in an approved area by providing continuous automated

Interactive eLearning - a safe place to practice.

PubMed

Einarson, Elisabeth; Moen, Anne; Kolberg, Ragnhild; Flingtorp, Gry; Linnerud, Eva

2009-01-01

Interactive web-based learning environment offers refreshing opportunities to create innovative solutions to explore and exploit informatics support on-the-job training. We report from a study where a hospital is created a interactive eLearning resource. The modules are creating a safe place to practice - to be used for introduction to the work and preparation for certification or re-certification of competencies.

Percutaneous tracheostomy in patients with cervical spine fractures--feasible and safe.

PubMed

Ben Nun, Alon; Orlovsky, Michael; Best, Lael Anson

2006-08-01

The aim of this study is to evaluate the short and long-term results of percutaneous tracheostomy in patients with documented cervical spine fracture. Between June 2000 and September 2005, 38 consecutive percutaneous tracheostomy procedures were performed on multi-trauma patients with cervical spine fracture. Modified Griggs technique was employed at the bedside in the general intensive care department. Staff thoracic surgeons and anesthesiologists performed all procedures. Demographics, anatomical conditions, presence of co-morbidities and complication rates were recorded. The average operative time was 10 min (6-15). Two patients had minor complications. One patients had minor bleeding (50 cc) and one had mild cellulitis. Nine patients had severe paraparesis or paraplegia prior to the PCT procedure and 29 were without neurological damage. There was no PCT related neurological deterioration. Twenty-eight patients were discharged from the hospital, 21 were decannulated. The average follow-up period was 18 months (1-48). There was no delayed, procedure related, complication. These results demonstrate that percutaneous tracheostomy is feasible and safe in patients with cervical spine fracture with minimal short and long-term morbidity. We believe that percutaneous tracheostomy is the procedure of choice for patients with cervical spine fracture who need prolonged ventilatory support.

Health Care Procedure Considerations and Individualized Health Care Plans

ERIC Educational Resources Information Center

Heller, Kathryn Wolff; Avant, Mary Jane Thompson

2011-01-01

Teachers need to maintain a safe, healthy environment for all their students in order to promote learning. However, there are additional considerations when students require health care procedures, such as tube feeding or clean intermittent catheterization. Teachers must effectively monitor their students and understand their roles and…

Effects of environmental and pharmacological manipulations on a novel delayed nonmatching-to-sample 'working memory' procedure in unrestrained rhesus monkeys.

PubMed

Hutsell, Blake A; Banks, Matthew L

2015-08-15

Working memory is a domain of 'executive function.' Delayed nonmatching-to-sample (DNMTS) procedures are commonly used to examine working memory in both human laboratory and preclinical studies. The aim was to develop an automated DNMTS procedure maintained by food pellets in rhesus monkeys using a touch-sensitive screen attached to the housing chamber. Specifically, the DNMTS procedure was a 2-stimulus, 2-choice recognition memory task employing unidimensional discriminative stimuli and randomized delay interval presentations. DNMTS maintained a delay-dependent decrease in discriminability that was independent of the retention interval distribution. Eliminating reinforcer availability during a single delay session or providing food pellets before the session did not systematically alter accuracy, but did reduce total choices. Increasing the intertrial interval enhanced accuracy at short delays. Acute Δ(9)-THC pretreatment produced delay interval-dependent changes in the forgetting function at doses that did not alter total choices. Acute methylphenidate pretreatment only decreased total choices. All monkeys were trained to perform NMTS at the 1s training delay within 60 days of initiating operant touch training. Furthermore, forgetting functions were reliably delay interval-dependent and stable over the experimental period (∼6 months). Consistent with previous studies, increasing the intertrial interval improved DNMTS performance, whereas Δ(9)-THC disrupted DNMTS performance independent of changes in total choices. Overall, the touchscreen-based DNMTS procedure described provides an efficient method for training and testing experimental manipulations on working memory in unrestrained rhesus monkeys. Copyright © 2015 Elsevier B.V. All rights reserved.

49 CFR 240.207 - Procedures for making the determination on vision and hearing acuity.

Code of Federal Regulations, 2014 CFR

2014-10-01

... writing that the person can safely operate without using the device. [56 FR 28254, June 19, 1991, as... 49 Transportation 4 2014-10-01 2014-10-01 false Procedures for making the determination on vision... CERTIFICATION OF LOCOMOTIVE ENGINEERS Implementation of the Certification Process § 240.207 Procedures for...

49 CFR 240.207 - Procedures for making the determination on vision and hearing acuity.

Code of Federal Regulations, 2012 CFR

2012-10-01

... writing that the person can safely operate without using the device. [56 FR 28254, June 19, 1991, as... 49 Transportation 4 2012-10-01 2012-10-01 false Procedures for making the determination on vision... CERTIFICATION OF LOCOMOTIVE ENGINEERS Implementation of the Certification Process § 240.207 Procedures for...

49 CFR 240.207 - Procedures for making the determination on vision and hearing acuity.

Code of Federal Regulations, 2013 CFR

2013-10-01

... writing that the person can safely operate without using the device. [56 FR 28254, June 19, 1991, as... 49 Transportation 4 2013-10-01 2013-10-01 false Procedures for making the determination on vision... CERTIFICATION OF LOCOMOTIVE ENGINEERS Implementation of the Certification Process § 240.207 Procedures for...

When Stakeholders Rebel: Lessons from a Safe Schools Program

ERIC Educational Resources Information Center

Gastic, Billie; Irby, Decoteau J.; Zdanis, Maureen

2008-01-01

In this essay, we describe our experiences working with a rebellious primary stakeholder, Sylvia, as evaluators of a district-wide safe schools program. Given the breadth of the program and its multiple target constituencies, we were confronted with the challenges of managing a large number of stakeholders, or those individuals and groups that…

Buying & Using Medicine Safely

MedlinePlus

... Generic Drugs - Patient Education Resources Patient and Prescriber materials: Videos, PSAs, factsheets and more. Spotlight Drugs@FDA Index to Drug-Specific Information Protecting Yourself Safe Disposal of Medicines Generic Medicines – safe, effective and ...

Do Leadership Style, Unit Climate, and Safety Climate Contribute to Safe Medication Practices?

PubMed

Farag, Amany; Tullai-McGuinness, Susan; Anthony, Mary K; Burant, Christopher

2017-01-01

This study aims at: examining if leadership style and unit climate predict safety climate; and testing the direct, indirect, and total effect of leadership style, unit climate, and safety climate on nurses' safe medication practices. The Institute of Medicine and nursing scholars propose that safety climate is a prerequisite to safety practices. However, there is limited empirical evidence about factors contributing to the development of safety climate and about the association with nurses' safe medication practices. This cross-sectional study used survey data from 246 RNs working in a Magnet® hospital. Leadership style and unit climate predicted 20% to 50% of variance on all safety climate dimensions. Model testing revealed the indirect impact of leadership style and unit climate on nurses' safe medication practices. Our hypothesized model explained small amount of the variance on nurses' safe medication practices. This finding suggests that nurses' safe medication practices are influenced by multiple contextual and personal factors that should be further examined.

Safe semi-supervised learning based on weighted likelihood.

PubMed

Kawakita, Masanori; Takeuchi, Jun'ichi

2014-05-01

We are interested in developing a safe semi-supervised learning that works in any situation. Semi-supervised learning postulates that n(') unlabeled data are available in addition to n labeled data. However, almost all of the previous semi-supervised methods require additional assumptions (not only unlabeled data) to make improvements on supervised learning. If such assumptions are not met, then the methods possibly perform worse than supervised learning. Sokolovska, Cappé, and Yvon (2008) proposed a semi-supervised method based on a weighted likelihood approach. They proved that this method asymptotically never performs worse than supervised learning (i.e., it is safe) without any assumption. Their method is attractive because it is easy to implement and is potentially general. Moreover, it is deeply related to a certain statistical paradox. However, the method of Sokolovska et al. (2008) assumes a very limited situation, i.e., classification, discrete covariates, n(')→∞ and a maximum likelihood estimator. In this paper, we extend their method by modifying the weight. We prove that our proposal is safe in a significantly wide range of situations as long as n≤n('). Further, we give a geometrical interpretation of the proof of safety through the relationship with the above-mentioned statistical paradox. Finally, we show that the above proposal is asymptotically safe even when n(')

Pre-procedural antibiotics for endoscopic urological procedures: Initial experience in individuals with spinal cord injury and asymptomatic bacteriuria.

PubMed

Chong, Julio T; Klausner, Adam P; Petrossian, Albert; Byrne, Michael D; Moore, Jewel R; Goetz, Lance L; Gater, David R; Grob, B Mayer

2015-03-01

The objective of this study was to compare the safety, efficacy, quality-of-life impact, and costs of a single dose or a longer course of pre-procedural antibiotics prior to elective endoscopic urological procedures in individuals with spinal cord injury and disorders (SCI/D) and asymptomatic bacteriuria. A prospective observational study. Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA. Sixty persons with SCI/D and asymptomatic bacteriuria scheduled to undergo elective endoscopic urological procedures. A single pre-procedural dose of antibiotics vs. a 3-5-day course of pre-procedural antibiotics. Objective and subjective measures of health, costs, and quality of life. There were no significant differences in vital signs, leukocytosis, adverse events, and overall satisfaction in individuals who received short-course vs. long-course antibiotics. There was a significant decrease in antibiotic cost (33.1 ± 47.6 vs. 3.6 ± 6.1 US$, P = 0.01) for individuals in the short-course group. In addition, there was greater pre-procedural anxiety (18 vs. 0%, P < 0.05) for individuals who received long-course antibiotics. SCI/D individuals with asymptomatic bacteriuria may be able to safely undergo most endoscopic urological procedures with a single dose of pre-procedural antibiotics. However, further research is required and even appropriate pre-procedural antibiotics may not prevent severe infections.

Modified end-to-side double-layer open pancreaticogastrostomy after Whipple procedure: surgical tips for a safe anastomosis.

PubMed

Dalla Valle, Raffaele; Rossini, Matteo; Lamecchi, Laura; Iaria, Maurizio

2018-03-01

Pancreatic fistula (PF) remains the Achilles' heel of pancreaticoduodenectomy (PD). Pancreaticogastrostomy (PG) appears to be associated with a lower risk of postoperative leak according to recent evidence. We started to fashion PG, especially in soft pancreas, modifying the original technique described by Bassi. At our institution, 105 PD procedures were carried out from January 2011 to December 2016; pancreatic-enteric continuity was restored by PG in 35 cases. Superior mesenteric/portal vein resection/reconstruction was necessary in three patients. A total of 34/35 patients underwent PG with an open anterior gastrostomy approach. Briefly, our double-layer PG anastomosis (illustrated by a video) starts with a posterior row of interrupted absorbable 4/0 monofilament sutures including the gastric serosa and the pancreatic capsule. It is essential to mobilize the left pancreas for 4-5 cm and to shape the posterior gastrostomy shorter than the pancreatic stump. After a wide anterior auxiliary gastrostomy the pancreas is invaginated into the stomach and an interrupted row of sutures between the posterior gastric wall (full-thickness) and the body of the pancreatic stump is fashioned. The anterior gastrostomy is closed with an absorbable running suture. Finally, a further layer of sutures is applied over the posterior suture line between the gastric serosa and the pancreatic capsule. The 90-day postoperative mortality was nihil. No biliary leakage was detected and the overall PF rate was 11.4% (4/35) according to the ISGPF study group. Only one patient suffered a grade B PF (in this case, PG was carried out only through a posterior gastrostomy), whereas three patients had a minor (grade A) PF. Our modified PG proved to be safe and easy to perform, while it carried excellent outcomes even in the setting of soft pancreas. Despite the limited number of cases, such modified PG appears promising, particularly for pancreatic remnants at higher risk of PF.

Procedures in complex systems: the airline cockpit.

PubMed

Degani, A; Wiener, E L

1997-05-01

In complex human-machine systems, successful operations depend on an elaborate set of procedures which are specified by the operational management of the organization. These procedures indicate to the human operator (in this case the pilot) the manner in which operational management intends to have various tasks done. The intent is to provide guidance to the pilots and to ensure a safe, logical, efficient, and predictable (standardized) means of carrying out the objectives of the job. However, procedures can become a hodge-podge. Inconsistent or illogical procedures may lead to noncompliance by operators. Based on a field study with three major airlines, the authors propose a model for procedure development called the "Four P's": philosophy, policies, procedures, and practices. Using this model as a framework, the authors discuss the intricate issue of designing flight-deck procedures, and propose a conceptual approach for designing any set of procedures. The various factors, both external and internal to the cockpit, that must be considered for procedure design are presented. In particular, the paper addresses the development of procedures for automated cockpits--a decade-long, and highly controversial issue in commercial aviation. Although this paper is based on airline operations, we assume that the principles discussed here are also applicable to other high-risk supervisory control systems, such as space flight, manufacturing process control, nuclear power production, and military operations.

SAFE: SPARQL Federation over RDF Data Cubes with Access Control.

PubMed

Khan, Yasar; Saleem, Muhammad; Mehdi, Muntazir; Hogan, Aidan; Mehmood, Qaiser; Rebholz-Schuhmann, Dietrich; Sahay, Ratnesh

2017-02-01

Several query federation engines have been proposed for accessing public Linked Open Data sources. However, in many domains, resources are sensitive and access to these resources is tightly controlled by stakeholders; consequently, privacy is a major concern when federating queries over such datasets. In the Healthcare and Life Sciences (HCLS) domain real-world datasets contain sensitive statistical information: strict ownership is granted to individuals working in hospitals, research labs, clinical trial organisers, etc. Therefore, the legal and ethical concerns on (i) preserving the anonymity of patients (or clinical subjects); and (ii) respecting data ownership through access control; are key challenges faced by the data analytics community working within the HCLS domain. Likewise statistical data play a key role in the domain, where the RDF Data Cube Vocabulary has been proposed as a standard format to enable the exchange of such data. However, to the best of our knowledge, no existing approach has looked to optimise federated queries over such statistical data. We present SAFE: a query federation engine that enables policy-aware access to sensitive statistical datasets represented as RDF data cubes. SAFE is designed specifically to query statistical RDF data cubes in a distributed setting, where access control is coupled with source selection, user profiles and their access rights. SAFE proposes a join-aware source selection method that avoids wasteful requests to irrelevant and unauthorised data sources. In order to preserve anonymity and enforce stricter access control, SAFE's indexing system does not hold any data instances-it stores only predicates and endpoints. The resulting data summary has a significantly lower index generation time and size compared to existing engines, which allows for faster updates when sources change. We validate the performance of the system with experiments over real-world datasets provided by three clinical organisations as

Estimated Maximal Safe Dosages of Tumescent Lidocaine

PubMed Central

Jeske, Daniel R.

2016-01-01

BACKGROUND: Tumescent lidocaine anesthesia consists of subcutaneous injection of relatively large volumes (up to 4 L or more) of dilute lidocaine (≤1 g/L) and epinephrine (≤1 mg/L). Although tumescent lidocaine anesthesia is used for an increasing variety of surgical procedures, the maximum safe dosage is unknown. Our primary aim in this study was to measure serum lidocaine concentrations after subcutaneous administration of tumescent lidocaine with and without liposuction. Our hypotheses were that even with large doses (i.e., >30 mg/kg), serum lidocaine concentrations would be below levels associated with mild toxicity and that the concentration-time profile would be lower after liposuction than without liposuction. METHODS: Volunteers participated in 1 to 2 infiltration studies without liposuction and then one study with tumescent liposuction totally by local anesthesia. Serum lidocaine concentrations were measured at 0, 2, 4, 6, 8, 10, 12, 14, 16, 18, and 24 hours after each tumescent lidocaine infiltration. Area under the curve (AUC∞) of the serum lidocaine concentration-time profiles and peak serum lidocaine concentrations (Cmax) were determined with and without liposuction. For any given milligram per kilogram dosage, the probability that Cmax >6 μg/mL, the threshold for mild lidocaine toxicity was estimated using tolerance interval analysis. RESULTS: In 41 tumescent infiltration procedures among 14 volunteer subjects, tumescent lidocaine dosages ranged from 19.2 to 52 mg/kg. Measured serum lidocaine concentrations were all <6 μg/mL over the 24-hour study period. AUC∞s with liposuction were significantly less than those without liposuction (P = 0.001). The estimated risk of lidocaine toxicity without liposuction at a dose of 28 mg/kg and with liposuction at a dose of 45 mg/kg was ≤1 per 2000. CONCLUSIONS: Preliminary estimates for maximum safe dosages of tumescent lidocaine are 28 mg/kg without liposuction and 45 mg/kg with liposuction. As a

Estimated Maximal Safe Dosages of Tumescent Lidocaine.

PubMed

Klein, Jeffrey A; Jeske, Daniel R

2016-05-01

Tumescent lidocaine anesthesia consists of subcutaneous injection of relatively large volumes (up to 4 L or more) of dilute lidocaine (≤1 g/L) and epinephrine (≤1 mg/L). Although tumescent lidocaine anesthesia is used for an increasing variety of surgical procedures, the maximum safe dosage is unknown. Our primary aim in this study was to measure serum lidocaine concentrations after subcutaneous administration of tumescent lidocaine with and without liposuction. Our hypotheses were that even with large doses (i.e., >30 mg/kg), serum lidocaine concentrations would be below levels associated with mild toxicity and that the concentration-time profile would be lower after liposuction than without liposuction. Volunteers participated in 1 to 2 infiltration studies without liposuction and then one study with tumescent liposuction totally by local anesthesia. Serum lidocaine concentrations were measured at 0, 2, 4, 6, 8, 10, 12, 14, 16, 18, and 24 hours after each tumescent lidocaine infiltration. Area under the curve (AUC∞) of the serum lidocaine concentration-time profiles and peak serum lidocaine concentrations (Cmax) were determined with and without liposuction. For any given milligram per kilogram dosage, the probability that Cmax >6 μg/mL, the threshold for mild lidocaine toxicity was estimated using tolerance interval analysis. In 41 tumescent infiltration procedures among 14 volunteer subjects, tumescent lidocaine dosages ranged from 19.2 to 52 mg/kg. Measured serum lidocaine concentrations were all <6 μg/mL over the 24-hour study period. AUC∞s with liposuction were significantly less than those without liposuction (P = 0.001). The estimated risk of lidocaine toxicity without liposuction at a dose of 28 mg/kg and with liposuction at a dose of 45 mg/kg was ≤1 per 2000. Preliminary estimates for maximum safe dosages of tumescent lidocaine are 28 mg/kg without liposuction and 45 mg/kg with liposuction. As a result of delayed systemic absorption, these

Transhepatic Hilar Approach for Perihilar Cholangiocarcinoma: Significance of Early Judgment of Resectability and Safe Vascular Reconstruction.

PubMed

Kuriyama, Naohisa; Isaji, Shuji; Tanemura, Akihiro; Iizawa, Yusuke; Kato, Hiroyuki; Murata, Yasuhiro; Azumi, Yoshinori; Kishiwada, Masashi; Mizuno, Shugo; Usui, Masanobu; Sakurai, Hiroyuki

2017-03-01

In the most common surgical procedure for perihilar cholangiocarcinoma, the margin status of the proximal bile duct is determined at the final step. Our procedure, the transhepatic hilar approach, confirms a cancer-negative margin status of the proximal bile duct first. We first performed a partial hepatic parenchymal transection to expose the hilar plate, and then transected the proximal bile duct to confirm margin status. Then, divisions of the hepatic artery and portal vein of the future resected liver are performed, followed by the residual hepatic parenchymal transection. The transhepatic hilar approach offers a wide surgical field for safe resection and reconstruction of the portal vein in the middle of the hepatectomy. We reviewed 23 patients with perihilar cholangiocarcinoma who underwent major hepatectomy using our procedure from 2011 to 2015. A combined vascular resection and reconstruction was carried out in 14 patients (60.9%). R0 resection was achieved in 17 patients (73.9%), and the overall 3-year survival rate was 52.9% (median survival time 52.4 months). The transhepatic hilar approach is useful and practicable regardless of local tumor extension, enabling us to determine tumor resectability and perform safe resection and reconstruction of the portal vein early in the operation.

Is There a Safe Level of Exposure to a Carcinogen?

ERIC Educational Resources Information Center

Hrudey, Steve E.; Krewski, Daniel

1995-01-01

Presents an approach to estimating the "safe" levels of low-dose exposure to carcinogens that involves working upward from the smallest conceivable chronic dose instead of extrapolating downward from high exposures. Discusses expert and public opinion and other issues related to quantitative cancer risk assessment. (LZ)

Exercising for Two. What's Safe for the Active Pregnant Woman?

ERIC Educational Resources Information Center

White, Jacqueline

1992-01-01

Clinical experience and recent research challenge the current standards of exercise duration and intensity for pregnant women. By carefully assessing patients' self-monitoring techniques, physicians can work with active women to create safe exercise programs during pregnancy. Safety guidelines for developing home exercise programs are included.…

Nonspecific abdominal pain is a safe diagnosis.

PubMed

Pennel, David John Laurie; Goergen, Nina; Driver, Chris P

2014-11-01

The aim of this study is to assess if a clinical diagnosis of nonspecific abdominal pain (NSAP) is safe and if patients with this initial diagnosis are likely to require further investigation or surgical intervention. 3323 patients admitted with NSAP from July 1990 to September 2012 utilizing a prospective database of all surgical admissions were included. Readmission over the period of the study and specifically within 30 days of their initial presentation was identified together with any invasive investigation or surgical intervention. 319 children (9.6%) were subsequently readmitted with abdominal pain at some point during the study period. Of these, 78 (2.3%) were readmitted within 30 days. 118 (3.5%) children subsequently had an operation or invasive investigation some point following their initial admission. Of these 33 (0.6%) had the procedure within 3 months of the initial admission. 13 patients had an appendicectomy within 3 months of the initial presentation. Of these histology confirmed appendicitis in 8 patients. This gives an overall incidence of "missed" appendicitis of 0.2 % (8/3323). This study confirms that a clinical diagnosis of nonspecific abdominal pain (NSAP) is safe in a pediatric population and the risk of "missing" appendicitis is only 0.2%. Patients and/or parents can be confidently reassured that the risk of missing organic pathology is very low. Copyright © 2014 Elsevier Inc. All rights reserved.

Cultivating the Art of Safe Space

ERIC Educational Resources Information Center

Hunter, Mary Ann

2008-01-01

Performance-making and peace-building are processes predicated on the production of safe space. But what is "safe space"? In performance-making, what is it that makes space safe without losing the creative potential of tension? What role is there for risk? And, once achieved, how does safe space become meaningful beyond its immediate…

Safe Affordable Fission Engine-(SAFE-) 100a Heat Exchanger Thermal and Structural Analysis

NASA Technical Reports Server (NTRS)

Steeve, B. E.

2005-01-01

A potential fission power system for in-space missions is a heat pipe-cooled reactor coupled to a Brayton cycle. In this system, a heat exchanger (HX) transfers the heat of the reactor core to the Brayton gas. The Safe Affordable Fission Engine- (SAFE-) 100a is a test program designed to thermally and hydraulically simulate a 95 Btu/s prototypic heat pipe-cooled reactor using electrical resistance heaters on the ground. This Technical Memorandum documents the thermal and structural assessment of the HX used in the SAFE-100a program.

