Science.gov

Sample records for safety review psr

  1. Technical Letter Report: Evaluation and Analysis of a Few International Periodic Safety Review Summary Reports

    SciTech Connect

    Chopra, Omesh K.; Diercks, Dwight R.; Ma, David Chia-Chiun

    At the request of the United States (U.S.) government, the International Atomic Energy Agency (IAEA) assembled a team of 20 senior safety experts to review the regulatory framework for the safety of operating nuclear power plants in the United States. This review focused on the effectiveness of the regulatory functions implemented by the NRC and on its commitment to nuclear safety and continuous improvement. One suggestion resulting from that review was that the U.S. Nuclear Regulatory Commission (NRC) incorporate lessons learned from periodic safety reviews (PSRs) performed in other countries as an input to the NRC’s assessment processes. In themore » U.S., commercial nuclear power plants (NPPs) are granted an initial 40-year operating license, which may be renewed for additional 20-year periods, subject to complying with regulatory requirements. The NRC has established a framework through its inspection, and operational experience processes to ensure the safe operation of licensed nuclear facilities on an ongoing basis. In contrast, most other countries do not impose a specific time limit on the operating licenses for NPPs, they instead require that the utility operating the plant perform PSRs, typically at approximately 10-year intervals, to assure continued safe operation until the next assessment. The staff contracted with Argonne National Laboratory (Argonne) to perform a pilot review of selected translated PSR assessment reports and related documentation from foreign nuclear regulatory authorities to identify any potential new regulatory insights regarding license renewal-related topics and NPP operating experience (OpE). A total of 14 PSR assessment documents from 9 countries were reviewed. For all of the countries except France, individual reports were provided for each of the plants reviewed. In the case of France, three reports were provided that reviewed the performance assessment of thirty-four 900-MWe reactors of similar design commissioned

  2. Lift truck safety review

    SciTech Connect

    Cadwallader, L.C.

    1997-03-01

    This report presents safety information about powered industrial trucks. The basic lift truck, the counterbalanced sit down rider truck, is the primary focus of the report. Lift truck engineering is briefly described, then a hazard analysis is performed on the lift truck. Case histories and accident statistics are also given. Rules and regulations about lift trucks, such as the US Occupational Safety an Health Administration laws and the Underwriter`s Laboratories standards, are discussed. Safety issues with lift trucks are reviewed, and lift truck safety and reliability are discussed. Some quantitative reliability values are given.

  3. Review of PSR framework and development of a DPSIR model to assess greenhouse effect in Taiwan.

    PubMed

    Huang, Hui-Fen; Kuo, Jeff; Lo, Shang-Lien

    2011-06-01

    In dealing with the complex issues of greenhouse gas (GHG) emission and climate change mitigation, many interrelated factors such as cost, level of technology development, supply and demand of energy, structure of industry, and expenditures on research and development exist. Using indicators to monitor environmental impacts and evaluate the efficacies of policies and regulations has been practiced for a long time, and it can serve as a useful tool for decision making and for comparison between different countries. Although numerous indicators have been developed for relevant subjects, integrated approaches that consider individual changes, dynamic interaction, and multi-dimensions of indicators are scarce. This paper aimed to develop a Driving Force-Pressure-State-Impact-Response (DPSIR) framework to assess the problems. This DPSIR model is mainly related to energy consumption, environmental impacts, and policy responses. The objectives of the paper were: (1) conduct a literature review on the indicators that have been used in GHG-related studies; (2) develop a DPSIR model that incorporates GHG-related indicators and evaluate their relationships using a cause-effect chain of GHG emission; and (3) develop a calculative method that can be used to explain the dynamic correlation among the interdependent indicators. Taiwan is a significant source of global GHG emissions. A case study, using the developed framework and Taiwan's actual data of the past two decades, was conducted. The results indicate that regulatory strategies for pollution control are inadequate in terms of ensuring environmental quality, and the nature does not have the capability to revert the impacts from the existing level of pollution.

  4. School Safety Review Checklist

    ERIC Educational Resources Information Center

    Vermont Department of Education, 2005

    2005-01-01

    The School Safety Review Checklist is an important component of the broader school crisis resources that have been developed by the Vermont School Crisis Planning Team. The Team is comprised of members from the law enforcement, emergency management, health, and education organizations who have worked throughout the year to update school and…

  5. Dutch pedestrian safety research review

    DOT National Transportation Integrated Search

    1999-12-01

    This report is one in a series of pedestrian safety synthesis reports prepared for the Federal Highway Administration to document pedestrian safety in other countries. This report reviews recent pedestrian safety research in the Netherlands. It addre...

  6. Rodent Control Pesticide Safety Review

    EPA Pesticide Factsheets

    EPA completed a safety review in 2008 of rat and mouse poison products. Many companies' products have our safety measures that reduce risks to humans, pets, and non-target wildlife. Products must be sold with bait stations that securely contain the poison.

  7. Annual Safety Education Review 1970.

    ERIC Educational Resources Information Center

    American Association for Health, Physical Education, and Recreation, Washington, DC.

    This booklet presents articles completed in 1970 by the Division of Safety Education of the American Association for Health, Physical Education, and Recreation. The 11 articles deal with the following topics: a) the problem of apathy in safety education, b) the safety aspects of archery and riflery, c) weight training for high school girls, d)…

  8. A literature review of safety culture.

    SciTech Connect

    Cole, Kerstan Suzanne; Stevens-Adams, Susan Marie; Wenner, Caren A.

    2013-03-01

    Workplace safety has been historically neglected by organizations in order to enhance profitability. Over the past 30 years, safety concerns and attention to safety have increased due to a series of disastrous events occurring across many different industries (e.g., Chernobyl, Upper Big-Branch Mine, Davis-Besse etc.). Many organizations have focused on promoting a healthy safety culture as a way to understand past incidents, and to prevent future disasters. There is an extensive academic literature devoted to safety culture, and the Department of Energy has also published a significant number of documents related to safety culture. The purpose of the current endeavormore » was to conduct a review of the safety culture literature in order to understand definitions, methodologies, models, and successful interventions for improving safety culture. After reviewing the literature, we observed four emerging themes. First, it was apparent that although safety culture is a valuable construct, it has some inherent weaknesses. For example, there is no common definition of safety culture and no standard way for assessing the construct. Second, it is apparent that researchers know how to measure particular components of safety culture, with specific focus on individual and organizational factors. Such existing methodologies can be leveraged for future assessments. Third, based on the published literature, the relationship between safety culture and performance is tenuous at best. There are few empirical studies that examine the relationship between safety culture and safety performance metrics. Further, most of these studies do not include a description of the implementation of interventions to improve safety culture, or do not measure the effect of these interventions on safety culture or performance. Fourth, safety culture is best viewed as a dynamic, multi-faceted overall system composed of individual, engineered and organizational models. By addressing all three

  9. Occupational Safety Review of High Technology Facilities

    SciTech Connect

    Lee Cadwallader

    2005-01-31

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

  10. Annual Safety Education Review 1972.

    ERIC Educational Resources Information Center

    American Association for Health, Physical Education, and Recreation, Washington, DC.

    This booklet presents articles completed in 1972 by the Division of Safety Education of the American Association for Health, Physical Education, and Recreation. The introductory article contains the accomplishments of the division in 1971-72. The major points covered are planning conferences, conventions and meetings; revising the operating code…

  11. The Interagency Nuclear Safety Review Panel's Galileo safety evaluation report

    SciTech Connect

    Nelson, R.C.; Gray, L.B.; Huff, D.A.

    The safety evaluation report (SER) for Galileo was prepared by the Interagency Nuclear Safety Review Panel (INSRP) coordinators in accordance with Presidential directive/National Security Council memorandum 25. The INSRP consists of three coordinators appointed by their respective agencies, the Department of Defense, the Department of Energy (DOE), and the National Aeronautics and Space Administration (NASA). These individuals are independent of the program being evaluated and depend on independent experts drawn from the national technical community to serve on the five INSRP subpanels. The Galileo SER is based on input provided by the NASA Galileo Program Office, review and assessment ofmore » the final safety analysis report prepared by the Office of Special Applications of the DOE under a memorandum of understanding between NASA and the DOE, as well as other related data and analyses. The SER was prepared for use by the agencies and the Office of Science and Technology Policy, Executive Office of the Present for use in their launch decision-making process. Although more than 20 nuclear-powered space missions have been previously reviewed via the INSRP process, the Galileo review constituted the first review of a nuclear power source associated with launch aboard the Space Transportation System.« less

  12. Why Science? Members of PSR Editorial Board Explain What Drew Them to Science

    ERIC Educational Resources Information Center

    Primary Science Review, 2006

    2006-01-01

    Members of "Primary Science Review" Editorial Board explain what drew them to science. Alan Peacock, "PSR" Editor, emphasises the need to preserve children's sense of wonderment about the world. Robert Collins, a science educator in the Faculty of Education, University of Strathclyde, thinks people are "secret science…

  13. Evolution of Cuphea PSR23 under cultivation

    USDA-ARS?s Scientific Manuscript database

    A series of experiments carried out under controlled environments and field conditions (2002-2008) evaluated populations of the potential oilseed crop PSR23, a selection from a cross between two wild Cuphea species (C. viscosissima and C. lanceolata) for indicators of evolution under cultivation and...

  14. [Improving patient safety through voluntary peer review].

    PubMed

    Kluge, S; Bause, H

    2015-01-01

    The intensive care unit (ICU) is one area of the hospital in which processes and communication are of primary importance. Errors in intensive care units can lead to serious adverse events with significant consequences for patients. Therefore quality and risk-management are important measures when treating critically ill patients. A pragmatic approach to support quality and safety in intensive care is peer review. This approach has gained significant acceptance over the past years. It consists of mutual visits by colleagues who conduct standardised peer reviews. These reviews focus on the systematic evaluation of the quality of an ICU's structure, its processes and outcome. Together with different associations, the State Chambers of Physicians and the German Medical Association have developed peer review as a standardized tool for quality improvement. The common goal of all stakeholders is the continuous and sustainable improvement in intensive care with peer reviews significantly increasing and improving communication between professions and disciplines. Peer reviews secure the sustainability of planned change processes and consequently lead the way to an improved culture of quality and safety.

  15. Review of Safety Reports Involving Electronic Flight Bags.

    DOT National Transportation Integrated Search

    2010-04-01

    Safety events in which Electronic Flight Bags (EFBs) were a factor are reviewed. Relevant reports were obtained from the public Aviation Safety Reporting System (ASRS) database and the National Transportation Safety Board (NTSB) accident report datab...

  16. National Ignition Facility Construction Safety Management Review

    SciTech Connect

    Warner, B.E.

    2000-02-01

    An accident occurred at the NIF construction site on January 13, 2000, in which a worker sustained a serious injury when a 42-inch-diameter duct fell during installation. Following the accident, NIF Project Management chartered two review teams: (1) an Incident Analysis Team to independently assess the direct and root causes of the accident, and (2) a Management Review Team to review the roles and responsibilities of the line, support, and construction management organizations involved. This report provides a discussion of the information gathered by the Management Review Team and provides a list of observations and recommendations based on an analysismore » of the information. The Management Review Team includes senior managers who represent several Directorates within LLNL and DOE OAK: Dick Billia representing Engineering; Dave Leary representing Business Services and Public Affairs; Jim Jackson representing Hazards Control; Chuck Taylor representing DOE OAK; Arnie Clobes representing the ICF/NIF Program; and Jon Yatabe and Bruce Warner (Chairperson) representing the NIF Project. The attached letter from the NIF Project Manager, Ed Moses, to the Management Review Team contains the team's Charter. The team was asked to evaluate the effectiveness of the line management and its supporting safety functions in managing safety during NIF construction. The evaluation was to include the current conventional facility construction, which is 85% complete, and upcoming activities such as Beampath Infrastructure System installation, which will begin in the next six months and which represents a significant amount of work over the next two to three years. The remainder of this document describes the Management Review Team's review process (Section 2), its observations gathered during the review (Section 3), and its recommendations to the NIF Project Manager based on those observations (Section 4).« less

  17. Are PSR 0656+14, PSR 0950+08, and PSR 1822-09 gamma ray pulsars?

    NASA Technical Reports Server (NTRS)

    Brown, Lawrence E.; Hartmann, Dieter H.

    1993-01-01

    The possible discovery of three new gamma-ray pulsars PSR 0656+14, PSR 0950+08, and PSR 1822-09 (Ma, Lu, Yu, and Young, 1993) in data obtained with the COS-B experiment is reinvestigated using a refined technique for pulsar light curve analysis. The results of this study do not confirm the previously claimed gamma-ray pulsar nature of any of these pulsars. Even when using the standard epoch folding technique in conjunction with energy-dependent acceptance cones, we do not detect pulsed gamma-ray emission from these sources. We suspect that insufficient position accuracy is the cause for the discrepancy between our results and those of Ma et al. (1993). We do not rule out that any one of the three candidates, or all of them, is in fact a gamma-ray pulsar, but their spin properties must differ from those derived by Ma et al. (1993). More work is needed to determine the correct high-energy properties of these three sources.

  18. Credit PSR. The flammable waste materials shed appears as seen ...

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

    Credit PSR. The flammable waste materials shed appears as seen when looking south (186°) from South Liquid Loop Road. Note the catch basin for retaining accidentally spilled substances. Wastes are stored in drums and other safety containers until disposal by burning at the Incinerator (4249/E-50) or by other means. Note the nearby sign warning of corrosive, flammable materials, and calling attention to a fire extinguisher; a telephone is provided to call for assistance in the event of an emergency. This structure is isolated to prevent the spread of fire, and it is lightly built so damage from a fire will be inexpensive to repair - Jet Propulsion Laboratory Edwards Facility, Waste Flammable Storage Building, Edwards Air Force Base, Boron, Kern County, CA

  19. TOY SAFETY SURVEILLANCE FROM ONLINE REVIEWS

    PubMed Central

    Winkler, Matt; Abrahams, Alan S.; Gruss, Richard; Ehsani, Johnathan P.

    2016-01-01

    Toy-related injuries account for a significant number of childhood injuries and the prevention of these injuries remains a goal for regulatory agencies and manufacturers. Text-mining is an increasingly prevalent method for uncovering the significance of words using big data. This research sets out to determine the effectiveness of text-mining in uncovering potentially dangerous children’s toys. We develop a danger word list, also known as a ‘smoke word’ list, from injury and recall text narratives. We then use the smoke word lists to score over one million Amazon reviews, with the top scores denoting potential safety concerns. We compare the smoke word list to conventional sentiment analysis techniques, in terms of both word overlap and effectiveness. We find that smoke word lists are highly distinct from conventional sentiment dictionaries and provide a statistically significant method for identifying safety concerns in children’s toy reviews. Our findings indicate that text-mining is, in fact, an effective method for the surveillance of safety concerns in children’s toys and could be a gateway to effective prevention of toy-product-related injuries. PMID:27942092

  20. Safety of human papillomavirus vaccines: a review.

    PubMed

    Stillo, Michela; Carrillo Santisteve, Paloma; Lopalco, Pier Luigi

    2015-05-01

    Between 2006 and 2009, two different human papillomavirus virus (HPV) vaccines were licensed for use: a quadrivalent (qHPVv) and a bivalent (bHPVv) vaccine. Since 2008, HPV vaccination programmes have been implemented in the majority of the industrialized countries. Since 2013, HPV vaccination has been part of the national programs of 66 countries including almost all countries in North America and Western Europe. Despite all the efforts made by individual countries, coverage rates are lower than expected. Vaccine safety represents one of the main concerns associated with the lack of acceptance of HPV vaccination both in the European Union/European Economic Area and elsewhere. Safety data published on bivalent and quadrivalent HPV vaccines, both in pre-licensure and post-licensure phase, are reviewed. Based on the latest scientific evidence, both HPV vaccines seem to be safe. Nevertheless, public concern and rumors about adverse events (AE) represent an important barrier to overcome in order to increase vaccine coverage. Passive surveillance of AEs is an important tool for detecting safety signals, but it should be complemented by activities aimed at assessing the real cause of all suspect AEs. Improved vaccine safety surveillance is the first step for effective communication based on scientific evidence.

  1. Safety of human papillomavirus vaccines: a review

    PubMed Central

    Stillo, Michela; Carrillo Santisteve, Paloma; Lopalco, Pier Luigi

    2015-01-01

    Introduction: Between 2006 and 2009, two different human papillomavirus virus (HPV) vaccines were licensed for use: a quadrivalent (qHPVv) and a bivalent (bHPVv) vaccine. Since 2008, HPV vaccination programmes have been implemented in the majority of the industrialized countries. Since 2013, HPV vaccination has been part of the national programs of 66 countries including almost all countries in North America and Western Europe. Despite all the efforts made by individual countries, coverage rates are lower than expected. Vaccine safety represents one of the main concerns associated with the lack of acceptance of HPV vaccination both in the European Union/European Economic Area and elsewhere. Areas covered: Safety data published on bivalent and quadrivalent HPV vaccines, both in pre-licensure and post-licensure phase, are reviewed. Expert opinion: Based on the latest scientific evidence, both HPV vaccines seem to be safe. Nevertheless, public concern and rumors about adverse events (AE) represent an important barrier to overcome in order to increase vaccine coverage. Passive surveillance of AEs is an important tool for detecting safety signals, but it should be complemented by activities aimed at assessing the real cause of all suspect AEs. Improved vaccine safety surveillance is the first step for effective communication based on scientific evidence. PMID:25689872

  2. Passenger safety, health, and comfort: a review.

    PubMed

    Rayman, R B

    1997-05-01

    Since the birth of aviation medicine approximately 80 yrs ago, practitioners and scientists have given their attention primarily to flight deck crew, cabin crew, and ground support personnel. However, in more recent years we have broadened our horizons to include the safety, health, and comfort of passengers flying commercial aircraft. This will be even more compelling as more passengers take to the air in larger aircraft and flying longer hours to more distant destinations. Further, we can expect to see more older passengers because people in many countries are living longer, healthier lives. The author first discusses the stresses imposed by ordinary commercial flight upon travelers such as airport tumult, barometric pressure changes, immobility, jet lag, noise/ vibration, and radiation. Medical considerations are next addressed describing inflight illness and medical care capability aboard U.S. air carriers. Passenger safety, cabin air quality, and the preventive medicine aspects of air travel are next reviewed in the context of passenger safety, health, and comfort. Recommendations are addressed to regulator agencies, airlines aircraft manufacturers, and the aerospace medicine community.

  3. Safety of human papillomavirus vaccines: a review.

    PubMed

    Macartney, Kristine K; Chiu, Clayton; Georgousakis, Melina; Brotherton, Julia M L

    2013-06-01

    Vaccination to prevent human papillomavirus (HPV)-related infection leading to cancer, particularly cervical cancer, is a major public health breakthrough. There are currently two licensed HPV vaccines, both of which contain recombinant virus-like particles of HPV types 16 and 18 (which account for approximately 70 % of cervical cancer). One vaccine also protects against HPV types 6 and 11, which cause genital warts. The safety profile of both vaccines was assessed extensively in randomised controlled clinical trials conducted prior to licensure and has been further elucidated following licensure from surveillance and specific studies in large populations. This review aims to examine current evidence regarding the safety of HPV vaccines. In summary, both vaccines are associated with relatively high rates of injection site reactions, particularly pain, but this is usually of short duration and resolves spontaneously. Systemic reactions have generally been mild and self-limited. Post vaccination syncope has occurred, but can be avoided with appropriate care. Serious vaccine-attributable adverse events, such as anaphylaxis, are rare, and although not recommended for use in pregnancy, abnormal pregnancy outcomes following inadvertent administration do not appear to be associated with vaccination. HPV vaccines are used in a three-dose schedule predominantly in adolescent females: as such case reports linking vaccination with a range of new onset chronic conditions, including autoimmune diseases, have been made. However, well-conducted population-based studies show no association between HPV vaccine and a range of such conditions. Whilst this reassuring safety profile affirms the positive risk benefit of vaccination, as HPV vaccine use expands into more diverse populations, including males, ongoing safety assessment using well-conducted studies is appropriate.

  4. Review of BART "C" Car Fire Safety Characteristics

    DOT National Transportation Integrated Search

    1987-09-01

    The report presents the results of a review of the fire safety characteristics of the prototype BART "C" Car. Initiated in response to a request from the Urban Mass Transportation Administration (UMTA) Region IX Administrator, the review has been str...

  5. New Developments on the PSR Instability

    NASA Astrophysics Data System (ADS)

    Macek, Robert

    2000-04-01

    A strong, fast, transverse instability has long been observed at the Los Alamos Proton Storage Ring (PSR) where it is a limiting factor on peak intensity. Most of the characteristics and experimental data are consistent with a two-stream instability (e-p) arising from coupled oscillations of the proton beam and an electron cloud. In past operations, where the average intensity was limited by beam losses, the instability was controlled by sufficient rf voltage in the ring. The need for higher beam intensity has motivated new work to better understand and control the instability. Results will be presented from studies of the production and characteristics of the electron cloud at various locations in the ring for both stable and unstable beams and suppression of electron cloud generation by TiN coatings. Studies of additional or alternate controls include application of dual harmonic rf, damping of the instability by higher order multipoles, damping by X,Y coupling from skew quadrupoles and the use of inductive inserts to compensate longitudinal space charge forces. Use of a skew quadrupole, heated inductive inserts and higher rf voltage from a refurbished rf buncher has enabled the PSR to accumulate stable beam intensity up to 9.7 micro-Coulombs (6 E13 protons) per macropulse, a significant increase (60over the previous maximum of 6 micro-Coulombs (3.7 E13 protons). However, slow losses were rather high and must be reduced for routine operation at repetition rates of 20 Hz or higher.