Risk of Cross-Contact for Gluten-Free Pizzas in Shared-Production Restaurants in Relation to Oven Cooking Procedures.

PubMed

Vincentini, Olimpia; Izzo, Martina; Maialetti, Francesca; Gonnelli, Elena; Neuhold, Susanna; Silano, Marco

2016-09-01

To allow celiac patients to have meals out, a growing number of restaurants and pizzas houses that simultaneously provide gluten-free (GF) pizzas and wheat-based (WB) pizzas have recently been opened in Italy. In these restaurants, GF pizzas are prepared with GF raw materials, following procedures that minimize the risk of gluten cross-contact. Here, we evaluate the risk of gluten cross-contact of GF pizzas in relation to the preparation procedures, thus aiming at identifying a safe procedure for cooking GF pizzas. Our results show that, when specific requirements are complied with, the simultaneous cooking of GF and WB pizzas is a procedure as safe as having an oven dedicated to GF pizzas or the alternate cooking of GF and WB pizzas in the same oven.

Students and School Adults: Partners in Keeping Schools Safe

ERIC Educational Resources Information Center

Gastic, Billie

2010-01-01

In this article, the author discusses the important roles that students, school staff and teachers play in keeping the school safe particularly from weapons. The author believes that one way that they do this is by working together to reduce the problem of weapons in school. The role of school staff and teachers extends beyond prevention and…

Ultrasound-Guided Percutaneous Catheter Drainage of Large Breast Abscesses in Lactating Women: How to Preserve Breastfeeding Safely.

PubMed

Falco, Giuseppe; Foroni, Monica; Castagnetti, Fabio; Marano, Luigi; Bordoni, Daniele; Rocco, Nicola; Marchesi, Vanessa; Iotti, Valentina; Vacondio, Rita; Ferrari, Guglielmo

2016-12-01

Management of breast abscess in lactating women remains controversial. During pregnancy, women may develop different kinds of benign breast lesions that could require a surgical incision performed under general anesthesia with consequent breastfeeding interruption. The purpose of this study was to prospectively evaluate the management of large breast abscesses with ultrasound-assisted drainage aiming at breastfeeding preservation. 34 lactating women with a diagnosis of unilateral breast abscess have been treated with an ultrasound (US)-assisted drainage of the abscess. A pigtail catheter was inserted into the fluid collection using the Seldinger technique under US guide and connected to a three stop way to allow drainage and irrigation of the cavity until its resolution. All procedures have been found safe and well tolerated. No recurrence was observed and breastfeeding was never interrupted. The described technique allows to avoid surgery and to preserve breastfeeding in well-selected patients with a safe, well-tolerated and cost-effective procedure.

Breastfeeding FAQs: Safely Storing Breast Milk

MedlinePlus

... Staying Safe Videos for Educators Search English Español Breastfeeding FAQs: Safely Storing Breast Milk KidsHealth / For Parents / Breastfeeding FAQs: Safely Storing Breast Milk What's in this ...

Safe Surgery Trainer Project Management Plan (PMP), Version 1.0

DTIC Science & Technology

2014-05-30

Methodology including SCRUM (see http://en.wikipedia.org/wiki/Scrum_(management) for more info). Although this Safe Surgery Trainer - PMP Version 1.0 5...Agile method similar to Scrum . The internal development team works on a minor iteration cycle that begins/ends on Wednesday. At the beginning of

Metabolic Energy Costs of USAF Explosive Ordnance Disposal Render Safe Procedures: Field Determinations

DTIC Science & Technology

1991-05-01

work requirement in the moderate to hard work category. This level of energy expenditure should be within the capacity of the average EOD technician...Review of the component tasks of the RSP indicates that peak, short-term work expenditure did not approach the estimated maximal work category (1.9 1 min...hazard which would significantly increase the total energy cost of the RSP. The majority of the expected increase in energy expenditure would result from

Development of a systems theoretical procedure for evaluation of the work organization of the cockpit crew of a civil transport airplane

NASA Technical Reports Server (NTRS)

Fricke, M.; Vees, C.

1983-01-01

To achieve optimum design for the man machine interface with aircraft, a description of the interaction and work organization of the cockpit crew is needed. The development of system procedure to evaluate the work organization of pilots while structuring the work process is examined. Statistical data are needed to simulate sequences of pilot actions on the computer. Investigations of computer simulation and applicability for evaluation of crew concepts are discussed.

Safe teleoperation based on flexible intraoperative planning for robot-assisted laser microsurgery.

PubMed

Mattos, Leonardo S; Caldwell, Darwin G

2012-01-01

This paper describes a new intraoperative planning system created to improve precision and safety in teleoperated laser microsurgeries. It addresses major safety issues related to real-time control of a surgical laser during teleoperated procedures, which are related to the reliability and robustness of the telecommunication channels. Here, a safe solution is presented, consisting in a new planning system architecture that maintains the flexibility and benefits of real-time teleoperation and keeps the surgeon in control of all surgical actions. The developed system is based on our virtual scalpel system for robot-assisted laser microsurgery, and allows the intuitive use of stylus to create surgical plans directly over live video of the surgical field. In this case, surgical plans are defined as graphic objects overlaid on the live video, which can be easily modified or replaced as needed, and which are transmitted to the main surgical system controller for subsequent safe execution. In the process of improving safety, this new planning system also resulted in improved laser aiming precision and improved capability for higher quality laser procedures, both due to the new surgical plan execution module, which allows very fast and precise laser aiming control. Experimental results presented herein show that, in addition to the safety improvements, the new planning system resulted in a 48% improvement in laser aiming precision when compared to the previous virtual scalpel system.

A Comparative Study on Safe Pile Capacity as Shown in Table 1 of IS 2911 (Part III): 1980

NASA Astrophysics Data System (ADS)

Pakrashi, Somdev

2017-06-01

Code of practice for design and construction of under reamed pile foundations: IS 2911 (Part-III)—1980 presents one table in respect of safe load for bored cast in situ under reamed piles in sandy and clayey soils including black cotton soils, stem dia. of pile ranging from 20 to 50 cm and its effective length being 3.50 m. A comparative study, was taken up by working out safe pile capacity for one 400 dia., 3.5 m long bored cast in situ under reamed pile based on subsoil properties obtained from soil investigation work as well as subsoil properties of different magnitudes of clayey, sandy soils and comparing the same with the safe pile capacity shown in Table 1 of that IS Code. The study reveals that safe pile capacity computed from subsoil properties, barring a very few cases, considerably differs from that shown in the aforesaid code and looks forward for more research work and study to find out a conclusive explanation of this probable anomaly.

Improved Quick Disconnect (QD) Interface Through Fail Safe Parts Identification

NASA Technical Reports Server (NTRS)

Blanch-Payne, Evelyn

2001-01-01

An extensive review of existing Quick Disconnects (QDs) mating and demating operations was performed to determine which shuttle part interface identifications and procedures contribute to human factor errors. The research methods used consisted of interviews with engineers and technicians, examination of incident reports, critiques of video and audio tapes of QD operations, and attendance of a Hyper QD operational course. The data strongly suggests that there are inherit human factor errors involved in QD operations. To promote fail-safe operations, QD interface problem areas and recommendations were outlined and reviewed. It is suggested that dialogue, investigations and recommendations continue.

Ex-utero intrapartum treatment procedure for giant neck masses--fetal and maternal outcomes.

PubMed

Lazar, David A; Olutoye, Oluyinka O; Moise, Kenneth J; Ivey, R Todd; Johnson, Anthony; Ayres, Nancy; Olutoye, Olutoyin A; Rodriguez, Manuel A; Cass, Darrell L

2011-05-01

For fetuses with giant neck masses and tracheal obstruction, an ex-utero intrapartum treatment (EXIT) procedure allows for safe nonemergent airway management while on placental support. Our objective was to examine fetal and maternal outcomes after EXIT procedure specifically for giant neck masses. The medical records of all patients referred to a comprehensive fetal center for a giant neck mass between 2001 and 2010 were reviewed retrospectively. Among 24 patients referred, an EXIT procedure was performed in 12 with evidence of tracheal compression. An EXIT procedure was not performed because of minimal tracheal involvement (n = 8), elective abortion (n = 2), fetal demise (n = 1), or obstetric complication (n = 1). In all fetuses, the airway was successfully secured; tracheal intubation was achieved with rigid bronchoscopy (n = 10), direct laryngoscopy (n = 1), and tracheostomy (n = 1). Eleven patients survived to discharge, whereas 1 patient with significant pulmonary hypoplasia died 8 days after emergency EXIT procedure. Of 11 surviving infants, 10 are neurodevelopmentally intact. All mothers who desired future pregnancies have subsequently had uncomplicated deliveries (n = 6). Ex-utero intrapartum treatment procedure for giant neck mass can be performed safely for both mother and child. Most fetuses can be orotracheally intubated with minimal long-term morbidity. The potential for future pregnancies is preserved. Copyright © 2011 Elsevier Inc. All rights reserved.

Transient Approximation of SAFE-100 Heat Pipe Operation

NASA Technical Reports Server (NTRS)

Bragg-Sitton, Shannon M.; Reid, Robert S.

2005-01-01

Engineers at Los Alamos National Laboratory (LANL) have designed several heat pipe cooled reactor concepts, ranging in power from 15 kWt to 800 kWt, for both surface power systems and nuclear electric propulsion systems. The Safe, Affordable Fission Engine (SAFE) is now being developed in a collaborative effort between LANL and NASA Marshall Space Flight Center (NASA/MSFC). NASA is responsible for fabrication and testing of non-nuclear, electrically heated modules in the Early Flight Fission Test Facility (EFF-TF) at MSFC. In-core heat pipes must be properly thawed as the reactor power starts. Computational models have been developed to assess the expected operation of a specific heat pipe design during start-up, steady state operation, and shutdown. While computationally intensive codes provide complete, detailed analyses of heat pipe thaw, a relatively simple. concise routine can also be applied to approximate the response of a heat pipe to changes in the evaporator heat transfer rate during start-up and power transients (e.g., modification of reactor power level) with reasonably accurate results. This paper describes a simplified model of heat pipe start-up that extends previous work and compares the results to experimental measurements for a SAFE-100 type heat pipe design.

Adult and pediatric anesthesia/sedation for gastrointestinal procedures outside of the operating room.

PubMed

Michel Foehn, Esther R

2015-08-01

This review presents current trends of safe and efficient anesthesia and sedation for adults and children for gastrointestinal procedures outside of the operating room with a special focus on total intravenous anesthesia (TIVA), target-controlled infusion (TCI), intravenous or topical lidocaine, and the use of the video laryngoscope. The concepts of a well tolerated and adequate anesthesia or sedation for gastrointestinal procedures outside of the operating room have to meet the needs of the adult and pediatric patients and the special requests of the gastroenterologists. Anesthesia and sedation of adults for gastrointestinal procedures with TIVA or TCI and spontaneous breathing is well established. Many institutions perform anesthesia for pediatric patients undergoing gastrointestinal procedures with an inhalational agent, especially in young children and for short procedures. Unlike adults, in young children the airways frequently must be secured with a tracheal tube or laryngeal mask. Respiration may be spontaneous, assisted, or controlled. TIVA and TCI are increasingly chosen for older children and longer procedures. A local anesthetic administered intravenously or topically to the upper airways and the use of the video laryngoscope can facilitate the insertion of the endoscope. Both anesthesiologists and nonanesthesiologists have to achieve a consensus and develop quality-improvement strategies to provide safe and efficient anesthesia and sedation for gastrointestinal procedures outside of the operating room for pediatric and adult patients. Techniques using TIVA, TCI, intravenous or topical application of lidocaine, and the video laryngoscope may improve and facilitate gastrointestinal procedures for the patients, the anesthesiologists, and the gastroenterologists.

The effect of equipment proximity on safe performance in a manufacturing setting.

PubMed

Abellon, O Elizabeth; Wilder, David A

2014-01-01

We examined the effect of equipment proximity on the safe performance of 3 assembly workers in a manufacturing setting. After a baseline period in which protective eyewear was kept 6.1 m from employee workstations, task clarification was used to inform participants to wear their eyewear while they worked. Next, the eyewear was moved to 1.5 m from employee workstations. After a return to the 6.1-m condition, the eyewear was again positioned 1.5 m from workstations. Results indicate that task clarification alone was ineffective, but safe performance increased when eyewear was stored in close proximity to employees. A social validity measure suggested that safe performance among the employees increased to levels comparable to that of an exemplary employee. © Society for the Experimental Analysis of Behavior.

The utility of caesarean myomectomy as a safe procedure: a retrospective analysis of 21 cases with review of literature.

PubMed

Kumar R, Ramesh; Patil, Manjula; Sa, Shruthi

2014-09-01

Myomectomy at the time of caesarean delivery has been discouraged because of the risk of intractable haemorrhage and increased postoperative morbidity. The aim of this study is to determine the safety and feasibility of caesarean myomectomy. A retrospective case control study done between June 2012 to May 2013 in a tertiary care teaching hospital in Karnataka, India which included 21 pregnant women with uterine fibroids who underwent myomectomy during caesarean section and were compared with 42 matched controls without uterine fibroids who had caesarean section alone during the same period. Primary outcome measures studied were incidence of haemorrhage and need for blood transfusion. Secondary outcome measures were duration of operation, length of hospital stay, postpartum fever and wound infection. Statistical analysis is done using IBMSPSS 20.0 software and students t-test. For calculation of incidence of haemorrhage Fisher's exact test is used. Mean age of the 21 cases was 31.81yrs and 47.62% were primigravida. Total 37 fibroids were removed. Subserosal were 30 cases(81.08%) while 1(2.07%) was submucous. 21(56.76%)fibroids were situated in fundal region and 3(8.11%) were in lower segment. Mean change in the haemoglobin from preoperative to postoperative period in the cases was 1.3gm/dl(±1.155mg/dl) and control was 1.05% (±.854mg/dl). Two of the cases(9.52%) required blood transfusion compared to none in control. None in either group required hysterectomy. Mean duration of surgery was 68.57min (±15.012min)and 51.55min (±9.595min) for controls which is statistically significant. This study shows that myomectomy during caesarean section is a safe procedure and is not associated with major intraoperative and postoperative complications.

MO-A-16A-01: QA Procedures and Metrics: In Search of QA Usability

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

Sathiaseelan, V; Thomadsen, B

Radiation therapy has undergone considerable changes in the past two decades with a surge of new technology and treatment delivery methods. The complexity of radiation therapy treatments has increased and there has been increased awareness and publicity about the associated risks. In response, there has been proliferation of guidelines for medical physicists to adopt to ensure that treatments are delivered safely. Task Group recommendations are copious, and clinical physicists' hours are longer, stretched to various degrees between site planning and management, IT support, physics QA, and treatment planning responsibilities.Radiation oncology has many quality control practices in place to ensure themore » delivery of high-quality, safe treatments. Incident reporting systems have been developed to collect statistics about near miss events at many radiation oncology centers. However, tools are lacking to assess the impact of these various control measures. A recent effort to address this shortcoming is the work of Ford et al (2012) who recently published a methodology enumerating quality control quantification for measuring the effectiveness of safety barriers. Over 4000 near-miss incidents reported from 2 academic radiation oncology clinics were analyzed using quality control quantification, and a profile of the most effective quality control measures (metrics) was identified.There is a critical need to identify a QA metric to help the busy clinical physicists to focus their limited time and resources most effectively in order to minimize or eliminate errors in the radiation treatment delivery processes. In this symposium the usefulness of workflows and QA metrics to assure safe and high quality patient care will be explored.Two presentations will be given:Quality Metrics and Risk Management with High Risk Radiation Oncology ProceduresStrategies and metrics for quality management in the TG-100 Era Learning Objectives: Provide an overview and the need for QA

Guidelines for design and safe handling of curved I-shaped steel girders.

DOT National Transportation Integrated Search

2010-02-01

The purpose of this set of guidelines is to summarize recommendations from work : completed as part of the Texas Department of Transportation (TxDOT) Research Project 0-5574 : entitled "Curved Plate Girder Design for Safe and Economic Construction." ...

Ticagrelor for Neuroendovascular Procedures: A Case Series.

PubMed

Davis, Kyle; Morrison, Christopher

2018-02-01

The development of thromboembolism is one of the most common complications of neuroendovascular procedures. Although several small studies have deemed clopidogrel safe and effective in the prevention of intracranial stent thrombosis, ticagrelor has yet to be assessed in this setting. The objective of this study was to retrospectively evaluate the safety and efficacy of ticagrelor in patients undergoing neuroendovascular procedures. A retrospective review of patients receiving ticagrelor following neuroendovascular aneurysm repair. A total of 5 patients undergoing neuroendovascular aneurysm repair received ticagrelor for a median of 5 days while hospitalized. Three patients were treated with stent-assisted coiling, while 2 received pipeline embolization devices. All patients received additional low-dose aspirin therapy. One patient received ticagrelor after experiencing a thrombotic event on clopidogrel, while a second patient was treated with ticagrelor after developing a dermatologic reaction to clopidogrel. Three (60%) patients were successfully treated and discharged on ticagrelor therapy. Two patients experienced cerebrovascular accidents following aneurysm repair while receiving ticagrelor, one of which was potentially due to medication omission. One (20%) patient receiving ticagrelor experienced a small retroperitoneal hematoma; however, ticagrelor therapy was continued without further complication. Therapy with ticagrelor may be a safe and effective treatment option for patients undergoing neuroendovascular aneurysm repair. However, future studies are warranted to substantiate these findings.

14 CFR 431.39 - Mission rules, procedures, contingency plans, and checklists.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Mission rules, procedures, contingency plans, and checklists. 431.39 Section 431.39 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION... safe conduct of mission operations during nominal and non-nominal vehicle flight. (b) Mission rules...

14 CFR 431.39 - Mission rules, procedures, contingency plans, and checklists.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Mission rules, procedures, contingency plans, and checklists. 431.39 Section 431.39 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION... safe conduct of mission operations during nominal and non-nominal vehicle flight. (b) Mission rules...

On the design of flight-deck procedures

NASA Technical Reports Server (NTRS)

Degani, Asaf; Wiener, Earl L.

1994-01-01

In complex human-machine systems, operations, training, and standardization depend on a elaborate set of procedures which are specified and mandated by the operational management of the organization. The intent is to provide guidance to the pilots, to ensure a logical, efficient, safe, and predictable means of carrying out the mission objectives. In this report the authors examine the issue of procedure use and design from a broad viewpoint. The authors recommend a process which we call 'The Four P's:' philosophy, policies, procedures, and practices. We believe that if an organization commits to this process, it can create a set of procedures that are more internally consistent, less confusing, better respected by the flight crews, and that will lead to greater conformity. The 'Four-P' model, and the guidelines for procedural development in appendix 1, resulted from cockpit observations, extensive interviews with airline management and pilots, interviews and discussion at one major airframe manufacturer, and an examination of accident and incident reports. Although this report is based on airline operations, we believe that the principles may be applicable to other complex, high-risk systems, such as nuclear power production, manufacturing process control, space flight, and military operations.

Safe Use of Pesticides, Guidelines. Occupational Safety and Health Series No. 38.

ERIC Educational Resources Information Center

International Labour Office, Geneva (Switzerland).

This document provides guidance on the safe use of pesticides in agricultural work. General principles are given and followed by more detailed safety requirements for the various pesticide application techniques. Finally, the medical aspects of pesticides are considered. (BB)

Transportation and aging: a research agenda for advancing safe mobility.

PubMed

Dickerson, Anne E; Molnar, Lisa J; Eby, David W; Adler, Geri; Bédard, Michel; Berg-Weger, Marla; Classen, Sherrilene; Foley, Daniel; Horowitz, Amy; Kerschner, Helen; Page, Oliver; Silverstein, Nina M; Staplin, Loren; Trujillo, Leonard

2007-10-01

We review what we currently know about older driver safety and mobility, and we highlight important research needs in a number of key areas that hold promise for achieving the safety and mobility goals for the aging baby boomers and future generations of older drivers. Through the use of a framework for transportation and safe mobility, we describe key areas of screening and assessment, remediation and rehabilitation, vehicle design and modification, technological advancements, roadway design, transitioning to nondriving, and alternative transportation to meet the goals of crash prevention and mobility maintenance for older adults. Four cross-cutting themes emerged from this review: safe transportation for older adults is important; older adults have a variety of needs, abilities, and resources; research to help meet the transportation needs of older adults may be of benefit to persons with disabilities; and transportation issues concerning older adults are multifaceted. Safe mobility is essential to continued engagement in civic, social, and community life, and to the human interactions necessary for health, well-being, and quality of life. When safe driving is no longer possible for older adults, safe and practicable alternative transportation must be available. Furthermore, older adults are individuals; they have specific needs, abilities, and resources. Not all older adults will have difficulty meeting their transportation needs and no single transportation solution will work for all people. Research and countermeasures intended to help meet the transportation needs of older adults will likely also benefit younger users of the transportation system, particularly those with disabilities. The issues surrounding the maintenance of safe transportation for older adults will require an interdisciplinary research approach if we are to make significant progress in the next decade as the baby boomers begin to reach age 70.

Robot-assisted laparoscopic (RAL) procedures in general surgery.

PubMed

Alimoglu, Orhan; Sagiroglu, Julide; Atak, Ibrahim; Kilic, Ali; Eren, Tunc; Caliskan, Mujgan; Bas, Gurhan

2016-09-01

Robotics was introduced in clinical practice more than two decades ago, and it has gained remarkable popularity for a wide variety of laparoscopic procedures. We report our results of robot-assisted laparoscopic surgery (RALS) in the most commonly applied general surgical procedures. Ninety seven patients underwent RALS from 2009 to 2012. Indications for RALS were cholelithiasis, gastric carcinoma, splenic tumors, colorectal carcinoma, benign colorectal diseases, non-toxic nodular goiter and incisional hernia. Records of patients were analyzed for demographic features, intraoperative and postoperative complications and conversion to open surgery. Forty six female and 51 male patients were operated and mean age was 58,4 (range: 25-88). Ninety three out of 97 procedures (96%) were completed robotically, 4 were converted to open surgery and there were 15 postoperative complications. There was no mortality. Wide variety of procedures of general surgery can be managed safely and effectively by RALS. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Using Opioids Safely After Surgery

MedlinePlus

... Adult , Geriatric Using Opioids Safely After Surgery Using Opioids Safely After Surgery Stick to the lowest dose ... need opioid pain medicine. If your doctor says opioids aren’t necessary. If your doctor thinks you ...

How Safe Is Safe Enough for Self-Driving Vehicles?

PubMed

Liu, Peng; Yang, Run; Xu, Zhigang

2018-05-21

Self-driving vehicles (SDVs) promise to considerably reduce traffic crashes. One pressing concern facing the public, automakers, and governments is "How safe is safe enough for SDVs?" To answer this question, a new expressed-preference approach was proposed for the first time to determine the socially acceptable risk of SDVs. In our between-subject survey (N = 499), we determined the respondents' risk-acceptance rate of scenarios with varying traffic-risk frequencies to examine the logarithmic relationships between the traffic-risk frequency and risk-acceptance rate. Logarithmic regression models of SDVs were compared to those of human-driven vehicles (HDVs); the results showed that SDVs were required to be safer than HDVs. Given the same traffic-risk-acceptance rates for SDVs and HDVs, their associated acceptable risk frequencies of SDVs and HDVs were predicted and compared. Two risk-acceptance criteria emerged: the tolerable risk criterion, which indicates that SDVs should be four to five times as safe as HDVs, and the broadly acceptable risk criterion, which suggests that half of the respondents hoped that the traffic risk of SDVs would be two orders of magnitude lower than the current estimated traffic risk. The approach and these results could provide insights for government regulatory authorities for establishing clear safety requirements for SDVs. © 2018 Society for Risk Analysis.