  6. 49 CFR 659.27 - Internal safety and security reviews.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAIL FIXED GUIDEWAY SYSTEMS; STATE SAFETY OVERSIGHT Role of the..., indicating that the rail transit agency is in compliance with its system safety program plan and system... security reviews indicate that the rail transit agency is not in compliance with its system safety program...

  7. Safety Education Impact and Good Practice: A Review

    ERIC Educational Resources Information Center

    Mulvaney, Caroline A.; Watson, Michael C.; Errington, Gail

    2012-01-01

    Purpose: The aim of this literature review was to examine recent evidence of the impact of safety education for children and young people on unintentional injury rates and to update an earlier review. Evidence was sought that linked safety education for children and young people in schools, centres and other settings with changes in knowledge,…

  8. Inhibition of Fear by Learned Safety Signals: minisymposium review

    PubMed Central

    Fernando, Anushka B. P.; Kazama, Andy M.; Jovanovic, Tanja; Ostroff, Linnaea E.; Sangha, Susan

    2012-01-01

    Safety signals are learned cues that predict the non-occurrence of an aversive event. As such, safety signals are potent inhibitors of fear and stress responses. Investigations of safety signal learning have increased over the last few years due in part to the finding that traumatized persons are unable to utilize safety cues to inhibit fear, making it a clinically relevant phenotype. The goal of this review is to present recent advances relating to the neural and behavioral mechanisms of safety learning and expression in rodents, non-human primates and humans. PMID:23055481

  9. Proposal for Ground Safety Review Coordination at ISS Launch Sites

    NASA Technical Reports Server (NTRS)

    Kirkpatrick, Paul D.

    2010-01-01

    As the transportation of ISS payloads and cargo shifts from KSC to other launch sites, close coordination of ground safety review processes would be of benefit to all parties. The benefit would have the launch sites receiving consistent data that would require less effort to review while still meeting their needs. Until recently, ground safety focus for the ISS program has been almost exclusively for prelaunch processing at KSC/post-landing processing at KSC/DFRC Each launch site, used by the ISS Program, has a ground safety review process. Ground safety viewed as local prerogative. Up till now, ground processing has consisted of low risk/low hazard items; but this will not always be the case. Recent coordination issues associated with the ground safety review of ORU's to be processed at Tanegashima for HTV-2, illustrate that IP ground safety review processes are not well understood by the ISS community at large. Confusion for data providers (US only?). Lack of internal review process for data being submitted to launch sites can lead to inconsistent submittals. NCRs/HRs. Majority of IP ground safety requirements are based upon old KHB 1700.7 (now KNPR 8715.3, Chapter 20). Proposals include: Establish a ground safety working group as part of the MS&MAP. Search for efficiencies in requirements and data submittal processes. Document processes in NSTS 13830/SSP 30599. Each launch site report out its payload ground safety status at the F2F (Monthly's as required). Completions/due dates/NCRs/issues/changes. Establish internal processes for review of ground safety submittals.

  10. Discretionary Review by the Occupational Safety and Health Review Commission: Is It Necessary?

    ERIC Educational Resources Information Center

    Moran, Robert D.

    1974-01-01

    Deficiencies in the Occupational Safety and Health Review Commission (OSAHRC), a court system created to carry out adjudicatory functions under the Williams-Steiger Occupational Safety and Health Act of 1970, are exposed and alternative solutions offered. (JT)

  11. Patient safety in otolaryngology: a descriptive review.

    PubMed

    Danino, Julian; Muzaffar, Jameel; Metcalfe, Chris; Coulson, Chris

    2017-03-01

    Human evaluation and judgement may include errors that can have disastrous results. Within medicine and healthcare there has been slow progress towards major changes in safety. Healthcare lags behind other specialised industries, such as aviation and nuclear power, where there have been significant improvements in overall safety, especially in reducing risk of errors. Following several high profile cases in the USA during the 1990s, a report titled "To Err Is Human: Building a Safer Health System" was published. The report extrapolated that in the USA approximately 50,000 to 100,000 patients may die each year as a result of medical errors. Traditionally otolaryngology has always been regarded as a "safe specialty". A study in the USA in 2004 inferred that there may be 2600 cases of major morbidity and 165 deaths within the specialty. MEDLINE via PubMed interface was searched for English language articles published between 2000 and 2012. Each combined two or three of the keywords noted earlier. Limitations are related to several generic topics within patient safety in otolaryngology. Other areas covered have been current relevant topics due to recent interest or new advances in technology. There has been a heightened awareness within the healthcare community of patient safety; it has become a major priority. Focus has shifted from apportioning blame to prevention of the errors and implementation of patient safety mechanisms in healthcare delivery. Type of Errors can be divided into errors due to action and errors due to knowledge or planning. In healthcare there are several factors that may influence adverse events and patient safety. Although technology may improve patient safety, it also introduces new sources of error. The ability to work with people allows for the increase in safety netting. Team working has been shown to have a beneficial effect on patient safety. Any field of work involving human decision-making will always have a risk of error. Within

  12. Tank waste remediation system nuclear criticality safety program management review

    SciTech Connect

    BRADY RAAP, M.C.

    1999-06-24

    This document provides the results of an internal management review of the Tank Waste Remediation System (TWRS) criticality safety program, performed in advance of the DOE/RL assessment for closure of the TWRS Nuclear Criticality Safety Issue, March 1994. Resolution of the safety issue was identified as Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) Milestone M-40-12, due September 1999.

  13. Driver Issues: Commercial Motor Vehicle Safety Literature Review

    DOT National Transportation Integrated Search

    2007-06-01

    The objective of this project was to provide the Federal Motor Carrier Safety Administration (FMCSA) with a more complete understanding of the non-regulatory factors which make for safer commercial motor vehicle (CMV) drivers. Through the review of a...

  14. Increasing teen safety belt use: a program and literature review.

    DOT National Transportation Integrated Search

    2005-09-01

    A comprehensive review of the scientific literature, State and Federal Government reports, and other sources of information : was conducted to determine the magnitude of the problem of teen safety belt use and to identify and summarize programs, : in...

  15. Drug use and highway safety : a review of the literature

    DOT National Transportation Integrated Search

    1971-07-01

    This report reviews the research literature concerning several aspects of drug use as it relates to traffic safety. Some of the topics covered include the effects of drugs, types of drug users; research problems in assessing risk; laboratory findings...

  16. Office of Safety and Mission Assurance Review Report

    NASA Technical Reports Server (NTRS)

    2000-01-01

    This document summarizes questions and concerns raised during the 1999 IV&V Facility's Annual Review Presentation to the Office of Safety and Mission Assurance (OSMA). Recommendations are provided for issues and action items identified.

  17. A review of models relevant to road safety.

    PubMed

    Hughes, B P; Newstead, S; Anund, A; Shu, C C; Falkmer, T

    2015-01-01

    It is estimated that more than 1.2 million people die worldwide as a result of road traffic crashes and some 50 million are injured per annum. At present some Western countries' road safety strategies and countermeasures claim to have developed into 'Safe Systems' models to address the effects of road related crashes. Well-constructed models encourage effective strategies to improve road safety. This review aimed to identify and summarise concise descriptions, or 'models' of safety. The review covers information from a wide variety of fields and contexts including transport, occupational safety, food industry, education, construction and health. The information from 2620 candidate references were selected and summarised in 121 examples of different types of model and contents. The language of safety models and systems was found to be inconsistent. Each model provided additional information regarding style, purpose, complexity and diversity. In total, seven types of models were identified. The categorisation of models was done on a high level with a variation of details in each group and without a complete, simple and rational description. The models identified in this review are likely to be adaptable to road safety and some of them have previously been used. None of systems theory, safety management systems, the risk management approach, or safety culture was commonly or thoroughly applied to road safety. It is concluded that these approaches have the potential to reduce road trauma. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Africa road safety review : final report

    DOT National Transportation Integrated Search

    2000-12-01

    A number of studies of road crashes worldwide (Jacobs et al, 2000) carried out by TRL in : recent years have shown that the road safety situation throughout the African continent is one : of the worst in the world. With approximately only 4 per cent ...

  19. HFE safety reviews of advanced nuclear power plant control rooms

    NASA Technical Reports Server (NTRS)

    Ohara, John

    1994-01-01

    Advanced control rooms (ACR's) will utilize human-system interface (HSI) technologies that may have significant implications for plant safety in that they will affect the operator's overall role and means of interacting with the system. The Nuclear Regulatory Commission (NRC) reviews the human factors engineering (HFE) aspects of HSI's to ensure that they are designed to good HFE principles and support performance and reliability in order to protect public health and safety. However, the only available NRC guidance was developed more than ten years ago, and does not adequately address the human performance issues and technology changes associated with ACR's. Accordingly, a new approach to ACR safety reviews was developed based upon the concept of 'convergent validity'. This approach to ACR safety reviews is described.

  20. [Should we establish patient safety leadership walkrounds? A systematic review].

    PubMed

    Girerd-Genessay, I; Michel, P

    2015-10-01

    Used for over a decade, patient safety leadership walkrounds (PSLWs) is a managerial method designed to enhance the implementation of safety measures in hospitals. In order to determine the effect of PSLWs in French hospitals, we reviewed the literature on participant perceptions and the impact of PSLW on the overall culture of safety. We conducted a systematic review of articles assessing the impact of PSLWs on the culture of safety (comparative studies) or the perceptions of caregivers and managers (qualitative studies). Five studies investigating safety culture and three studies investigating participant perception were identified. PSLWs were associated with an improvement in safety culture and the overall safety climate. The presence of caregivers during the PSLWs was important to achieve improvement. PSLWs improved the dialogue between caregivers and managers, and improved knowledge on care safety. Some problems concerning managerial PSLW attendance and counter-productive attitudes have occasionally been reported. PSLWs improve safety culture. Their effectiveness depends on the way they are implemented. They should initially be tested in France to ensure their feasibility and acceptability in our healthcare system. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  1. Medication safety programs in primary care: a scoping review.

    PubMed

    Khalil, Hanan; Shahid, Monica; Roughead, Libby

    2017-10-01

    Medication safety plays an essential role in all healthcare organizations; improving this area is paramount to quality and safety of any wider healthcare program. While several medication safety programs in the hospital setting have been described and the associated impact on patient safety evaluated, no systematic reviews have described the impact of medication safety programs in the primary care setting. A preliminary search of the literature demonstrated that no systematic reviews, meta-analysis or scoping reviews have reported on medication safety programs in primary care; instead they have focused on specific interventions such as medication reconciliation or computerized physician order entry. This scoping review sought to map the current medication safety programs used in primary care. The current scoping review sought to examine the characteristics of medication safety programs in the primary care setting and to map evidence on the outcome measures used to assess the effectiveness of medication safety programs in improving patient safety. The current review considered participants of any age and any condition using care obtained from any primary care services. We considered studies that focussed on the characteristics of medication safety programs and the outcome measures used to measure the effectiveness of these programs on patient safety in the primary care setting. The context of this review was primary care settings, primary healthcare organizations, general practitioner clinics, outpatient clinics and any other clinics that do not classify patients as inpatients. We considered all quantitative studied published in English. A three-step search strategy was utilized in this review. Data were extracted from the included studies to address the review question. The data extracted included type of medication safety program, author, country of origin, aims and purpose of the study, study population, method, comparator, context, main findings and outcome

  2. Using systematic review in occupational safety and health.

    PubMed

    Howard, John; Piacentino, John; MacMahon, Kathleen; Schulte, Paul

    2017-11-01

    Evaluation of scientific evidence is critical in developing recommendations to reduce risk. Healthcare was the first scientific field to employ a systematic review approach for synthesizing research findings to support evidence-based decision-making and it is still the largest producer and consumer of systematic reviews. Systematic reviews in the field of occupational safety and health are being conducted, but more widespread use and adoption would strengthen assessments. In 2016, NIOSH asked RAND to develop a framework for applying the traditional systematic review elements to the field of occupational safety and health. This paper describes how essential systematic review elements can be adapted for use in occupational systematic reviews to enhance their scientific quality, objectivity, transparency, reliability, utility, and acceptability. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  3. Achievements and challenges of Space Station Freedom's safety review process

    NASA Astrophysics Data System (ADS)

    Robinson, David W.

    1993-07-01

    The most complex space vehicle in history, Space Station Freedom, is well underway to completion, and System Safety is a vital part of the program. The purpose is to summarize and illustrate the progress that over one-hundred System Safety engineers have made in identifying, documenting, and controlling the hazards inherent in the space station. To date, Space Station Freedom has been reviewed by NASA's safety panels through the first six assembly flights, when Freedom achieves a configuration known as Man Tended Capability. During the eight weeks of safety reviews spread out over a year and a half, over 200 preliminary hazard reports were presented. Along the way NASA and its contractors faced many challenges, made much progress, and even learned a few lessons.

  4. Achievements and challenges of Space Station Freedom's safety review process

    NASA Technical Reports Server (NTRS)

    Robinson, David W.

    1993-01-01

    The most complex space vehicle in history, Space Station Freedom, is well underway to completion, and System Safety is a vital part of the program. The purpose is to summarize and illustrate the progress that over one-hundred System Safety engineers have made in identifying, documenting, and controlling the hazards inherent in the space station. To date, Space Station Freedom has been reviewed by NASA's safety panels through the first six assembly flights, when Freedom achieves a configuration known as Man Tended Capability. During the eight weeks of safety reviews spread out over a year and a half, over 200 preliminary hazard reports were presented. Along the way NASA and its contractors faced many challenges, made much progress, and even learned a few lessons.

  5. Search for optical pulsations in PSR J0337+1715

    DOE PAGES

    Strader, M. J.; Archibald, A. M.; Meeker, S. R.; ...

    2016-03-20

    In this study, we report on a search for optical pulsations from PSR J0337+1715 at its observed radio pulse period. PSR J0337+1715 is a millisecond pulsar (2.7 ms spin period) in a triple hierarchical system with two white dwarfs, and has a known optical counterpart with g-band magnitude 18. The observations were done with the Array Camera for Optical to Near-IR Spectrophotometry (ARCONS) at the 200" Hale telescope at Palomar Observatory. No significant pulsations were found in the range 4000-11000 angstroms, and we can limit pulsed emission in g-band to be fainter than 25 mag.

  6. Narrative review of the UK Patient Safety Research Portfolio.

    PubMed

    Waring, Justin; Rowley, Emma; Dingwall, Robert; Palmer, Cecily; Murcott, Toby

    2010-01-01

    The UK Patient Safety Research Portfolio (PSRP) commissioned 38 studies investigating the threats to patient safety in various clinical settings and evaluating safety-related service interventions. This paper reviews 27 of these studies, drawing out emergent and cross-cutting themes in terms of theory, research methods and thematic findings. Given the diversity of PSRP studies, the paper takes a narrative approach that allows for qualitative description, interpretation and synthesis of the studies and their findings. The theoretical review shows the majority of PSRP studies draw upon a patient safety 'orthodoxy', developed from the concepts and models associated with the human factors approach. The methodological review shows that a diverse range of research designs and techniques have been utilized. Although many follow in the 'scientific' tradition, interpretative, mixed and innovative methods have been integral to research. The thematic review of findings highlights significant contributions to knowledge in the areas of 'people', 'organizations', and 'technology'. As well as identifying the various sources of risk in the organization and delivery of patient care, the studies also evaluate and make recommendations about service change and improvement. The PSRP has provided the foundations for significant theoretical, methodological and empirical advances in the area of patient safety. The findings and recommendations make important contributions to policy formulation and implementation as well as professional and managerial practice. Through this body of research the PSRP has supported the formation and growth of a thriving research community across academic, policy and professional communities.

  7. Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review

    PubMed Central

    Hall, Louise H.; Johnson, Judith; Watt, Ian; Tsipa, Anastasia; O’Connor, Daryl B.

    2016-01-01

    Objective To determine whether there is an association between healthcare professionals’ wellbeing and burnout, with patient safety. Design Systematic research review. Data Sources PsychInfo (1806 to July 2015), Medline (1946 to July 2015), Embase (1947 to July 2015) and Scopus (1823 to July 2015) were searched, along with reference lists of eligible articles. Eligibility Criteria for Selecting Studies Quantitative, empirical studies that included i) either a measure of wellbeing or burnout, and ii) patient safety, in healthcare staff populations. Results Forty-six studies were identified. Sixteen out of the 27 studies that measured wellbeing found a significant correlation between poor wellbeing and worse patient safety, with six additional studies finding an association with some but not all scales used, and one study finding a significant association but in the opposite direction to the majority of studies. Twenty-one out of the 30 studies that measured burnout found a significant association between burnout and patient safety, whilst a further four studies found an association between one or more (but not all) subscales of the burnout measures employed, and patient safety. Conclusions Poor wellbeing and moderate to high levels of burnout are associated, in the majority of studies reviewed, with poor patient safety outcomes such as medical errors, however the lack of prospective studies reduces the ability to determine causality. Further prospective studies, research in primary care, conducted within the UK, and a clearer definition of healthcare staff wellbeing are needed. Implications This review illustrates the need for healthcare organisations to consider improving employees’ mental health as well as creating safer work environments when planning interventions to improve patient safety. Systematic Review Registration PROSPERO registration number: CRD42015023340. PMID:27391946

  8. Prevention through pre-review in occupational health and safety.

    PubMed Central

    Richter, E D; Kretzmer, D

    1980-01-01

    Occupational health problems have needlessly been produced at many worksites as a consequence of their not having been anticipated during design and construction. Pre-review may be an effective and efficient mechanism for preventive intervention in occupational health and safety. Legal and administrative precedents are cited from the United States and other countries. Proposals are presented, with Israel as an example, which aim to implement the principle of pre-review. PMID:7352610

  9. Similarity of PSR J1906+0746 TO PSR J0737-3039: A Candidate of a New Double Pulsar System?

    NASA Astrophysics Data System (ADS)

    Yang, Yi-Yan; Zhang, Cheng-Min; Li, Di; Wang, De-Hua; Pan, Yuan-Yue; Lingfu, Rong-Feng; Zhou, Zhu-Wen

    2017-02-01

    PSR J1906+0746 is a nonrecycled strong magnetic field neutron star (NS), sharing the properties of the secondary-formed NS PSR J0737-3039B in the double pulsar system PSR J0737-3039AB. By comparing the orbital parameters of PSR J1906+0746 with those of PSR J0737-3039AB, we conclude that both systems have a similar origin and evolution history, involving an e-capture process for forming the second-born NS, like in the case of PSR J0737-3039B. We expect the companion of PSR J1906+0746 to be a long-lived recycled pulsar with radio beams that currently cannot be observed from Earth. We suggest possible ways to detect its presence. To compare PSR J1906+0746 with PSR J0737-3039, we also present the mass distribution of eight pairs of double NSs and find that in double NSs the mass of the recycled pulsar is usually larger than that of the nonrecycled one, which may be the result of accretion.

  10. Credit PSR. This interior view of the building equipment room ...

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

    Credit PSR. This interior view of the building equipment room displays heat exchangers and fan units with insulated piping for hot and cold water at left. Environmental controls and fire fighting system controls appear at right - Jet Propulsion Laboratory Edwards Facility, Propellant Curing Building, Edwards Air Force Base, Boron, Kern County, CA

  11. 1. Credit PSR. This view captures the main entrance to ...

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

    1. Credit PSR. This view captures the main entrance to the Administration/Shops Building, constructed in 1963, looking north northeast (30°). The plaque at the base of the flagpole commemorates the first firing of a liquid-fueled rocket engine at Test Stand "A" in 1945. - Jet Propulsion Laboratory Edwards Facility, Administration & Shops Building, Edwards Air Force Base, Boron, Kern County, CA

  12. Credit PSR. This view shows the north and west facades ...

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

    Credit PSR. This view shows the north and west facades of the building as seen when looking east southeast (1100). This structure was used to test regenerative fuel cells in 1995 - Jet Propulsion Laboratory Edwards Facility, Weigh & Test Preparation Building, Edwards Air Force Base, Boron, Kern County, CA

  13. 8. Credit PSR. Interior of Building 4305, looking west under ...

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

    8. Credit PSR. Interior of Building 4305, looking west under elliptical laminated wooden roof arches. Lower surfaces are ceilings of offices built within structure; cylindrical and rectangular ducts are for air conditioning. - Edwards Air Force Base, North Base, Unicon Portable Hangar, First & C Streets, Boron, Kern County, CA

  14. 4. Credit PSR. View east at west and south facades ...

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

    4. Credit PSR. View east at west and south facades of Unicon Portable Hangar with immediate ancillary structures. Building 4307 (Supply & Equipment Warehouse) appears at left, Building 4303 (Air Compressor Plant) in middle foreground, and Building 4306 (Boiler House) at the southwest corner of the hangar. - Edwards Air Force Base, North Base, Unicon Portable Hangar, First & C Streets, Boron, Kern County, CA

  15. Credit PSR. Interior view shows the building equipment room as ...

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

    Credit PSR. Interior view shows the building equipment room as seen looking south southwest (206°) from the doorway. The control console contains switches for chiller pumps, fans, heaters, temperature controls, and alarms - Jet Propulsion Laboratory Edwards Facility, Solid Propellant Conditioning Building, Edwards Air Force Base, Boron, Kern County, CA

  16. On the age of PSR B 1509-58

    NASA Astrophysics Data System (ADS)

    Gvaramadze, V. V.