Aortic root repair for thoracic aorta false aneurysm following Bentall procedure.

PubMed

Kumar, Sanjay; Jones, Steve; Sivananthan, U M; McGoldrick, J P

2008-08-01

The Bentall procedure for aortic root replacement in Marfan's syndrome is safe and durable. We describe successful repair of periprosthetic valvular leak, 12 years following Bentall repair with composite graft. The aim of this report is to analyse and evaluate technical factors leading to this unusual occurrence.

Safe paediatric intensive care. Part 1: Does more medical care lead to improved outcome?

PubMed

Frey, Bernhard; Argent, Andrew

2004-06-01

Neonatal and paediatric intensive care has improved the prognosis for seriously sick infants and children. This has happened because of a pragmatic approach focused on stabilisation of vital functions and immense technological advances in diagnostic and therapeutic procedures. However, the belief that more medical care must inevitably lead to improved health is increasingly being questioned. This issue is especially relevant in developing countries where the introduction of highly specialised paediatric intensive care may not lead to an overall fall in child mortality. Even in developed countries, the complexity and availability of therapeutics and invasive procedures may put seriously ill children at additional risk. In both developing and industrialised countries the use of safe and simple procedures for appropriate periods, particular attention to drug prescription patterns and selection of appropriate aims and modes of therapy, including non-invasive methods, may minimise the risks of paediatric intensive care.

Simultaneous resection for colorectal cancer with synchronous liver metastases is a safe procedure: Outcomes at a single center in Turkey.

PubMed

Dulundu, Ender; Attaallah, Wafi; Tilki, Metin; Yegen, Cumhur; Coskun, Safak; Coskun, Mumin; Erdim, Aylin; Tanrikulu, Eda; Yardimci, Samet; Gunal, Omer

2017-05-23

The optimal surgical strategy for treating colorectal cancer with synchronous liver metastases is subject to debate. The current study sought to evaluate the outcomes of simultaneous colorectal cancer and liver metastases resection in a single center. Prospectively collected data on all patients with synchronous colorectal liver metastases who underwent simultaneous resection with curative intent were analyzed retrospectively. Patient outcomes were compared depending on the primary tumor location and type of liver resection (major or minor). Between January 2005 and August 2016, 108 patients underwent simultaneous resection of primary colorectal cancer and liver metastases. The tumor was localized to the right side of the colon in 24 patients (22%), to the left side in 40 (37%), and to the rectum in 44 (41%). Perioperative mortality occurred in 3 patients (3%). Postoperative complications were noted in 32 patients (30%), and most of these complications (75%) were grade 1 to 3 according to the Clavien-Dindo classification. Neither perioperative mortality nor the rate of postoperative complications after simultaneous resection differed among patients with cancer of the right side of the colon, those with cancer of the left side of the colon, and those with rectal cancer (4%, 2.5%, and 2%, respectively, p = 0.89) and (17%, 33%, and 34%, respectively; p = 0.29)]. The 5-year overall survival of the entire sample was 54% and the 3-year overall survival was 67 %. In conclusion, simultaneous resection for primary colorectal cancer and liver metastases is a safe procedure and can be performed without excess morbidity in carefully selected patients regardless of the location of the primary tumor and type of hepatectomy.

Costing imaging procedures.

PubMed

Bretland, P M

1988-01-01

The existing National Health Service financial system makes comprehensive costing of any service very difficult. A method of costing using modern commercial methods has been devised, classifying costs into variable, semi-variable and fixed and using the principle of overhead absorption for expenditure not readily allocated to individual procedures. It proved possible to establish a cost spectrum over the financial year 1984-85. The cheapest examinations were plain radiographs outside normal working hours, followed by plain radiographs, ultrasound, special procedures, fluoroscopy, nuclear medicine, angiography and angiographic interventional procedures in normal working hours. This differs from some published figures, particularly those in the Körner report. There was some overlap between fluoroscopic interventional and the cheaper nuclear medicine procedures, and between some of the more expensive nuclear medicine procedures and the cheaper angiographic ones. Only angiographic and the few more expensive nuclear medicine procedures exceed the cost of the inpatient day. The total cost of the imaging service to the district was about 4% of total hospital expenditure. It is shown that where more procedures are undertaken, the semi-variable and fixed (including capital) elements of the cost decrease (and vice versa) so that careful study is required to assess the value of proposed economies. The method is initially time-consuming and requires a computer system with 512 Kb of memory, but once the basic costing system is established in a department, detailed financial monitoring should become practicable. The necessity for a standard comprehensive costing procedure of this nature, based on sound cost accounting principles, appears inescapable, particularly in view of its potential application to management budgeting.

Why do workers behave unsafely at work? Determinants of safe work practices in industrial workers.

PubMed

Garcia, A M; Boix, P; Canosa, C

2004-03-01

To explore the relation between safety climate (workers' perceptions regarding management's attitudes towards occupational safety and health) and workers' behaviour at work. Cross sectional survey of workers at the pottery industry in Castellon, Spain. Sampling was stratified by plant size and workers' gender, according to data on the working population at this setting. A total of 734 production workers were interviewed. Information was collected on safety climate and workers' behaviour towards occupational risks with a specific questionnaire. A safety climate index (SCI, scale 0-100) was constructed adding scores for each item measuring safety climate in the questionnaire. Workers' unsafe behaviour was analysed for the different safety climate index levels. Mean score for SCI was 71.90 (SD 19.19). There were no differences in SCI scores according to age, gender, education, children at charge, seniority at work, or type of employment. Small workplaces (<50 workers) showed significantly worse SCI (mean 67.23, SD 19.73) than the largest factories (>200 workers). Lower levels of SCI (SCI <50) were related to workers' unsafe behaviours (full/high accord with the statement "I excessively expose myself to hazards in my work", adjusted odds ratio ORa 2.79, 95% CI 1.60 to 4.88), and to lack of compliance with safety rules (ORa 12.83, 95% CI 5.92 to 27.80). Safety climate measures workers' perception of organisational factors related to occupational health and safety (for example, management commitment to risk prevention or priorities of safety versus production). In this study these factors are strongly associated with workers' attitudes towards safety at work. Longitudinal studies can further clarify the relation between safety climate and workers' behaviour regarding occupational safety and health.

The SAFE-T assessment tool: derivation and validation of a web-based application for point-of-care evaluation of gastroenterology fellow performance in colonoscopy.

PubMed

Kumar, Navin L; Kugener, Guillaume; Perencevich, Molly L; Saltzman, John R

2018-01-01

Attending assessment is a critical part of endoscopic education for gastroenterology fellows. The aim of this study was to develop and validate a concise assessment tool to evaluate real-time fellow performance in colonoscopy administered via a web-based application. The Skill Assessment in Fellow Endoscopy Training (SAFE-T) tool was derived as a novel 5-question evaluation tool that captures both summative and formative feedback adapted into a web-based application. A prospective study of 15 gastroenterology fellows (5 fellows each from years 1 to 3 of training) was performed using the SAFE-T tool. An independent reviewer evaluated a subset of these procedures and completed the SAFE-T tool and Mayo Colonoscopy Skills Assessment Tool (MCSAT) for reliability testing. Twenty-six faculty completed 350 SAFE-T evaluations of the 15 fellows in the study. The mean SAFE-T overall score (year 1, 2.00; year 2, 3.84; year 3, 4.28) differentiated each sequential fellow year of training (P < .0001). The mean SAFE-T overall score decreased with increasing case complexity score, with straightforward cases compared with average cases (4.07 vs 3.50, P < .0001), and average cases compared with challenging cases (3.50 vs 3.08, P = .0134). In dual-observed procedures, the SAFE-T tool showed excellent inter-rater reliability with a kappa agreement statistic of 0.898 (P < .0001). Correlation of the SAFE-T overall score with the MCSAT overall hands-on and individual motor scores was excellent (each r > 0.90, P < .0001). We developed and validated the SAFE-T assessment tool, a concise and web-based means of assessing real-time gastroenterology fellow performance in colonoscopy. Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Peri-procedural risk stratification and management of patients with Williams syndrome.

PubMed

Collins Ii, R Thomas; Collins, Margaret G; Schmitz, Michael L; Hamrick, Justin T

2017-03-01

Williams syndrome (WS) is a congenital, multisystem disorder affecting the cardiovascular, connective tissue, and central nervous systems in 1 in 10 000 live births. Cardiovascular involvement is the most common cause of morbidity and mortality in patients with WS, and noninvasive and invasive procedures are common. Sudden cardiovascular collapse in patients with WS is a well-known phenomenon, especially in the peri-procedural period. Detailed guidelines for peri-procedural management of patients with WS are limited. The goal of this review is to provide thoughtful, safe and effective management strategies for the peri-procedural care of patients with WS with careful consideration of hemodynamic impacts of anesthetic strategies. In addition, an expanded risk stratification system for anesthetic administration is provided. © 2017 Wiley Periodicals, Inc.

How to Safely Give Acetaminophen

MedlinePlus

... Educators Search English Español How to Safely Give Acetaminophen KidsHealth / For Parents / How to Safely Give Acetaminophen ... without getting a doctor's OK first. What Is Acetaminophen Also Called? Acetaminophen is the generic name of ...

Designing Flight-Deck Procedures

NASA Technical Reports Server (NTRS)

Degani, Asaf; Wiener, L.; Shafto, Mike (Technical Monitor)

1995-01-01

A complex human-machine system consists of more than merely one or more human operators and a collection of hardware components. In order to operate a complex system successfully, the human-machine system must be supported by an organizational infrastructure of operating concepts, rules, guidelines, and documents. The coherency of such operating concepts, in terms of consistency and logic, is vitally important for the efficiency and safety of any complex system. In high-risk endeavors such as aircraft operations, space flight, nuclear power production, manufacturing process control, and military operations, it is essential that such support be flawless, as the price of operational error can be high. When operating rules are not adhered to, or the rules are inadequate for the task at hand, not only will the system's goals be thwarted, but there may also be tragic human and material consequences. To ensure safe and predictable operations, support to the operators, in this case flight crews, often comes in the form of standard operating procedures. These provide the crew with step-by-step guidance for carrying out their operations. Standard procedures do indeed promote uniformity, but they do so at the risk of reducing the role of human operators to a lower level. Management, however, must recognize the danger of over-procedurization, which fails to exploit one of the most valuable assets in the system, the intelligent operator who is "on the scene." The alert system designer and operations manager recognize that there cannot be a procedure for everything, and the time will come in which the operators of a complex system will face a situation for which there is no written procedure. Procedures, whether executed by humans or machines, have their place, but so does human cognition.

Promoting safe motherhood through the private sector in low- and middle-income countries.

PubMed Central

Brugha, Ruair; Pritze-Aliassime, Susanne

2003-01-01

The formal private sector could play a significant role in determining whether success or failure is achieved in working towards goals for safe motherhood in many low- and middle-income settings. Established private providers, especially nurses/midwives, have the potential to contribute to safe motherhood practices if they are involved in the care continuum. However, they have largely been overlooked by policy-makers in low-income settings. The private sector (mainly doctors) contributes to overprovision and high Caesarean section rates in settings where it provides care to wealthier segments of the population; such care is often funded through third-party payment schemes. In poorer settings, especially rural areas, private nurses/midwives and the women who choose to use them are likely to experience similar constraints to those encountered in the public sector - for example, poor or unaffordable access to higher level facilities for the management of obstetrical emergencies. Policy-makers at the country-level need to map the health system and understand the nature and distribution of the private sector, and what influences it. This potential resource could then be mobilized to work towards the achievement of safe motherhood goals. PMID:14576894

Keratorefractive procedures

NASA Astrophysics Data System (ADS)

Seiler, Theo

1991-11-01

Two laser types are going to find a place in refractive surgery of the cornea: the excimer laser (193 nm) and mid-infrared YAG lasers, such as Ho:YAG (2.1 micrometers ) and Er:YAG (2.94 micrometers ). Whereas the excimer laser used for photorefractive keratectomy (PRK) and phototherapeutic keratectomy (PTK) is currently studied in clinical trials, Ho:YAG and Er:YAG lasers are still in the state of preclinical evaluation. For myopic corrections excimer laser PRK has shown to be safe and effective in the range up to -7.0 D. The results compare favorably with conventional procedures such as radial keratotomy. Complications are rare. Hyperopic and astigmatic corrections using the Ho:YAG laser (HOT) are effective, but safety and stability has yet to be proven. Er:YAG laser photoablation yields a healing response in animal eyes similar to the excimer laser.

Are nursing students safe when choosing gluteal intramuscular injection locations?

PubMed

Cornwall, J

2011-01-01

Nurses are required to perform gluteal intramuscular (IM) injections in practice. There are dangers associated with erroneous performance of this task, particularly with dorsogluteal injections. Knowledge regarding safe injection practice is therefore vital for nursing students. Fifty-eight second year students at a New Zealand Nursing School were given schematic drawings of the posterior and lateral aspects of the gluteal region. They were asked to mark and justify the safest location for gluteal IM injections. Fifty-seven students marked the dorsal schematic and one the lateral, with 38 (66.7%) marking in the upper outer quadrant (UOQ). Twenty indicating the UOQ (52.6%) wrote 'sciatic' or 'nerve' in justifying their location. Nineteen (33.3%) marked a location outside the UOQ; nine (47.4%) of these mentioned 'sciatic' or 'nerve' as reasons for injection safety. Overall, 50% of students mentioned 'sciatic' or 'nerve' in justifying the safety of their chosen injection location. Results suggest some second year nursing students do not understand safe gluteal IM injection locations and rationale. Current teaching practices and IM injection techniques could be revisited to prepare students more effectively; this may help prevent pathologies arising from this procedure.

Prediction of noise constrained optimum takeoff procedures

NASA Technical Reports Server (NTRS)

Padula, S. L.

1980-01-01

An optimization method is used to predict safe, maximum-performance takeoff procedures which satisfy noise constraints at multiple observer locations. The takeoff flight is represented by two-degree-of-freedom dynamical equations with aircraft angle-of-attack and engine power setting as control functions. The engine thrust, mass flow and noise source parameters are assumed to be given functions of the engine power setting and aircraft Mach number. Effective Perceived Noise Levels at the observers are treated as functionals of the control functions. The method is demonstrated by applying it to an Advanced Supersonic Transport aircraft design. The results indicate that automated takeoff procedures (continuously varying controls) can be used to significantly reduce community and certification noise without jeopardizing safety or degrading performance.

Fracture control procedures for aircraft structural integrity

NASA Technical Reports Server (NTRS)

Wood, H. A.

1972-01-01

The application of applied fracture mechanics in the design, analysis, and qualification of aircraft structural systems are reviewed. Recent service experiences are cited. Current trends in high-strength materials application are reviewed with particular emphasis on the manner in which fracture toughness and structural efficiency may affect the material selection process. General fracture control procedures are reviewed in depth with specific reference to the impact of inspectability, structural arrangement, and material on proposed analysis requirements for safe crack growth. The relative impact on allowable design stress is indicated by example. Design criteria, material, and analysis requirements for implementation of fracture control procedures are reviewed together with limitations in current available data techniques. A summary of items which require further study and attention is presented.

A Cooperative Communication System for the Advancement of Safe, Effective, and Efficient Patient Care

DTIC Science & Technology

2017-02-01

for the ever-changing environment of work that must be successfully navigated. The Cooperative Communication System (CCS) is a Health Information...presented a comprehensive picture of the BICU cognitive work , including synchronization on the BICU, the barriers to safe and effective care that...room spared the need to orient participants to an unfamiliar work setting and made it possible to include environmental factors and cues that a

A comparison of reliability and conventional estimation of safe fatigue life and safe inspection intervals

NASA Technical Reports Server (NTRS)

Hooke, F. H.

1972-01-01

Both the conventional and reliability analyses for determining safe fatigue life are predicted on a population having a specified (usually log normal) distribution of life to collapse under a fatigue test load. Under a random service load spectrum, random occurrences of load larger than the fatigue test load may confront and cause collapse of structures which are weakened, though not yet to the fatigue test load. These collapses are included in reliability but excluded in conventional analysis. The theory of risk determination by each method is given, and several reasonably typical examples have been worked out, in which it transpires that if one excludes collapse through exceedance of the uncracked strength, the reliability and conventional analyses gave virtually identical probabilities of failure or survival.

Determination of phthalate esters in soil using a quick, easy, cheap, effective, rugged, and safe method followed by GC-MS.

PubMed

Liu, Qianjun; Chen, Di; Wu, Jiyuan; Yin, Guangcai; Lin, Qintie; Zhang, Min; Hu, Huawen

2018-04-01

A quick, easy, cheap, effective, rugged, and safe procedure was designed to extract pesticide residues from fruits and vegetables with a high percentage of water. It has not been used extensively for the extraction of phthalate esters from sediments, soils, and sludges. In this work, this procedure was combined with gas chromatography with mass spectrometry to determine 16 selected phthalate esters in soil. The extraction efficiency of the samples was improved by ultrasonic extraction and dissolution of the soil samples in ultra-pure water, which promoted the dispersion of the samples. Furthermore, we have simplified the extraction step and reduced the risk of organic solvent contamination by minimizing the use of organic solvents. Different extraction solvents and clean-up adsorbents were compared to optimize the procedure. Dichloromethane/n-hexane (1:1, v/v) and n-hexane/acetone (1:1, v/v) were selected as the extractants from the six extraction solvents tested. C18/primary secondary amine (1:1, m/m) was selected as the sorbent from the five clean-up adsorbents tested. The recoveries from the spiked soils ranged from 70.00 to 117.90% with relative standard deviation values of 0.67-4.62%. The proposed approach was satisfactorily applied for the determination of phthalate esters in 12 contaminated soil samples. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

49 CFR Appendix E to Part 240 - Recommended Procedures for Conducting Skill Performance Tests

Code of Federal Regulations, 2010 CFR

2010-10-01

... tailor their testing procedures to the specific operational realities. This appendix contains FRA's..., headlight? —Couple to cars at a safe speed? —Properly control in train slack and buff forces? —Properly use...

75 FR 20854 - Medical Device Use in the Home Environment: Implications for the Safe and Effective Use of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-21

...] Medical Device Use in the Home Environment: Implications for the Safe and Effective Use of Medical Device... related to the safe and effective use of medical device technology in the home environment. The workshop... the home environment. FDA will solicit feedback on: 1. The agency's current working definition of...

Safe and effective speed reductions for freeway work zones phase 2.

DOT National Transportation Integrated Search

2014-09-01

Freeway preservation projects typically require construction workers to conduct their : work in close proximity to ongoing traffic and often reduce traffic flow to a single lane while work is : undertaken in an adjacent lane. Due to the short-term na...

InaSAFE applications in disaster preparedness

NASA Astrophysics Data System (ADS)

Pranantyo, Ignatius Ryan; Fadmastuti, Mahardika; Chandra, Fredy

2015-04-01

Disaster preparedness activities aim to reduce the impact of disasters by being better prepared to respond when a disaster occurs. In order to better anticipate requirements during a disaster, contingency planning activities can be undertaken prior to a disaster based on a realistic disaster scenario. InaSAFE is a tool that can inform this process. InaSAFE is a free and open source software that estimates the impact to people and infrastructure from potential hazard scenarios. By using InaSAFE, disaster managers can develop scenarios of disaster impacts (people and infrastructures affected) to inform their contingency plan and emergency response operation plan. While InaSAFE provides the software framework exposure data and hazard data are needed as inputs to run this software. Then InaSAFE can be used to forecast the impact of the hazard scenario to the exposure data. InaSAFE outputs include estimates of the number of people, buildings and roads are affected, list of minimum needs (rice and clean water), and response checklist. InaSAFE is developed by Indonesia's National Disaster Management Agency (BNPB) and the Australian Government, through the Australia-Indonesia Facility for Disaster Reduction (AIFDR), in partnership with the World Bank - Global Facility for Disaster Reduction and Recovery (GFDRR). This software has been used in many parts of Indonesia, including Padang, Maumere, Jakarta, and Slamet Mountain for emergency response and contingency planning.

Implications for patient safety in the use of safe patient handling equipment: a national survey.

PubMed

Elnitsky, Christine A; Lind, Jason D; Rugs, Deborah; Powell-Cope, Gail

2014-12-01

The prevalence of musculoskeletal injuries among nursing staff has been high due to patient handling and movement. Internationally, healthcare organizations are integrating technological equipment into patient handling and movement to improve safety. Although evidence shows that safe patient handling programs reduce work-related musculoskeletal injuries in nursing staff, it is not clear how safe these new programs are for patients. The objective of this study was to explore adverse patient events associated with safe patient handling programs and preventive approaches in US Veterans Affairs medical centers. The study surveyed a convenience sample of safe patient handling program managers from 51 US Department of Veterans Affairs medical centers to collect data on skin-related and fall-related adverse patient events. Both skin- and fall-related adverse patient events associated with safe patient handling occurred at VA Medical centers. Skin-related events included abrasions, contusions, pressure ulcers and lacerations. Fall-related events included sprains and strains, fractures, concussions and bleeding. Program managers described contextual factors in these adverse events and ways of preventing the events. The use of safe patient handling equipment can pose risks for patients. This study found that organizational factors, human factors and technology factors were associated with patient adverse events. The findings have implications for how nursing professionals can implement safe patient handling programs in ways that are safe for both staff and patients. Published by Elsevier Ltd.

Strategies for Countering Terrorist Safe Havens

DTIC Science & Technology

2014-02-20

within safe havens, tactical containment, pseudo operations, and surrogate security forces. The thesis draws from four historical case studies to...leadership targeting within safe havens, tactical containment, pseudo operations, and surrogate security forces. The thesis draws from four historical case ...surrogate forces and pseudo operations—provide viable potential options for USSOF to counter the complex problem of safe havens. Overall, the case

Safe drinking water and waterborne outbreaks.

PubMed

Moreira, N A; Bondelind, M

2017-02-01

The present work compiles a review on drinking waterborne outbreaks, with the perspective of production and distribution of microbiologically safe water, during 2000-2014. The outbreaks are categorised in raw water contamination, treatment deficiencies and distribution network failure. The main causes for contamination were: for groundwater, intrusion of animal faeces or wastewater due to heavy rain; in surface water, discharge of wastewater into the water source and increased turbidity and colour; at treatment plants, malfunctioning of the disinfection equipment; and for distribution systems, cross-connections, pipe breaks and wastewater intrusion into the network. Pathogens causing the largest number of affected consumers were Cryptosporidium, norovirus, Giardia, Campylobacter, and rotavirus. The largest number of different pathogens was found for the treatment works and the distribution network. The largest number of affected consumers with gastrointestinal illness was for contamination events from a surface water source, while the largest number of individual events occurred for the distribution network.

An XML Representation for Crew Procedures

NASA Technical Reports Server (NTRS)

Simpson, Richard C.

2005-01-01

NASA ensures safe operation of complex systems through the use of formally-documented procedures, which encode the operational knowledge of the system as derived from system experts. Crew members use procedure documentation on the ground for training purposes and on-board space shuttle and space station to guide their activities. Investigators at JSC are developing a new representation for procedures that is content-based (as opposed to display-based). Instead of specifying how a procedure should look on the printed page, the content-based representation will identify the components of a procedure and (more importantly) how the components are related (e.g., how the activities within a procedure are sequenced; what resources need to be available for each activity). This approach will allow different sets of rules to be created for displaying procedures on a computer screen, on a hand-held personal digital assistant (PDA), verbally, or on a printed page, and will also allow intelligent reasoning processes to automatically interpret and use procedure definitions. During his NASA fellowship, Dr. Simpson examined how various industries represent procedures (also called business processes or workflows), in areas such as manufacturing, accounting, shipping, or customer service. A useful method for designing and evaluating workflow representation languages is by determining their ability to encode various workflow patterns, which depict abstract relationships between the components of a procedure removed from the context of a specific procedure or industry. Investigators have used this type of analysis to evaluate how well-suited existing workflow representation languages are for various industries based on the workflow patterns that commonly arise across industry-specific procedures. Based on this type of analysis, it is already clear that existing workflow representations capture discrete flow of control (i.e., when one activity should start and stop based on when other

Evaluating the utility of 3D TRUS image information in guiding intra-procedure registration for motion compensation

NASA Astrophysics Data System (ADS)

De Silva, Tharindu; Cool, Derek W.; Romagnoli, Cesare; Fenster, Aaron; Ward, Aaron D.

2014-03-01

In targeted 3D transrectal ultrasound (TRUS)-guided biopsy, patient and prostate movement during the procedure can cause target misalignments that hinder accurate sampling of pre-planned suspicious tissue locations. Multiple solutions have been proposed for motion compensation via registration of intra-procedural TRUS images to a baseline 3D TRUS image acquired at the beginning of the biopsy procedure. While 2D TRUS images are widely used for intra-procedural guidance, some solutions utilize richer intra-procedural images such as bi- or multi-planar TRUS or 3D TRUS, acquired by specialized probes. In this work, we measured the impact of such richer intra-procedural imaging on motion compensation accuracy, to evaluate the tradeoff between cost and complexity of intra-procedural imaging versus improved motion compensation. We acquired baseline and intra-procedural 3D TRUS images from 29 patients at standard sextant-template biopsy locations. We used the planes extracted from the 3D intra-procedural scans to simulate 2D and 3D information available in different clinically relevant scenarios for registration. The registration accuracy was evaluated by calculating the target registration error (TRE) using manually identified homologous fiducial markers (micro-calcifications). Our results indicate that TRE improves gradually when the number of intra-procedural imaging planes used in registration is increased. Full 3D TRUS information helps the registration algorithm to robustly converge to more accurate solutions. These results can also inform the design of a fail-safe workflow during motion compensation in a system using a tracked 2D TRUS probe, by prescribing rotational acquisitions that can be performed quickly and easily by the physician immediately prior to needle targeting.

"Heidelberg standard examination" and "Heidelberg standard procedures" - Development of faculty-wide standards for physical examination techniques and clinical procedures in undergraduate medical education.

PubMed

Nikendei, C; Ganschow, P; Groener, J B; Huwendiek, S; Köchel, A; Köhl-Hackert, N; Pjontek, R; Rodrian, J; Scheibe, F; Stadler, A-K; Steiner, T; Stiepak, J; Tabatabai, J; Utz, A; Kadmon, M

2016-01-01

The competent physical examination of patients and the safe and professional implementation of clinical procedures constitute essential components of medical practice in nearly all areas of medicine. The central objective of the projects "Heidelberg standard examination" and "Heidelberg standard procedures", which were initiated by students, was to establish uniform interdisciplinary standards for physical examination and clinical procedures, and to distribute them in coordination with all clinical disciplines at the Heidelberg University Hospital. The presented project report illuminates the background of the initiative and its methodological implementation. Moreover, it describes the multimedia documentation in the form of pocketbooks and a multimedia internet-based platform, as well as the integration into the curriculum. The project presentation aims to provide orientation and action guidelines to facilitate similar processes in other faculties.

Making abortions safe: a matter of good public health policy and practice.

PubMed Central

Berer, M.

2000-01-01

Globally, abortion mortality accounts for at least 13% of all maternal mortality. Unsafe abortion procedures, untrained abortion providers, restrictive abortion laws and high mortality and morbidity from abortion tend to occur together. Preventing mortality and morbidity from abortion in countries where these remain high is a matter of good public health policy and medical practice, and constitutes an important part of safe motherhood initiatives. This article examines the changes in policy and health service provision required to make abortions safe. It is based on a wide-ranging review of published and unpublished sources. In order to be effective, public health measures must take into account the reasons why women have abortions, the kind of abortion services required and at what stages of pregnancy, the types of abortion service providers needed, and training, cost and counselling issues. The transition from unsafe to safe abortions demands the following: changes at national policy level; abortion training for service providers and the provision of services at the appropriate primary level health service delivery points; and ensuring that women access these services instead of those of untrained providers. Public awareness that abortion services are available is a crucial element of this transition, particularly among adolescent and single women, who tend to have less access to reproductive health services generally. PMID:10859852

Safe Schools, Safe Students. Proceedings of the National Education Goals Panel/National Alliance of Pupil Services Organizations Conference on "Safe Schools, Safe Students: A Collaborative Approach to Achieving Safe, Disciplined, and Drug-free Schools Conducive to Learning" (Washington, D.C., October 28-29, 1994).

ERIC Educational Resources Information Center

Talley, Ronda C., Ed.; Walz, Garry R., Ed.

The "Safe Schools, Safe Students" conference brought together leading researchers and practitioners in order to share knowledge about innovative safety strategies being used in America's schools. The papers here represent the thinking of scientific experts and school-based pupil service providers who are implementing programs to prevent…

Laparoscopic Whipple procedure: review of the literature.

PubMed

Gagner, Michel; Palermo, Mariano

2009-01-01

Laparoscopic pancreatic surgery represents one of the most advanced applications for laparoscopic surgery currently in use. In the past, minimally invasive techniques were only used for diagnostic laparoscopy, staging of pancreatic cancer, and palliative procedures for unresectable pancreatic cancer. With new advances in technology and instrumentation, some sophisticated procedures are currently available, such as the Whipple procedure, one of the most sophisticated applications of minimally invasive surgery. A review of the literature shows that 146 laparoscopic Whipple procedures have been published worldwide since 1994. The authors analyzed blood loss, mean operating time, hospital stay, conversion rate, mean age, mortality rate, lymph nodes in the pathologic findings, follow up, and complications. Mean age was 59.1 years; mean operating time was 439 min. The average blood loss for the reviewed literature was 143 mL; median hospital stay was 18 days; conversion rate was 46%; number of lymph nodes in the pathologic findings was 19; and mortalities related to the procedure was low, 2 patients (1.3%) and the complication rate was 16% (23/46 patients). Complications included 2 hemorrhages, 4 bowel obstructions, 1 stress ulcer, 1 delay of gastric emptying, 4 pneumonias, and 11 leaks. This review demonstrates that the laparoscopic Whipple procedure is not only feasible but also safe, with low mortality and acceptable rates of complications.

HAL-RAR (Doppler guided haemorrhoid artery ligation with recto-anal repair) is a safe and effective procedure for haemorrhoids. Results of a prospective study after two-years follow-up.

PubMed

Hoyuela, Carlos; Carvajal, Fernando; Juvany, Montserrat; Troyano, Daniel; Trias, Miquel; Martrat, Antoni; Ardid, Jordi; Obiols, Joan

2016-04-01

To analyse prospectively results of HAL-RAR technique by evaluating pain, perioperative complications and clinical outcome after two years followup. A prospective study design including 30 consecutive patients with haemorrhoids grade III-IV treated from June 2012. After discharge, patients received a specific questionnaire to record postoperative pain, delayed complications, evolution/disappearance of the symptoms that led to the surgical intervention (bleeding, prolapse, itching, pain and soiling). A visual analog scale (VAS) was used to measure pain. Outpatient follow-up was carried out at 7 days, and 1, 6 and 12 months and annually thereafter. Pre, intra and postoperative data (including physical examination) had been recorded prospectively. The median operating time (range) was 40 (26-60) minutes. Average hospital stay (range) was 11 (3-25) hours. No postoperative complications were observed in 29 cases (96.6%). Median follow-up was 26 (12-36) months. All the patients attended the follow-up. Mean postoperative pain was VAS = 1.7 on the seventh day and it was practically non-existent (VAS = 0.7) 1 month after the procedure. 87.5% of patients confirmed complete relief of symptoms after 30 days and 93% of patients feel free of symptoms 6 months after the procedure. No patient has experienced late complications as dyschezia, urgency, soiling or faecal incontinence. After 24 months follow-up, recurrence of bleeding and prolapse was observed in only 1 patient; 93% of patients have considered results of HAL-RAR as very good or excellent. HAL-RAR is safe and almost painless technique and it has very good results in the control of haemorrhoidal symptoms. This procedure should be considered as an effective first treatment option for haemorrhoids. Copyright © 2016 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Promoting Safe Walking and Biking to School: The Marin County Success Story

PubMed Central

Staunton, Catherine E.; Hubsmith, Deb; Kallins, Wendi

2003-01-01

Walking and biking to school can be an important part of a healthy lifestyle, yet most US children do not start their day with these activities. The Safe Routes to School Program in Marin County, California, is working to promote walking and biking to school. Using a multipronged approach, the program identifies and creates safe routes to schools and invites communitywide involvement. By its second year, the program was serving 4665 students in 15 schools. Participating public schools reported an increase in school trips made by walking (64%), biking (114%), and carpooling (91%) and a decrease in trips by private vehicles carrying only one student (39%). PMID:12948957

Promoting safe walking and biking to school: the Marin County success story.

PubMed

Staunton, Catherine E; Hubsmith, Deb; Kallins, Wendi

2003-09-01

Walking and biking to school can be an important part of a healthy lifestyle, yet most US children do not start their day with these activities. The Safe Routes to School Program in Marin County, California, is working to promote walking and biking to school. Using a multipronged approach, the program identifies and creates safe routes to schools and invites communitywide involvement. By its second year, the program was serving 4665 students in 15 schools. Participating public schools reported an increase in school trips made by walking (64%), biking (114%), and carpooling (91%) and a decrease in trips by private vehicles carrying only one student (39%).

Steering teens safe: a randomized trial of a parent-based intervention to improve safe teen driving.

PubMed

Peek-Asa, Corinne; Cavanaugh, Joseph E; Yang, Jingzhen; Chande, Vidya; Young, Tracy; Ramirez, Marizen

2014-07-31

Crashes are the leading cause of death for teens, and parent-based interventions are a promising approach. We assess the effectiveness of Steering Teens Safe, a parent-focused program to increase safe teen driving. Steering Teens Safe aimed to improve parental communication with teens about safe driving using motivational interviewing techniques in conjunction with 19 safe driving lessons. A randomized controlled trial involved 145 parent-teen dyads (70 intervention and 75 control). Intervention parents received a 45-minute session to learn the program with four follow-up phone sessions, a DVD, and a workbook. Control parents received a standard brochure about safe driving. Scores were developed to measure teen-reported quantity and quality of parental communication about safe driving. The main outcome measure was a previously validated Risky Driving Score reported by teens. Because the Score was highly skewed, a generalized linear model based on a gamma distribution was used for analysis. Intervention teens ranked their parent's success in talking about driving safety higher than control teens (p = 0.035) and reported that their parents talked about more topics (non-significant difference). The Risky Driving Score was 21% lower in intervention compared to control teens (85% CI = 0.60, 1.00). Interaction between communication quantity and the intervention was examined. Intervention teens who reported more successful communication had a 42% lower Risky Driving Score (95% CI = 0.37, 0.94) than control parents with less successful communication. This program had a positive although not strong effect, and it may hold the most promise in partnership with other programs, such as Driver's Education or Graduated Driver's License policies. ClinicalTrials.gov NCT01014923. Registered Nov. 16, 2009.

Safe biodegradable fluorescent particles

DOEpatents

Martin, Sue I [Berkeley, CA; Fergenson, David P [Alamo, CA; Srivastava, Abneesh [Santa Clara, CA; Bogan, Michael J [Dublin, CA; Riot, Vincent J [Oakland, CA; Frank, Matthias [Oakland, CA

2010-08-24

A human-safe fluorescence particle that can be used for fluorescence detection instruments or act as a safe simulant for mimicking the fluorescence properties of microorganisms. The particle comprises a non-biological carrier and natural fluorophores encapsulated in the non-biological carrier. By doping biodegradable-polymer drug delivery microspheres with natural or synthetic fluorophores, the desired fluorescence can be attained or biological organisms can be simulated without the associated risks and logistical difficulties of live microorganisms.

Checkout and Standard Use Procedures for the Mark III Space Suit Assembly

NASA Technical Reports Server (NTRS)

Valish, Dana J.

2012-01-01

The operational pressure range is the range to which the suit can be nominally operated for manned testing. The top end of the nominal operational pressure range is equivalent to 1/2 the proof pressure. Structural pressure is 1.5 times the specified test pressure for any given test. Proof pressure is the maximum unmanned pressure to which the suit was tested by the vendor prior to delivery. The maximum allowable working pressure (MAWP) is 90% of the proof pressure. The pressure systems RVs are set to keep components below their MAWPs. If the suit is pressurized over its MAWP, the suit will be taken out of service and an in-depth inspection/review of the suit will be performed before the suit is put back in service. The procedures outlined in this document should be followed as written. However, the suit test engineer (STE) may make redline changes real-time, provided those changes are recorded in the anomaly section of the test data sheet. If technicians supporting suit build-up, check-out, and/or test execution believe that a procedure can be improved, they should notify their lead. If procedures are incorrect to the point of potentially causing hardware damage or affecting safety, bring the problem to the technician lead and/or STE s attention and stop work until a solution (temporary or permanent) is authorized. Certain steps in the procedure are marked with a DV , for Designated Verifier. The Designated Verifier for this procedure is an Advanced Space Suit Technology Development Laboratory technician, not directly involved in performing the procedural steps, who will verify that the step was performed as stated. The steps to be verified by the DV were selected based on one or more of the following criteria: the step was deemed significant in ensuring the safe performance of the test, the data recorded in the step is of specific interest in monitoring the suit system operation, or the step has a strong influence on the successful completion of test objectives

Peroral endoscopic myotomy: An emerging minimally invasive procedure for achalasia

PubMed Central

Vigneswaran, Yalini; Ujiki, Michael B

2015-01-01

Peroral endoscopic myotomy (POEM) is an emerging minimally invasive procedure for the treatment of achalasia. Due to the improvements in endoscopic technology and techniques, this procedure allows for submucosal tunneling to safely endoscopically create a myotomy across the hypertensive lower esophageal sphincter. In the hands of skilled operators and experienced centers, the most common complications of this procedure are related to insufflation and accumulation of gas in the chest and abdominal cavities with relatively low risks of devastating complications such as perforation or delayed bleeding. Several centers worldwide have demonstrated the feasibility of this procedure in not only early achalasia but also other indications such as redo myotomy, sigmoid esophagus and spastic esophagus. Short-term outcomes have showed great clinical efficacy comparable to laparoscopic Heller myotomy (LHM). Concerns related to postoperative gastroesophageal reflux remain, however several groups have demonstrated comparable clinical and objective measures of reflux to LHM. Although long-term outcomes are necessary to better understand durability of the procedure, POEM appears to be a promising new procedure. PMID:26468336

Task analysis method for procedural training curriculum development.

PubMed

Riggle, Jakeb D; Wadman, Michael C; McCrory, Bernadette; Lowndes, Bethany R; Heald, Elizabeth A; Carstens, Patricia K; Hallbeck, M Susan

2014-06-01

A central venous catheter (CVC) is an important medical tool used in critical care and emergent situations. Integral to proper care in many circumstances, insertion of a CVC introduces the risk of central line-associated blood stream infections and mechanical adverse events; proper training is important for safe CVC insertion. Cognitive task analysis (CTA) methods have been successfully implemented in the medical field to improve the training of postgraduate medical trainees, but can be very time-consuming to complete and require a significant time commitment from many subject matter experts (SMEs). Many medical procedures such as CVC insertion are linear processes with well-documented procedural steps. These linear procedures may not require a traditional CTA to gather the information necessary to create a training curriculum. Accordingly, a novel, streamlined CTA method designed primarily to collect cognitive cues for linear procedures was developed to be used by medical professionals with minimal CTA training. This new CTA methodology required fewer trained personnel, fewer interview sessions, and less time commitment from SMEs than a traditional CTA. Based on this study, a streamlined CTA methodology can be used to efficiently gather cognitive information on linear medical procedures for the creation of resident training curricula and procedural skills assessments.

Safe Haven.

ERIC Educational Resources Information Center

Bush, Gail

2003-01-01

Discusses school libraries as safe havens for teenagers and considers elements that foster that atmosphere, including the physical environment, lack of judgments, familiarity, leisure, and a welcoming nature. Focuses on the importance of relationships, and taking the time to listen to teens and encourage them. (LRW)

Evaluation of combinations of procedures in cesarean section.

PubMed

Stark, M; Chavkin, Y; Kupfersztain, C; Guedj, P; Finkel, A R

1995-03-01

To evaluate a procedure for cesarean section, consisting of a number of surgical techniques adopted from various sources and further developed. The principal elements of the cesarean section procedure followed were: the Joel-Cohen method for opening the abdomen, suturing the uterus in one layer, and non-closure of the visceral and parietal peritoneal layers. The postoperative recovery of women who underwent this procedure (JCl--group) was compared with that of women who had undergone a Pfannenstiel incision, in which the uterus is sutured in two layers, and both peritoneal layers sutured (Pf2++ group). The incidence of postoperative febrile morbidity was 7.7% in the JCl--group compared with 19.8% in the Pf2++ group (P < 0.05). Adhesions were found in 6.3% of repeat operations after the JCl--operation compared with 28.8% after the Pf2++ operation (P < 0.05), and there was a non-significant trend toward fewer postoperative analgesics in the JCl--group. The cesarean section procedure we have devised is not only safe, but has a lower risk of long- and short-term complications.

JJ Stent Removal under Ultrasound Guidance in Women: It is Simple and Safe.

PubMed

Amer, Bernard; Gupta, Sandeep; Kanwar, Vijayendra S; Lodh, Bijit; Khumukcham, Somarendra; Akoijam, Kaku Singh

2014-12-01

With the increase in number of patients treated for urological problems with endoscopic procedures, the number of patients with JJ stent is also increasing. The amount of workload thus incurred multiplies, even to the point that, sometimes we waste more time in the operating room removing JJ stents than the actual endourological procedures. Here in our institute, we have devised a very simple and effective way of removing JJ stents in women and also determined the efficacy, safety and cost of JJ stent removal under ultrasound guidance in women in comparison to cystoscopic removal. Two hundred women attending the Department of Urology from July 2012 to July 2013 at RIMS hospital were randomly divided into two arms. One hundred women had their JJ stent removed with cystoscope and another 100 women had their JJ stent removed under ultrasound guidance using simple surgical tools available at the hospital. The primary comparative points were waiting time for operating room appointment date, cost of the procedure, time taken for the procedure, discomfort or pain felt by the patient and urethral injuries. In all the parameters, stent removal under ultrasound guidance was significantly better except for urethral injuries where both the procedures had similar outcomes. We concluded that JJ stent removal under ultrasound guidance in women was simple, effective and safe.

Analogous selection processes in declarative and procedural working memory: N-2 list-repetition and task-repetition costs.

PubMed

Gade, Miriam; Souza, Alessandra S; Druey, Michel D; Oberauer, Klaus

2017-01-01

Working memory (WM) holds and manipulates representations for ongoing cognition. Oberauer (Psychology of Learning and Motivation, 51, 45-100, 2009) distinguishes between two analogous WM sub-systems: a declarative WM which handles the objects of thought, and a procedural WM which handles the representations of (cognitive) actions. Here, we assessed whether analogous effects are observed when participants switch between memory sets (declarative representations) and when they switch between task sets (procedural representations). One mechanism assumed to facilitate switching in procedural WM is the inhibition of previously used, but currently irrelevant task sets, as indexed by n-2 task-repetition costs (Mayr & Keele, Journal of Experimental Psychology: General, 129(1), 4-26, 2000). In this study we tested for an analogous effect in declarative WM. We assessed the evidence for n-2 list-repetition costs across eight experiments in which participants switched between memory lists to perform speeded classifications, mental arithmetic, or a local recognition test. N-2 list-repetition costs were obtained consistently in conditions assumed to increase interference between memory lists, and when lists formed chunks in long-term memory. Further analyses across experiments revealed a substantial contribution of episodic memory to n-2 list-repetition costs, thereby questioning the interpretation of n-2 repetition costs as reflecting inhibition. We reanalyzed the data of eight task-switching experiments, and observed that episodic memory also contributes to n-2 task-repetition costs. Taken together, these results show analogous processing principles in declarative and procedural WM, and question the relevance of inhibitory processes for efficient switching between mental sets.

Visual field defects may not affect safe driving.

PubMed

Dow, Jamie

2011-10-01

In Quebec a driver whose acquired visual field defect renders them ineligible for a driver's permit renewal may request an exemption from the visual field standard by demonstrating safe driving despite the defect. For safety reasons it was decided to attempt to identify predictors of failure on the road test in order to avoid placing driving evaluators in potentially dangerous situations when evaluating drivers with visual field defects. During a 4-month period in 2009 all requests for exemptions from the visual field standard were collected and analyzed. All available medical and visual field data were collated for 103 individuals, of whom 91 successfully completed the evaluation process and obtained a waiver. The collated data included age, sex, type of visual field defect, visual field characteristics, and concomitant medical problems. No single factor, or combination of factors, could predict failure of the road test. All 5 failures of the road test had cognitive problems but 6 of the successful drivers also had known cognitive problems. Thus, cognitive problems influence the risk of failure but do not predict certain failure. Most of the applicants for an exemption were able to complete the evaluation process successfully, thereby demonstrating safe driving despite their handicap. Consequently, jurisdictions that have visual field standards for their driving permit should implement procedures to evaluate drivers with visual field defects that render them unable to meet the standard but who wish to continue driving.

Per-Oral Endoscopic Myotomy (POEM) After Previous Laparoscopic Heller Myotomy Is Feasible and Safe in a Porcine Model.

PubMed

Miles, Luke F; Frelich, Matthew J; Gould, Jon C; Dua, Kulwinder S; Jensen, Eric S; Kastenmeier, Andrew S

2015-10-01

We sought to evaluate the feasibility, safety, and difficulty of performing the per-oral endoscopic myotomy (POEM) procedure in the setting of a prior Heller myotomy using a survival porcine model. Four pigs underwent laparoscopic Heller myotomy with Dor partial anterior fundoplication followed by the POEM performed 4 weeks later. Two additional pigs served as controls, undergoing only the POEM. All procedures were completed without complications. The revisional POEM was not significantly more difficult than POEM controls based on procedure time, POEM procedure components, or procedure difficulty scores. Revisional POEM had a longer mean operative time when compared with Heller myotomy (126.0 vs. 83.8 min; P<0.01) but had a lower total difficulty score (28.6 vs. 52.1; P≪0.01). A POEM after previous Heller myotomy is safe and feasible in the porcine model and has potential as an option for patients suffering from recurrent or persistent symptoms after failed surgical myotomy.