    2001-07-01

    It is generally accepted that the PSR B 1509-58 is associated with the supernova remnant (SNR) MSH 15-52 (G 320.4-01.2). The spin-down age of the pulsar is =~ 1700 years, while the size and the general appearance of the SNR suggest that this system is much older. A few possible explanations of this discrepancy have been put forward. We offer an alternative one and suggest that the high spin-down rate of the pulsar characterizes only a relatively short period of its (present) spin history, and that the enhanced braking torque is connected with the interaction between the pulsar's magnetosphere and the dense matter of a circumstellar clump (created during the late evolutionary stages of the supernova (SN) progenitor star). Our suggestion implies that the ``true" age of PSR B 1509-58 could be much larger than the spin-down age, and therefore the SNR MSH 15-52 is a middle-aged remnant similar to the Vela SNR (G 263.9-3.3). We also suggest that the dense (neutral) gas of the circumstellar clump could be responsible for the enhanced neutral hydrogen absorption towards PSR B 1509-58, and that the optical emission of an optical counterpart for PSR B 1509-58 should rather be attributed to a bow shock around this pulsar than to the pulsar itself.

  17. Credit PSR. Northeast and southwest facades of Sewage Pumping Station ...

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

    Credit PSR. Northeast and southwest facades of Sewage Pumping Station (Building 4330). Building retains its World War II construction materials and character. In the background at the extreme left is Building 4305 (Unicon Portable Hangar) - Edwards Air Force Base, North Base, Sewage Pumping Station, Southwest of E Street, Boron, Kern County, CA

  18. 7. Credit PSR. Detail view looks east at Building 4306 ...

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

    7. Credit PSR. Detail view looks east at Building 4306 (Boiler House) and at the south facade of Building 4305. Ground disturbance in foreground was a pit lined with plastic film for placement of a temporary fuel tank. - Edwards Air Force Base, North Base, Unicon Portable Hangar, First & C Streets, Boron, Kern County, CA

  19. Credit PSR. This view shows the south and east facades ...

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

    Credit PSR. This view shows the south and east facades of this concrete block facility as seen when looking northwest (320°). Note the outdoor emergency shower; the roof has lightning rods installed at corners - Jet Propulsion Laboratory Edwards Facility, Oxidizer Weigh & Storage Building, Edwards Air Force Base, Boron, Kern County, CA

  20. Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review.

    PubMed

    Hall, Louise H; Johnson, Judith; Watt, Ian; Tsipa, Anastasia; O'Connor, Daryl B

    2016-01-01

    To determine whether there is an association between healthcare professionals' wellbeing and burnout, with patient safety. Systematic research review. PsychInfo (1806 to July 2015), Medline (1946 to July 2015), Embase (1947 to July 2015) and Scopus (1823 to July 2015) were searched, along with reference lists of eligible articles. Quantitative, empirical studies that included i) either a measure of wellbeing or burnout, and ii) patient safety, in healthcare staff populations. Forty-six studies were identified. Sixteen out of the 27 studies that measured wellbeing found a significant correlation between poor wellbeing and worse patient safety, with six additional studies finding an association with some but not all scales used, and one study finding a significant association but in the opposite direction to the majority of studies. Twenty-one out of the 30 studies that measured burnout found a significant association between burnout and patient safety, whilst a further four studies found an association between one or more (but not all) subscales of the burnout measures employed, and patient safety. Poor wellbeing and moderate to high levels of burnout are associated, in the majority of studies reviewed, with poor patient safety outcomes such as medical errors, however the lack of prospective studies reduces the ability to determine causality. Further prospective studies, research in primary care, conducted within the UK, and a clearer definition of healthcare staff wellbeing are needed. This review illustrates the need for healthcare organisations to consider improving employees' mental health as well as creating safer work environments when planning interventions to improve patient safety. PROSPERO registration number: CRD42015023340.

  1. Economic evaluation in patient safety: a literature review of methods.

    PubMed

    de Rezende, Bruna Alves; Or, Zeynep; Com-Ruelle, Laure; Michel, Philippe

    2012-06-01

    Patient safety practices, targeting organisational changes for improving patient safety, are implemented worldwide but their costs are rarely evaluated. This paper provides a review of the methods used in economic evaluation of such practices. International medical and economics databases were searched for peer-reviewed publications on economic evaluations of patient safety between 2000 and 2010 in English and French. This was complemented by a manual search of the reference lists of relevant papers. Grey literature was excluded. Studies were described using a standardised template and assessed independently by two researchers according to six quality criteria. 33 articles were reviewed that were representative of different patient safety domains, data types and evaluation methods. 18 estimated the economic burden of adverse events, 3 measured the costs of patient safety practices and 12 provided complete economic evaluations. Healthcare-associated infections were the most common subject of evaluation, followed by medication-related errors and all types of adverse events. Of these, 10 were selected that had adequately fulfilled one or several key quality criteria for illustration. This review shows that full cost-benefit/utility evaluations are rarely completed as they are resource intensive and often require unavailable data; some overcome these difficulties by performing stochastic modelling and by using secondary sources. Low methodological transparency can be a problem for building evidence from available economic evaluations. Investing in the economic design and reporting of studies with more emphasis on defining study perspectives, data collection and methodological choices could be helpful for strengthening our knowledge base on practices for improving patient safety.

  2. Improving Patient Safety Culture in Primary Care: A Systematic Review.

    PubMed

    Verbakel, Natasha J; Langelaan, Maaike; Verheij, Theo J M; Wagner, Cordula; Zwart, Dorien L M

    2016-09-01

    Patient safety culture, described as shared values, attitudes and behavior of staff in a health-care organization, gained attention as a subject of study as it is believed to be related to the impact of patient safety improvements. However, in primary care, it is yet unknown, which effect interventions have on the safety culture. To review literature on the use of interventions that effect patient safety culture in primary care. Searches were performed in PubMed, EMBASE, CINAHL, and PsychINFO on March 4, 2013. Terms defining safety culture were combined with terms identifying intervention and terms indicating primary care. Inclusion followed if the intervention effected patient safety culture, and effect measures were reported. The search yielded 214 articles from which two were eligible for inclusion. Both studies were heterogeneous in their interventions and outcome; we present a qualitative summary. One study described the implementation of an electronic medical record system in general practices as part of patient safety improvements. The other study facilitated 2 workshops for general practices, one on risk management and another on significant event audit. Results showed signs of improvement, but the level of evidence was low because of the design and methodological problems. These studies in general practice provide a first understanding of improvement strategies and their effect in primary care. As the level of evidence was low, no clear preference can be determined. Further research is needed to help practices make an informed choice for an intervention.

  3. [Patient safety in home care - A review of international recommendations].

    PubMed

    Czakert, Judith; Lehmann, Yvonne; Ewers, Michael

    2018-06-08

    In recent years there has been a growing trend towards nursing care at home in general as well as towards intensive home care being provided by specialized home care services in Germany. However, resulting challenges for patient safety have rarely been considered. Against this background we aimed to explore whether international recommendations for patient safety in home care in general and in intensive home care in particular already exist and how they can stimulate further practice development in Germany. A review of online English documents containing recommendations for patient safety in intensive home care was conducted. Available documents were analyzed and compared in terms of their form and content. Overall, a small number of relevant documents could be identified. None of these documents exclusively refer to the intensive home care sector. Despite their differences, however, the analysis of four selected documents showed similarities, e. g., regarding specific topics of patient safety (communication, involvement of patients and their relatives, risk assessment, medication management, qualification). Furthermore, strengths and weaknesses of the documents became apparent: e. g., an explicit understanding of patient safety, a literature-based introduction to safety topics or an adaptation of the recommendations to the specific features of home care were occasionally lacking. This document analysis provides interesting input to the formal and content-related development of specific recommendations and to practice development in Germany to improve patient safety in home care. Copyright © 2018. Published by Elsevier GmbH.

  4. Safety analysis and review system (SARS) assessment report

    SciTech Connect

    Browne, E.T.

    1981-03-01

    Under DOE Order 5481.1, Safety Analysis and Review System for DOE Operations, safety analyses are required for DOE projects in order to ensure that: (1) potential hazards are systematically identified; (2) potential impacts are analyzed; (3) reasonable measures have been taken to eliminate, control, or mitigate the hazards; and (4) there is documented management authorization of the DOE operation based on an objective assessment of the adequacy of the safety analysis. This report is intended to provide the DOE Office of Plans and Technology Assessment (OPTA) with an independent evaluation of the adequacy of the ongoing safety analysis effort. Asmore » part of this effort, a number of site visits and interviews were conducted, and FE SARS documents were reviewed. The latter included SARS Implementation Plans for a number of FE field offices, as well as safety analysis reports completed for certain FE operations. This report summarizes SARS related efforts at the DOE field offices visited and evaluates the extent to which they fulfill the requirements of DOE 5481.1.« less

  5. A Review of Recent Advances in Perioperative Patient Safety.

    PubMed

    Fowler, Alexander J

    2013-01-01

    Major complications in surgery affect up to 16% of surgical procedures. Over the past 50 years, many patient safety initiatives have attempted to reduce such complications. Since the formation of the National Patient Safety Agency in 2001, there have been major advances in patient safety. Most recently, the production and implementation of the Surgical Safety Checklist by the World Health Organisation (WHO), a checklist ensuring that certain 'never events' (wrong-site surgery, wrong operation etc.) do not occur, irrespective of healthcare allowance. In this review, a summary of recent advances in patient safety are considered - including improvements in communication, understanding of human factors that cause mistakes, and strategies developed to minimise these. Additionally, the synthesis of best medical practice and harm minimisation is examined, with particular emphasis on communication and appreciation of human factors in the operating theatre. This is based on the resource management systems developed in other high risk industries (e.g. nuclear), and has also been adopted for other high risk medical areas. The WHO global movement to reduce surgical mortality has been highly successful, especially in the healthcare systems of developing nations where mortality reductions of up to 50% have been observed, and reductions in patient complications of 4%. Incident reporting has long been a key component of patient safety and continues to be so; allowing reflection and improved guideline formation. All patients are placed at risk in the surgical environment. It is crucial that this risk is minimised, whilst optimising the patient's outcome. In this review, recent advances in perioperative patient safety are examined and placed in context.

  6. Effect of electronic device use on pedestrian safety : a literature review.

    DOT National Transportation Integrated Search

    2016-04-01

    This literature review on the effect of electronic device use on pedestrian safety is part of a research project sponsored by the Office of Behavioral Safety Research in the National Highway Traffic Safety Administration (NHTSA). An extensive literat...

  7. Patient Safety Learning Systems: A Systematic Review and Qualitative Synthesis.

    PubMed

    2017-01-01

    A patient safety learning system (sometimes called a critical incident reporting system) refers to structured reporting, collation, and analysis of critical incidents. To inform a provincial working group's recommendations for an Ontario Patient Safety Event Learning System, a systematic review was undertaken to determine design features that would optimize its adoption into the health care system and would inform implementation strategies. The objective of this review was to address two research questions: (a) what are the barriers to and facilitators of successful adoption of a patient safety learning system reported by health professionals and (b) what design components maximize successful adoption and implementation? To answer the first question, we used a published systematic review. To answer the second question, we used scoping study methodology. Common barriers reported in the literature by health care professionals included fear of blame, legal penalties, the perception that incident reporting does not improve patient safety, lack of organizational support, inadequate feedback, lack of knowledge about incident reporting systems, and lack of understanding about what constitutes an error. Common facilitators included a non-accusatory environment, the perception that incident reporting improves safety, clarification of the route of reporting and of how the system uses reports, enhanced feedback, role models (such as managers) using and promoting reporting, legislated protection of those who report, ability to report anonymously, education and training opportunities, and clear guidelines on what to report. Components of a patient safety learning system that increased successful adoption and implementation were emphasis on a blame-free culture that encourages reporting and learning, clear guidelines on how and what to report, making sure the system is user-friendly, organizational development support for data analysis to generate meaningful learning outcomes

  8. A Review of Research on Driving Styles and Road Safety.

    PubMed

    Sagberg, Fridulv; Selpi; Piccinini, Giulio Francesco Bianchi; Engström, Johan

    2015-11-01

    The aim of this study was to outline a conceptual framework for understanding driving style and, on this basis, review the state-of-the-art research on driving styles in relation to road safety. Previous research has indicated a relationship between the driving styles adopted by drivers and their crash involvement. However, a comprehensive literature review of driving style research is lacking. A systematic literature search was conducted, including empirical, theoretical, and methodological research, on driving styles related to road safety. A conceptual framework was proposed whereby driving styles are viewed in terms of driving habits established as a result of individual dispositions as well as social norms and cultural values. Moreover, a general scheme for categorizing and operationalizing driving styles was suggested. On this basis, existing literature on driving styles and indicators was reviewed. Links between driving styles and road safety were identified and individual and sociocultural factors influencing driving style were reviewed. Existing studies have addressed a wide variety of driving styles, and there is an acute need for a unifying conceptual framework in order to synthesize these results and make useful generalizations. There is a considerable potential for increasing road safety by means of behavior modification. Naturalistic driving observations represent particularly promising approaches to future research on driving styles. Knowledge about driving styles can be applied in programs for modifying driver behavior and in the context of usage-based insurance. It may also be used as a means for driver identification and for the development of driver assistance systems. © 2015, Human Factors and Ergonomics Society.

  9. A Review of General Aviation Safety (1984-2017).

    PubMed

    Boyd, Douglas D

    2017-07-01

    General aviation includes all civilian aviation apart from operations involving paid passenger transport. Unfortunately, this category of aviation holds a lackluster safety record, accounting for 94% of civil aviation fatalities. In 2014, of 1143 general aviation accidents, 20% were fatal compared with 0 of 29 airline mishaps in the United States. Herein, research findings over the past 30 yr will be reviewed. Accident risk factors (e.g., adverse weather, geographical region, post-impact fire, gender differences) will be discussed. The review will also summarize the development and implementation of stringent crashworthiness designs with multi-axis dynamic testing and head-injury protection and its impact on mitigating occupant injury severity. The benefits and drawbacks of new technology and human factor considerations associated with increased general aviation automation will be debated. Data on the safety of the aging general aviation population and increased drug usage will also be described. Finally, areas in which general aviation occupant survival could be improved and injury severity mitigated will be discussed with the view of equipping aircraft with 1) crash-resistant fuel tanks to reduce post-impact conflagration; 2) after-market ballistic parachutes for older aircraft; and 3) current generation electronic locator beacons to hasten site access by first responders.Boyd DD. A review of general aviation safety (1984-2017). Aerosp Med Hum Perform. 2017; 88(7):657-664.

  10. Safety of ceftriaxone in paediatrics: a systematic review protocol.

    PubMed

    Zeng, Linan; Choonara, Imti; Zhang, Lingli; Xue, Song; Chen, Zhe; He, Miaomiao

    2017-08-21

    Ceftriaxone is widely used in children in the treatment of sepsis. However, concerns have been raised about the safety of ceftriaxone, especially in young children. The aim of this review is to systematically evaluate the safety of ceftriaxone in children of all age groups. MEDLINE, PubMed, Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, International Pharmaceutical Abstracts and adverse drug reaction (ADR) monitoring systems will be systematically searched for randomised controlled trials (RCTs), cohort studies, case-control studies, cross-sectional studies, case series and case reports evaluating the safety of ceftriaxone in children. The Cochrane risk of bias tool, Newcastle-Ottawa and quality assessment tools developed by the National Institutes of Health will be used for quality assessment. Meta-analysis of the incidence of ADRs from RCTs and prospective studies will be done. Subgroup analyses will be performed for age and dosage regimen. Formal ethical approval is not required as no primary data are collected. This systematic review will be disseminated through a peer-reviewed publication and at conference meetings. CRD42017055428. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Interstellar scintillation observations for PSR B0355+54

    NASA Astrophysics Data System (ADS)

    Xu, Y. H.; Lee, K. J.; Hao, L. F.; Wang, H. G.; Liu, Z. Y.; Yue, Y. L.; Yuan, J. P.; Li, Z. X.; Wang, M.; Dong, J.; Tan, J. J.; Chen, W.; Bai, J. M.

    2018-06-01

    In this paper, we report our investigation of pulsar scintillation phenomena by monitoring PSR B0355+54 at 2.25 GHz for three successive months using the Kunming 40-m radio telescope. We measured the dynamic spectrum, the two-dimensional correlation function and the secondary spectrum. These observations have a high signal-to-noise ratio (S/N ≥ 100). We detected scintillation arcs, which are rarely observable using such a small telescope. The sub-microsecond scale width of the scintillation arc indicates that the transverse scale of the structures on the scattering screen is as compact as astronomical unit size. Our monitoring shows that the scintillation bandwidth, the time-scale and the arc curvature of PSR B0355+54 were varying temporally. A plausible explanation would need to invoke a multiple-scattering-screen or multiple-scattering-structure scenario, in which different screens or ray paths dominate the scintillation process at different epochs.

  12. Observations of a fast transverse instability in the PSR

    NASA Astrophysics Data System (ADS)

    Neuffer, D.; Colton, E.; Fitzgerald, D.; Hardek, T.; Hutson, R.; Macek, R.; Plum, M.; Thiessen, H.; Wang, T.-S.

    1992-09-01

    A fast instability with beam loss is observed in the Los Alamos Proton Storage Ring (PSR) when the injected beam current exceeds a threshold value, with both bunched and unbunched beams. Large coherent transverse oscillations occur prior to and during beam loss. The threshold depends strongly on rf voltage, beam-pulse shape, beam size, nonlinear fields, and beam environmental. Results of recent observations of the instability are reported; possible causes of the instability are discussed. Recent measurements and calculations indicate that the instability is an "e-p"-type instability, driven by coupled oscillations with electrons trapped within the proton beam. Future experiments toward further understanding of the instability are discussed, and methods of increasing PSR beam storage are suggested.

  13. 29 CFR 2200.108 - Official Seal of the Occupational Safety and Health Review Commission.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Official Seal of the Occupational Safety and Health Review... Occupational Safety and Health Review Commission. The seal of the Commission shall consist of: A gold eagle... background, encircled by a white band edged in black and inscribed “Occupational Safety and Health Review...

  14. 29 CFR 2200.108 - Official Seal of the Occupational Safety and Health Review Commission.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Official Seal of the Occupational Safety and Health Review... Occupational Safety and Health Review Commission. The seal of the Commission shall consist of: A gold eagle... background, encircled by a white band edged in black and inscribed “Occupational Safety and Health Review...

  15. 29 CFR 2200.108 - Official Seal of the Occupational Safety and Health Review Commission.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Official Seal of the Occupational Safety and Health Review... Occupational Safety and Health Review Commission. The seal of the Commission shall consist of: A gold eagle... background, encircled by a white band edged in black and inscribed “Occupational Safety and Health Review...

  16. 9. Credit PSR. Interior of Building 4305, looking east under ...

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

    9. Credit PSR. Interior of Building 4305, looking east under elliptical laminated wooden roof arches. Lower surfaces are ceilings of offices built within structure by the National Aeronautics and Space Adminstration (NASA) in 1977; cylindrical and rectangular ducts are for air conditioning. Suspended lighting fixtures date from building's original use as an aircraft hangar. - Edwards Air Force Base, North Base, Unicon Portable Hangar, First & C Streets, Boron, Kern County, CA

  17. 1. Credit PSR. View looks north from aircraft apron at ...

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

    1. Credit PSR. View looks north from aircraft apron at south and east facades of the first hangar built at North Base in 1942. Note Building 4306 attached to hangar in distance; this structure is the boiler house to heat hangar during winters. Cable reels in foreground are from fiber optic and electrical cable installations ongoing at Edwards Air Force Base. - Edwards Air Force Base, North Base, Unicon Portable Hangar, First & C Streets, Boron, Kern County, CA

  18. Credit PSR. This photograph displays the south and east facades ...

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

    Credit PSR. This photograph displays the south and east facades of the storage facility as seen when looking to the west northwest (288°). The concrete pit in the foreground is a catch basin designed to hold run-off from spilled oxidizers or clean-up operations, thus preventing them from contaminating the soil - Jet Propulsion Laboratory Edwards Facility, Solid Oxidizer Storage, Edwards Air Force Base, Boron, Kern County, CA

  19. Credit PSR. This interior view shows the vacuum tumble dryer. ...

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

    Credit PSR. This interior view shows the vacuum tumble dryer. The tumble dryer is lined with a water jacket to maintain temperature during the drying of ammonium perchlorate ("AP"); water enters and exits the dryer jacket through the pipe fittings along the horizontal center line of the dryer. The wall at the right is constructed to blow out in the event of an explosion - Jet Propulsion Laboratory Edwards Facility, Oxidizer Dryer Building, Edwards Air Force Base, Boron, Kern County, CA

  20. Recent Timing Results for PSR B1259 - 63

    NASA Astrophysics Data System (ADS)

    Wex, N.; Johnston, S.

    The binary pulsar PSR B1259 - 63 is in a highly eccentric 3.4 yr orbit around the Be star SS 2883. Timing observations of this pulsar, made over a 7 yr period using the Parkes 64 m radio-telescope, cover two periastron passages, in 1990 August and 1994 January. The timing observations of PSR B1259 - 63 clearly show evidence for timing noise which is domina ted by a cubic term. Unfortunately, the large amplitude timing noise and data over only two complete orbits make it difficult to produce a unique timing solution for this pulsar. However, if the long term behavior of timing noise is completely modeled by a cubic term, both dot ω and dot x terms are required in the timing model which could be a result of a precessing orbit caused by the quadrupole moment of the tilted companion star. In this paper we summarise the timing observations for the PSR B1259 - 63 system; full details are given in Wex et al. (1997).