Leadership for Safe and Inclusive Schools: An Examination of Lesbian, Gay, Bisexual and Transgender Educators' Perceptions of School Climate

ERIC Educational Resources Information Center

Wright, Tiffany

2009-01-01

Effective school leaders work to assist students and staff alike in feeling safe within the school environment. Educators need to feel safe in order to successfully carry out their professional responsibilities. Historically and presently, lesbian, gay, bisexual, and transgender (LGBT) educators have felt unsafe in school settings, even though…

More than a Safe Space

ERIC Educational Resources Information Center

Sadowski, Michael

2016-01-01

Over the past three decades, much of the conversation about LGBTQ students in schools has centered on safety--anti-bullying policies, the "safe space" of gay-straight alliances, and "safe zones" marked by rainbow-colored stickers on classroom doors. In this article, Michael Sadowski argues that it's time to move beyond safety…

Evolution of the Hubble Space Telescope Safing Systems

NASA Technical Reports Server (NTRS)

Pepe, Joyce; Myslinski, Michael

2006-01-01

The Hubble Space Telescope (HST) was launched on April 24 1990, with an expected lifespan of 15 years. Central to the spacecraft design was the concept of a series of on-orbit shuttle servicing missions permitting astronauts to replace failed equipment, update the scientific instruments and keep the HST at the forefront of astronomical discoveries. One key to the success of the Hubble mission has been the robust Safing systems designed to monitor the performance of the observatory and to react to keep the spacecraft safe in the event of equipment anomaly. The spacecraft Safing System consists of a range of software tests in the primary flight computer that evaluate the performance of mission critical hardware, safe modes that are activated when the primary control mode is deemed inadequate for protecting the vehicle, and special actions that the computer can take to autonomously reconfigure critical hardware. The HST Safing System was structured to autonomously detect electrical power system, data management system, and pointing control system malfunctions and to configure the vehicle to ensure safe operation without ground intervention for up to 72 hours. There is also a dedicated safe mode computer that constantly monitors a keep-alive signal from the primary computer. If this signal stops, the safe mode computer shuts down the primary computer and takes over control of the vehicle, putting it into a safe, low-power configuration. The HST Safing system has continued to evolve as equipment has aged, as new hardware has been installed on the vehicle, and as the operation modes have matured during the mission. Along with the continual refinement of the limits used in the safing tests, several new tests have been added to the monitoring system, and new safe modes have been added to the flight software. This paper will focus on the evolution of the HST Safing System and Safing tests, and the importance of this evolution to prolonging the science operations of the

[Evaluation of ergonomic load of clinical nursing procedures].

PubMed

Yan, P; Zhang, L; Li, F Y; Yang, Y; Wang, Y N; Huang, A M; Dai, Y L; Yao, H

2017-08-20

Objective: To evaluate the ergonomic load of clinical nursing procedures and to provide evidence for the prevention and management of work-related musculoskeletal disorders (WMSDs) in nurses. Methods: Based on the nursing unit characteristics and the common departments involving patient-turning procedures, 552 nurses were selected from 6 clinical departments from July to September, 2016. The ergonomic load of four types of patient-turning procedures, i.e., turning the patient's body, changing the bed linen of in-bed patients, moving patients, and chest physiotherapy, was evaluated by the on-site inspectors and self-evaluated by the operators using the Quick Exposure Check. The exposure value, exposure level, and exposure rate of WMSDs were assessed based on the procedure-related physical loads on the back, shoulders/arms, wrists/hands and neck, as well as the loads from work rhythm and work pressure. Results: All surveyed subjects were females who were aged mostly between 26-30 years (49.46%) , with a mean age of 29.66±5.28 years. These nurses were mainly from the Department of Infection (28.99%) and Spine Surgery (21.56%) . There were significant differences in the back, shoulders/arms, neck, work rhythm, and work pressure scores between different nursing procedures ( F =16.613, 5.884, 3.431, 3.222, and 5.085, respectively; P <0.05) . Patient-turning nursing procedures resulted in high to intermediate physical load in nurses. Procedures with high to low level of WMSDs exposure were patient turning (72.69%) , bed linen changing (67.15%) , patient transfer (65.82%) , and chest physiotherapy (58.34%) . In particular, patient turning was considered as very high-risk procedure, whereas others were considered as high-risk procedures. Conclusion: Patient-turning nursing procedures result in high ergonomic load in the operators. Therefore, more focus should be placed on the ergonomics of the caretakers and nurses.

Optimal working zone division for safe track maintenance in The Netherlands.

PubMed

den Hertog, D; van Zante-de Fokkert, J I; Sjamaar, S A; Beusmans, R

2005-09-01

After a sequence of serious accidents, the safety of rail track workers became an urgent and political problem in The Netherlands. It turned out that the rail track workers had one of the most dangerous jobs. The board of the Dutch Railways decided that the Dutch railway infrastructure had to be divided into so-called working zones. Moreover, to carry out maintenance activities, that particular working zone of the railway system had to be taken out of service. An essential problem was how to divide the Dutch railway infrastructure into working zones such that all parties involved are satisfied. Since many parties with conflicting interests were involved, this problem was extremely difficult. In this paper we show the division rules we developed, and which had been implemented in The Netherlands.

Fracture mechanics. [review of fatigue crack propagation and technology of constructing safe structures

NASA Technical Reports Server (NTRS)

Hardrath, H. F.

1974-01-01

Fracture mechanics is a rapidly emerging discipline for assessing the residual strength of structures containing flaws due to fatigue, corrosion or accidental damage and for anticipating the rate of which such flaws will propagate if not repaired. The discipline is also applicable in the design of structures with improved resistance to such flaws. The present state of the design art is reviewed using this technology to choose materials, to configure safe and efficient structures, to specify inspection procedures, to predict lives of flawed structures and to develop reliability of current and future airframes.

46 CFR 160.053-6 - Procedure for approval.

Code of Federal Regulations, 2014 CFR

2014-10-01

...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Work Vests, Unicellular Plastic Foam § 160.053-6 Procedure for approval. (a) General. Work vests for use on merchant vessels are approved only by the Commandant, U.S. Coast Guard. Manufacturers seeking approval of a work vest shall follow the procedures of this section...

46 CFR 160.053-6 - Procedure for approval.

Code of Federal Regulations, 2012 CFR

2012-10-01

...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Work Vests, Unicellular Plastic Foam § 160.053-6 Procedure for approval. (a) General. Work vests for use on merchant vessels are approved only by the Commandant, U.S. Coast Guard. Manufacturers seeking approval of a work vest shall follow the procedures of this section...

46 CFR 160.053-6 - Procedure for approval.

Code of Federal Regulations, 2013 CFR

2013-10-01

...: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Work Vests, Unicellular Plastic Foam § 160.053-6 Procedure for approval. (a) General. Work vests for use on merchant vessels are approved only by the Commandant, U.S. Coast Guard. Manufacturers seeking approval of a work vest shall follow the procedures of this section...

Managing Cassini Safe Mode Attitude at Saturn

NASA Technical Reports Server (NTRS)

Burk, Thomas A.

2010-01-01

The Cassini spacecraft was launched on October 15, 1997 and arrived at Saturn on June 30, 2004. It has performed detailed observations and remote sensing of Saturn, its rings, and its satellites since that time. In the event safe mode interrupts normal orbital operations, Cassini has flight software fault protection algorithms to detect, isolate, and recover to a thermally safe and commandable attitude and then wait for further instructions from the ground. But the Saturn environment is complex, and safety hazards change depending on where Cassini is in its orbital trajectory around Saturn. Selecting an appropriate safe mode attitude that insures safe operation in the Saturn environment, including keeping the star tracker field of view clear of bright bodies, while maintaining a quiescent, commandable attitude, is a significant challenge. This paper discusses the Cassini safe table management strategy and the key criteria that must be considered, especially during low altitude flybys of Titan, in deciding what spacecraft attitude should be used in the event of safe mode.

Aerosols and Particulates Workshop Sampling Procedures and Venues Working Group Summary

NASA Technical Reports Server (NTRS)

Pachlhofer, Peter; Howard, Robert

1999-01-01

The Sampling Procedures and Venues Workgroup discussed the potential venues available and issues associated with obtaining measurements. Some of the issues included Incoming Air Quality, Sampling Locations, Probes and Sample Systems. The following is a summary of the discussion of the issues and venues. The influence of inlet air to the measurement of exhaust species, especially trace chemical species, must be considered. Analysis procedures for current engine exhaust emissions regulatory measurements require adjustments for air inlet humidity. As a matter of course in scientific investigations, it is recommended that "background" measurements for any species, particulate or chemical, be performed during inlet air flow before initiation of combustion, if possible, and during the engine test period as feasible and practical. For current regulatory measurements, this would be equivalent to setting the "zero" level for conventional gas analyzers. As a minimum, it is recommended that measurements of the humidity and particulates in the incoming air be taken at the start and end of each test run. Additional measurement points taken during the run are desirable if they can be practically obtained. It was felt that the presence of trace gases in the incoming air is not a significant problem. However, investigators should consider the ambient levels and influences of local air pollution for species of interest. Desired measurement locations depend upon the investigation requirements. A complete investigation of phenomenology of particulate formation and growth requires measurements at a number of locations both within the engine and in the exhaust field downstream of the nozzle exit plane. Desirable locations for both extractive and in situ measurements include: (1) Combustion Zone (Multiple axial locations); (2) Combustor Exit (Multiple radial locations for annular combustors); (3) Turbine Stage (Inlet and exit of the stage); (4) Exit Nozzle (Multiple axial locations

Guide to Controlling Asthma at Work

MedlinePlus

... asthma to flare-up. Some exposures in the work environment have been associated with causing asthma symptoms. 1 ... 1-800-LUNGUSA). Employers are responsible for providing safe work conditions, including healthy air. Although many laws have ...

"Safe Schools within Safe Communities: A Regional Summit in the Heartland." Policy Briefs Special Report.

ERIC Educational Resources Information Center

Huertas, Aurelio, Jr.; Sullivan, Carol

This report documents the proceedings of a regional policy seminar hosted by the Iowa Department of Education with support from the North Central Regional Educational Laboratory (NCREL) and the Midwest Regional Center for Drug-Free Schools and Communities (MRC). The seminar, "Safe Schools Within Safe Communities," was held on September 19-20,…

Retroperitoneal endoscopic adrenalectomy is safe and effective.

PubMed

Schreinemakers, J M J; Kiela, G J; Valk, G D; Vriens, M R; Rinkes, I H M Borel

2010-11-01

The aim of this study was to review an experience with retroperitoneal endoscopic adrenalectomy (REA). This is the procedure of choice for adrenal tumours at this institution. Between 1997 and 2008, 112 REAs were performed in a single university centre. Data were retrieved retrospectively from a prospectively collected database, including information on patient demographics, surgical procedure, complications and hospital stay. One hundred and twelve REAs were carried out successfully in 105 patients, including seven bilateral adrenalectomies. Thirty-nine patients with unilateral adrenal disease had a phaeochromocytoma, of whom 16 had multiple endocrine neoplasia syndrome type 2, 21 patients had Cushing's disease and 20 had Conn's disease. Median body mass index was 27 (interquartile range 23-29) kg/m(2). The median duration of unilateral operations was 100 (90-130) min with a median blood loss of 5 ml. Median tumour size was 3.1 (2.0-4.4) cm. Conversion from REA to open surgery was needed in two patients. Seven patients experienced postoperative complications (2 major, 5 minor). One patient needed a reoperation. The median postoperative hospital stay was 3 days. A learning curve with a significant decrease in operating time was observed over the years. REA appears to be a safe and effective surgical technique for adrenal gland tumours up to 6 cm in diameter, with a minimal complication rate. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Complications of intrauterine intravascular blood transfusion: lessons learned after 1678 procedures.

PubMed

Zwiers, C; Lindenburg, I T M; Klumper, F J; de Haas, M; Oepkes, D; Van Kamp, I L

2017-08-01

Maternal alloimmunization to fetal red-blood-cell antigens is a major cause of fetal anemia, which can lead to hydrops and perinatal death if untreated. The cornerstone of management during pregnancy is intrauterine intravascular blood transfusion (IUT). Although this procedure is considered relatively safe, complications continue to occur. The aim of this study was to evaluate rates of procedure-related complications and perinatal loss following IUT, and their change over time, in order to identify factors leading to improved outcome. This was a retrospective analysis of all IUTs for red-cell alloimmunization performed at the national referral center for fetal therapy in The Netherlands, from 1988 to 2015. Differences in complication rates and their associations with alterations in transfusion technique after 2001 were assessed. Between 1988 and 2015, 1678 IUTs were performed in 589 fetuses. For IUTs performed in 2001 and onwards, there was significant improvement in survival (88.6% vs 97.0%, P < 0.001) and a decline in procedure-related complications per fetus (9.8% vs 3.3%, P = 0.001) and per procedure (3.4% vs 1.2%, P = 0.003) compared with those performed before 2001. Procedure-related perinatal loss declined from 4.7% to 1.8% per fetus (P = 0.053). Beneficial changes in transfusion technique were routine use of fetal paralysis, increased use of intrahepatic transfusion and avoidance of arterial puncture. IUT has become an increasingly safe procedure in recent years when performed by experienced hands. The chosen technique should be fine-tuned according to the patient's individual situation. The declining complication rates are most likely related to center volume: this rare procedure is best performed in experienced fetal therapy centers. © 2016 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. © 2016 Authors. Ultrasound in Obstetrics & Gynecology

Safe sedation practices among gastroenterology registrars: do we need more training?

PubMed Central

Mohanaruban, Aruchuna; Bryce, Kathleen; Radhakrishnan, Archchana; Gallaher, Joseph; Johnson, Gavin

2015-01-01

Endoscopy training is a central component of gastroenterology training for the vast majority of UK trainees, and integral to this is the practice of safe sedation. The majority of endoscopic procedures are performed with the patient under conscious sedation with a benzodiazepine, often combined with an opioid. Little data exists on the practice of sedation among gastroenterology trainees, including their degree of knowledge of the common sedation agents used and their actions. Using both an online and paper-based questionnaire, we surveyed current gastroenterology speciality trainees (ST) in the UK and received 78 responses giving a response rate of 10%. Fifty-one per cent of the trainees did not receive structured training in safe sedation, despite national guidelines advising this to be an essential part of the training programme, and 92% felt a structured sedation course would be beneficial. We also identified some gaps in trainees’ knowledge of the action of sedation agents. We propose that a formal training session in sedation or an e-learning module could be incorporated as part of a deanery or trust induction for gastroenterology trainees and kept under regular review. PMID:28839813

Safe Use Practices for Pesticides

Science.gov Websites

; Environment Human Health Animal Health Safe Use Practices Food Safety Environment Air Water Soil Wildlife Ingredients Low-Risk Pesticides Organic Pesticide Ingredients Pesticide Incidents Human Exposure Pet Exposure Home Page Pesticide Health and Safety Information Safe Use Practices for Pesticides Related Topics

Is Prevent a Safe Space?

ERIC Educational Resources Information Center

Ramsay, Peter

2017-01-01

In this article, I test the claims of the UK government and universities that the Prevent programme aims to create a safe space for the discussion of "extremist" ideas in universities. I do this by comparing the main elements of the Prevent duty that has been imposed on universities with those of safe spaces as imagined by student…

Gender difference in safe and unsafe practice of pesticide handling in tobacco farmers of malaysia.

PubMed

Bin Nordin, R; Araki, S; Sato, H; Yokoyama, K; Bin Wan Muda, W A; Win Kyi, D

2001-01-01

To identify gender difference in safe and unsafe practice of pesticide handling in tobacco farmers of Malaysia, we conducted a 20-item questionnaire interview on storage of pesticide (4 questions), mixing of pesticide (3 questions), use of personal protective equipment and clothing while spraying pesticide (7 questions), activities during and after spraying of pesticide (5 questions), and maintenance of pesticide sprayer (1 question) in 496 tobacco farmers (395 males and 101 females) in Bachok District, Kelantan, Malaysia. Duration of employment was significantly longer in females than those in males (p<0.001). In addition, proportion with no formal education in females was significantly higher than those in males (p<0.05). The following eight common factors were extracted from the 20 questionnaires by principal components factor analysis after varimax rotation in all farmers: (1) use of personal protective equipment, (2) unsafe work habit, (3) reading and following instructions on pesticide label, (4) security, storage and disposal of pesticide container, (5) safe work habit, (6) proper handling of pesticide and maintenance of pesticide sprayer, (7) use of personal protective clothing, and (8) safe handling of pesticide. Results of analysis of covariance for the eight factor scores of all male and female farmers, controlling for educational level and duration of employment, showed that: (1) factor scores for use of personal protective equipment (p<0.001), use of personal protective clothing (p<0.001) and safe work habit (p<0.001) in females were significantly lower than those in males; (2) conversely, factor scores for reading and following instruction on pesticide label (p<0.001) and proper handling of pesticide and maintenance of pesticide sprayer (p<0.01) in males were significantly lower than those in females; and (3) there were no significant differences in other three factor scores (p>0.05). We therefore conclude that: (1) for female tobacco farmers, choice

Gender Difference in Safe and Unsafe Practice of Pesticide Handling in Tobacco Farmers of Malaysia

PubMed Central

BIN NORDIN, Rusli; ARAKI, Shunichi; SATO, Hajime; YOKOYAMA, Kazuhito; BIN WAN MUDA, Wan Abdul Manan; WIN KYI, Daw

2001-01-01

To identify gender difference in safe and unsafe practice of pesticide handling in tobacco farmers of Malaysia, we conducted a 20-item questionnaire interview on storage of pesticide (4 questions), mixing of pesticide (3 questions), use of personal protective equipment and clothing while spraying pesticide (7 questions), activities during and after spraying of pesticide (5 questions), and maintenance of pesticide sprayer (1 question) in 496 tobacco farmers (395 males and 101 females) in Bachok District, Kelantan, Malaysia. Duration of employment was significantly longer in females than those in males (p<0.001). In addition, proportion with no formal education in females was significantly higher than those in males (p<0.05). The following eight common factors were extracted from the 20 questionnaires by principal components factor analysis after varimax rotation in all farmers: (1) use of personal protective equipment, (2) unsafe work habit, (3) reading and following instructions on pesticide label, (4) security, storage and disposal of pesticide container, (5) safe work habit, (6) proper handling of pesticide and maintenance of pesticide sprayer, (7) use of personal protective clothing, and (8) safe handling of pesticide. Results of analysis of covariance for the eight factor scores of all male and female farmers, controlling for educational level and duration of employment, showed that: (1) factor scores for use of personal protective equipment (p<0.001), use of personal protective clothing (p<0.001) and safe work habit (p<0.001) in females were significantly lower than those in males; (2) conversely, factor scores for reading and following instruction on pesticide label (p<0.001) and proper handling of pesticide and maintenance of pesticide sprayer (p<0.01) in males were significantly lower than those in females; and (3) there were no significant differences in other three factor scores (p>0.05). We therefore conclude that: (1) for female tobacco farmers, choice

75 FR 29391 - National Safe Boating Week, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-26

... Safe Boating Week, 2010 By the President of the United States of America A Proclamation Our Nation's... National Safe Boating Week to practicing safe techniques so boaters of all ages can enjoy this pastime... annually the 7-day period prior to Memorial Day weekend as ``National Safe Boating Week.'' NOW, THEREFORE...

Laparoscopic retroperitoneal lymph-node dissection with the waterjet is technically feasible and safe in testis-cancer patient.

PubMed

Corvin, Stefan; Sturm, Wolfgang; Schlatter, Evelin; Anastasiadis, Aristotelis; Kuczyk, Markus; Stenzl, Arnulf

2005-09-01

The acceptance of open retroperitoneal lymph node dissection (RPLND) for stage I and II nonseminomatous testicular cancer has decreased because of the intraoperative and postoperative morbidity of the procedure. Laparoscopic RPLND is a minimally invasive and safe alternative for low-stage germ-cell tumors. It is, however, technically demanding and should therefore be performed only in experienced centers. The purpose of the present study was to evaluate the waterjet technique for laparoscopic RPLND. A series of 18 patients with clinical stage I testis cancer (group A) and 7 patients who had received chemotherapy for stage II disease (group B) underwent laparoscopic RPLND at our institution. The procedure was performed identically to the open approach using the modified template according to Weissbach and associates. The waterjet was used for removal of lymphatic tissue from the aorta and the vena cava, as well as from the sympathetic trunk. The operation was completed in all patients without conversion to open surgery. The mean operating time was 232 +/- 48 minutes. The waterjet was able to remove lymphatic tissue easily and atraumatically. At pressures of 20 bar, the lymph-node capsule remained completely intact, thus avoiding tumor-cell spread. Antegrade ejaculation could be preserved in all patients, who, to date, show no evidence of disease. The waterjet allows the safe and complete removal of lymphatic tissue, leaving vulnerable anatomic structures intact. It can decrease the learning curve of laparoscopic RPLND and contribute to better acceptance of this procedure.

78 FR 32558 - Expedited Approval of Alternative Test Procedures for the Analysis of Contaminants Under the Safe...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-31

...This action announces the U.S. Environmental Protection Agency's (EPA's) approval of alternative testing methods for use in measuring the levels of contaminants in drinking water and determining compliance with national primary drinking water regulations. The Safe Drinking Water Act (SDWA) authorizes EPA to approve the use of alternative testing methods through publication in the Federal Register. EPA is using this streamlined authority to make 84 additional methods available for analyzing drinking water samples. This expedited approach provides public water systems, laboratories, and primacy agencies with more timely access to new measurement techniques and greater flexibility in the selection of analytical methods, thereby reducing monitoring costs while maintaining public health protection.

Evaluation of the ROSA™ Spine robot for minimally invasive surgical procedures.

PubMed

Lefranc, M; Peltier, J

2016-10-01

The ROSA® robot (Medtech, Montpellier, France) is a new medical device designed to assist the surgeon during minimally invasive spine procedures. The device comprises a patient-side cart (bearing the robotic arm and a workstation) and an optical navigation camera. The ROSA® Spine robot enables accurate pedicle screw placement. Thanks to its robotic arm and navigation abilities, the robot monitors movements of the spine throughout the entire surgical procedure and thus enables accurate, safe arthrodesis for the treatment of degenerative lumbar disc diseases, exactly as planned by the surgeon. Development perspectives include (i) assistance at all levels of the spine, (ii) improved planning abilities (virtualization of the entire surgical procedure) and (iii) use for almost any percutaneous spinal procedures not limited in screw positioning such as percutaneous endoscopic lumbar discectomy, intracorporeal implant positioning, over te top laminectomy or radiofrequency ablation.

Investigation of abort procedures for space shuttle-type vehicles

NASA Technical Reports Server (NTRS)

Powell, R. W.; Eide, D. G.

1974-01-01

An investigation has been made of abort procedures for space shuttle-type vehicles using a point mass trajectory optimization program known as POST. This study determined the minimum time gap between immediate and once-around safe return to the launch site from a baseline due-East launch trajectory for an alternate space shuttle concept which experiences an instantaneous loss of 25 percent of the total main engine thrust.

Gastroscopy: a primary diagnostic procedure.

PubMed

Coleman, W H

1988-03-01

EGD, using 1986 models of either the fiberoptic gastroscope or the videoscope, is a safe and accurate procedure that can be performed by any physician trained in the technique of endoscope passage. It may be performed at large medical centers or small rural hospitals, outpatient clinics, or even private offices. Patients themselves have indicated preference for endoscopic evaluation over the double-contrast barium meal after they have experienced both procedures. The short time of procedure, its accuracy, safety, and its relative lack of discomfort to the patient lend it readily to being an initial component in the primary evaluation of symptoms of abdominal distress, gastrointestinal bleeding, dysphagia, esophageal reflux, persistent vomiting, and odynophagia. It is essential in the evaluation of complications of esophageal reflux and the evaluation of abnormal radiological findings in the upper gastrointestinal tract. It should never be overlooked in evaluating the patient with iron deficiency anemia of unknown etiology. Economic pressures have already moved EGD from the surgery wards to endoscopy labs and to the outpatient setting. These same forces will project more physicians into the role of the diagnostic endoscopist and the patient will benefit by decreased medical costs, quicker diagnosis and treatment, and enhanced continuity of care.

30 CFR 77.312 - Fail safe monitoring systems.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Fail safe monitoring systems. 77.312 Section 77... Thermal Dryers § 77.312 Fail safe monitoring systems. Thermal dryer systems and controls shall be protected by a fail safe monitoring system which will safely shut down the system and any related equipment...

30 CFR 77.312 - Fail safe monitoring systems.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Fail safe monitoring systems. 77.312 Section 77... Thermal Dryers § 77.312 Fail safe monitoring systems. Thermal dryer systems and controls shall be protected by a fail safe monitoring system which will safely shut down the system and any related equipment...

30 CFR 77.312 - Fail safe monitoring systems.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Fail safe monitoring systems. 77.312 Section 77... Thermal Dryers § 77.312 Fail safe monitoring systems. Thermal dryer systems and controls shall be protected by a fail safe monitoring system which will safely shut down the system and any related equipment...

30 CFR 77.312 - Fail safe monitoring systems.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Fail safe monitoring systems. 77.312 Section 77... Thermal Dryers § 77.312 Fail safe monitoring systems. Thermal dryer systems and controls shall be protected by a fail safe monitoring system which will safely shut down the system and any related equipment...

30 CFR 77.312 - Fail safe monitoring systems.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Fail safe monitoring systems. 77.312 Section 77... Thermal Dryers § 77.312 Fail safe monitoring systems. Thermal dryer systems and controls shall be protected by a fail safe monitoring system which will safely shut down the system and any related equipment...

29 CFR 1915.15 - Maintenance of safe conditions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Enclosed Spaces and Other Dangerous Atmospheres in Shipyard Employment § 1915.15 Maintenance of safe... into spaces that have been certified “Safe for Workers” or “Safe for Hot Work” shall be disconnected... certificates. A competent person shall visually inspect and test each space certified as “Safe for Workers” or...

29 CFR 1915.15 - Maintenance of safe conditions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Enclosed Spaces and Other Dangerous Atmospheres in Shipyard Employment § 1915.15 Maintenance of safe... into spaces that have been certified “Safe for Workers” or “Safe for Hot Work” shall be disconnected... certificates. A competent person shall visually inspect and test each space certified as “Safe for Workers” or...

Radiation exposure from fluoroscopy during orthopedic surgical procedures

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

Riley, S.A.

1989-11-01

The use of fluoroscopy has enabled orthopedic surgeons to become technically more proficient. In addition, these surgical procedures tend to have less associated patient morbidity by decreasing operative time and minimizing the area of the operative field. The trade-off, however, may be an increased risk of radiation exposure to the surgeon on an annual or lifetime basis. The current study was designed to determine the amount of radiation received by the primary surgeon and the first assistant during selected surgical procedures involving the use of fluoroscopy. Five body sites exposed to radiation were monitored for dosage. The results of thismore » study indicate that with appropriate usage, (1) radiation exposure from fluoroscopy is relatively low; (2) the surgeon's dominant hand receives the most exposure per case; and (3) proper maintenance and calibration of fluoroscopic machines are important factors in reducing exposure risks. Therefore, with proper precautions, the use of fluoroscopy in orthopedic procedures can remain a safe practice.« less

23 CFR 630.1008 - State-level processes and procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... review are intended to lead to improvements in work zone processes and procedures, data and information... 23 Highways 1 2010-04-01 2010-04-01 false State-level processes and procedures. 630.1008 Section... OPERATIONS PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1008 State-level processes and...

33 CFR 83.06 - Safe speed (Rule 6).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Safe speed (Rule 6). 83.06... Safe speed (Rule 6). Every vessel shall at all times proceed at a safe speed so that she can take... prevailing circumstances and conditions. In determining a safe speed the following factors shall be among...

33 CFR 83.06 - Safe speed (Rule 6).

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Safe speed (Rule 6). 83.06... Safe speed (Rule 6). Every vessel shall at all times proceed at a safe speed so that she can take... prevailing circumstances and conditions. In determining a safe speed the following factors shall be among...

34 CFR 675.49 - Procedures and records.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false Procedures and records. 675.49 Section 675.49 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL WORK-STUDY PROGRAMS Work-Colleges Program § 675.49 Procedures and records. In...

Working with Research Integrity-Guidance for Research Performing Organisations: The Bonn PRINTEGER Statement.

PubMed

Forsberg, Ellen-Marie; Anthun, Frank O; Bailey, Sharon; Birchley, Giles; Bout, Henriette; Casonato, Carlo; Fuster, Gloria González; Heinrichs, Bert; Horbach, Serge; Jacobsen, Ingrid Skjæggestad; Janssen, Jacques; Kaiser, Matthias; Lerouge, Inge; van der Meulen, Barend; de Rijcke, Sarah; Saretzki, Thomas; Sutrop, Margit; Tazewell, Marta; Varantola, Krista; Vie, Knut Jørgen; Zwart, Hub; Zöller, Mira

2018-05-31

This document presents the Bonn PRINTEGER Consensus Statement: Working with Research Integrity-Guidance for research performing organisations. The aim of the statement is to complement existing instruments by focusing specifically on institutional responsibilities for strengthening integrity. It takes into account the daily challenges and organisational contexts of most researchers. The statement intends to make research integrity challenges recognisable from the work-floor perspective, providing concrete advice on organisational measures to strengthen integrity. The statement, which was concluded February 7th 2018, provides guidance on the following key issues: § 1. Providing information about research integrity § 2. Providing education, training and mentoring § 3. Strengthening a research integrity culture § 4. Facilitating open dialogue § 5. Wise incentive management § 6. Implementing quality assurance procedures § 7. Improving the work environment and work satisfaction § 8. Increasing transparency of misconduct cases § 9. Opening up research § 10. Implementing safe and effective whistle-blowing channels § 11. Protecting the alleged perpetrators § 12. Establishing a research integrity committee and appointing an ombudsperson § 13. Making explicit the applicable standards for research integrity.

Realistic Testing of the Safe Affordable Fission Engine (SAFE-100) Thermal Simulator Using Fiber Bragg Gratings

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

Stinson-Bagby, Kelly L.; Fielder, Robert S.; Van Dyke, Melissa K.

2004-02-04

The motivation for the reported research was to support NASA space nuclear power initiatives through the development of advanced fiber optic sensors for space-based nuclear power applications. Distributed high temperature measurements were made with 20 FBG temperature sensors installed in the SAFE-100 thermal simulator at the NASA Marshal Space Flight Center. Experiments were performed at temperatures approaching 800 deg. C and 1150 deg. C for characterization studies of the SAFE-100 core. Temperature profiles were successfully generated for the core during temperature increases and decreases. Related tests in the SAFE-100 successfully provided strain measurement data.

33 CFR 62.27 - Safe water marks.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Safe water marks. 62.27 Section 62.27 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM The U.S. Aids to Navigation System § 62.27 Safe water marks. Safe...

75 FR 1734 - Children’s Online Privacy Protection Rule Safe Harbor Proposed Self-Regulatory Guidelines; i-SAFE...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-13

...The Federal Trade Commission publishes this notice and request for public comment concerning proposed self-regulatory guidelines submitted by i-SAFE, Inc. under the safe harbor provision of the Children's Online Privacy Protection Rule.

Measurement of functional capacity requirements to aid in development of an occupation-specific rehabilitation training program to help firefighters with cardiac disease safely return to work.

PubMed

Adams, Jenny; Roberts, Joanne; Simms, Kay; Cheng, Dunlei; Hartman, Julie; Bartlett, Charles

2009-03-15

We designed a study to measure the functional capacity requirements of firefighters to aid in the development of an occupation-specific training program in cardiac rehabilitation; 23 healthy male firefighters with no history of heart disease completed a fire and rescue obstacle course that simulated 7 common firefighting tasks. They wore complete personal protective equipment and portable metabolic instruments that included a data collection mask. We monitored each subject's oxygen consumption (VO(2)) and working heart rate, then calculated age-predicted maximum heart rates (220 - age) and training target heart rates (85% of age-predicted maximum heart rate). During performance of the obstacle course, the subjects' mean working heart rates and peak heart rates were higher than the calculated training target heart rates (t(22) = 5.69 [working vs target, p <0.001] and t(22) = 15.14 [peak vs target, p <0.001]). These findings, with mean results for peak VO(2) (3,447 ml/min) and metabolic equivalents (11.9 METs), show that our subjects' functional capacity greatly exceeded that typically attained by patients in traditional cardiac rehabilitation programs (5 to 8 METs). In conclusion, our results indicate the need for intense, occupation-specific cardiac rehabilitation training that will help firefighters safely return to work after a cardiac event.

Curiosity's Autonomous Surface Safing Behavior Design

NASA Technical Reports Server (NTRS)

Neilson, Tracy A.; Manning, Robert M.

2013-01-01

The safing routines on all robotic deep-space vehicles are designed to put the vehicle in a power and thermally safe configuration, enabling communication with the mission operators on Earth. Achieving this goal is made a little more difficult on Curiosity because the power requirements for the core avionics and the telecommunication equipment exceed the capability of the single power source, the Multi-Mission Radioisotope Thermoelectric Generator. This drove the system design to create an operational mode, called "sleep mode", where the vehicle turns off most of the loads in order to charge the two Li-ion batteries. The system must keep the vehicle safe from over-heat and under-heat conditions, battery cell failures, under-voltage conditions, and clock failures, both while the computer is running and while the system is sleeping. The other goal of a safing routine is to communicate. On most spacecraft, this simply involves turning on the receiver and transmitter continuously. For Curiosity, Earth is above the horizon only a part of the day for direct communication to the Earth, and the orbiter overpass opportunities only occur a few times a day. The design must robustly place the Rover in a communicable condition at the correct time. This paper discusses Curiosity's autonomous safing behavior and describes how the vehicle remains power and thermally safe while sleeping, as well as a description of how the Rover communicates with the orbiters and Earth at specific times.

33 CFR 62.27 - Safe water marks.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Safe water marks. 62.27 Section... UNITED STATES AIDS TO NAVIGATION SYSTEM The U.S. Aids to Navigation System § 62.27 Safe water marks. Safe water marks indicate that there is navigable water all around the mark. They are often used to indicate...

33 CFR 62.27 - Safe water marks.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Safe water marks. 62.27 Section... UNITED STATES AIDS TO NAVIGATION SYSTEM The U.S. Aids to Navigation System § 62.27 Safe water marks. Safe water marks indicate that there is navigable water all around the mark. They are often used to indicate...

33 CFR 62.27 - Safe water marks.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Safe water marks. 62.27 Section... UNITED STATES AIDS TO NAVIGATION SYSTEM The U.S. Aids to Navigation System § 62.27 Safe water marks. Safe water marks indicate that there is navigable water all around the mark. They are often used to indicate...

The Role of Working Memory Gating in Task Switching: A Procedural Version of the Reference-Back Paradigm

PubMed Central

Kessler, Yoav

2017-01-01

Models of working memory (WM) suggest that the contents of WM are separated from perceptual input by a gate, that enables shielding information against interference when closed, and allows for rapid updating when open. Recent work in the declarative WM domain provided evidence for this notion, demonstrating the behavioral cost of opening and closing the gate. The goal of the present work was to examine gating in procedural WM, namely in a task-switching experiment. In each trial, participants were presented with a digit and a task cue, indicating whether the required task was a parity or a magnitude decision. Critically, a colored frame around the stimulus indicated whether the task cue was relevant (attend trials), or whether it had to be ignored, and the previous task set should be applied regardless of the present cue (ignore trials). Switching between tasks, and between ignore and attend trials, was manipulated. The results of two experiments demonstrated that the cost of gate opening was eliminated in task switching trials, implying that both processes operate in parallel. PMID:29312095

Removing Hair Safely

MedlinePlus

... For Consumers Home For Consumers Consumer Updates Removing Hair Safely Share Tweet Linkedin Pin it More sharing ... related to common methods of hair removal. Laser Hair Removal In this method, a laser destroys hair ...

Power control of SAFE reactor using fuzzy logic

NASA Astrophysics Data System (ADS)

Irvine, Claude

2002-01-01

Controlling the 100 kW SAFE (Safe Affordable Fission Engine) reactor consists of design and implementation of a fuzzy logic process control system to regulate dynamic variables related to nuclear system power. The first phase of development concentrates primarily on system power startup and regulation, maintaining core temperature equilibrium, and power profile matching. This paper discusses the experimental work performed in those areas. Nuclear core power from the fuel elements is simulated using resistive heating elements while heat rejection is processed by a series of heat pipes. Both axial and radial nuclear power distributions are determined from neuronic modeling codes. The axial temperature profile of the simulated core is matched to the nuclear power profile by varying the resistance of the heating elements. The SAFE model establishes radial temperature profile equivalence by establishing 32 control zones as the nodal coordinates. Control features also allow for slow warm up, since complete shutoff can occur in the heat pipes if heat-source temperatures drop/rise below a certain minimum value, depending on the specific fluid and gas combination in the heat pipe. The entire system is expected to be self-adaptive, i.e., capable of responding to long-range changes in the space environment. Particular attention in the development of the fuzzy logic algorithm shall ensure that the system process remains at set point, virtually eliminating overshoot on start-up and during in-process disturbances. The controller design will withstand harsh environments and applications where it might come in contact with water, corrosive chemicals, radiation fields, etc. .

A fail-safe CMOS logic gate

NASA Technical Reports Server (NTRS)

Bobin, V.; Whitaker, S.

1990-01-01

This paper reports a design technique to make Complex CMOS Gates fail-safe for a class of faults. Two classes of faults are defined. The fail-safe design presented has limited fault-tolerance capability. Multiple faults are also covered.

Standardized Procedure Content And Data Structure Based On Human Factors Requirements For Computer-Based Procedures

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

Bly, Aaron; Oxstrand, Johanna; Le Blanc, Katya L

2015-02-01

Most activities that involve human interaction with systems in a nuclear power plant are guided by procedures. Traditionally, the use of procedures has been a paper-based process that supports safe operation of the nuclear power industry. However, the nuclear industry is constantly trying to find ways to decrease the human error rate, especially the human errors associated with procedure use. Advances in digital technology make computer-based procedures (CBPs) a valid option that provides further enhancement of safety by improving human performance related to procedure use. The transition from paper-based procedures (PBPs) to CBPs creates a need for a computer-based proceduremore » system (CBPS). A CBPS needs to have the ability to perform logical operations in order to adjust to the inputs received from either users or real time data from plant status databases. Without the ability for logical operations the procedure is just an electronic copy of the paper-based procedure. In order to provide the CBPS with the information it needs to display the procedure steps to the user, special care is needed in the format used to deliver all data and instructions to create the steps. The procedure should be broken down into basic elements and formatted in a standard method for the CBPS. One way to build the underlying data architecture is to use an Extensible Markup Language (XML) schema, which utilizes basic elements to build each step in the smart procedure. The attributes of each step will determine the type of functionality that the system will generate for that step. The CBPS will provide the context for the step to deliver referential information, request a decision, or accept input from the user. The XML schema needs to provide all data necessary for the system to accurately perform each step without the need for the procedure writer to reprogram the CBPS. The research team at the Idaho National Laboratory has developed a prototype CBPS for field workers as well as

Taking Medicines Safely After Alcohol or Drug Abuse Recovery

MedlinePlus

... Kids and Teens Pregnancy and Childbirth Women Men Seniors Your Health Resources Healthcare Management End-of-Life Issues Insurance & Bills Self Care Working With Your Doctor Drugs, Procedures & Devices Over-the- ...

The effect of repeated laser stimuli to ink-marked skin on skin temperature-recommendations for a safe experimental protocol in humans.

PubMed

Madden, Victoria J; Catley, Mark J; Grabherr, Luzia; Mazzola, Francesca; Shohag, Mohammad; Moseley, G Lorimer

2016-01-01

Background. Nd:YAP laser is widely used to investigate the nociceptive and pain systems, generating perpetual and laser-evoked neurophysiological responses. A major procedural concern for the use of Nd:YAP laser stimuli in experimental research is the risk of skin damage. The absorption of Nd:YAP laser stimuli is greater in darker skin, or in pale skin that has been darkened with ink, prompting some ethics boards to refuse approval to experimenters wishing to track stimulus location by marking the skin with ink. Some research questions, however, require laser stimuli to be delivered at particular locations or within particular zones, a requirement that is very difficult to achieve if marking the skin is not possible. We thoroughly searched the literature for experimental evidence and protocol recommendations for safe delivery of Nd:YAP laser stimuli over marked skin, but found nothing. Methods. We designed an experimental protocol to define safe parameters for the use of Nd:YAP laser stimuli over skin that has been marked with black dots, and used thermal imaging to assess the safety of the procedure at the forearm and the back. Results. Using thermal imaging and repeated laser stimulation to ink-marked skin, we demonstrated that skin temperature did not increase progressively across the course of the experiment, and that the small change in temperature seen at the forearm was reversed during the rest periods between blocks. Furthermore, no participant experienced skin damage due to the procedure. Conclusion. This protocol offers parameters for safe, confident and effective experimentation using repeated Nd:YAP laser on skin marked with ink, thus paving the way for investigations that depend on it.

Safe mobility for older people notebook

DOT National Transportation Integrated Search

1999-04-01

The Safe Mobility for Older People Notebook is a research product of the "Model Driver Screening and Evaluation Program" project sponsored by NHTSA, and is intended as a resource to support program initiatives promoting the safe mobility of older per...

Hybrid procedure in living donor liver transplantation.

PubMed

Soyama, A; Takatsuki, M; Hidaka, M; Adachi, T; Kitasato, A; Kinoshita, A; Natsuda, K; Baimakhanov, Z; Kuroki, T; Eguchi, S

2015-04-01

We have previously reported a hybrid procedure that uses a combination of laparoscopic mobilization of the liver and subsequent hepatectomy under direct vision in living donor liver transplantation (LDLT). We present the details of this hybrid procedure and the outcomes of the procedure. Between January 1997 and August 2014, 204 LDLTs were performed at Nagasaki University Hospital. Among them, 67 recent donors underwent hybrid donor hepatectomy. Forty-one donors underwent left hemihepatectomy, 25 underwent right hemihepatectomy, and 1 underwent posterior sectionectomy. First, an 8-cm subxiphoid midline incision was made; laparoscopic mobilization of the liver was then achieved with a hand-assist through the midline incision under the pneumoperitoneum. Thereafter, the incision was extended up to 12 cm for the right lobe and posterior sector graft and 10 cm left lobe graft procurement. Under direct vision, parenchymal transection was performed by means of the liver-hanging maneuver. The hybrid procedure for LDLT recipients was indicated only for selected cases with atrophic liver cirrhosis without a history of upper abdominal surgery, significant retroperitoneal collateral vessels, or hypertrophic change of the liver (n = 29). For total hepatectomy and splenectomy, the midline incision was sufficiently extended. All of the hybrid donor hepatectomies were completed without an extra subcostal incision. No significant differences were observed in the blood loss or length of the operation compared with conventional open procedures. All of the donors have returned to their preoperative activity level, with fewer wound-related complaints compared with those treated with the use of the conventional open procedure. In recipients treated with the hybrid procedure, no clinically relevant drawbacks were observed compared with the recipients treated with a regular Mercedes-Benz-type incision. Our hybrid procedure was safely conducted with the same quality as the conventional

Standardizing care and monitoring for anesthesia or procedural sedation delivered outside the operating room.

PubMed

Eichhorn, Volker; Henzler, Dietrich; Murphy, Michael F

2010-08-01

The purpose of this review is to summarize recommendations for the safe and efficient conductance of sedation and anesthesia at remote locations; and to define safety standards, monitoring techniques, quality of care and procedural eligibility. Anesthesia outside of the operating room is rapidly increasing in numbers, which has seen a growth of older and sicker patients. These circumstances have created a need for guidelines, for both specialist anesthesia providers and nonanesthesia-trained practitioners, that define patient selection, minimum monitoring (hemodynamics and respiration), facility design and equipment, policy framework, recovery facilities and policies. The patient's safety throughout all stages of sedation and/or anesthesia is the most pertinent goal. Recent data emphasize the importance of monitoring pulse oximetry and end-tidal carbon dioxide for any sedating or anesthetic procedure. Substandard monitoring combined with oversedation and subsequent respiratory depression are implicated as the main reasons for catastrophic sedation and anesthetic outcomes at remote locations. Patient selection, procedure appropriateness and location appropriateness are the key elements defining the provision of safe anesthesia care outside the operating room. Titratable, short-acting intravenous drugs are preferred such as propofol and remifentanil.

Development of utility generic functional requirements for electronic work packages and computer-based procedures

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

Oxstrand, Johanna

The Nuclear Electronic Work Packages - Enterprise Requirements (NEWPER) initiative is a step toward a vision of implementing an eWP framework that includes many types of eWPs. This will enable immediate paper-related cost savings in work management and provide a path to future labor efficiency gains through enhanced integration and process improvement in support of the Nuclear Promise (Nuclear Energy Institute 2016). The NEWPER initiative was organized by the Nuclear Information Technology Strategic Leadership (NITSL) group, which is an organization that brings together leaders from the nuclear utility industry and regulatory agencies to address issues involved with information technology usedmore » in nuclear-power utilities. NITSL strives to maintain awareness of industry information technology-related initiatives and events and communicates those events to its membership. NITSL and LWRS Program researchers have been coordinating activities, including joint organization of NEWPER-related meetings and report development. The main goal of the NEWPER initiative was to develop a set of utility generic functional requirements for eWP systems. This set of requirements will support each utility in their process of identifying plant-specific functional and non-functional requirements. The NEWPER initiative has 140 members where the largest group of members consists of 19 commercial U.S. nuclear utilities and eleven of the most prominent vendors of eWP solutions. Through the NEWPER initiative two sets of functional requirements were developed; functional requirements for electronic work packages and functional requirements for computer-based procedures. This paper will describe the development process as well as a summary of the requirements.« less

33 CFR 62.27 - Safe water marks.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Safe water marks. 62.27 Section 62.27 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM The U.S. Aids to Navigation System § 62.27 Safe water marks. Safe water marks indicate that there is...