  1. Review article: practical current issues in perioperative patient safety.

    PubMed

    Eichhorn, John H

    2013-02-01

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

  2. [A systematic review of the effectiveness of workplace safety interventions].

    PubMed

    Baldasseroni, A; Olimpi, Nadia; Bonaccorsi, G

    2009-01-01

    The authors carried out a systematic review of the effectiveness of workplace safety interventions, as a part of a wider project funded by CCM, Centre for Disease Control. Several electronic bibliographic databases were checked, using a standardized string selection. The string contained the following four items: the intervention; job features; type of injury; efficacy/effectiveness. Of the various databases consulted, Web of Science was the most efficient. Overall 5531 articles were selected. After reading the title and abstract, 4695 were excluded and eventually 35 systematic reviews were selected, which synthesized 769 original articles. The main topics of the selected systematic reviews were: certain sectors (building industry, agriculture, health care); personal protective equipment; work organization and prevention management at plant level; evaluation of prevention policies by national and regional authorities. A clear need for multiple bibliographical data-base search emerged at the end of this study.

  3. The safety of bone allografts used in dentistry: a review.

    PubMed

    Holtzclaw, Dan; Toscano, Nicholas; Eisenlohr, Lisa; Callan, Don

    2008-09-01

    Recent media reports concerning "stolen body parts" have shaken the public's trust in the safety of and the use of ethical practices involving human allografts. The authors provide a comprehensive review of the safety aspects of human bone allografts. The authors reviewed U.S. government regulations, industry standards, independent industry association guidelines, company guidelines and scientific articles related to the use of human bone allografts in the practice of dentistry published in the English language. The use of human bone allografts in the practice of dentistry involves the steps of procurement, processing, use and tracking. Rigorous donor screening and aseptic proprietary processing programs have rendered the use of human bone allografts safe and effective as a treatment option. When purchasing human bone allografts for the practice of dentistry, one should choose products accredited by the American Association of Tissue Banks for meeting uniformly high safety and quality control measures. Knowledge of human bone allograft procurement, processing, use and tracking procedures may allow dental clinicians to better educate their patients and address concerns about this valuable treatment option.

  4. Phenomenological studies on sodium for CSP applications: A safety review

    NASA Astrophysics Data System (ADS)

    Armijo, Kenneth M.; Andraka, Charles E.

    2016-05-01

    Sodium Heat transfer fluids (HTF) such as sodium, can achieve temperatures above 700°C to obtain power cycle performance improvements for reducing large infrastructure costs of high-temperature systems. Current concentrating solar power (CSP) sensible HTF's (e.g. air, salts) have poor thermal conductivity, and thus low heat transfer capabilities, requiring a large receiver. The high thermal conductivity of sodium has demonstrated high heat transfer rates on dish and towers systems, which allow a reduction in receiver area by a factor of two to four, reducing re-radiation and convection losses and cost by a similar factor. Sodium produces saturated vapor at pressures suitable for transport starting at 600°C and reaches one atmosphere at 870°C, providing a wide range of suitable operating conditions that match proposed high temperature, isothermal power cycles. This advantage could increase the efficiency while lowering the cost of CSP tower systems. Although there are a number of desirable thermal performance advantages associated with sensible sodium, its propensity to rapidly oxidize presents safety challenges. This investigation presents a literature review that captures historical operations/handling lessons for advanced sodium receiver designs, and the current state-of-knowledge related to sodium combustion behavior. Technical and operational solutions addressing sodium safety and applications in CSP will be discussed, including unique safety hazards and advantages using latent sodium. Lessons obtained from the nuclear industry with sensible and latent systems will also be discussed in the context of safety challenges and risk mitigation solutions.

  5. SRTC criticality safety technical review: Nuclear Criticality Safety Evaluation 93-04 enriched uranium receipt

    SciTech Connect

    Rathbun, R.

    Review of NMP-NCS-930087, {open_quotes}Nuclear Criticality Safety Evaluation 93-04 Enriched Uranium Receipt (U), July 30, 1993, {close_quotes} was requested of SRTC (Savannah River Technology Center) Applied Physics Group. The NCSE is a criticality assessment to determine the mass limit for Engineered Low Level Trench (ELLT) waste uranium burial. The intent is to bury uranium in pits that would be separated by a specified amount of undisturbed soil. The scope of the technical review, documented in this report, consisted of (1) an independent check of the methods and models employed, (2) independent HRXN/KENO-V.a calculations of alternate configurations, (3) application of ANSI/ANS 8.1,more » and (4) verification of WSRC Nuclear Criticality Safety Manual procedures. The NCSE under review concludes that a 500 gram limit per burial position is acceptable to ensure the burial site remains in a critically safe configuration for all normal and single credible abnormal conditions. This reviewer agrees with that conclusion.« less

  6. Findings of a review of spacecraft fire safety needs

    NASA Technical Reports Server (NTRS)

    Apostolakis, G. E.; Catton, I.; Paulos, T.; Paxton, K.; Jones, S.

    1992-01-01

    Discussions from a workshop to guide UCLA and NASA investigators on the state of knowledge and perceived needs in spacecraft fire safety and its risk management are reviewed, for an introduction to an analytical and experimental project in this field. The report summarizes the workshop discussions and includes the visual aids used in the presentations. Probabilistic Safety Assessment (PSA) methods, which are currently not used, would be of great value to the designs and operation of future human-crew spacecraft. Key points in the discussions were the importance of understanding and testing smoldering as a likely fire scenario in space and the need for smoke damage modeling, since many fire-risk models ignore this mechanism and consider only heat damage.

  7. Biological Effects and Safety in Magnetic Resonance Imaging: A Review

    PubMed Central

    Hartwig, Valentina; Giovannetti, Giulio; Vanello, Nicola; Lombardi, Massimo; Landini, Luigi; Simi, Silvana

    2009-01-01

    Since the introduction of Magnetic Resonance Imaging (MRI) as a diagnostic technique, the number of people exposed to electromagnetic fields (EMF) has increased dramatically. In this review, based on the results of a pioneer study showing in vitro and in vivo genotoxic effects of MRI scans, we report an updated survey about the effects of non-ionizing EMF employed in MRI, relevant for patients’ and workers’ safety. While the whole data does not confirm a risk hypothesis, it suggests a need for further studies and prudent use in order to avoid unnecessary examinations, according to the precautionary principle. PMID:19578460

  8. Safety focused modeling of lithium-ion batteries: A review

    NASA Astrophysics Data System (ADS)

    Abada, S.; Marlair, G.; Lecocq, A.; Petit, M.; Sauvant-Moynot, V.; Huet, F.

    2016-02-01

    Safety issues pertaining to Li-ion batteries justify intensive testing all along their value chain. However, progress in scientific knowledge regarding lithium based battery failure modes, as well as remarkable technologic breakthroughs in computing science, now allow for development and use of prediction tools to assist designers in developing safer batteries. Subsequently, this paper offers a review of significant modeling works performed in the area with a focus on the characterization of the thermal runaway hazard and their relating triggering events. Progress made in models aiming at integrating battery ageing effect and related physics is also discussed, as well as the strong interaction with modeling-focused use of testing, and the main achievements obtained towards marketing safer systems. Current limitations and new challenges or opportunities that are expected to shape future modeling activity are also put in perspective. According to market trends, it is anticipated that safety may still act as a restraint in the search for acceptable compromise with overall performance and cost of lithium-ion based and post lithium-ion rechargeable batteries of the future. In that context, high-throughput prediction tools capable of screening adequate new components properties allowing access to both functional and safety related aspects are highly desirable.

  9. Integrated Approaches to Occupational Health and Safety: A Systematic Review.

    PubMed

    Cooklin, A; Joss, N; Husser, E; Oldenburg, B

    2017-09-01

    The study objective was to conduct a systematic review of the effectiveness of integrated workplace interventions that combine health promotion with occupational health and safety. Electronic databases (n = 8), including PsychInfo and MEDLINE, were systematically searched. Studies included were those that reported on workplace interventions that met the consensus definition of an "integrated approach," published in English, in the scientific literature since 1990. Data extracted were occupation, worksite, country, sample size, intervention targets, follow-up period, and results reported. Quality was assessed according to American College of Occupational and Environmental Medicine Practice Guidelines. Heterogeneity precluded formal meta-analyses. Results were classified according to the outcome(s) assessed into five categories (health promotion, injury prevention, occupational health and safety management, psychosocial, and return-on-investment). Narrative synthesis of outcomes was performed. A total of 31 eligible studies were identified; 23 (74%) were (quasi-)experimental trials. Effective interventions were most of those aimed at improving employee physical or mental health. Less consistent results were reported from integrated interventions targeting occupational health and safety management, injury prevention, or organizational cost savings. Integrated approaches have been posed as comprehensive solutions to complex issues. Empirical evidence, while still emerging, provides some support for this. Continuing investment in, and evaluation of, integrated approaches are worthwhile.

  10. 14 CFR 414.19 - Technical criteria for reviewing a safety approval application.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...-developed criteria must define— (i) Design and minimum performance; (ii) Quality assurance system... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Technical criteria for reviewing a safety... AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION LICENSING SAFETY APPROVALS Safety Approval Review and...

  11. Lessons learned from the Galileo and Ulysses flight safety review experience

    SciTech Connect

    Bennett, Gary L.

    In preparation for the launches of the Galileo and Ulysses spacecraft, a very comprehensive aerospace nuclear safety program and flight safety review were conducted. A review of this work has highlighted a number of important lessons which should be considered in the safety analysis and review of future space nuclear systems. These lessons have been grouped into six general categories: (1) establishment of the purpose, objectives and scope of the safety process; (2) establishment of charters defining the roles of the various participants; (3) provision of adequate resources; (4) provision of timely peer-reviewed information to support the safety program; (5)more » establishment of general ground rules for the safety review; and (6) agreement on the kinds of information to be provided from the safety review process.« less

  12. Phenomenological Studies on Sodium for CSP Applications: A Safety Review

    SciTech Connect

    Armijo, Kenneth Miguel; Andraka, Charles E.

    Sodium as a heat transfer fluid (HTF) can achieve temperatures above 700°C to improve power cycle performance for reducing large infrastructure costs of high-temperature systems. Current concentrating solar power (CSP) sensible HTF’s (e.g. air, salts) have poor thermal conductivity, and thus low heat transfer capabilities, requiring a large receiver. The high thermal conductivity of sodium has demonstrated high heat transfer rates on dish and towers systems, which allow a reduction in receiver area by a factor of two to four, reducing re-radiation and convection losses and cost by a similar factor. Sodium produces saturated vapor at pressures suitable for transportmore » starting at 600°C and reaches one atmosphere at 870°C, providing a wide range of suitable latent operating conditions that match proposed high temperature, isothermal input power cycles. This advantage could increase the receiver and system efficiency while lowering the cost of CSP tower systems. Although there are a number of desirable thermal performance advantages associated with sodium, its propensity to rapidly oxidize presents safety challenges. This investigation presents a literature review that captures historical operations/handling lessons for advanced sodium systems, and the current state-of-knowledge related to sodium combustion behavior. Technical and operational solutions addressing sodium safety and applications in CSP will be discussed, including unique safety hazards and advantages using latent sodium. Operation and maintenance experience from the nuclear industry with sensible and latent systems will also be discussed in the context of safety challenges and risk mitigation solutions.« less

  13. Safety and risks of nitrous oxide labor analgesia: a review.

    PubMed

    Rooks, Judith P

    2011-01-01

    This review of the safety and risks of nitrous oxide (N(2) O) labor analgesia presents results of a search for evidence of its effects on labor, the mother, the fetus, the neonate, breastfeeding, and maternal-infant bonding. Concerns about apoptotic damage to the brains of immature mammals exposed to high doses of N(2) O during late gestation, possible cardiovascular risks from hyperhomocysteinemia caused by N(2) O, a hypothesis that children exposed to N(2) O during birth are more likely to become addicted to amphetamine drugs as adults, and possible occupational risks for those who provide care to women using N(2) O/O(2) labor analgesia are discussed in detail. Research relevant to the 4 special concerns and to the effects of N(2) O analgesia on labor and the mother-child dyad were examined in depth. Three recent reviews of the biologic, toxicologic, anesthetic, analgesic, and anxiolytic effects of N(2) O; 3 reviews of the safety of 50% N(2) O/oxygen (O(2) ) in providing analgesia in a variety of health care settings; and a 2002 systematic review of N(2) O/O(2) labor analgesia were used. Nitrous oxide analgesia is safe for mothers, neonates, and those who care for women during childbirth if the N(2) O is delivered as a 50% blend with O(2) , is self-administered, and good occupational hygiene is practiced. Because of the strong correlation between dose and harm from exposure to N(2) O, concerns based on effects of long exposure to high anesthetic-level doses of N(2) O have only tenuous, hypothetical pertinence to the safety of N(2) O/O(2) labor analgesia. Nitrous oxide labor analgesia is safe for the mother, fetus, and neonate and can be made safe for caregivers. It is simple to administer, does not interfere with the release and function of endogenous oxytocin, and has no adverse effects on the normal physiology and progress of labor. © 2011 by the American College of Nurse-Midwives.

  14. Credit PSR. Photograph displays the west and south elevations as ...

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

    Credit PSR. Photograph displays the west and south elevations as seen when looking east northeast (56°). The small doors at the left lead to the building equipment room which houses heating and cooling equipment (part of which is visible outdoors along adjacent exterior wall). High double doors lead to the dryer room; a 1-ton hoist is used to move heavy containers and dryer trays within the building. Note the lightning rods on roof corners - Jet Propulsion Laboratory Edwards Facility, Oxidizer Dryer Building, Edwards Air Force Base, Boron, Kern County, CA

  15. Credit PSR. This view shows southeast and southwest facades as ...

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

    Credit PSR. This view shows southeast and southwest facades as seen when looking east northeast (70°). This steel frame building is clad in "Transite" board (fire- resistant, pressed asbestos composition board). This structure was built as a back-up to Building 4237/E-38, but no equipment was ever installed. It was equipped instead to conduct tensile tests on propellant samples. In 1984, it was converted into a back-up structure supporting Building 4283/E-84, Propellant Processing Building. Small amounts of HMX propellants were processed and dried here - Jet Propulsion Laboratory Edwards Facility, Oxidizer Dryer Blender Building, Edwards Air Force Base, Boron, Kern County, CA

  16. 1. Credit PSR. This view displays the north and west ...

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

    1. Credit PSR. This view displays the north and west facades of Test Stand "G" (Vibration Facility) as seen when looking east southeast (110°). Test Stand "G" no longer houses the vibrator; it now houses an autoclave due to the changing nature of the testing work. The Vibration Facility was Test Stand "G"'s historic function. Test Stand "E" is at the far right. The Vibration Facility subjected motor and engine assemblies to various vibration patterns in order to simulate flight conditions and evaluate the durability of engine and motor designs. - Jet Propulsion Laboratory Edwards Facility, Test Stand G, Edwards Air Force Base, Boron, Kern County, CA

  17. Credit PSR. This view shows the west and north facades ...

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

    Credit PSR. This view shows the west and north facades of the storage facility as seen when approaching from Circle Drive, looking east (92°). The metal shed at right was the original structure; the second shed is a later addition. All structures are metal frame covered with metal cladding, grounding them electrically and rendering them fireproof. The entire facility was rated for a maximum of 100,000 pounds (45,450 Kg) of class 1.3 materials, and four personnel - Jet Propulsion Laboratory Edwards Facility, Solid Oxidizer Storage, Edwards Air Force Base, Boron, Kern County, CA

  18. Credit PSR. This image depicts the southwest and southeast facades ...

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

    Credit PSR. This image depicts the southwest and southeast facades as seen when looking north. The concrete block lean-to in the foreground is the facility control room. Between this room and the X-ray room is a four foot thick concrete wall (which can be seen as a "step" between the lowest and highest roof planes) intended as X-ray shielding for operators. The X-ray chamber faces away from the JPL Edwards Facility toward a fenced desert area - Jet Propulsion Laboratory Edwards Facility, Radiographic Inspection Building, Edwards Air Force Base, Boron, Kern County, CA

  19. Credit PSR. This view of the interior of the weighing ...

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

    Credit PSR. This view of the interior of the weighing facility looks through the open double doors on the south side. A Toledo scale, rated at 3,000 pounds (1,363 Kg), is installed in the center of the floor; the smaller scale in the corner is rated for 200 pounds (91 Kg). The wall-mounted recording device records quantities weighed and serves as a record displaying that substances were in fact weighed. Note the explosion-proof fluorescent lighting above, and the 0.5 ton hoist - Jet Propulsion Laboratory Edwards Facility, Oxidizer Weigh & Storage Building, Edwards Air Force Base, Boron, Kern County, CA

  20. Recent study of beam stability in the PSR

    NASA Astrophysics Data System (ADS)

    Wang, T. S. F.; Cooper, R.; Fitzgerald, D.; Frankle, S.; Hardek, T.; Hutson, R.; Macek, R.; Ohmori, C.; Plum, M.; Thiessen, H.

    1993-05-01

    A fast transverse instability with beam loss has been observed in the 800 MeV Los Alamos Pro Ring (PSR) when the injected beam intensity reaches 2 - 4(10)(exp 13) protons per pulse. Previous observations indicate that the instability is most likely driven by electrons trapped within the proton beam. Theoretical study shown that beam leakage into the inter-bunch gap leads to electron trapping. Recent experiments were carried out by using the newly implemented 'pinger' and by varying the machine transition gamma to explore further the 'e-p' instability and the nature of the instability. This paper summarizes some of these recent experimental results and theoretical studies.

  1. Credit PSR. This view shows the east and north facades ...

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

    Credit PSR. This view shows the east and north facades of the storage facility as seen when looking south southwest. This fireproof all-metal structure was rated for a maximum of 50,000 pounds (22,730 Kg) of class 1.4 materials and four personnel. The concrete catch basin at left was designed to retain any spilled chemicals, preventing them from contaminating the soil. Spills were collected from the building and apron via a concrete lined gutter - Jet Propulsion Laboratory Edwards Facility, Solid Fuel Storage Building, Edwards Air Force Base, Boron, Kern County, CA

  2. Predicting the Starquakes in PSR J0537-6910

    NASA Technical Reports Server (NTRS)

    Middleditch, J.; Marshall, F. E.; Wang, Q. D.; Gotthelf, E. V.; Zhang, W.

    2007-01-01

    We report the results of more than seven years of monitoring of PSR J0537-6910, the 16 ms pulsar in the Large Magellanic Cloud, using data acquired with the Rossi X-ray Timing Explorer. During this campaign the pulsar experienced 22 sudden increases in frequency ("glitches" - 21 with increases of at least eight microHz) amounting to a total gain of over six parts per million of rotation frequency superposed on its gradual spindown of nu-dot = -2 x 10(exp -l0) Hz /s. The time interval from one glitch to the next obeys a strong linear correlation to the amplitude of the first glitch, with a mean slope of about 400 days per part per million (6.5 days per micro Hz), such that these intervals can be predicted to within a few days, an accuracy which has never before been seen in any other pulsar. There appears to be an upper limit of approximately 40 micro Hz for the size of glitches in all pulsars, with the 1999 April glitch of PSR J0537-6910 as the largest so far. The change of its spindown across the glitches, delta (nu-dot), appears to have the same hard lower limit of -1.5 x 10 (exp -13) Hz/s, as, again, that observed in all other pulsars. The spindown continues to increase in the long term, nu-dot = -10(exp -21) Hz / s(exp 2), and thus the timing age of PSR 505374910 (-0.5 nu nu-dot (exp -1) continues to decrease at a rate of nearly one year every year, consistent with movement of its magnetic moment away from its rotational axis by one radian every 10,000 years, or about one meter per year. PSR J0537-6910 was likely to have been born as a nearly-aligned rotator spinning at 75-80 Hz, with a absolute value of nu considerably smaller than its current value of 2x 10(exp -10) Hz per second. Its pulse profile consists of a single pulse which is found to be flat at its peak for at least 0.02 cycles. Glitch activity may grow exponentially with a timescale of 170 years nu nu-dot ((nu nu-dot)(sub crab))exp -l in all young pulsars.

  3. Credit PSR. The interior of the grinder room appears as ...

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

    Credit PSR. The interior of the grinder room appears as seen looking southeast (148°), showing the remaining grinder equipment in the building. Note the blow-out wall in the background, and the water sprinkler head positioned over the hopper. The hopper top is connected to the dust receiver in the adjacent room. The blow-out wall is constructed to relieve pressure easily should an explosion occur, thus minimizing damage to the rest of the building structure. The floor has a conductive coating which dissipates static electrical charges that might otherwise cause fires - Jet Propulsion Laboratory Edwards Facility, Oxidizer Grinder Building, Edwards Air Force Base, Boron, Kern County, CA

  4. Credit PSR. This view shows the southeast and northeast facades ...

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

    Credit PSR. This view shows the southeast and northeast facades of building as seen when looking west (264°). The open double doors reveal the curing room, which was kept at ambient temperatures. A maximum of 10,000 pounds (4,545 Kg) of class 1.1 propellants were permitted in this room, along with a maximum of 4 people. A separate room at the west end of the building housed temperature control equipment. Note the lightning rods on roof corners - Jet Propulsion Laboratory Edwards Facility, Solid Propellant Conditioning Building, Edwards Air Force Base, Boron, Kern County, CA

  5. Statewide traffic safety study phase I : review of current traffic safety research, practice, analytical procedures and databases.