Developing Safe Schools Partnerships with Law Enforcement

ERIC Educational Resources Information Center

Rosiak, John

2009-01-01

Safe schools are the concern of communities throughout the world. If a school is safe, and if children feel safe, students "are better able to learn. But what are the steps to make" this happen? First, it is important to understand the problem: What are the threats to school safety? These include crime-related behaviors that find their way to…

Totally tubeless percutaneous nephrolithotomy: is it safe and effective in preschool children?

PubMed

Ozturk, Ahmet; Guven, Selcuk; Kilinc, Mehmet; Topbaş, Emrah; Piskin, Mesut; Arslan, Mehmet

2010-12-01

After the introduction of tubeless percutaneous nephrolithotomy (PNL), many studies conducted in adult patients have confirmed its efficacy and safety. There are limited studies reporting that tubeless PNL can be safely applied in children, however. Furthermore, there are no reports that evaluate the use of totally tubeless PNL in children. The present study evaluates the results of totally tubeless PNL in preschool children. The data of children seen in our clinic who were considered suitable for totally tubeless PNL were analyzed. Of 16 children, 8 patients underwent totally tubeless PNL (group 1) and 8 standard PNL (group 2). The two groups of patients were compared with regard to length of hospitalization, analgesic requirements, transfusion rates, hemoglobin (Hb) decrease, and immediate, early, and late complications. The mean ages of the patients were 56.6 months (9-84 mos) and 56.0 months (5-84 mos), and the mean follow-up was 21.5 months (3-44 mos) and 43.4 months (36-54 mos) in groups 1 and 2, respectively. Both groups were similar with regard to age, stone size, Hb change, and complications. Although operation duration, hospitalization period, and analgesic requirement were less in the totally tubeless PNL group, these differences were not statistically significant. The latest application of PNL, totally tubeless PNL, is also a safe and effective procedure in very small children if they are selected properly and if the surgeon has sufficient experience with the procedure. More studies with a higher number of participants are needed, however, to confirm that totally tubeless PNL increases the comfort of pediatric patients, decreases their hospitalization period, and is more economical.

The BMC ACCESS project: the development of a medically enhanced safe haven shelter.

PubMed

Lincoln, Alisa; Johnson, Peggy; Espejo, Dennis; Plachta-Elliott, Sara; Lester, Peggy; Shanahan, Christopher; Abbott, Susan; Cabral, Howard; Jamanka, Amber; Delman, Jonathan; Kenny, Patty

2009-10-01

This paper describes the development and implementation of the Boston Medical Center (BMC) Advanced Clinical Capacity for Engagement, Safety, and Services Project. In October 2002, the BMC Division of Psychiatry became the first such entity to open a Safe Haven shelter for people who are chronically homeless, struggling with severe mental illness, and actively substance abusing. The low-demand Safe Haven model targets the most difficult to reach population and serves as a "portal of entry" to the mental health and addiction service systems. In this paper, the process by which this blended funded, multi-level collaboration, consisting of a medical center, state, city, local, and community-based consumer organizations, was created and is maintained, as well as the clinical model of care is described. Lessons learned from creating the Safe Haven Shelter and the development and implementation of the consumer-informed evaluation are discussed as well as implications for future work with this population.

Safe haven laws as crime control theater.

PubMed

Hammond, Michelle; Miller, Monica K; Griffin, Timothy

2010-07-01

This article examines safe haven laws, which allow parents to legally abandon their infants. The main objective is to determine whether safe haven laws fit the criteria of crime control theater, a term used to describe public policies that produce the appearance, but not the effect, of crime control, and as such are essentially socially constructed "solutions" to socially constructed crime "problems." The analysis will apply the principles of crime control theater to safe haven laws. Specifically, the term crime control theater applies to laws that are reactionary responses to perceived criminal threats and are often widely supported as a way to address the crime in question. Such laws are attractive because they appeal to mythic narratives (i.e., saving an innocent child from a predator); however they are likely ineffective due to the complexity of the crime. These laws can have deleterious effects when policymakers make false claims of success and stunt public discourse (e.g., drawing attention away from more frequent and preventable crimes). This analysis applies these criteria to safe haven laws to determine whether such laws can be classified as crime control theater. Many qualities inherent to crime control theater are present in safe haven laws. For example, the laws are highly publicized, their intentions lack moral ambiguity, rare cases of success legitimize law enforcement and other agencies, and they appeal to the public sense of responsibility in preventing crime. Yet the goal of saving infant lives may be unattainable. These qualities make the effectiveness of the laws questionable and suggest they may be counterproductive. This analysis determined that safe haven laws are socially constructed solutions to the socially constructed problem of child abandonment. Safe haven laws are appropriately classified as crime control theater. It is imperative that further research be conducted to examine the effectiveness and collateral effects of safe haven laws

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR DEFINING WORKING DATABASES AND DATA ENTRY FORMS (HAND ENTRY) (UA-D-3.0)

EPA Science Inventory

The purpose of this SOP is to outline a standard approach to naming and defining variables, data types, and data entry forms. This procedure applies to all working databases created during the NHEXAS project and the "Border" study. Keywords: databases; standards.

The National...

Using Medications Safely

MedlinePlus

... health systems play an important role in preventing medication errors. To make sure you use medicines safely and effectively, ASHP recommends that you: Keep a list of all medications that you take (prescribed drugs, nonprescription medicines, herbal ...

When Is Safe, Safe Enough?

ERIC Educational Resources Information Center

Neil, Kirk

2002-01-01

Discusses events affecting parental school-safety concerns and what school districts can do to alleviate those concerns. Addresses post-September 11 crisis-management procedures, preventing sports-related student deaths, maintaining healthy indoor air quality. (PKP)

Advanced Outage and Control Center: Strategies for Nuclear Plant Outage Work Status Capabilities

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

Gregory Weatherby

The research effort is a part of the Light Water Reactor Sustainability (LWRS) Program. LWRS is a research and development program sponsored by the Department of Energy, performed in close collaboration with industry to provide the technical foundations for licensing and managing the long-term, safe and economical operation of current nuclear power plants. The LWRS Program serves to help the US nuclear industry adopt new technologies and engineering solutions that facilitate the continued safe operation of the plants and extension of the current operating licenses. The Outage Control Center (OCC) Pilot Project was directed at carrying out the applied researchmore » for development and pilot of technology designed to enhance safe outage and maintenance operations, improve human performance and reliability, increase overall operational efficiency, and improve plant status control. Plant outage management is a high priority concern for the nuclear industry from cost and safety perspectives. Unfortunately, many of the underlying technologies supporting outage control are the same as those used in the 1980’s. They depend heavily upon large teams of staff, multiple work and coordination locations, and manual administrative actions that require large amounts of paper. Previous work in human reliability analysis suggests that many repetitive tasks, including paper work tasks, may have a failure rate of 1.0E-3 or higher (Gertman, 1996). With between 10,000 and 45,000 subtasks being performed during an outage (Gomes, 1996), the opportunity for human error of some consequence is a realistic concern. Although a number of factors exist that can make these errors recoverable, reducing and effectively coordinating the sheer number of tasks to be performed, particularly those that are error prone, has the potential to enhance outage efficiency and safety. Additionally, outage management requires precise coordination of work groups that do not always share similar objectives

APIC position paper: Safe injection, infusion, and medication vial practices in health care.

PubMed

Dolan, Susan A; Arias, Kathleen Meehan; Felizardo, Gwen; Barnes, Sue; Kraska, Susan; Patrick, Marcia; Bumsted, Amelia

2016-07-01

The transmission of bloodborne viruses and other microbial pathogens to patients during routine health care procedures continues to occur because of the use of improper injection, infusion, medication vial, and point-of-care testing practices by health care personnel. These unsafe practices occur in various clinical settings and result in unacceptable and devastating events for patients. This document updates the Association for Professionals in Infection Control and Epidemiology 2010 position paper on safe injection, infusion, and medication vial practices in health care. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Managing drugs safely.

PubMed

van den Anker, John N

2005-02-01

There is hard data to show that newborn infants are more likely than adults to experience adverse reactions to drugs. Paradoxically, drug-related legislation to ensure safe and effective drug use in humans neglected neonates until 2002, when the Best Pharmaceuticals Act for Children was signed into law in the USA. The situation for neonates should now catch up with that for adults and neonates will be prescribed more licensed drugs in the near future. If we are to be able to analyze the underlying system errors to improve the safe use of drugs in the studied patient population, reporting of adverse drug events and reactions needs to happen in a blame free environment. In addition, computerized physician order entry will certainly further improve the current situation by preventing errors in ordering, transcribing, verifying, and transmitting medication orders.

10 CFR 1706.7 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Procedures. 1706.7 Section 1706.7 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD ORGANIZATIONAL AND CONSULTANT CONFLICTS OF INTERESTS § 1706.7 Procedures. (a) Pre... the same defense nuclear facility that is the subject of the proposed new work (including overlap...

10 CFR 1706.7 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Procedures. 1706.7 Section 1706.7 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD ORGANIZATIONAL AND CONSULTANT CONFLICTS OF INTERESTS § 1706.7 Procedures. (a) Pre... the same defense nuclear facility that is the subject of the proposed new work (including overlap...

10 CFR 1706.7 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Procedures. 1706.7 Section 1706.7 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD ORGANIZATIONAL AND CONSULTANT CONFLICTS OF INTERESTS § 1706.7 Procedures. (a) Pre... the same defense nuclear facility that is the subject of the proposed new work (including overlap...

10 CFR 1706.7 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Procedures. 1706.7 Section 1706.7 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD ORGANIZATIONAL AND CONSULTANT CONFLICTS OF INTERESTS § 1706.7 Procedures. (a) Pre... the same defense nuclear facility that is the subject of the proposed new work (including overlap...

Safe medication management in specialized home healthcare - an observational study.

PubMed

Lindblad, Marléne; Flink, Maria; Ekstedt, Mirjam

2017-08-24

Medication management is a complex, error-prone process. The aim of this study was to explore what constitutes the complexity of the medication management process (MMP) in specialized home healthcare and how healthcare professionals handle this complexity. The study is theoretically based in resilience engineering. Data were collected during the MMP at three specialized home healthcare units in Sweden using two strategies: observation of workplaces and shadowing RNs in everyday work, including interviews. Transcribed material was analysed using grounded theory. The MMP in home healthcare was dynamic and complex with unclear boundaries of responsibilities, inadequate information systems and fluctuating work conditions. Healthcare professionals adapted their everyday clinical work by sharing responsibility and simultaneously being authoritative and preserving patients' active participation, autonomy and integrity. To promote a safe MMP, healthcare professionals constantly re-prioritized goals, handled gaps in communication and information transmission at a distance by creating new bridging solutions. Trade-offs and workarounds were necessary elements, but also posed a threat to patient safety, as these interim solutions were not systematically evaluated or devised learning strategies. To manage a safe medication process in home healthcare, healthcare professionals need to adapt to fluctuating conditions and create bridging strategies through multiple parallel activities distributed over time, space and actors. The healthcare professionals' strategies could be integrated in continuous learning, while preserving boundaries of safety, instead of being more or less interim solutions. Patients' and family caregivers' as active partners in the MMP may be an underestimated resource for a resilient home healthcare.

The recommended Threshold Limit Values for heat exposure fail to maintain body core temperature within safe limits in older working adults.

PubMed

Lamarche, Dallon T; Meade, Robert D; D'Souza, Andrew W; Flouris, Andreas D; Hardcastle, Stephen G; Sigal, Ronald J; Boulay, Pierre; Kenny, Glen P

2017-09-01

body core temperature from exceeding 38°C in older workers. Furthermore, a stable core temperature was not achieved within safe limits (i.e., ≤38°C) indicating that the TLV® guidelines may not adequately protect all individuals during work in hot conditions.

"Safe Spaces"? Sites of Bilingualism for Young Learners in Home, School and Community

ERIC Educational Resources Information Center

Conteh, Jean; Brock, Avril

2011-01-01

Drawing together the work of two researchers engaged in ongoing, longitudinal research with practitioners in early years and bilingual complementary settings, this article argues that bilingual learners in the early years need and are entitled to particular kinds of "safe spaces" to succeed in their education. Historical and policy contexts, and…

An Automated Safe-to-Mate (ASTM) Tester

NASA Technical Reports Server (NTRS)

Nguyen, Phuc; Scott, Michelle; Leung, Alan; Lin, Michael; Johnson, Thomas

2013-01-01

Safe-to-mate testing is a common hardware safety practice where impedance measurements are made on unpowered hardware to verify isolation, continuity, or impedance between pins of an interface connector. A computer-based instrumentation solution has been developed to resolve issues. The ASTM is connected to the circuit under test, and can then quickly, safely, and reliably safe-to-mate the entire connector, or even multiple connectors, at the same time.

Choosing Wisely in pediatric anesthesia: An interpretation from the German Scientific Working Group of Paediatric Anaesthesia (WAKKA).

PubMed

Becke, Karin; Eich, Christoph; Höhne, Claudia; Jöhr, Martin; Machotta, Andreas; Schreiber, Markus; Sümpelmann, Robert

2018-05-30

Inspired by the Choosing Wisely initiative, a group of pediatric anesthesiologists representing the German Working Group on Paediatric Anaesthesia (WAKKA) coined and agreed upon 10 concise positive ("dos") or negative ("don'ts") evidence-based recommendations. (i) In infants and children with robust indications for surgical, interventional, or diagnostic procedures, anesthesia or sedation should not be avoided or delayed due to the potential neurotoxicity associated with the exposure to anesthetics. (ii) In children without relevant preexisting illnesses (ie, ASA status I/II) who are scheduled for elective minor or medium-risk surgical procedures, no routine blood tests should be performed. (iii) Parental presence during the induction of anesthesia should be an option for children whenever possible. (iv) Perioperative fasting should be safe and child-friendly with shorter real fasting times and more liberal postoperative drinking and enteral feeding. (v) Perioperative fluid therapy should be safe and effective with physiologically composed balanced electrolyte solutions to maintain a normal extracellular fluid volume; addition of 1%-2.5% glucose to avoid lipolysis, hypoglycemia, and hyperglycemia, and colloids as needed to maintain a normal blood volume. (vi) To achieve safe and successful airway management, the locally accepted airway algorithm and continued teaching and training of basic and alternative techniques of ventilation and endotracheal intubation are required. (vii) Ultrasound and imaging systems (eg, transillumination) should be available for achieving central venous access and challenging peripheral venous and arterial access. (viii) Perioperative disturbances of the patient's homeostasis, such as hypotension, hypocapnia, hypothermia, hypoglycemia, hyponatremia, and severe anemia, should not be ignored and should be prevented or treated immediately. (ix) Pediatric patients with an elevated perioperative risk, eg, preterm and term neonates, infants

Virtually 'in the heat of the moment': insula activation in safe sex negotiation among risky men.

PubMed

Smith, Benjamin J; Xue, Feng; Droutman, Vita; Barkley-Levenson, Emily; Melrose, A James; Miller, Lynn C; Monterosso, John R; Bechara, Antoine; Appleby, Paul R; Christensen, John L; Godoy, Carlos G; Read, Stephen J

2018-01-01

HIV is most prevalent among men who have sex with men (MSM), and although most MSM use condoms consistently during casual sex, some take risks. To better understand the psychology of those risky decisions, we examined neural correlates of playing a virtual sexual 'hook up' game in an functional magnetic resonance imaging scanner in MSM who had, in the past 90 days, been sexually risky (N = 76) or safe (N = 31). We found that during potentially risky sexual choices, previously risky MSM had more right insula activity than previously safe MSM. Real-life sexual risk was related to trait positive and negative urgency. Insula activity that differentiated risky and safe MSM was related to trait positive and negative urgency. Future work should further examine if, and to what extent, insula activation during safe sex negotiation drives MSM's rash risky sexual decision-making. © The Author (2017). Published by Oxford University Press.

Strategies for safe injections.

PubMed Central

Battersby, A.; Feilden, R.; Stoeckel, P.; Da Silva, A.; Nelson, C.; Bass, A.

1999-01-01

In 1998, faced with growing international concern, WHO set out an approach for achieving injection safety that encompassed all elements from patients' expectations and doctors' prescribing habits to waste disposal. This article follows that lead and describes the implications of the approach for two injection technologies: sterilizable and disposable. It argues that focusing on any single technology diverts attention from the more fundamental need for health services to develop their own comprehensive strategies for safe injections. National health authorities will only be able to ensure that injections are administered safely if they take an approach that encompasses the whole system, and choose injection technologies that fit their circumstances. PMID:10680247

Can Naturoptics for Safe Recovery of Vision Fund Brazilians' Educations?

NASA Astrophysics Data System (ADS)

Flávia Ribiero, Silvia; Carmem Ribeiro Duarte, Célia; Mc Leod, Roger David

2008-10-01

Directors of Naturoptics for Safe Recovery of Vision, Inc., US Patent Office, April 8, 2008, trademark issued, grants ``The David Matthew Mc Leod Memorial Award,'' to individuals like Sylvia Flavia Ribeiro. Instructions at American locations enhance patenting, trade-marking, and propagation to individuals, and youth through parents. Naturoptics' earnings go by agreed percentages to named academic entities and awardees who sign non-disclosure agreements. These say the US Government trademarked the processes as safe, and that diagnostic or treatment techniques are not used, necessary, or allowed for Naturoptic Methods. These educationally explain how the inventor, Roger David Mc Leod, recovered his vision. Taught processes are released to awardees signing agreements this is an educational service, providing teaching services for clients. Non-disclosure agreements are required from clients. Work-study grants, ``The Kaan Balam Matagamon Memorial Award,'' in memory of DMM, may be awarded through the American Indians in Science and Engineering Society, AISES, and to other women and minorities.

Improving the safety and quality of nursing care through standardized operating procedures in Bosnia and Herzegovina.

PubMed

Ausserhofer, Dietmar; Rakic, Severin; Novo, Ahmed; Dropic, Emira; Fisekovic, Eldin; Sredic, Ana; Van Malderen, Greet

2016-06-01

We explored how selected 'positive deviant' healthcare facilities in Bosnia and Herzegovina approach the continuous development, adaptation, implementation, monitoring and evaluation of nursing-related standard operating procedures. Standardized nursing care is internationally recognized as a critical element of safe, high-quality health care; yet very little research has examined one of its key instruments: nursing-related standard operating procedures. Despite variability in Bosnia and Herzegovina's healthcare and nursing care quality, we assumed that some healthcare facilities would have developed effective strategies to elevate nursing quality and safety through the use of standard operating procedures. Guided by the 'positive deviance' approach, we used a multiple-case study design to examine a criterion sample of four facilities (two primary healthcare centres and two hospitals), collecting data via focus groups and individual interviews. In each studied facility, certification/accreditation processes were crucial to the initiation of continuous development, adaptation, implementation, monitoring and evaluation of nursing-related SOPs. In one hospital and one primary healthcare centre, nurses working in advanced roles (i.e. quality coordinators) were responsible for developing and implementing nursing-related standard operating procedures. Across the four studied institutions, we identified a consistent approach to standard operating procedures-related processes. The certification/accreditation process is enabling necessary changes in institutions' organizational cultures, empowering nurses to take on advanced roles in improving the safety and quality of nursing care. Standardizing nursing procedures is key to improve the safety and quality of nursing care. Nursing and Health Policy are needed in Bosnia and Herzegovina to establish a functioning institutional framework, including regulatory bodies, educational systems for developing nurses' capacities or the

Unsupervised laparoscopic appendicectomy by surgical trainees is safe and time-effective.

PubMed

Wong, Kenneth; Duncan, Tristram; Pearson, Andrew

2007-07-01

Open appendicectomy is the traditional standard treatment for appendicitis. Laparoscopic appendicectomy is perceived as a procedure with greater potential for complications and longer operative times. This paper examines the hypothesis that unsupervised laparoscopic appendicectomy by surgical trainees is a safe and time-effective valid alternative. Medical records, operating theatre records and histopathology reports of all patients undergoing laparoscopic and open appendicectomy over a 15-month period in two hospitals within an area health service were retrospectively reviewed. Data were analysed to compare patient features, pathology findings, operative times, complications, readmissions and mortality between laparoscopic and open groups and between unsupervised surgical trainee operators versus consultant surgeon operators. A total of 143 laparoscopic and 222 open appendicectomies were reviewed. Unsupervised trainees performed 64% of the laparoscopic appendicectomies and 55% of the open appendicectomies. There were no significant differences in complication rates, readmissions, mortality and length of stay between laparoscopic and open appendicectomy groups or between trainee and consultant surgeon operators. Conversion rates (laparoscopic to open approach) were similar for trainees and consultants. Unsupervised senior surgical trainees did not take significantly longer to perform laparoscopic appendicectomy when compared to unsupervised trainee-performed open appendicectomy. Unsupervised laparoscopic appendicectomy by surgical trainees is safe and time-effective.

Sedation with intranasal midazolam of Angolan children undergoing invasive procedures.

PubMed

Kawanda, Lumana; Capobianco, Ivan; Starc, Meta; Felipe, Daniel; Zanon, Davide; Barbi, Egidio; Munkela, Nadine; Rodrigues, Verónica; Malundo, Lúis; Not, Tarcisio

2012-07-01

Ambulatory surgery is a daily requirement in poor countries, and limited means and insufficient trained staff lead to the lack of attention to the patient's pain. Midazolam is a rapid-onset, short-acting benzodiazepine which is used safely to reduce pain in children. We evaluated the practicability of intranasal midazolam sedation in a suburban hospital in Luanda (Angola), during the surgical procedures. Intranasal midazolam solution was administered at a dose of 0.5 mg/kg. Using the Ramsay's reactivity score, we gave a score to four different types of children's behaviour: moaning, shouting, crying and struggling, and the surgeon evaluated the ease of completing the surgical procedure using scores from 0 (very easy) to 3 (managing with difficulty). Eighty children (median age, 3 years) were recruited, and 140 surgical procedures were performed. Fifty-two children were treated with midazolam during 85 procedures, and 28 children were not treated during 55 procedures. We found a significant difference between the two groups on the shouting, crying and struggling parameters (p < 0.001). The mean score of the ease of completing the procedures was significantly different among the two groups (p < 0.0001). These results provide a model of procedural sedation in ambulatory surgical procedures in poor countries, thus abolishing pain and making the surgeon's job easier. © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.

Medical tongue piercing – development and evaluation of a surgical protocol and the perception of procedural discomfort of the participants

PubMed Central

2014-01-01

Background A system providing disabled persons with control of various assistive devices with the tongue has been developed at Aalborg University in Denmark. The system requires an activation unit attached to the tongue with a small piercing. The aim of this study was to establish and evaluate a safe and tolerable procedure for medical tongue piercing and to evaluate the expected and perceived procedural discomfort. Methods Four tetraplegic subjects volunteered for the study. A surgical protocol for a safe insertion of a tongue barbell piercing was presented using sterilized instruments and piercing parts. Moreover, post-procedural observations of participant complications such as bleeding, edema, and infection were recorded. Finally, procedural discomforts were monitored by VAS scores of pain, changes in taste and speech as well as problems related to hitting the teeth. Results The piercings were all successfully inserted in less than 5 min and the pain level was moderate compared with oral injections. No bleeding, infection, embedding of the piercing, or tooth/gingival injuries were encountered; a moderate edema was found in one case without affecting the speech. In two cases the piercing rod later had to be replaced by a shorter rod, because participants complained that the rod hit their teeth. The replacements prevented further problems. Moreover, loosening of balls was encountered, which could be prevented with the addition of dental glue. No cases of swallowing or aspiration of the piercing parts were recorded. Conclusions The procedure proved simple, fast, and safe for insertion of tongue piercings for tetraplegic subjects in a clinical setting. The procedure represented several precautions in order to avoid risks in these susceptible participants with possible co-morbidity. No serious complications were encountered, and the procedure was found tolerable to the participants. The procedure may be used in future studies with tongue piercings being a

Tangential gunshot wound with MagSafe ammunition.