    DOT National Transportation Integrated Search

    2005-05-01

    This report synthesized the research findings of Phase I of the Statewide Traffic Safety Study of Louisiana, sponsored by the Louisiana Department of Transportation and Development. The objective of Phase I was to provide a comprehensive review of th...

  6. 29 CFR 2200.108 - Official Seal of the Occupational Safety and Health Review Commission.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Official Seal of the Occupational Safety and Health Review... HEALTH REVIEW COMMISSION RULES OF PROCEDURE Miscellaneous Provisions § 2200.108 Official Seal of the Occupational Safety and Health Review Commission. The seal of the Commission shall consist of: A gold eagle...

  7. 29 CFR 2200.108 - Official Seal of the Occupational Safety and Health Review Commission.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Official Seal of the Occupational Safety and Health Review... HEALTH REVIEW COMMISSION RULES OF PROCEDURE Miscellaneous Provisions § 2200.108 Official Seal of the Occupational Safety and Health Review Commission. The seal of the Commission shall consist of: A gold eagle...

  8. Cinnamaldehyde in diabetes: A review of pharmacology, pharmacokinetics and safety.

    PubMed

    Zhu, Ruyuan; Liu, Haixia; Liu, Chenyue; Wang, Lili; Ma, Rufeng; Chen, Beibei; Li, Lin; Niu, Jianzhao; Fu, Min; Zhang, Dongwei; Gao, Sihua

    2017-08-01

    Cinnamaldehyde, one of the active components derived from Cinnamon, has been used as a natural flavorant and fragrance agent in kitchen and industry. Emerging studies have been performed over the past decades to evaluate its beneficial role in management of diabetes and its complications. This review highlights recent advances of cinnamaldehyde in its glucolipid lowering effects, its pharmacokinetics, and its safety by consulting the Pubmed, China Knowledge Resource Integrated, China Science and Technology Journal, National Science and Technology Library, Wanfang Data, and the Web of Science Databases. For the inquiries, keywords such as Cinnamon, cinnamaldehyde, property, synthesis, diabetes, obesity, pharmacokinetics, and safety were used in various combinations. Accumulating evidence supports the notion that cinnamaldehyde exhibits glucolipid lowering effects in diabetic animals by increasing glucose uptake and improving insulin sensitivity in adipose and skeletal muscle tissues, improving glycogen synthesis in liver, restoring pancreatic islets dysfunction, slowing gastric emptying rates, and improving diabetic renal and brain disorders. Cinnamaldehyde exerts these effects through its action on multiple signaling pathways, including PPARs, AMPK, PI3K/IRS-1, RBP4-GLUT4, and ERK/JNK/p38MAPK, TRPA1-ghrelin and Nrf2 pathways. In addition, cinnamaldehyde seems to regulate the activities of PTP1B and α-amylase. Furthermore, cinnamaldehyde has the potential of metalizing into cinnamyl alcohol and methyl cinnamate and cinnamic acid in the body. Finally, there is a potential toxicity concern about this compound. In summary, cinnamaldehyde supplementation is shown to improve glucose and lipid homeostasis in diabetic animals, which may provide a new option for diabetic intervention. To this end, further scientific evidences are required from clinical trials on its glucose regulating effects and safety. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Safety and tolerability review of lorcaserin in clinical trials.

    PubMed

    Greenway, F L; Shanahan, W; Fain, R; Ma, T; Rubino, D

    2016-10-01

    Lorcaserin is a novel selective serotonin 2C receptor agonist indicated by the US Food and Drug Administration for chronic weight management in adults with obesity or overweight with ≥1 comorbidity. The safety and efficacy of lorcaserin were established during two Phase III clinical trials in patients without diabetes (BLOOM and BLOSSOM) and one Phase III clinical trial in patients with type 2 diabetes (BLOOM-DM). Headache was the most common adverse event experienced by patients during all Phase III trials. Additional adverse events occurring in >5% of patients receiving lorcaserin included dizziness, fatigue, nausea, dry mouth and constipation in patients without diabetes, and hypoglycaemia, back pain, cough and fatigue in patients with diabetes. In a pooled analysis of echocardiographic data collected during the three lorcaserin Phase III trials, the incidence of FDA-defined valvulopathy was similar in patients taking lorcaserin and the placebo. Here, the safety profile of lorcaserin at the FDA-approved dose of 10 mg twice daily is reviewed using data from the lorcaserin Phase III programme, with a focus on theoretical adverse events commonly associated with agonists of the serotonin receptor family. Based on the lorcaserin Phase III clinical trial data, lorcaserin is safe and well tolerated in the indicated patient populations. © 2016 World Obesity.

  10. Safety of treatment options for spondyloarthritis: a narrative review.

    PubMed

    D'Angelo, Salvatore; Carriero, Antonio; Gilio, Michele; Ursini, Francesco; Leccese, Pietro; Palazzi, Carlo

    2018-05-01

    Spondyloarthritis (SpA) are chronic inflammatory diseases with overlapping pathogenic mechanisms and clinical features. Treatment armamentarium against SpA includes non-steroidal anti-inflammatory drugs, glucocorticoids, conventional disease-modifying antirheumatic drugs (DMARDs, including sulfasalazine, methotrexate, leflunomide, cyclosporine), targeted synthetic DMARDs (apremilast) and biological DMARDs (TNF inhibitors, anti-IL 12/23 and anti-IL-17 agents). Areas covered: A narrative review of published literature on safety profile of available SpA treatment options was performed. Readers will be provided with a comprehensive overview on frequent and rare adverse events associated with each drug listed in current SpA treatment recommendations. Expert opinion: The overall safety profile of such molecules is good and serious adverse events are rare but need to be promptly recognized and treated. However, the monitoring of adverse events is a major challenge for clinicians because it is not adequately addressed by current treatment recommendations. A tailored treatment is crucial and rheumatologists must accurately select patients in order to identify those more susceptible to develop adverse events.

  11. Efficacy and safety of novel antipsychotics: a critical review.

    PubMed

    Balestrieri, Matteo; Vampini, Claudio; Bellantuono, Cesario

    2000-10-01

    Efficacy and safety of novel antipsychotic (AP) drugs (amisulpride, olanzapine, quetiapine, ziprasidone and zotepine) have been reviewed. Data on their antipsychotic efficacy and side effects profile have been evaluated only on the basis of controlled trials so far published. Overall, all these drugs have shown an antipsychotic efficacy on positive symptoms of schizophrenia similar to that of the conventional AP drugs. On negative symptoms, all novel AP drugs, except quetiapine and ziprasidone, demonstrated a better efficacy than haloperidol. Long-term efficacy of these AP drugs in the maintenance treatment of schizophrenia needs to be explored by further, better-designed, epidemiological studies. The safety profile shows that the novel AP drugs are generally well-tolerated and induce significantly less acute extrapyramidal side effects in comparison with haloperidol. Some methodological flaws in the experimental design of the clinical trials analysed are discussed. Although these novel AP drugs have potential clinical advantages, a number of relevant questions still remain to be addressed, in order to establish the impact of these drugs in the overall treatment of schizophrenia. Copyright 2000 John Wiley & Sons, Ltd.

  12. Carbon Stripper Foils Used in the Los Alamos PSR

    NASA Astrophysics Data System (ADS)

    Borden, M.; Plum, M. A.; Sugai, I.

    1997-05-01

    Carbon stripper foils produced by the modified controlled ACDC arc discharge method (mCADAD) at the Institute for Nuclear Study by Dr. Isao Sugai have been tested and used for high current 800-MeV beam production in the Proton Storage Ring (PSR) since 1993. Two approximately 110 μg/cm2 foils are sandwiched together to produce an equivalent 220 μg/cm^2 foil. The combined foil is supported by 4-5 μm diameter carbon fibers attached to an aluminum frame. These foils have survived as long as five months during PSR normal beam production of near 70 μA on target average current. Typical life-times of other foils vary from seven to fourteen days with lower on-target average current. Beam loss data also indicate that Sugai's foils have slower shrinkage rates than other foils. Equipment has been assembled and used to produce foils by the mCADAD method at Los Alamos. These foils will be tested during 1997 operation.

  13. Recent progress on beam stability study in the PSR

    NASA Astrophysics Data System (ADS)

    Wang, Tai-Sen F.; Channell, Paul J.; Cooper, Richard K.; Fitzgerald, Daniel H.; Hardek, Tom; Hutson, Richard; Jason, Andrew J.; Macek, Robert J.; Plum, Michael A.; Wilkinson, Carol

    A fast transverse instability has been observed in the Los Alamos Proton Storage Ring (PSR) when the injected beam intensity reaches more than 2 (times) 10(exp 13) protons per pulse. Understanding the cause and control of this instability has taken on new importance as the neutron-scattering community considers the next generation of accelerator-driven spallation-neutron sources, which call for peak-proton intensities of 10(exp 14) per pulse or higher. Previous observations and theoretical studies indicate that the instability in the PSR is most likely driven by electrons trapped within the proton beam. Recent studies using an experimental electron-clearing system and voltage-biased pinger-electrodes for electron clearing and collection support this hypothesis. Experiments have also been performed to study the instability threshold when varying the electron production rate. Theoretical studies include a computer simulation of a simplified model for the e -- p instability and the investigation of possible electron confinement in the ring-element magnetic fields. This paper reports some recent results from these studies.

  14. The Spin-down of PSR B1509-58

    NASA Astrophysics Data System (ADS)

    Gvaramadze, V. V.

    It is generally accepted that the PSR B1509-58 is associated with the supernova remnant (SNR) MSH 15-52 . The spin-down age of the pulsar is years, while the size and the general appearance of the SNR suggest that this system is much older. A few possible explanations of this discrepancy have been put forward. We offer an alternative one and suggest that the high spin-down rate of the pulsar characterizes only a relatively short period of its (present) spin history, and that the enhanced braking torque is connected with the interaction between the pulsar's magnetosphere and the dense matter of a circumstellar clump (created during the late evolutionary stages of the supernova (SN) progenitor star). Our suggestion implies that the "true" age of PSR B1509-58 could be much larger than the spin-down age, and therefore the SNR MSH 15-52 is a middle-aged remnant similar to the Vela SNR. Some possible consequences of our suggestion are discussed.

  15. Statin Therapy: Review of Safety and Potential Side Effects.

    PubMed

    Ramkumar, Satish; Raghunath, Ajay; Raghunath, Sudhakshini

    2016-11-01

    Hydroxymethyl glutaryl coenzyme A reductase inhibitors, commonly called statins, are some of the most commonly prescribed medications worldwide. Evidence suggests that statin therapy has significant mortality and morbidity benefit for both primary and secondary prevention from cardiovascular disease. Nonetheless, concern has been expressed regarding the adverse effects of long term statin use. The purpose of this article was to review the current medical literature regarding the safety of statins. Major trials and review articles on the safety of statins were identified in a search of the MEDLINE database from 1980 to 2016, which was limited to English articles. Myalgia is the most common side effect of statin use, with documented rates from 1-10%. Rhabdomyolysis is the most serious adverse effect from statin use, though it occurs quite rarely (less than 0.1%). The most common risk factors for statin-related myopathy include hypothyroidism, polypharmacy and alcohol abuse. Derangement in liver function tests is common, affecting up to 1% of patients; however, the clinical significance of this is unknown. Some statin drugs are potentially diabetogenic and the risk appears to increase in those patients on higher doses. Pitavastatin has not been associated with increased risk of diabetes. Statins have not been proven to increase the risk of malignancy, dementia, mood disorders or acute interstitial nephritis. However, statins do have multiple drug interactions, primarily those which interact with the cytochrome p450 enzyme group. Overall, statin drugs appear to be safe for use in the vast majority of patients. However, patients with multiple medical co-morbidities are at increased risk of adverse effects from long-term statin use.

  16. Current Sports: Medicine Issues. Annual Safety Education Review--1973.

    ERIC Educational Resources Information Center

    Craig, Timothy T., Ed.

    This document is a collection of papers whose theme is sports safety. Section one, "Government Interest in Sports Safety," includes an article on Washington, D.C.'s focus on sports safety. Section two, "Medical Aspects of Safety in Sports," includes articles regarding the medical basis of restriction from athletics, orthopaedic restrictions, and…

  17. Psr1, a nuclear localized protein that regulates phosphorus metabolism in Chlamydomonas.

    PubMed

    Wykoff, D D; Grossman, A R; Weeks, D P; Usuda, H; Shimogawara, K

    1999-12-21

    Understanding the ways in which phosphorus metabolism is regulated in photosynthetic eukaryotes is critical for optimizing crop productivity and managing aquatic ecosystems in which phosphorus can be a major source of pollution. Here we describe a gene encoding a regulator of phosphorus metabolism, designated Psr1 (phosphorus starvation response), from a photosynthetic eukaryote. The Psr1 protein is critical for acclimation of the unicellular green alga Chlamydomonas reinhardtii to phosphorus starvation. The N-terminal half of Psr1 contains a region similar to myb DNA-binding domains and the C-terminal half possesses glutamine-rich sequences characteristic of transcriptional activators. The level of Psr1 increases at least 10-fold upon phosphate starvation, and immunocytochemical studies demonstrate that this protein is nuclear-localized under both nutrient-replete and phosphorus-starvation conditions. Finally, Psr1 and angiosperm proteins have domains that are similar, suggesting a possible role for Psr1 homologs in the control of phosphorus metabolism in vascular plants. With the identification of regulators such as Psr1 it may become possible to engineer photosynthetic organisms for more efficient utilization of phosphorus and to establish better practices for the management of agricultural lands and natural ecosystems.

  18. A systematic review of occupational safety and health business cases.

    PubMed

    Verbeek, Jos; Pulliainen, Marjo; Kankaanpää, Eila

    2009-12-01

    Business cases are commonly developed as means to rationalize investment. We systematically reviewed 26 reported cases on occupational safety and health (OSH) interventions to assess if health and productivity arguments make a good business case. To be included in the review, studies had to analyze the costs and benefits, including productivity, of an OSH intervention at the enterprise level. We searched Medline and Embase for studies and used Google search in addition. Two reviewers independently selected studies and extracted data. The intervention profitability was calculated in euros (euro in 2008) as the first year's benefits minus the total intervention costs per worker. The payback period was calculated as the intervention costs divided by the first year's benefits. We found three ex-ante and 23 ex-post cases. In 20 cases, the study design was a before-after comparison without a control group. Generally a 100% reduction of injuries or sickness absence was assumed. In two cases, productivity and quality increases were very large. The main benefit was avoided sick leave. Depreciation or discounting was applied only in a minority of cases. The intervention profitability was negative in seven studies, up to euro 500 per employee in 12 studies and more than euro 500 per employee in seven studies. The payback period was less than half a year for 19 studies. Only a few studies included sensitivity analyses. Few ex-ante business cases for management decisions on OSH are reported. Guidelines for reporting and evaluation are needed. Business cases need more sound assumptions on the effectiveness of interventions and should incorporate greater uncertainty into their design. Ex-post evaluation should be based preferably on study designs that control for trends at a time different from that of the intervention.

  19. 78 FR 47804 - Verification, Validation, Reviews, and Audits for Digital Computer Software Used in Safety...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-06

    ..., ``Configuration Management Plans for Digital Computer Software used in Safety Systems of Nuclear Power Plants... Digital Computer Software Used in Safety Systems of Nuclear Power Plants AGENCY: Nuclear Regulatory..., Reviews, and Audits for Digital Computer Software Used in Safety Systems of Nuclear Power Plants.'' This...

  20. A Review of Research on Procedures for Teaching Safety Skills to Persons with Developmental Disabilities

    ERIC Educational Resources Information Center

    Dixon, Dennis R.; Bergstrom, Ryan; Smith, Marlena N.; Tarbox, Jonathan

    2010-01-01

    Safety skills are an important but often neglected area of training for persons with developmental disabilities (DD). The present study reviewed the literature on teaching safety skills to persons with DD. Safety skills involve a variety of behaviors such as knowing how to cross the street or what to do in case of a house fire. A number of studies…

  1. 78 FR 64538 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Safety...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-29

    ... for OMB Review; Comment Request; Safety Standards for Underground Coal Mine Ventilation--Belt Entry... the Mine Safety and Health Administration (MSHA) sponsored information collection request (ICR) titled, ``Safety Standards for Underground Coal Mine Ventilation--Belt Entry Used as an Intake Air Course to...

  2. A review of seafood safety after the deepwater horizon blowout.

    PubMed

    Gohlke, Julia M; Doke, Dzigbodi; Tipre, Meghan; Leader, Mark; Fitzgerald, Timothy

    2011-08-01

    The Deepwater Horizon (DH) blowout resulted in fisheries closings across the Gulf of Mexico. Federal agencies, in collaboration with impacted Gulf states, developed a protocol to determine when it is safe to reopen fisheries based on sensory and chemical analyses of seafood. All federal waters have been reopened, yet concerns have been raised regarding the robustness of the protocol to identify all potential harmful exposures and protect the most sensitive populations. We aimed to assess this protocol based on comparisons with previous oil spills, published testing results, and current knowledge regarding chemicals released during the DH oil spill. We performed a comprehensive review of relevant scientific journal articles and government documents concerning seafood contamination and oil spills and consulted with academic and government experts. Protocols to evaluate seafood safety before reopening fisheries have relied on risk assessment of health impacts from polycyclic aromatic hydrocarbon (PAH) exposures, but metal contamination may also be a concern. Assumptions used to determine levels of concern (LOCs) after oil spills have not been consistent across risk assessments performed after oil spills. Chemical testing results after the DH oil spill suggest PAH levels are at or below levels reported after previous oil spills, and well below LOCs, even when more conservative parameters are used to estimate risk. We recommend use of a range of plausible risk parameters to set bounds around LOCs, comparisons of post-spill measurements with baseline levels, and the development and implementation of long-term monitoring strategies for metals as well as PAHs and dispersant components. In addition, the methods, results, and uncertainties associated with estimating seafood safety after oil spills should be communicated in a transparent and timely manner, and stakeholders should be actively involved in developing a long-term monitoring strategy.

  3. A system review of the Virginia Alcohol Safety Action Program.

    DOT National Transportation Integrated Search

    1980-01-01

    In March 1979, the Virginia General Assembly gave the Virginia Department of Transportation Safety (VDTS) the power and responsibility to make binding policy and set standards for the local Virginia Alcohol Safety Action Projects across the state. In...

  4. Credit PSR. This view depicts the southwest and southeast facades ...

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

    Credit PSR. This view depicts the southwest and southeast facades as seen when looking west southwest (260°). The building consists of a small lean-to control room and a two-story space containing a large casting pit. The pit, which can be seen through the open doors, was never used due to changes in JPL's mission. This steel frame structure is clad in "Transite" board (a fire resistant pressed asbestos composite material) and interior lighting consists of individual explosion proof lamps mounted around the walls. The building was rated for 10,000 pounds (4,545 Kg) of class 2 materials and four personnel. It was licensed 5 June 1989 for ammonium perchlorate (NH4C10,), ammonium nitrate (NH4NO3), and sodium nitrate (NaNO3) - Jet Propulsion Laboratory Edwards Facility, Casting & Curing Building, Edwards Air Force Base, Boron, Kern County, CA

  5. Gamma Radiation from PSR B1055-52

    NASA Technical Reports Server (NTRS)

    Thompson, D. J.; Bailes, M.; Bertsch, D. L.; Cordes, J.; DAmico, N. D.; Esposito, J. A.; Finley, J.; Hartman, R. C.; Hermsen, W.; Kanbach, G.; hide

    1998-01-01

    The telescopes on the Compton Gamma Ray Observatory (CCRO) have observed PSR B1055-52 a number of times between 1991 and 1998. From these data, a more detailed picture of the gamma radiation from this source has been developed, showing several characteristics which distinguish this pulsar: the light curve is complex; there is no detectable unpulsed emission; the energy spectrum is flat, with no evidence of a sharp high-energy cutoff up to greater than 4 GeV. Comparisons of the gamma-ray data with observations at longer wavelengths show that no two of the known gamma-ray pulsars have quite the same characteristics; this diversity makes interpretation in terms of theoretical models difficult.

  6. Gamma Radiation from PSR B1055-52

    NASA Technical Reports Server (NTRS)

    Thompson, D. J.; Bailes, M.; Bertsch, D. L.; Cordes, J.; DAmico, N.; Esposito, J. A.; Finley, J.; Hartman, R. C.; Hermsen, W.; Kanbach, G.; hide

    1999-01-01

    The telescopes on the Compton Gamma Ray Observatory (CGRO) have observed PSR B1055-52 a number of times between 1991 and 1998. From these data, a more detailed picture of the gamma radiation from this source has been developed, showing several characteristics which distinguish this pulsar: the light curve is complex; there is no detectable unpulsed emission; the energy spectrum is flat, with no evidence of a sharp high-energy cutoff up to greater than 4 GeV. Comparisons of the gamma-ray data with observations at longer wavelengths show that no two of the known gamma-ray pulsars have quite the same characteristics; this diversity makes interpretation in terms of theoretical models difficult.

  7. Credit PSR. The northwest and southwest facades appear as seen ...

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

    Credit PSR. The northwest and southwest facades appear as seen when looking northeast (460). Doors have been opened to show the interiors of the oxidizer dust receiver room at left; the building equipment room (air conditioning) is on the right. The dust receiver is a Roto-Clone Type N hydrostatic precipitator, which uses a 5 horsepower vacuum motor. Refrigeration units are mounted on pads immediately to the right of the building in this view. The grinder room is at the far end of the building; access to it is gained via double doors on the left where a hoist beam projects out from the top of the door opening. Building 4284/E85 (Oxidizer Dryer Blender) appears in the left background; 4283/E-84 (Oxidizer Grinder) appears in the right background - Jet Propulsion Laboratory Edwards Facility, Oxidizer Grinder Building, Edwards Air Force Base, Boron, Kern County, CA

  8. Safety of Epinephrine in Digital Nerve Blocks: A Literature Review.

    PubMed

    Ilicki, Jonathan

    2015-11-01

    Digital nerve blocks are commonly performed in emergency departments. Health care practitioners are often taught to avoid performing blocks with epinephrine due to a risk of digital necrosis. To review the literature on the safety of epinephrine 1:100,000-200,000 (5-10 μg/mL) with local anesthetics in digital nerve blocks in healthy patients and in patients with risk for poor peripheral circulation. PubMed, Web of Science, and the Cochrane Library were searched in June 2014 using the query "digital block AND epinephrine OR digital block AND adrenaline". The searches were performed without any limits. Sixty-three articles were identified, and 39 of these were found to be relevant. These include nine reviews, 12 randomized control trials, and 18 other articles. Most studies excluded patients with risk for poor peripheral circulation. Two studies described using epinephrine on patients with vascular comorbidities. No study reported digital necrosis or gangrene attributable to epinephrine, either in healthy patients or in patients with risk for poor peripheral circulation. In total, at least 2797 digital nerve blocks with epinephrine have been performed without any complications. Epinephrine 1:100,000-200,000 (5-10 μg/mL) is safe to use in digital nerve blocks in healthy patients. Physiological studies show epinephrine-induced vasoconstriction to be transient. There are no reported cases of epinephrine-induced harm to patients with risk for poor peripheral circulation despite a theoretical risk of harmful epinephrine-induced vasoconstriction. A lack of reported complications suggests that the risk of epinephrine-induced vasoconstriction to digits may be overstated. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Safety of High Speed Magnetic Levitation Transportation Systems: Preliminary Safety Review of the Transrapid Maglev System

    DOT National Transportation Integrated Search

    1990-11-01

    The safety of various magnetically levitated trains under development for possible : implementation in the United States is of direct concern to the Federal Railroad : Administration. This report, one in a series of planned reports on maglev safety, ...

  10. Review of health safety aspects of nanotechnologies in food production.

    PubMed

    Bouwmeester, Hans; Dekkers, Susan; Noordam, Maryvon Y; Hagens, Werner I; Bulder, Astrid S; de Heer, Cees; ten Voorde, Sandra E C G; Wijnhoven, Susan W P; Marvin, Hans J P; Sips, Adriënne J A M

    2009-02-01

    Due to new, previously unknown, properties attributed to engineered nanoparticles many new products are introduced in the agro-food area. Nanotechnologies cover many aspects, such as disease treatment, food security, new materials for pathogen detection, packaging materials and delivery systems. As with most new and evolving technologies, potential benefits are emphasized, while little is known on safety of the application of nanotechnologies in the agro-food sector. This review gives an overview of scientific issues that need to be addressed with priority in order to improve the risk assessment for nanoparticles in food. The following research topics are considered to contribute pivotally to risk assessment of nanotechnologies and nanoparticles in food products. Set a definition for NPs to facilitate regulatory discussions, prioritization of research and exchange of study results. Develop analytical tools for the characterization of nanoparticles in complex biological matrices like food. Establish relevant dose metrics for nanoparticles used for both interpretation of scientific studies as well as regulatory frameworks. Search for deviant behavior (kinetics) and novel effects (toxicity) of nanoparticles and assess the validity of currently used test systems following oral exposure. Estimate the consumer exposure to nanoparticles.

  11. The fetal safety of Levetiracetam: a systematic review.

    PubMed

    Chaudhry, Shahnaz Akhtar; Jong, Geert't; Koren, Gideon

    2014-07-01

    To systematically review the available published evidence on the fetal safety of Levetiracetam with focus on birth defects. Eight studies met the inclusion criteria; five pregnancy registries and one population based cohort study. A total of 27 major congenital malformations were reported among 1213 Levetiracetam monotherapy - exposed pregnant women, yielding an overall major malformation rate of 2.2% (27/1213) [95% confidence interval of 1.53-3.22]. In contrast, Levetiracetam polytherapy was associated with significantly higher malformation rate of 6.3% (34/541) [95% CI of 4.53-8.65] (P<0.001). Additionally 2 studies investigating child neurodevelopment in Levetiracetam - exposed children revealed that the measured achievements were well above those children exposed to valproic acid, and similar to unexposed controls. The current evidence suggests that the overall risk of major malformation after first trimester exposure to Levetiracetam is within the population baseline risk of 1-3%, with no apparent adverse effects on long term child development. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. The Safety of Ingested Caffeine: A Comprehensive Review

    PubMed Central

    Temple, Jennifer L.; Bernard, Christophe; Lipshultz, Steven E.; Czachor, Jason D.; Westphal, Joslyn A.; Mestre, Miriam A.

    2017-01-01

    Caffeine is the most widely consumed psychoactive drug in the world. Natural sources of caffeine include coffee, tea, and chocolate. Synthetic caffeine is also added to products to promote arousal, alertness, energy, and elevated mood. Over the past decade, the introduction of new caffeine-containing food products, as well as changes in consumption patterns of the more traditional sources of caffeine, has increased scrutiny by health authorities and regulatory bodies about the overall consumption of caffeine and its potential cumulative effects on behavior and physiology. Of particular concern is the rate of caffeine intake among populations potentially vulnerable to the negative effects of caffeine consumption: pregnant and lactating women, children and adolescents, young adults, and people with underlying heart or other health conditions, such as mental illness. Here, we review the research into the safety and safe doses of ingested caffeine in healthy and in vulnerable populations. We report that, for healthy adults, caffeine consumption is relatively safe, but that for some vulnerable populations, caffeine consumption could be harmful, including impairments in cardiovascular function, sleep, and substance use. We also identified several gaps in the literature on which we based recommendations for the future of caffeine research. PMID:28603504

  13. Commercial Crew Program and the Safety Technical Review Board

    NASA Technical Reports Server (NTRS)

    Mullen, Macy

    2016-01-01

    The Commercial Crew Program (CCP) is unique to any other program office at NASA. After the agency suffered devastating budget cuts and the Shuttle Program retired, the U.S. gave up its human spaceflight capabilities. Since 2011 the U.S. has been dependent on Russia to transport American astronauts and cargo to the International Space Station (ISS) and back. NASA adapted and formed CCP, which gives private, domestic, aerospace companies unprecedented reign over America's next ride to space. The program began back in 2010 with 5 companies and is now in the final phase of certification with 2 commercial partners. The Commercial Crew Program is made up of 7 divisions, each working rigorously with the commercial providers to complete the certification phase. One of these 7 divisions is Systems Engineering and Integration (SE&I) which is partly comprised of the Safety Technical Review Board (STRB). The STRB is primarily concerned with mitigating improbable, but catastrophic hazards. It does this by identifying, managing, and tracking these hazards in reports. With the STRB being in SE&I, it significantly contributes to the overall certification of the partners' vehicles. After the partners receive agency certification approval, they will have the capability to provide the U.S. with a reliable, safe, and cost-effective means of human spaceflight and cargo transport to the ISS and back.

  14. The safety of acupuncture during pregnancy: a systematic review

    PubMed Central

    Park, Jimin; Sohn, Youngjoo; White, Adrian R; Lee, Hyangsook

    2014-01-01

    Objective Although there is a growing interest in the use of acupuncture during pregnancy, the safety of acupuncture is yet to be rigorously investigated. The objective of this review is to identify adverse events (AEs) associated with acupuncture treatment during pregnancy. Methods We searched Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED) and five Korean databases up to February 2013. Reference lists of relevant articles were screened for additional reports. Studies were included regardless of their design if they reported original data and involved acupuncture needling and/or moxibustion treatment for any conditions in pregnant women. Studies of acupuncture for delivery, abortion, assisted reproduction or postpartum conditions were excluded. AE data were extracted and assessed in terms of severity and causality, and incidence was determined. Results Of 105 included studies, detailed AEs were reported only in 25 studies represented by 27 articles (25.7%). AEs evaluated as certain, probable or possible in the causality assessment were all mild/moderate in severity, with needling pain being the most frequent. Severe AEs or deaths were few and all considered unlikely to have been caused by acupuncture. Total AE incidence was 1.9%, and the incidence of AEs evaluated as certainly, probably or possibly causally related to acupuncture was 1.3%. Conclusions Acupuncture during pregnancy appears to be associated with few AEs when correctly applied. PMID:24554789

  15. Patient safety in psychiatric inpatient care: a literature review.

    PubMed

    Kanerva, A; Lammintakanen, J; Kivinen, T

    2013-08-01

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

  16. Safety impacts of bicycle infrastructure: A critical review.

    PubMed

    DiGioia, Jonathan; Watkins, Kari Edison; Xu, Yanzhi; Rodgers, Michael; Guensler, Randall

    2017-06-01

    This paper takes a critical look at the present state of bicycle infrastructure treatment safety research, highlighting data needs. Safety literature relating to 22 bicycle treatments is examined, including findings, study methodologies, and data sources used in the studies. Some preliminary conclusions related to research efficacy are drawn from the available data and findings in the research. While the current body of bicycle safety literature points toward some defensible conclusions regarding the safety and effectiveness of certain bicycle treatments, such as bike lanes and removal of on-street parking, the vast majority treatments are still in need of rigorous research. Fundamental questions arise regarding appropriate exposure measures, crash measures, and crash data sources. This research will aid transportation departments with regard to decisions about bicycle infrastructure and guide future research efforts toward understanding safety impacts of bicycle infrastructure. Copyright © 2017 Elsevier Ltd and National Safety Council. All rights reserved.

  17. Polymerase Spiral Reaction (PSR): A novel isothermal nucleic acid amplification method.

    PubMed

    Liu, Wei; Dong, Derong; Yang, Zhan; Zou, Dayang; Chen, Zeliang; Yuan, Jing; Huang, Liuyu

    2015-07-29

    In this study, we report a novel isothermal nucleic acid amplification method only requires one pair of primers and one enzyme, termed Polymerase Spiral Reaction (PSR) with high specificity, efficiency, and rapidity under isothermal condition. The recombinant plasmid of blaNDM-1 was imported to Escherichia coli BL21, and selected as the microbial target. PSR method employs a Bst DNA polymerase and a pair of primers designed targeting the blaNDM-1 gene sequence. The forward and reverse Tab primer sequences are reverse to each other at their 5' end (Nr and N), whereas their 3' end sequences are complementary to their respective target nucleic acid sequences. The PSR method was performed at a constant temperature 61 °C-65 °C, yielding a complicated spiral structure. PSR assay was monitored continuously in a real-time turbidimeter instrument or visually detected with the aid of a fluorescent dye (SYBR Greenı), and could be finished within 1 h with a high accumulation of 10(9) copies of the target and a fine sensitivity of 6 CFU per reaction. Clinical evaluation was also conducted using PSR, showing high specificity of this method. The PSR technique provides a convenient and cost-effective alternative for clinical screening, on-site diagnosis and primary quarantine purposes.

  18. FMCSA safety program effectiveness measurement : compliance review effectiveness model results for carriers with compliance reviews in fiscal year 2009.

    DOT National Transportation Integrated Search

    2014-04-01

    In FY 2009, Federal and State enforcement personnel conducted more than 15,000 compliance reviews (CRs) on individual motor carriers. It is intended that through education, heightened safety regulation awareness, and the enforcement effects of the CR...

  19. FMCSA safety program effectiveness measurement : compliance review effectiveness model results for carriers with compliance reviews in FY 2008

    DOT National Transportation Integrated Search

    2012-09-30

    In FY 2008, Federal and State enforcement personnel conducted 14,906 compliance reviews (CRs) on individual motor carriers. It is intended that through education, heightened safety regulation awareness, and the enforcement effects of the CR, carriers...

  20. A critical review on toxicological safety of 2-alkylcyclobutanones

    NASA Astrophysics Data System (ADS)

    Song, Beom-Seok; Choi, Soo-Jeong; Jin, Young-Bae; Park, Jong-Heum; Kim, Jae-Kyung; Byun, Eui-Baek; Kim, Jae-Hun; Lee, Ju-Woon; Kim, Gang-Sung; Marchioni, Eric

    2014-10-01

    2-Alkylcyclobutanones (2-ACBs) are known as unique radiolytic products generated from the major fatty acids and triglycerides in food through only irradiation. Since 1990, studies on the toxicological safety of 2-ACBs have been conducted extensively with synthetic compounds. Mutagenicity tests of 2-ACBs on the microorganisms reviewed in this study clearly indicate that no evidence was observed, while several in vitro studies demonstrated the cytotoxicity of 2-ACBs through cell death. Moreover, the genotoxicity of 2-ACBs was suggested as DNA strand breaks were observed. However, these findings should be interpreted with caution because genotoxicity may result from cytotoxicity, which causes DNA damage or from cell membrane destruction and indirect oxidative DNA damage. Therefore, elucidation of the mechanism of genotoxic effects is needed. With regards to the suggestion of Raul et al. (2002) who showed the promoting effect of colon cancer by the administration of 2-ACBs, further studies are needed to correct some experimental design errors. Moreover, an in-vivo experiment that evaluated the metabolism of 2-ACBs has revealed that 2-dDCB was metabolized into cyclic alcohol and excreted through fecal discharge. In conclusion, it is considered that the ingestion of 2-ACBs through irradiated foods is unlikely to affect the human health. However, more specific studies are required to identify the fate of 2-ACBs in body and the LD50 values. The determination of chronic toxicity by long-term exposure to low concentrations of 2-ACBs has to be evaluated more clearly to determine if these compounds are safe to human.

  1. The Association Between Professional Burnout and Engagement With Patient Safety Culture and Outcomes: A Systematic Review.

    PubMed

    Mossburg, Sarah E; Dennison Himmelfarb, Cheryl

    2018-06-25

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

  2. Evaluation and review of the safety management system implementation in the Royal Thai Air Force

    NASA Astrophysics Data System (ADS)

    Chaiwan, Sakkarin

    This study was designed to determine situation and effectiveness of the safety management system currently implemented in the Royal Thai Air Force. Reviewing the ICAO's SMS and the RTAF's SMS was conducted to identify similarities and differences between the two safety management systems. Later, the researcher acquired safety statistics from the RTAF Safety Center to investigate effectiveness of its safety system. The researcher also collected data to identify other factors affecting effectiveness of the safety system during conducting in-depth interviews. Findings and Conclusions: The study shows that the Royal Thai Air Force has never applied the International Civil Aviation Organization's Safety management System to its safety system. However, the RTAF's SMS and the ICAO's SMS have been developed based on the same concepts. These concepts are from Richard H. Woods's book, Aviation safety programs: A management handbook. However, the effectiveness of the Royal Thai Air Force's safety system is in good stance. An accident rate has been decreasing regularly but there are no known factors to describe the increasing rate, according to the participants' opinion. The participants have informed that there are many issues to be resolved to improve the RTAF's safety system. Those issues are cooperation among safety center's staffs, attitude toward safety of the RTAF senior commanders, and safety standards.

  3. Review of safety reports involving electronic flight bags

    DOT National Transportation Integrated Search

    2009-04-27

    Electronic Flight Bags (EFBs) are a relatively new device used by pilots. Even so, 37 safety-related events involving EFBs were identified from the public online Aviation Safety Reporting System (ASRS) database as of June 2008. In addition, two accid...

  4. Guidelines for Reviewers and the Editor at the Nuclear Safety Information Center.

    ERIC Educational Resources Information Center

    Whetsel, H. B.

    The main purpose of this report is to help novice reviewers accelerate their apprenticeship at the Nuclear Safety Information Center, a computerized information service sponsored by the U.S. Atomic Energy Commission. Guidelines for reviewers are presented in Part 1; Part 2 contains guidelines for the novice editor. The goal of the reviewers and…

  5. NASA Expendable Launch Vehicle (ELV) Payload Safety Review Process

    NASA Technical Reports Server (NTRS)

    Starbus, Calvert S.; Donovan, Shawn; Dook, Mike; Palo, Tom

    2007-01-01

    Issues addressed by this program: (1) Complicated roles and responsibilities associated with multi-partner projects (2) Working relationships and communications between all organizations involved in the payload safety process (3) Consistent interpretation and implementation of safety requirements from one project to the rest (4) Consistent implementation of the Tailoring Process (5) Clearly defined NASA decision-making-authority (6) Bring Agency-wide perspective to each ElV payload project. Current process requires a Payload Safety Working Group (PSWG) for eac payload with representatives from all involved organizations.

  6. Review of Studies on Pedestrian and Bicyclist Safety, 1991-2007

    DOT National Transportation Integrated Search

    2012-06-01

    This report reviews the pedestrian and bicyclist safety research literature in print as of 2007. It summarizes and synthesizes the key studies, evaluates existing knowledge and identifies research gaps and provides recommendations for future directio...

  7. Mobile site safety review for the transuranic (TRU) waste characterization program

    SciTech Connect

    Not Available

    1996-11-01

    This Safety Review Document (SRD) applies to the Active/Passive Neutron Examination and Assay (APNEA) system installed on a Lockheed Martin Specialty Components, Inc., (Specialty Components) trailer. The APNEA is designed to perform nuclear waste drum assay. The purpose of this document is to describe the safety features of the APNEA system.

  8. A Review of Interventions To Increase Driving Safety among Teenage Drivers.

    ERIC Educational Resources Information Center

    Mattox, John R., II

    Young drivers across the United States represent a persistent traffic safety problem. Many interventions have been imposed on these drivers but few studies have evaluated the impact of these interventions on risky behaviors or traffic safety measures. To fill this gap, a review was undertaken to examine the most rigorous methodological evaluations…

  9. 41 CFR 128-1.8009 - Review of Seismic Safety Program.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Review of Seismic Safety Program. 128-1.8009 Section 128-1.8009 Public Contracts and Property Management Federal Property Management Regulations System (Continued) DEPARTMENT OF JUSTICE 1-INTRODUCTION 1.80-Seismic Safety Program...

  10. Factors Associated With Barcode Medication Administration Technology That Contribute to Patient Safety: An Integrative Review.

    PubMed

    Strudwick, Gillian; Reisdorfer, Emilene; Warnock, Caroline; Kalia, Kamini; Sulkers, Heather; Clark, Carrie; Booth, Richard

    In an effort to prevent medication errors, barcode medication administration technology has been implemented in many health care organizations. An integrative review was conducted to understand the effect of barcode medication administration technology on medication errors, and characteristics of use demonstrated by nurses contribute to medication safety. Addressing poor system use may support improved patient safety through the reduction of medication administration errors.

  11. 77 FR 50723 - Verification, Validation, Reviews, and Audits for Digital Computer Software Used in Safety...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-22

    ... Digital Computer Software Used in Safety Systems of Nuclear Power Plants AGENCY: Nuclear Regulatory..., ``Verification, Validation, Reviews, and Audits for Digital Computer Software used in Safety Systems of Nuclear... NRC regulations promoting the development of, and compliance with, software verification and...

  12. Thirty Year Review of Safety Skill Instruction for Persons with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Mechling, Linda C.

    2008-01-01

    This review synthesizes the empirical literature (1976-2006) focusing on teaching personal safety skills to persons with intellectual disabilities. Thirty-six investigations were identified which provided information on six areas of instruction: (a) pedestrian/street crossing safety; (b) home accident prevention; (c) application of first aid…

  13. FERMI LARGE AREA TELESCOPE DETECTION OF PULSED gamma-RAYS FROM THE VELA-LIKE PULSARS PSR J1048-5832 AND PSR J2229+6114

    SciTech Connect

    Abdo, A. A.; Ackermann, M.; Ajello, M.

    2009-12-01

    We report the detection of gamma-ray pulsations (>=0.1 GeV) from PSR J2229+6114 and PSR J1048-5832, the latter having been detected as a low-significance pulsar by EGRET. Data in the gamma-ray band were acquired by the Large Area Telescope (LAT) aboard the Fermi Gamma-ray Space Telescope, while the radio rotational ephemerides used to fold the gamma-ray light curves were obtained using the Green Bank Telescope, the Lovell telescope at Jodrell Bank, and the Parkes Telescope. The two young radio pulsars, located within the error circles of the previously unidentified EGRET sources 3EG J1048-5840 and 3EG J2227+6122, present spin-down characteristics similar tomore » the Vela pulsar. PSR J1048-5832 shows two sharp peaks at phases 0.15 +- 0.01 and 0.57 +- 0.01 relative to the radio pulse confirming the EGRET light curve, while PSR J2229+6114 presents a very broad peak at phase 0.49 +- 0.01. The gamma-ray spectra above 0.1 GeV of both pulsars are fit with power laws having exponential cutoffs near 3 GeV, leading to integral photon fluxes of (2.19 +- 0.22 +- 0.32) x 10{sup -7} cm{sup -2} s{sup -1} for PSR J1048-5832 and (3.77 +- 0.22 +- 0.44) x 10{sup -7} cm{sup -2} s{sup -1} for PSR J2229+6114. The first uncertainty is statistical and the second is systematic. PSR J1048-5832 is one of the two LAT sources which were entangled together as 3EG J1048-5840. These detections add to the growing number of young gamma-ray pulsars that make up the dominant population of GeV gamma-ray sources in the Galactic plane.« less

  14. Fermi LAT Detection of Pulsed Gamma-Rays From the Vela-Like Pulsars PSR J1048-5832 and PSR J2229+6114

    SciTech Connect

    Abdo, A.A.; /Naval Research Lab, Wash., D.C. /Federal City Coll.; Ackermann, M.