PubMed

Rapkiewicz, Amy V; Tamburri, Robert; Basoa, Mark E; Catanese, Charles A

2005-09-01

MagSafe ammunition is a type of unconventional prefragmented ammunition. A fatal tangential gunshot wound involving MagSafe ammunition is presented. The ammunition and wound characteristics are discussed.

Creating Safe Spaces for Music Learning

ERIC Educational Resources Information Center

Hendricks, Karin S.; Smith, Tawnya D.; Stanuch, Jennifer

2014-01-01

This article offers a practical model for fostering emotionally safe learning environments that instill in music students a positive sense of self-belief, freedom, and purpose. The authors examine the implications for music educators of creating effective learning environments and present recommendations for creating a safe space for learning,…

Defect specific maintenance of SG tubes -- How safe is it?

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

Cizelj, L.; Mavko, B.; Dvorsek, T.

1997-02-01

The efficiency of the defect specific plugging criterion for outside diameter stress corrosion cracking at tube support plates is assessed. The efficiency is defined by three parameters: (1) number of plugged tubes, (2) probability of steam generator tube rupture and (3) predicted accidental leak rate through the defects. A probabilistic model is proposed to quantify the probability of tube rupture, while procedures available in literature were used to define the accidental leak rates. The defect specific plugging criterion was then compared to the performance of traditional (45%) plugging criterion using realistic data from Krsko nuclear power plant. Advantages of themore » defect specific approach over the traditional one are clearly shown. Some hints on the optimization of safe life of steam generator are also given.« less

Laser patterning of platinum electrodes for safe neurostimulation

NASA Astrophysics Data System (ADS)

Green, R. A.; Matteucci, P. B.; Dodds, C. W. D.; Palmer, J.; Dueck, W. F.; Hassarati, R. T.; Byrnes-Preston, P. J.; Lovell, N. H.; Suaning, G. J.

2014-10-01

Objective. Laser surface modification of platinum (Pt) electrodes was investigated for use in neuroprosthetics. Surface modification was applied to increase the surface area of the electrode and improve its ability to transfer charge within safe electrochemical stimulation limits. Approach. Electrode arrays were laser micromachined to produce Pt electrodes with smooth surfaces, which were then modified with four laser patterning techniques to produce surface structures which were nanosecond patterned, square profile, triangular profile and roughened on the micron scale through structured laser interference patterning (SLIP). Improvements in charge transfer were shown through electrochemical impedance spectroscopy (EIS), cyclic voltammetry (CV) and biphasic stimulation at clinically relevant levels. A new method was investigated and validated which enabled the assessment of in vivo electrochemically safe charge injection limits. Main results. All of the modified surfaces provided electrical advantage over the smooth Pt. The SLIP surface provided the greatest benefit both in vitro and in vivo, and this surface was the only type which had injection limits above the threshold for neural stimulation, at a level shown to produce a response in the feline visual cortex when using an electrode array implanted in the suprachoroidal space of the eye. This surface was found to be stable when stimulated with more than 150 million clinically relevant pulses in physiological saline. Significance. Critical to the assessment of implant devices is accurate determination of safe usage limits in an in vivo environment. Laser patterning, in particular SLIP, is a superior technique for improving the performance of implant electrodes without altering the interfacial electrode chemistry through coating. Future work will require chronic in vivo assessment of these electrode patterns.

TANK OPERATIONS CONTRACT CONSTRUCTION MANAGEMENT METHODOLOGY UTILIZING THE AGENCY METHOD OF CONSTRUCTION MANAGEMENT TO SAFELY AND EFFECTIVELY COMPLETE NUCLEAR CONSTRUCTION WORK

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

LESO KF; HAMILTON HM; FARNER M

Washington River Protection Solutions, LLC (WRPS) has faced significant project management challenges in managing Davis-Bacon construction work that meets contractually required small business goals. The unique challenge is to provide contracting opportunities to multiple small business construction subcontractors while performing high hazard work in a safe and productive manner. Previous to the Washington River Protection Solutions, LLC contract, Construction work at the Hanford Tank Farms was contracted to large companies, while current Department of Energy (DOE) Contracts typically emphasize small business awards. As an integral part of Nuclear Project Management at Hanford Tank Farms, construction involves removal of old equipmentmore » and structures and installation of new infrastructure to support waste retrieval and waste feed delivery to the Waste Treatment Plant. Utilizing the optimum construction approach ensures that the contractors responsible for this work are successful in meeting safety, quality, cost and schedule objectives while working in a very hazardous environment. This paper describes the successful transition from a traditional project delivery method that utilized a large business general contractor and subcontractors to a new project construction management model that is more oriented to small businesses. Construction has selected the Agency Construction Management Method. This method was implemented in the first quarter of Fiscal Year (FY) 2009, where Construction Management is performed by substantially home office resources from the URS Northwest Office in Richland, Washington. The Agency Method has allowed WRPS to provide proven Construction Managers and Field Leads to mentor and direct small business contractors, thus providing expertise and assurance of a successful project. Construction execution contracts are subcontracted directly by WRPS to small or disadvantaged contractors that are mentored and supported by DRS personnel

Safe prescribing: a titanic challenge

PubMed Central

Routledge, Philip A

2012-01-01

The challenge to achieve safe prescribing merits the adjective ‘titanic’. The organisational and human errors leading to poor prescribing (e.g. underprescribing, overprescribing, misprescribing or medication errors) have parallels in the organisational and human errors that led to the loss of the Titanic 100 years ago this year. Prescribing can be adversely affected by communication failures, critical conditions, complacency, corner cutting, callowness and a lack of courage of conviction, all of which were also factors leading to the Titanic tragedy. These issues need to be addressed by a commitment to excellence, the final component of the ‘Seven C's’. Optimal prescribing is dependent upon close communication and collaborative working between highly trained health professionals, whose role is to ensure maximum clinical effectiveness, whilst also protecting their patients from avoidable harm. Since humans are prone to error, and the environments in which they work are imperfect, it is not surprising that medication errors are common, occurring more often during the prescribing stage than during dispensing or administration. A commitment to excellence in prescribing includes a continued focus on lifelong learning (including interprofessional learning) in pharmacology and therapeutics. This should be accompanied by improvements in the clinical working environment of prescribers, and the encouragement of a strong safety culture (including reporting of adverse incidents as well as suspected adverse drug reactions whenever appropriate). Finally, members of the clinical team must be prepared to challenge each other, when necessary, to ensure that prescribing combines the highest likelihood of benefit with the lowest potential for harm. PMID:22738396

Traps and Treasures: How To Stay Safe and Avoid the Perils of School Construction.

ERIC Educational Resources Information Center

Marshall, Colin A.

2002-01-01

Provides steps school administrators can take to ensure safe construction: stay visible, update students, separate students and construction workers, engage workers in the educational process, monitor student movement, observe construction workers, barricade work areas, watch for stored materials, check emergency exits daily, conduct fire drills,…

Safe electrode trajectory planning in SEEG via MIP-based vessel segmentation

NASA Astrophysics Data System (ADS)

Scorza, Davide; Moccia, Sara; De Luca, Giuseppe; Plaino, Lisa; Cardinale, Francesco; Mattos, Leonardo S.; Kabongo, Luis; De Momi, Elena

2017-03-01

Stereo-ElectroEncephaloGraphy (SEEG) is a surgical procedure that allows brain exploration of patients affected by focal epilepsy by placing intra-cerebral multi-lead electrodes. The electrode trajectory planning is challenging and time consuming. Various constraints have to be taken into account simultaneously, such as absence of vessels at the electrode Entry Point (EP), where bleeding is more likely to occur. In this paper, we propose a novel framework to help clinicians in defining a safe trajectory and focus our attention on EP. For each electrode, a Maximum Intensity Projection (MIP) image was obtained from Computer Tomography Angiography (CTA) slices of the brain first centimeter measured along the electrode trajectory. A Gaussian Mixture Model (GMM), modified to include neighborhood prior through Markov Random Fields (GMM-MRF), is used to robustly segment vessels and deal with the noisy nature of MIP images. Results are compared with simple GMM and manual global Thresholding (Th) by computing sensitivity, specificity, accuracy and Dice similarity index against manual segmentation performed under the supervision of an expert surgeon. In this work we present a novel framework which can be easily integrated into manual and automatic planner to help surgeon during the planning phase. GMM-MRF qualitatively showed better performance over GMM in reproducing the connected nature of brain vessels also in presence of noise and image intensity drops typical of MIP images. With respect Th, it is a completely automatic method and it is not influenced by inter-subject variability.

76 FR 30495 - National Safe Boating Week, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-25

... Safe Boating Week, 2011 By the President of the United States of America A Proclamation As Americans... to watergoers. National Safe Boating Week is an opportunity to highlight the importance of safety... can save lives. Each year for National Safe Boating Week, the United States Coast Guard partners with...

23 CFR 630.1012 - Project-level procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Project-level procedures. 630.1012 Section 630.1012... PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1012 Project-level procedures. (a) This section... maintained at an equivalent or better level than existed prior to project implementation. The scope of the...

"From safe source to safe sink" development of colorimetric assay for gabapentin in bulk drug and capsules using naturally derived genipin.

PubMed

Winotapun, Weerapath; Kongpakwattana, Khachen; Dejpittayanunt, Sirirat; Pathomcharoensukchai, Suwaparp; Suksaran, Udomluck; Nuntharatanapong, Nopparat; Rojanarata, Theerasak

2012-09-15

A novel colorimetric assay for gabapentin in bulk drug and capsules has been developed via a safety-and-sustainability concerning concept. The method relied on the reaction of primary amino group of drug with non-toxic and eco-friendly genipin in totally aqueous medium to form the blue product which was subsequently measured by visible spectrophotometry at 590 nm. Under the optimized conditions, Beer's law was obeyed in the concentration range of 0.15-0.50 mM (r(2)=0.9998). It was accurate, precise and insensitive to the interferences from all related compounds specified in the United States Pharmacopeia as well as commonly used excipients. Furthermore, it gave the assay results in agreement with the pharmacopeial chromatographic method. Owing to the environmental concern and responsibility, a fast and facile method was also proposed for the treatment of waste generated from the assay based on the decoloration by using gypsum as a cheap and commonly available adsorbent. After the treatment, more than 95% of the initial blue product was removed from the waste solution and the treated waste was proven to be safe for aquatic organisms, as studied in brine shrimp and guppy fishes. Therefore, this work not only reports for the first time the application of naturally derived genipin to drug analysis, but also presents a new and contemporary paradigm that illustrates the fully benign-by-design development of the analytical methodologies in the era of Green Chemistry, starting from the safe source of reagents toward the safe sink when waste is released into the environment. Copyright © 2012 Elsevier B.V. All rights reserved.

Biosafety standards for working with Crimean-Congo hemorrhagic fever virus.

PubMed

Weidmann, Manfred; Avsic-Zupanc, Tatjana; Bino, Silvia; Bouloy, Michelle; Burt, Felicity; Chinikar, Sadegh; Christova, Iva; Dedushaj, Isuf; El-Sanousi, Ahmed; Elaldi, Nazif; Hewson, Roger; Hufert, Frank T; Humolli, Isme; Jansen van Vuren, Petrus; Koçak Tufan, Zeliha; Korukluoglu, Gülay; Lyssen, Pieter; Mirazimi, Ali; Neyts, Johan; Niedrig, Matthias; Ozkul, Aykut; Papa, Anna; Paweska, Janusz; Sall, Amadou A; Schmaljohn, Connie S; Swanepoel, Robert; Uyar, Yavuz; Weber, Friedemann; Zeller, Herve

2016-11-01

In countries from which Crimean-Congo haemorrhagic fever (CCHF) is absent, the causative virus, CCHF virus (CCHFV), is classified as a hazard group 4 agent and handled in containment level (CL)-4. In contrast, most endemic countries out of necessity have had to perform diagnostic tests under biosafety level (BSL)-2 or -3 conditions. In particular, Turkey and several of the Balkan countries have safely processed more than 100 000 samples over many years in BSL-2 laboratories. It is therefore advocated that biosafety requirements for CCHF diagnostic procedures should be revised, to allow the tests required to be performed under enhanced BSL-2 conditions with appropriate biosafety laboratory equipment and personal protective equipment used according to standardized protocols in the countries affected. Downgrading of CCHFV research work from CL-4, BSL-4 to CL-3, BSL-3 should also be considered.

Virtually ‘in the heat of the moment’: insula activation in safe sex negotiation among risky men

PubMed Central

Xue, Feng; Droutman, Vita; Barkley-Levenson, Emily; Melrose, A James; Miller, Lynn C; Monterosso, John R; Bechara, Antoine; Appleby, Paul R; Christensen, John L; Godoy, Carlos G; Read, Stephen J

2018-01-01

Abstract HIV is most prevalent among men who have sex with men (MSM), and although most MSM use condoms consistently during casual sex, some take risks. To better understand the psychology of those risky decisions, we examined neural correlates of playing a virtual sexual ‘hook up’ game in an functional magnetic resonance imaging scanner in MSM who had, in the past 90 days, been sexually risky (N = 76) or safe (N = 31). We found that during potentially risky sexual choices, previously risky MSM had more right insula activity than previously safe MSM. Real-life sexual risk was related to trait positive and negative urgency. Insula activity that differentiated risky and safe MSM was related to trait positive and negative urgency. Future work should further examine if, and to what extent, insula activation during safe sex negotiation drives MSM’s rash risky sexual decision-making. PMID:29149326

Terminal Area Procedures for Paired Runways

NASA Technical Reports Server (NTRS)

Lozito, Sandy

2011-01-01

Parallel Runway operations have been found to increase capacity within the National Airspace (NAS) however, poor visibility conditions reduce this capacity [1]. Much research has been conducted to examine the concepts and procedures related to parallel runways however, there has been no investigation of the procedures associated with the strategic and tactical pairing of aircraft for these operations. This study developed and examined the pilot and controller procedures and information requirements for creating aircraft pairs for parallel runway operations. The goal was to achieve aircraft pairing with a temporal separation of 15s(+/- 10s error) at a coupling point that is about 12 nmi from the runway threshold. Two variables were explored for the pilot participants: Two levels of flight deck automation (current-day flight deck automation, and a prototype future automation) as well as two flight deck displays that assisted in pilot conformance monitoring. The controllers were also provided with automation to help create and maintain aircraft pairs. Data showed that the operations in this study were found to be acceptable and safe. Workload when using the pairing procedures and tools was generally low for both controllers and pilots, and situation awareness (SA) was typically moderate to high. There were some differences based upon the display and automation conditions for the pilots. Future research should consider the refinement of the concepts and tools for pilot and controller displays and automation for parallel runway concepts.

48 CFR 24.103 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... work statement specifically identifies the system of records on individuals and the design, development, or operation work to be performed; and (2) Make available, in accordance with agency procedures... contracting officer shall review requirements to determine whether the contract will involve the design...

23 CFR 630.1008 - State-level processes and procedures.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 630.1008 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1008 State-level processes and... sustain their respective work zone safety and mobility policies. State-level processes and procedures...

23 CFR 630.1008 - State-level processes and procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 630.1008 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1008 State-level processes and... sustain their respective work zone safety and mobility policies. State-level processes and procedures...

23 CFR 630.1008 - State-level processes and procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 630.1008 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS PRECONSTRUCTION PROCEDURES Work Zone Safety and Mobility § 630.1008 State-level processes and... sustain their respective work zone safety and mobility policies. State-level processes and procedures...

Safe injection practice among health care workers, Gharbiya, Egypt.

PubMed

Ismail, Nanees A; Aboul Ftouh, Aisha M; El Shoubary, Waleed H

2005-01-01

A cross-sectional study was conducted in 25 health care facilities in Gharbiya governorate to assess safe injection practices among health care workers (HCWs). Two questionnaires, one to collect information about administrative issues related to safe injection and the other to collect data about giving injections, exposure to needle stick injuries, hepatitis B vaccination status and safe injection training. Practices of injections were observed using a standardized checklist. The study revealed that there was lack of both national and local infection control policies and lack of most of the supplies needed for safe injection practices. Many safe practices were infrequent as proper needle manipulation before disposal (41%), safe needle disposal (47.5%), reuse of used syringe & needle (13.2%) and safe syringe disposal (0%). Exposure to needle stick injuries were common among the interviewed HCWs (66.2%) and hand washing was the common post exposure prophylaxis measure (63.4%). Only 11.3% of HCWs had full course hepatitis B vaccination. Infection control -including safe injections- training programs should be afforded to all HCWs.

Characteristics, treatment, and outcomes of periprocedural cerebrovascular accidents during electrophysiologic procedures.

PubMed

Harb, Serge C; Thomas, George; Saliba, Walid I; Nakhoul, Georges N; Hussein, Ayman A; Duarte, Valeria E; Bhargava, Mandeep; Baranowski, Bryan; Tchou, Patrick; Dresing, Thomas; Callahan, Thomas; Kanj, Mohamed; Natale, Andrea; Lindsay, Bruce D; Wazni, Oussama M

2013-06-01

We sought to identify the characteristics, treatment, and outcomes of periprocedural cerebrovascular accident (PCVA) during electrophysiologic (EP) procedures. Periprocedural cerebrovascular accident is one of the most feared complications during EP procedures with very few data regarding its characteristics, management, and outcomes. Between January 1998 and December 2008, we reviewed 30,032 invasive EP procedures for PCVA occurrence and characteristics. Management and outcomes were also determined. Thirty-eight CVAs were identified. Twenty (53 %) were intraprocedural and 18 (47 %) postprocedural. Thirty-two (84 %) were classified as strokes and six (16 %) as transient ischemic attacks. All CVAs except one (37, 97 %) were ischemic and the vast majority occurred during ablation procedures (36, 95 %). Among the 31 patients with ischemic stroke, 11 (35 %) were treated with reperfusion (eight catheter-based therapy and three intravenous t-PA) of whom five (46 %) had complete recovery, three (27 %) had partial recovery, and three (27 %) had no recovery. No hemorrhagic transformations occurred. Periprocedural cerebrovascular accident during EP procedures is rare and is almost always ischemic. It occurs more frequently during ablation procedures. Reperfusion therapy is feasible and safe.

Procedural Error and Task Interruption

DTIC Science & Technology

2016-09-30

red for research on errors and individual differences . Results indicate predictive validity for fluid intelligence and specifi c forms of work...TERMS procedural error, task interruption, individual differences , fluid intelligence, sleep deprivation 16. SECURITY CLASSIFICATION OF: 17...and individual differences . It generates rich data on several kinds of errors, including procedural errors in which steps are skipped or repeated

Method matters: Systematic effects of testing procedure on visual working memory sensitivity

PubMed Central

Makovski, Tal; Watson, Leah M.; Koutstaal, Wilma; Jiang, Yuhong V.

2010-01-01

Visual working memory (WM) is traditionally considered a robust form of visual representation that survives changes in object motion, observer's position, and other visual transients. This study presents data that are inconsistent with the traditional view. We show that memory sensitivity is dramatically influenced by small variations in the testing procedure, supporting the idea that representations in visual WM are susceptible to interference from testing. In this study, participants were shown an array of colors to remember. After a short retention interval, memory for one of the items was tested with either a same-different task or a 2-alternative-forced-choice (2AFC) task. Memory sensitivity was much lower in the 2AFC task than in the same-different task. This difference was found regardless of encoding similarity or whether visual WM required a fine memory resolution or a coarse resolution. The 2AFC disadvantage was reduced when participants were informed shortly before testing which item would be probed. The 2AFC disadvantage diminished in perceptual tasks and was not found in tasks probing visual long-term memory. These results support memory models that acknowledge the labile nature of visual WM, and have implications for the format of visual WM and its assessment. PMID:20854011

Is endoscopic papillary large balloon dilation safe for treating large CBD stones?

PubMed

Shim, Chan Sup; Kim, Ji Wan; Lee, Tae Yoon; Cheon, Young Koog

2016-01-01

In recent years, endoscopic papillary large balloon dilation (EPLBD) with endoscopic sphincterotomy (EST) has been shown to be an effective technique for the removal of large or difficult common bile duct (CBD) stones, as an alternative to EST. Reviewing the literature published since 2003, it is understood that EPLBD has fewer associated overall complications than EST. Bleeding occurred less frequently with EPLBD than with EST. There was no significant difference in postendoscopic retrograde cholangiopancreatography pancreatitis or perforation. Recent accumulated results of EPLBD with or even without EST suggest that it is a safe and effective procedure for the removal of large or difficult bile duct stones without any additional risk of severe adverse events, when performed under appropriate guidelines. Since use of a larger balloon can tear the sphincter as well as the bile duct, possibly resulting in bleeding and perforation, a balloon size that is equal to or smaller in diameter than the diameter of the native distal bile duct is recommended. The maximum transverse diameter of the stone and the balloon-stone diameter ratio have a tendency to affect the success or failure of complete removal of stones by large balloon dilation to prevent adverse effects such as perforation and bleeding. One should take into account the size of the native bile duct, the size and burden of stones, the presence of stricture of distal bile duct, and the presence of the papilla in or adjacent to a diverticulum. Even though the results of EPLBD indicate that it is a relatively safe procedure in patients with common duct stones with a dilated CBD, the recommended guidelines should be followed strictly for the prevention of major adverse events such as bleeding and perforation.

Support to the Safe Motherhood Programme in Nepal: an integrated approach.

PubMed

Barker, Carol E; Bird, Cherry E; Pradhan, Ajit; Shakya, Ganga

2007-11-01

Evidence gathered from 1997 to 2006 indicates progress in reducing maternal mortality in Nepal, but public health services are still constrained by resource and staff shortages, especially in rural areas. The five-year Support to the Safe Motherhood Programme builds on the experience of the Nepal Safer Motherhood Project (1997-2004). It is working with the Government of Nepal to build capacity to institute a minimum package of essential maternity services, linking evidence-based policy development with health system strengthening. It has supported long-term planning, working towards skilled attendance at every birth, safe blood supplies, staff training, building management capacity, improving monitoring systems and use of process indicators, promoting dialogue between women and providers on quality of care, and increasing equity and access at district level. An incentives scheme finances transport costs to a health facility for all pregnant women and incentives to health workers attending deliveries, with free services and subsidies to facilities in the poorest 25 districts. Despite bureaucracy, frequent transfer of key government staff and political instability, there has been progress in policy development, and public health sector expenditure has increased. For the future, a human resources strategy with career paths that encourage skilled staff to stay in the government service is key.

77 FR 31147 - National Safe Boating Week, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-24

... Safe Boating Week, 2012 By the President of the United States of America A Proclamation For generations... friends and family a well- loved tradition. During National Safe Boating Week, we renew our commitment to... mark National Safe Boating Week, let us reflect on that important mission and resolve to do our part to...