    We report the detection of {gamma}-ray pulsations ({ge}0.1 GeV) from PSR J2229+6114 and PSR J1048-5832, the latter having been detected as a low-significance pulsar by EGRET. Data in the {gamma}-ray band were acquired by the Large Area Telescope (LAT) aboard the Fermi Gamma-ray Space Telescope, while the radio rotational ephemerides used to fold the {gamma}-ray light curves were obtained using the Green Bank Telescope, the Lovell telescope at Jodrell Bank, and the Parkes Telescope. The two young radio pulsars, located within the error circles of the previously unidentified EGRET sources 3EG J1048-5840 and 3EG J2227+6122, present spin-down characteristics similar tomore » the Vela pulsar. PSR J1048-5832 shows two sharp peaks at phases 0.15 {+-} 0.01 and 0.57 {+-} 0.01 relative to the radio pulse confirming the EGRET light curve, while PSR J2229+6114 presents a very broad peak at phase 0.49 {+-} 0.01. The {gamma}-ray spectra above 0.1 GeV of both pulsars are fit with power laws having exponential cutoffs near 3 GeV, leading to integral photon fluxes of (2.19 {+-} 0.22 {+-} 0.32) x 10{sup -7} cm{sup -2} s{sup -1} for PSR J1048-5832 and (3.77 {+-} 0.22 {+-} 0.44) x 10{sup -7} cm{sup -2} s{sup -1} for PSR J2229+6114. The first uncertainty is statistical and the second is systematic. PSR J1048-5832 is one of the two LAT sources which were entangled together as 3EG J1048-5840. These detections add to the growing number of young {gamma}-ray pulsars that make up the dominant population of GeV {gamma}-ray sources in the Galactic plane.« less

  15. FERMI Large Area Telescope Detection of Pulsed γ-Rays from the Vela-Like Pulsars PSR J1048–5832 and PSR J2229+6114

    DOE PAGES

    Abdo, A. A.; Ackermann, M.; Ajello, M.; ...

    2009-11-11

    Within this paper, we report the detection of γ-ray pulsations (≥0.1 GeV) from PSR J2229+6114 and PSR J1048–5832, the latter having been detected as a low-significance pulsar by EGRET. Data in the γ-ray band were acquired by the Large Area Telescope (LAT) aboard the Fermi Gamma-ray Space Telescope, while the radio rotational ephemerides used to fold the γ-ray light curves were obtained using the Green Bank Telescope, the Lovell telescope at Jodrell Bank, and the Parkes Telescope. The two young radio pulsars, located within the error circles of the previously unidentified EGRET sources 3EG J1048–5840 and 3EG J2227+6122, present spin-downmore » characteristics similar to the Vela pulsar. PSR J1048–5832 shows two sharp peaks at phases 0.15 ± 0.01 and 0.57 ± 0.01 relative to the radio pulse confirming the EGRET light curve, while PSR J2229+6114 presents a very broad peak at phase 0.49 ± 0.01. The γ-ray spectra above 0.1 GeV of both pulsars are fit with power laws having exponential cutoffs near 3 GeV, leading to integral photon fluxes of (2.19 ± 0.22 ± 0.32) × 10 –7 cm –2 s –1 for PSR J1048–5832 and (3.77 ± 0.22 ± 0.44) × 10 –7 cm –2 s –1 for PSR J2229+6114. The first uncertainty is statistical and the second is systematic. PSR J1048–5832 is one of the two LAT sources which were entangled together as 3EG J1048–5840. In conclusion, these detections add to the growing number of young γ-ray pulsars that make up the dominant population of GeV γ-ray sources in the Galactic plane.« less

  16. Timing irregularities of PSR J1705-1906

    NASA Astrophysics Data System (ADS)

    Liu, Y. L.; Yuan, J. P.; Wang, J. B.; Liu, X. W.; Wang, N.; Yuen, R.

    2018-05-01

    Timing analysis of PSR J1705-1906 using data from Nanshan 25-m and Parkes 64-m radio telescopes, which span over fourteen years, shows that the pulsar exhibits significant proper motion, and rotation instability. We updated the astrometry parameters and the spin parameters of the pulsar. In order to minimize the effect of timing irregularities on measuring its position, we employ the Cholesky method to analyse the timing noise. We obtain the proper motion of -77(3) mas yr-1 in right ascension and -38(29) mas yr-1 in declination. The power spectrum of timing noise is analyzed for the first time, which gives the spectral exponent α =-5.2 for the power-law model indicating that the fluctuations in spin frequency and spin-down rate dominate the red noise. We detect two small glitches from this pulsar with fractional jump in spin frequency of Δ ν /ν ˜ 2.9 × 10^{-10} around MJD 55199 and Δ ν /ν ˜ 2.7× 10^{-10} around MJD 55953. Investigations of pulse profile at different time segments suggest no significant changes in the pulse profiles around the two glitches.

  17. The binary nature of PSR J2032+4127

    DOE PAGES

    Lyne, A. G.; Stappers, B. W.; Keith, M. J.; ...

    2015-05-22

    PSR J2032+4127 is a γ-ray and radio-emitting pulsar which has been regarded as a young luminous isolated neutron star. However, its recent spin-down rate has extraordinarily increased by a factor of 2. Here we present evidence that this is due to its motion as a member of a highly-eccentric binary system with an ~15–M⊙ Be star, MT91 213. Timing observations show that, not only are the positions of the two stars coincident within 0.4 arcsec, but timing models of binary motion of the pulsar fit the data much better than a model of a young isolated pulsar. MT91 213, andmore » hence the pulsar, lie in the Cyg OB2 stellar association, which is at a distance of only 1.4–1.7 kpc. The pulsar is currently on the near side of, and accelerating towards, the Be star, with an orbital period of 20–30 yr. Finally, the next periastron is well constrained to occur in early 2018, providing an opportunity to observe enhanced high-energy emission as seen in other Be-star binary systems.« less

  18. High-energy Variability of PSR J1311-3430

    DOE PAGES

    An, Hongjun; Romani, Roger W.; Johnson, Tyrel; ...

    2017-11-21

    Here, we have studied the variability of the black-widow-type binary millisecond pulsar PSR J1311–3430 from optical to gamma-ray energies. We confirm evidence for orbital modulation in the weak off-pulse ≳200 MeV emission, with a peak atmore » $${\\phi }_{B}\\approx 0.8$$, following pulsar inferior conjunction. The peak has a relatively hard spectrum, extending above ~1 GeV. XMM-Newton and Swift UV observations also show that this source's strong X-ray flaring activity is associated with optical/UV flares. With a duty cycle of ~7%–19%, this flaring is quite prominent with an apparent power-law intensity distribution. Flares are present at all orbital phases, with a slight preference for $${\\phi }_{B}=0.5\\mbox{--}0.7$$. We explore possible connections of these variabilities with the intrabinary shock and magnetic activity on the low-mass secondary.« less

  19. The Cosmetic Ingredient Review Program-Expert Safety Assessments of Cosmetic Ingredients in an Open Forum.

    PubMed

    Boyer, Ivan J; Bergfeld, Wilma F; Heldreth, Bart; Fiume, Monice M; Gill, Lillian J

    The Cosmetic Ingredient Review (CIR) is a nonprofit program to assess the safety of ingredients in personal care products in an open, unbiased, and expert manner. Cosmetic Ingredient Review was established in 1976 by the Personal Care Products Council (PCPC), with the support of the US Food and Drug Administration (USFDA) and the Consumer Federation of America (CFA). Cosmetic Ingredient Review remains the only scientific program in the world committed to the systematic, independent review of cosmetic ingredient safety in a public forum. Cosmetic Ingredient Review operates in accordance with procedures modeled after the USFDA process for reviewing over-the-counter drugs. Nine voting panel members are distinguished, such as medical professionals, scientists, and professors. Three nonvoting liaisons are designated by the USFDA, CFA, and PCPC to represent government, consumer, and industry, respectively. The annual rate of completing safety assessments accelerated from about 100 to more than 400 ingredients by implementing grouping and read-across strategies and other approaches. As of March 2017, CIR had reviewed 4,740 individual cosmetic ingredients, including 4,611 determined to be safe as used or safe with qualifications, 12 determined to be unsafe, and 117 ingredients for which the information is insufficient to determine safety. Examples of especially challenging safety assessments and issues are presented here, including botanicals. Cosmetic Ingredient Review continues to strengthen its program with the ongoing cooperation of the USFDA, CFA, the cosmetics industry, and everyone else interested in contributing to the process.

  20. Experience With Laser Safety In The USA--A Review

    NASA Astrophysics Data System (ADS)

    Sliney, David H.

    1986-10-01

    Following several research programs in the 1960's aimed at studying the adverse biological effects of lasers and other optical radiation sources, laser occupational exposure limits were set and general safety standards were developed. Today, the experience from laser accidents and the development of new lasers and new applications have altered the format of the exposure limits and the safety procedures. It is critically important to distinguish between different biological injury mechanisms. The biological effects of ultraviolet radiation upon the skin and eye are additive over a period of at least one workday, and require different safety procedures. The scattered UV irradiance from excimer lasers may be quite hazardous, depending upon wavelength and action spectra. Since laser technology is young, the exposure of an individual in natural sunlight must be studied to evaluate the potential for chronic effects. The safety measures necessary in the use of lasers depend upon a hazard evaluation. The appropriate control measures and alternate means of enclosure, baffling, and operational control measures are presented. Present laser safety standards are explained briefly. Eye protective techniques and eyewear are considered for a variety of sources. The optical properties of enclosure materials are also discussed.

  1. PSR J1618-3921: a recycled pulsar in an eccentric orbit

    NASA Astrophysics Data System (ADS)

    Octau, F.; Cognard, I.; Guillemot, L.; Tauris, T. M.; Freire, P. C. C.; Desvignes, G.; Theureau, G.

    2018-04-01

    Context. The 11.99 ms pulsar PSR J1618-3921 orbits a He white dwarf companion of probably low mass with a period of 22.7 d. The pulsar was discovered in a survey of the intermediate Galactic latitudes at 1400 MHz that was conducted with the Parkes radio telescope in the late 1990s. Although PSR J1618-3921 was discovered more than 15 years ago, only limited information has been published about this pulsar, which has a surprisingly high orbital eccentricity (e ≃ 0.027) considering its high spin frequency and the likely low mass of the companion. Aims: The focus of this work is a precise measurement of the spin and the astrometric and orbital characteristics of PSR J1618-3921. This was done with timing observations made at the Nançay Radio Telescope from 2009 to 2017. Methods: We analyzed the timing data recorded at the Nançay Radio Telescope over several years to characterize the properties of PSR J1618-3921. A rotation ephemeris for this pulsar was obtained by analyzing the arrival times of the radio pulses at the telescope. Results: We confirm the unusual eccentricity of PSR J1618-3921 and discuss several hypotheses regarding its formation in the context of other discoveries of recycled pulsars in eccentric orbits.

  2. Patient safety and health policy: a history and review.

    PubMed

    Small, Stephen D; Barach, Paul

    2002-12-01

    Policy initiatives on many fronts have converged to improve patient safety. A major tension that characterizes this process is the attempt to achieve a balance between learning and control in complex systems with technical, social, and organizational components. Efforts to improve learning are marked by better information flow, discovery, flexibility in thinking, embracing of failures as learning opportunities, and core incentives to promote voluntary participation of all stakeholders in the process. Efforts to improve accountability are traditionally marked by public disclosure, meeting of certain widely disseminated standards, availability of performance measures, exposure to legal liability, and compliance with mandated directives (statutes, regulations, accreditation requirements). In some sense, these directions are mutually exclusive. Although a more collaborative regulatory-improvement model would be helpful in creating an industrywide safety culture, it is likely that learning and accountability functions will follow separate tracks. An exception would be policy that stimulates organizations to comply with regulation by showing how well and by what methods they are learning and how others can profit from these experiences. Any approach to improving patient safety should, at a minimum, include a nonpunitive in-depth mechanism for reporting incidents, postincident evaluations for identification of system changes to prevent subsequent occurrences, and state-guaranteed legislative protection from discovery for all aspects of information gathered to improve patient safety. Nonpunitive approaches have yielded useful results in other industries [43]. State and federal courts, state licensing boards, and accrediting bodies such as JCAHO all function to maintain accountability and standards; however, the very fear of existing legal liability or its misapplication are the greatest hurdles to pioneering patient-safety efforts. The health care system needs to transform

  3. Safety Behaviors in Adults With Social Anxiety: Review and Future Directions.

    PubMed

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

    2016-09-01

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

  4. Enhancing the NASA Expendable Launch Vehicle Payload Safety Review Process Through Program Activities

    NASA Technical Reports Server (NTRS)

    Palo, Thomas E.

    2007-01-01

    The safety review process for NASA spacecraft flown on Expendable Launch Vehicles (ELVs) has been guided by NASA-STD 8719.8, Expendable Launch Vehicle Payload Safety Review Process Standard. The standard focused primarily on the safety approval required to begin pre-launch processing at the launch site. Subsequent changes in the contractual, technical, and operational aspects of payload processing, combined with lessons-learned supported a need for the reassessment of the standard. This has resulted in the formation of a NASA ELV Payload Safety Program. This program has been working to address the programmatic issues that will enhance and supplement the existing process, while continuing to ensure the safety of ELV payload activities.

  5. Classification of antecedents towards safety use of health information technology: A systematic review.

    PubMed

    Salahuddin, Lizawati; Ismail, Zuraini

    2015-11-01

    This paper provides a systematic review of safety use of health information technology (IT). The first objective is to identify the antecedents towards safety use of health IT by conducting systematic literature review (SLR). The second objective is to classify the identified antecedents based on the work system in Systems Engineering Initiative for Patient Safety (SEIPS) model and an extension of DeLone and McLean (D&M) information system (IS) success model. A systematic literature review (SLR) was conducted from peer-reviewed scholarly publications between January 2000 and July 2014. SLR was carried out and reported based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. The related articles were identified by searching the articles published in Science Direct, Medline, EMBASE, and CINAHL databases. Data extracted from the resultant studies included are to be analysed based on the work system in Systems Engineering Initiative for Patient Safety (SEIPS) model, and also from the extended DeLone and McLean (D&M) information system (IS) success model. 55 articles delineated to be antecedents that influenced the safety use of health IT were included for review. Antecedents were identified and then classified into five key categories. The categories are (1) person, (2) technology, (3) tasks, (4) organization, and (5) environment. Specifically, person is attributed by competence while technology is associated to system quality, information quality, and service quality. Tasks are attributed by task-related stressor. Organisation is related to training, organisation resources, and teamwork. Lastly, environment is attributed by physical layout, and noise. This review provides evidence that the antecedents for safety use of health IT originated from both social and technical aspects. However, inappropriate health IT usage potentially increases the incidence of errors and produces new safety risks. The review cautions future

  6. Energy Storage System Safety: Plan Review and Inspection Checklist

    SciTech Connect

    Cole, Pam C.; Conover, David R.

    Codes, standards, and regulations (CSR) governing the design, construction, installation, commissioning, and operation of the built environment are intended to protect the public health, safety, and welfare. While these documents change over time to address new technology and new safety challenges, there is generally some lag time between the introduction of a technology into the market and the time it is specifically covered in model codes and standards developed in the voluntary sector. After their development, there is also a timeframe of at least a year or two until the codes and standards are adopted. Until existing model codes andmore » standards are updated or new ones are developed and then adopted, one seeking to deploy energy storage technologies or needing to verify the safety of an installation may be challenged in trying to apply currently implemented CSRs to an energy storage system (ESS). The Energy Storage System Guide for Compliance with Safety Codes and Standards1 (CG), developed in June 2016, is intended to help address the acceptability of the design and construction of stationary ESSs, their component parts, and the siting, installation, commissioning, operations, maintenance, and repair/renovation of ESS within the built environment.« less

  7. 78 FR 11902 - Review of Gun Safety Technologies

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-20

    ... Technologies AGENCY: National Institute of Justice, JPO, DOJ. ACTION: Notice. SUMMARY: Following the President... emerging gun safety technologies and plans to issue a report on the availability and use of those technologies. NIJ seeks input from all interested stakeholders to help inform its technology assessment and...

  8. Mars Observer: Phase 0 safety review data package

    NASA Technical Reports Server (NTRS)

    1986-01-01

    The Mars Observer Program has as its primary objectives a study of the geochemistry, atmospheric dynamics, atmosphere/surface interactions, seasonal variations, and magnetic field characteristics of Mars. The Mars Observer Spacecraft, safety critical spacecraft subsystems, ground support equipment, ground operations scenario, requirements matrix, and equipment specifications are described.

  9. Aviation and healthcare: a comparative review with implications for patient safety.

    PubMed

    Kapur, Narinder; Parand, Anam; Soukup, Tayana; Reader, Tom; Sevdalis, Nick

    2016-01-01

    Safety in aviation has often been compared with safety in healthcare. Following a recent article in this journal, the UK government set up an Independent Patient Safety Investigation Service, to emulate a similar well-established body in aviation. On the basis of a detailed review of relevant publications that examine patient safety in the context of aviation practice, we have drawn up a table of comparative features and a conceptual framework for patient safety. Convergence and divergence of safety-related behaviours across aviation and healthcare were derived and documented. Key safety-related domains that emerged included Checklists, Training, Crew Resource Management, Sterile Cockpit, Investigation and Reporting of Incidents and Organisational Culture. We conclude that whilst healthcare has much to learn from aviation in certain key domains, the transfer of lessons from aviation to healthcare needs to be nuanced, with the specific characteristics and needs of healthcare borne in mind. On the basis of this review, it is recommended that healthcare should emulate aviation in its resourcing of staff who specialise in human factors and related psychological aspects of patient safety and staff wellbeing. Professional and post-qualification staff training could specifically include Cognitive Bias Avoidance Training, as this appears to play a key part in many errors relating to patient safety and staff wellbeing.

  10. Aviation and healthcare: a comparative review with implications for patient safety

    PubMed Central

    Parand, Anam; Soukup, Tayana; Reader, Tom; Sevdalis, Nick

    2015-01-01

    Safety in aviation has often been compared with safety in healthcare. Following a recent article in this journal, the UK government set up an Independent Patient Safety Investigation Service, to emulate a similar well-established body in aviation. On the basis of a detailed review of relevant publications that examine patient safety in the context of aviation practice, we have drawn up a table of comparative features and a conceptual framework for patient safety. Convergence and divergence of safety-related behaviours across aviation and healthcare were derived and documented. Key safety-related domains that emerged included Checklists, Training, Crew Resource Management, Sterile Cockpit, Investigation and Reporting of Incidents and Organisational Culture. We conclude that whilst healthcare has much to learn from aviation in certain key domains, the transfer of lessons from aviation to healthcare needs to be nuanced, with the specific characteristics and needs of healthcare borne in mind. On the basis of this review, it is recommended that healthcare should emulate aviation in its resourcing of staff who specialise in human factors and related psychological aspects of patient safety and staff wellbeing. Professional and post-qualification staff training could specifically include Cognitive Bias Avoidance Training, as this appears to play a key part in many errors relating to patient safety and staff wellbeing. PMID:26770817

  11. Defining and Measuring Safety Climate: A Review of the Construction Industry Literature.

    PubMed

    Schwatka, Natalie V; Hecker, Steven; Goldenhar, Linda M

    2016-06-01

    Safety climate measurements can be used to proactively assess an organization's effectiveness in identifying and remediating work-related hazards, thereby reducing or preventing work-related ill health and injury. This review article focuses on construction-specific articles that developed and/or measured safety climate, assessed safety climate's relationship with other safety and health performance indicators, and/or used safety climate measures to evaluate interventions targeting one or more indicators of safety climate. Fifty-six articles met our inclusion criteria, 80% of which were published after 2008. Our findings demonstrate that researchers commonly defined safety climate as perception based, but the object of those perceptions varies widely. Within the wide range of indicators used to measure safety climate, safety policies, procedures, and practices were the most common, followed by general management commitment to safety. The most frequently used indicators should and do reflect that the prevention of work-related ill health and injury depends on both organizational and employee actions. Safety climate scores were commonly compared between groups (e.g. management and workers, different trades), and often correlated with subjective measures of safety behavior rather than measures of ill health or objective safety and health outcomes. Despite the observed limitations of current research, safety climate has been promised as a useful feature of research and practice activities to prevent work-related ill health and injury. Safety climate survey data can reveal gaps between management and employee perceptions, or between espoused and enacted policies, and trigger communication and action to narrow those gaps. The validation of safety climate with safety and health performance data offers the potential for using safety climate measures as a leading indicator of performance. We discuss these findings in relation to the related concept of safety culture and

  12. 78 FR 4477 - Review of Safety Analysis Reports for Nuclear Power Plants, Introduction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-22

    ... NUCLEAR REGULATORY COMMISSION [NRC-2012-0268] Review of Safety Analysis Reports for Nuclear Power... Analysis Reports for Nuclear Power Plants: LWR Edition.'' The new subsection is the Standard Review Plan... Nuclear Power Plants: Integral Pressurized Water Reactor (iPWR) Edition.'' DATES: Comments must be filed...

  13. Pulsed high-energy gamma rays from PSR 1055-52

    NASA Technical Reports Server (NTRS)

    Fierro, J. M.; Bertsch, D. L.; Brazier, K. T.; Chiang, J.; D'Amico, N.; Fichtel, C. E.; Hartman, R. C.; Hunter, S. D.; Johnston, S.; Kanbach, G.

    1993-01-01

    The Energetic Gamma Ray Experiment Telescope (EGRET) aboard the Compton Gamma Ray Observatory has detected a high-energy gamma-ray source at a position coincident with that of the radio pulsar PSR 1055-52. Analysis of the EGRET data at the radio pulsar period of 197 ms has revealed pulsed gamma-radiation at energies above 300 MeV, making PSR 1055-52 the fifth detected high-energy gamma-ray pulsar. The pulsed radiation from PSR 1055-52 has a very hard photon spectral index of -1.18 +/- 0.16 and a high efficiency for converting its rotational energy into gamma-rays. No unpulsed emission was observed.

  14. Mechanical and thermal disturbances of the PSR Moderate Focus-Mission Structure

    NASA Technical Reports Server (NTRS)

    Shih, Choon-Foo; Lou, Michael C.

    1991-01-01

    The primary objective of this paper is to evaluate the optical pointing performance of the PSR Moderate Focus-Mission Structure when subjected to both mechanical and thermal disturbances. The mechanical disturbances are based on secondary mirror chopping. Results indicate that dynamic responses of the primary reflector and the secondary reflector subjected to chopping disturbances of the secondary reflector about its center of mass are within the figure maintenance control capabilities. The effects of modal damping, truss-type secondary support, interface boundary constraints, and alternate configurations, are also evaluated in the analysis. Thermal distortions of the structure were also evaluated based on the on-orbit temperature profiles derived from the submillimeter telescope missions. Results from thermal deformation analysis indicate that figure initialization control is needed for the PSR Moderate Focus-Mission. However, a figure maintenance system may not be required if adequate thermal isolation is incorporated into the support truss design for the PSR Moderate Focus-Mission Structure.

  15. Status of patient safety culture in Arab countries: a systematic review

    PubMed Central

    Almashrafi, Ahmed; Banarsee, Ricky

    2017-01-01

    Objectives To explore the status of patient safety culture in Arab countries based on the findings of the Hospital Survey on Patient Safety Culture (HSPSC). Design Systematic review. Methods We performed electronic searches of the MEDLINE, EMBASE, CINAHL, ProQuest and PsychINFO, Google Scholar and PubMed databases, with manual searches of bibliographies of included articles and key journals. We included studies that were conducted in the Arab countries that were focused on patient safety culture. 2 reviewers independently verified that the studies met the inclusion criteria and critically assessed the quality of the studies. Results 18 studies met our inclusion criteria. The review identified that non-punitive response to error is seen as a serious issue which needs to be improved. Healthcare professionals in the Arab countries tend to think that a ‘culture of blame’ still exists that prevents them from reporting incidents. We found an overall similarity between the reported composite score for dimension of teamwork within units in all of the reviewed studies. Teamwork within units was found to be better than teamwork across hospital units. All of the reviewed studies reported that organisational learning and continuous improvement was satisfactory as the average score of this dimension for all studies was 73.2%. Moreover, the review found that communication openness seems to be a concerning issue for healthcare professionals in the Arab countries. Conclusions There is a need to promote patient safety culture as a strategy for improving the patient safety in the Arab world. Improving patient safety culture should include all stakeholders, like policymakers, healthcare providers and those responsible for medical education. This review was limited only to English language publications. The varied settings in which the HSPSC was used may have influenced the areas of strengths and weaknesses as healthcare workers' perception of safety culture may differ. PMID

  16. The objective impact of clinical peer review on hospital quality and safety.

    PubMed

    Edwards, Marc T

    2011-01-01

    Despite its importance, the objective impact of clinical peer review on the quality and safety of care has not been studied. Data from 296 acute care hospitals show that peer review program and related organizational factors can explain up to 18% of the variation in standardized measures of quality and patient safety. The majority of programs rely on an outmoded and dysfunctional process model. Adoption of best practices informed by the continuing study of peer review program effectiveness has the potential to significantly improve patient outcomes.

  17. Patient safety risks associated with telecare: a systematic review and narrative synthesis of the literature.

    PubMed

    Guise, Veslemøy; Anderson, Janet; Wiig, Siri

    2014-11-25

    Patient safety risk in the homecare context and patient safety risk related to telecare are both emerging research areas. Patient safety issues associated with the use of telecare in homecare services are therefore not clearly understood. It is unclear what the patient safety risks are, how patient safety issues have been investigated, and what research is still needed to provide a comprehensive picture of risks, challenges and potential harm to patients due to the implementation and use of telecare services in the home. Furthermore, it is unclear how training for telecare users has addressed patient safety issues. A systematic review of the literature was conducted to identify patient safety risks associated with telecare use in homecare services and to investigate whether and how these patient safety risks have been addressed in telecare training. Six electronic databases were searched in addition to hand searches of key items, reference tracking and citation tracking. Strict inclusion and exclusion criteria were set. All included items were assessed according to set quality criteria and subjected to a narrative synthesis to organise and synthesize the findings. A human factors systems framework of patient safety was used to frame and analyse the results. 22 items were included in the review. 11 types of patient safety risks associated with telecare use in homecare services emerged. These are in the main related to the nature of homecare tasks and practices, and person-centred characteristics and capabilities, and to a lesser extent, problems with the technology and devices, organisational issues, and environmental factors. Training initiatives related to safe telecare use are not described in the literature. There is a need to better identify and describe patient safety risks related to telecare services to improve understandings of how to avoid and minimize potential harm to patients. This process can be aided by reframing known telecare implementation

  18. A Review of the Quality and Safety of Irradiated Food.

    DTIC Science & Technology

    1987-01-01

    Construction or Planned.................16 Figure 4: Changes in the Levels of Certain Vitamins in Different Meats Irradiated at High Doses..........24...In the twenty year5 prior to this action, irradiation had been approved for wheat, wheat products, and white potatoes but the process wa- * never used...restriu-t the ujse of . this process or require some type ol labeling. Conumri %>:~ concern about the safety and quality of irradiated food - ha

  19. A 100-Year Review: Microbiology and safety of milk handling.

    PubMed

    Boor, Kathryn J; Wiedmann, Martin; Murphy, Sarah; Alcaine, Sam

    2017-12-01

    Microbes that may be present in milk can include pathogens, spoilage organisms, organisms that may be conditionally beneficial (e.g., lactic acid bacteria), and those that have not been linked to either beneficial or detrimental effects on product quality or human health. Although milk can contain a full range of organisms classified as microbes (i.e., bacteria, viruses, fungi, and protozoans), with few exceptions (e.g., phages that affect fermentations, fungal spoilage organisms, and, to a lesser extent, the protozoan pathogens Cryptosporidium and Giardia) dairy microbiology to date has focused predominantly on bacteria. Between 1917 and 2017, our understanding of the microbes present in milk and the tools available for studying those microbes have changed dramatically. Improved microbiological tools have enabled enhanced detection of known microbes in milk and dairy products and have facilitated better identification of pathogens and spoilage organisms that were not known or well recognized in the early 20th century. Starting before 1917, gradual introduction and refinement of pasteurization methods throughout the United States and many other parts of the world have improved the safety and quality of milk and dairy products. In parallel to pasteurization, others strategies for reducing microbial contamination throughout the dairy chain (e.g., improved dairy herd health, raw milk tests, clean-in-place technologies) also played an important role in improving microbial milk quality and safety. Despite tremendous advances in reducing microbial food safety hazards and spoilage issues, the dairy industry still faces important challenges, including but not limited to the need for improved science-based strategies for safety of raw milk cheeses, control of postprocessing contamination, and control of sporeforming pathogens and spoilage organisms. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  20. Observation of pulsed hard X-rays/gamma-rays from PSR 1509-58

    NASA Astrophysics Data System (ADS)

    Gunji, S.; Hirayama, M.; Kamae, T.; Miyazaki, S.; Sekimoto, Y.; Takahashi, T.; Tamura, T.; Tanaka, M.; Yamasaki, N.; Yamagami, T.; Nomachi, M.; Murakami, H.; Braga, J.; Neri, J. A.

    1994-06-01

    We observed a young rotation-powered pulsar, PSR 1509-58, in the hard X-ray/gamma-ray or the soft gamma-ray band with a balloon-borne detector in Brazil on 1991 November 19 (UT). With a timing analysis we detected pulsations in the energy band 94-240 keV at the 150.687 ms period determined from radio observations. The pulsating flux is (7.1 +/- 1.7) x 10-4 per sq cm per sec in this band, and the energy spectrum follows a power law with photon index alpha = 1.64 +/- 0.4. The averaged pulse profile shows a broad single peak with a sharp rise and has a duty cycle around 50% or higher: these features are similar to what have been observed in the X-ray band by the Ginga satellite. Based on the data available now, the fraction of energy transformed from rotational energy loss to pulsed/nonpulsed soft gamma-ray radiation is estimated. If the solid angle swept by the pulsed beam is about the same as for the Crab pulsar (PSR 0531+21) and the Vela pulsar (PSR 0833-45), PSR 1509-58 turn out to be an extremely efficient pulsar, converting a large fraction of its rotational energy loss to radiation, as the outer gap model predicts. The observed pulsed spectrum, however, is strong in the soft gamma-ray band, in a sharp contrast to what has been observed in the Vela pulsar, a pulsar expected to be similar PSR 1509-58 in the outer gap model. The fact that the pulse profile remains broad and single-peaked in the soft gamma-ray band is also new for Crab-like pulsars. In these regards, PSR 1509-58 may require some alteration to the standard outer gap model or even a new model for gamma-ray emission in pulsars.

  1. RADIO IMAGING OBSERVATIONS OF PSR J1023+0038 IN AN LMXB STATE

    SciTech Connect

    Deller, A. T.; Moldon, J.; Patruno, A.

    2015-08-10

    The transitional millisecond pulsar (MSP) binary system PSR J1023+0038 re-entered an accreting state in 2013 June in which it bears many similarities to low-mass X-ray binaries (LMXBs) in quiescence or near-quiescence. At a distance of just 1.37 kpc, PSR J1023+0038 offers an unsurpassed ability to study low-level accretion onto a highly magnetized compact object. We have monitored PSR J1023+0038 intensively using radio imaging with the Karl G. Jansky Very Large Array, the European VLBI Network and the Low Frequency Array, seeing rapidly variable, flat spectrum emission that persists over a period of six months. The flat spectrum and variability aremore » indicative of synchrotron emission originating in an outflow from the system, most likely in the form of a compact, partially self-absorbed jet, as is seen in LMXBs at higher accretion rates. The radio brightness, however, greatly exceeds extrapolations made from observations of more vigorously accreting neutron star LMXB systems. We postulate that PSR J1023+0038 is undergoing radiatively inefficient “propeller-mode” accretion, with the jet carrying away a dominant fraction of the liberated accretion luminosity. We confirm that the enhanced γ-ray emission seen in PSR J1023+0038 since it re-entered an accreting state has been maintained; the increased γ-ray emission in this state can also potentially be associated with propeller-mode accretion. Similar accretion modes can be invoked to explain the radio and X-ray properties of the other two known transitional MSP systems XSS J12270–4859 and PSR J1824–2452I (M28I), suggesting that radiatively inefficient accretion may be a ubiquitous phenomenon among (at least one class of) neutron star binaries at low accretion rates.« less

  2. Measurement of patient safety: a systematic review of the reliability and validity of adverse event detection with record review

    PubMed Central

    Hanskamp-Sebregts, Mirelle; Zegers, Marieke; Vincent, Charles; van Gurp, Petra J; de Vet, Henrica C W; Wollersheim, Hub

    2016-01-01

    Objectives Record review is the most used method to quantify patient safety. We systematically reviewed the reliability and validity of adverse event detection with record review. Design A systematic review of the literature. Methods We searched PubMed, EMBASE, CINAHL, PsycINFO and the Cochrane Library and from their inception through February 2015. We included all studies that aimed to describe the reliability and/or validity of record review. Two reviewers conducted data extraction. We pooled κ values (κ) and analysed the differences in subgroups according to number of reviewers, reviewer experience and training level, adjusted for the prevalence of adverse events. Results In 25 studies, the psychometric data of the Global Trigger Tool (GTT) and the Harvard Medical Practice Study (HMPS) were reported and 24 studies were included for statistical pooling. The inter-rater reliability of the GTT and HMPS showed a pooled κ of 0.65 and 0.55, respectively. The inter-rater agreement was statistically significantly higher when the group of reviewers within a study consisted of a maximum five reviewers. We found no studies reporting on the validity of the GTT and HMPS. Conclusions The reliability of record review is moderate to substantial and improved when a small group of reviewers carried out record review. The validity of the record review method has never been evaluated, while clinical data registries, autopsy or direct observations of patient care are potential reference methods that can be used to test concurrent validity. PMID:27550650

  3. The X-ray-emitting trail of the nearby pulsar PSR1929 + 10

    NASA Technical Reports Server (NTRS)

    Wang, Q. D.; Li, Zhi-Yun; Begelman, Mitchell C.

    1993-01-01

    The paper reports the detection by the Rosat satellite of a nebula associated with the nearby pulsar PSR1929 + 10, which is of a type different from the pulsar-wind nebulae produced by direct interaction of the relativistic wind from older pulsars with the interstellar medium (ISM) (Blandorf et al., 1973). The PSR1929 + 10 nebula appears as a linear diffuse X-ray feature in the direction opposite to the pulsar's proper motion, with the pulsar wind confined by the ram-pressure arising from the high velocity of the pulsar through the ISM. This results in a trail of relativistic electrons with enhanced emissions of synchrotron radiation.

  4. Multipacting on the trailing edge of proton beam bunches in the PSR and SNS

    NASA Astrophysics Data System (ADS)

    Danilov, V.; Aleksandrov, A.; Galambos, J.; Jeon, D.; Holmes, J.; Olsen, D.

    1999-12-01

    The Proton Storage Ring (PSR) in Los Alamos has a fast intensity-limiting instability, which may result from an electron cloud interaction with the circulating proton beam leading to a transverse mode coupling instability. The most probable mechanism of the electron creation is multipacting. Though the effect depends on many parameters, a model is presented which predicts a large electron creation in the vacuum chamber. A comparison of this effect between the PSR in Los Alamos and the Spallation Neutron Source (SNS) in Oak Ridge is given. In addition, several possibilities to reduce multipactor are discussed.

  5. A systematic review of patient safety in mental health: a protocol based on the inpatient setting.

    PubMed

    D'Lima, Danielle; Archer, Stephanie; Thibaut, Bethan Ines; Ramtale, Sonny Christian; Dewa, Lindsay H; Darzi, Ara

    2016-11-29

    Despite the growing international interest in patient safety as a discipline, there has been a lack of exploration of its application to mental health. It cannot be assumed that findings based upon physical health in acute care hospitals can be applied to mental health patients, disorders and settings. To the authors' knowledge, there has only been one review of the literature that focuses on patient safety research in mental health settings, conducted in Canada in 2008. We have identified a need to update this review and develop the methodology in order to strengthen the findings and disseminate internationally for advancement in the field. This systematic review will explore the existing research base on patient safety in mental health within the inpatient setting. To conduct this systematic review, a thorough search across multiple databases will be undertaken, based upon four search facets ("mental health", "patient safety", "research" and "inpatient setting"). The search strategy has been developed based upon the Canadian review accompanied with input from the National Reporting and Learning System (NRLS) taxonomy of patient safety incidents and the Diagnostic and Statistical Manual of Mental Disorders (fifth edition). The screening process will involve perspectives from at least two researchers at all stages with a third researcher invited to review when discrepancies require resolution. Initial inclusion and exclusion criteria have been developed and will be refined iteratively throughout the process. Quality assessment and data extraction of included articles will be conducted by at least two researchers. A data extraction form will be developed, piloted and iterated as necessary in accordance with the research question. Extracted information will be analysed thematically. We believe that this systematic review will make a significant contribution to the advancement of patient safety in mental health inpatient settings. The findings will enable the

  6. Food Safety Evaluation Based on Near Infrared Spectroscopy and Imaging: A Review.

    PubMed

    Fu, Xiaping; Ying, Yibin

    2016-08-17

    In recent years, due to the increasing consciousness of food safety and human health, much progress has been made in developing rapid and nondestructive techniques for the evaluation of food hazards, food authentication, and traceability. Near infrared (NIR) spectroscopy and imaging techniques have gained wide acceptance in many fields because of their advantages over other analytical techniques. Following a brief introduction of NIR spectroscopy and imaging basics, this review mainly focuses on recent NIR spectroscopy and imaging applications for food safety evaluation, including (1) chemical hazards detection; (2) microbiological hazards detection; (3) physical hazards detection; (4) new technology-induced food safety concerns; and (5) food traceability. The review shows NIR spectroscopy and imaging to be effective tools that will play indispensable roles for food safety evaluation. In addition, on-line/real-time applications of these techniques promise to be a huge growth field in the near future.

  7. Multivitamin/mineral supplements: Rationale and safety - A systematic review.

    PubMed

    Biesalski, Hans K; Tinz, Jana

    2017-01-01

    Multivitamin/mineral supplements (MVM) are widely used in many populations. In particular, in pregnant women, MVM together with iron and folic acid are recommended to improve birth outcome and reduce low birth weight and rates of miscarriage. However, MVM use is common in the general population. This raises questions regarding the safety of long-term use of these supplements. To estimate the safety of MVM use, we performed a literature search for randomized, controlled studies for supplements with a combination of at least nine vitamins and three minerals at a maximum concentration of 100% of the recommended dietary allowance. We found nine studies evaluating the use and efficacy of MVM in pregnant women and healthy adults and six studies in the elderly where adverse effects were explicitly addressed. Only minor adverse effects (e.g., unspecific gastrointestinal symptoms) were reported in all studies. In particular, there were no significant differences between treatment and placebo groups. MVM use within the range of the dietary reference intake will not result in excess intake, even when including the impact of food and fortified food, and does not increase mortality. Taken together, these findings indicate that MVM can be safe for long-term use (more than 10 y). Copyright © 2016 Elsevier Inc. All rights reserved.

  8. A review of wiring system safety in space power systems

    NASA Technical Reports Server (NTRS)

    Stavnes, Mark W.; Hammoud, Ahmad N.

    1993-01-01

    Wiring system failures have resulted from arc propagation in the wiring harnesses of current aerospace vehicles. These failures occur when the insulation becomes conductive upon the initiation of an arc. In some cases, the conductive path of the carbon arc track displays a high enough resistance such that the current is limited, and therefore may be difficult to detect using conventional circuit protection. Often, such wiring failures are not simply the result of insulation failure, but are due to a combination of wiring system factors. Inadequate circuit protection, unforgiving system designs, and careless maintenance procedures can contribute to a wiring system failure. This paper approaches the problem with respect to the overall wiring system, in order to determine what steps can be taken to improve the reliability, maintainability, and safety of space power systems. Power system technologies, system designs, and maintenance procedures which have led to past wiring system failures will be discussed. New technologies, design processes, and management techniques which may lead to improved wiring system safety will be introduced.

  9. Safety of Sculptra: a review of clinical trial data.

    PubMed

    Engelhard, Peter; Humble, Gail; Mest, Douglas

    2005-12-01

    The development of facial lipoatrophy as a result of highly active antiretroviral therapy (HAART) used to treat patients with human immunodeficiency virus (HIV) has adversely affected patient quality of life and compliance with therapy. Thanks to modern pharmacotherapies, HIV can now be viewed as a chronic disease; however, this welcome change has exacerbated the effect of facial lipoatrophy since HIV-infected patients can now expect to live longer and healthier lives but remain subject to public scrutiny of their ongoing disease state. Sculptra (Dermik Laboratories, Berwyn, PA, USA) has recently been introduced in the USA for correction of the appearance of facial lipoatrophy. The device affords long-lasting restoration while still being non-permanent, thus providing an extended but adjustable cosmetic effect. The safety profile of this product has been observed in four investigator-initiated clinical trials of more than 250 HIV patients and in numerous investigator reports, with no serious adverse events or infections deemed associated with the product. Maintenance of the excellent safety profile for this injectable device requires adherence to a novel technique and appreciation of its unique attributes.

  10. Haunted exoplanets around the pulsar PSR1257+12 received scary names. (Italian Title: Battezzati 3 esopianeti attorno alla pulsar PSR1257+12)

    NASA Astrophysics Data System (ADS)

    Ciprari, L.

    2016-05-01

    Following the competition Name Exoworlds, organized by the International Astronomical Union (IAU), and on a proposal submitted from Planetarium Alto Adige/Südtirol, won with 2305 votes, the exoplanetary system PSR1257 + 12, consisting of a millisecond neutron star and three planets of roughly the mass of our Earth, has officially received the name Lich for the pulsar and Draugr, Poltergeist and Phobetor for the three exoplanets.

  11. 75 FR 80538 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Safety...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-22

    ...The Department of Labor (DOL) hereby announces the submission of the Mine Safety and Health Administration (MSHA)sponsored information collection request (ICR) titled, ``Safety Defects; Examination, Correction, and Records,'' to the Office of Management and Budget (OMB) for review and approval for continued use in accordance with the Paperwork Reduction Act of 1995 (Pub. L. 104-13, 44 U.S.C. chapter 35).

  12. Manned space flight nuclear system safety. Volume 7: Literature review. Part 1: Literature search and evaluation

    NASA Technical Reports Server (NTRS)

    1972-01-01

    A review of the literature used in conducting the manned space flight nuclear system safety study is presented. The objectives of the presentation are to identify and evaluate for potential application to study the existing related literature and to provide the information required to include the related literature in the NASA Aerospace Safety Research and Data Institute. More than 15,000 documents were evaluated and identification forms were prepared for 850 reports.

  13. A Review of Digital Addiction: A Call for Safety Education

    ERIC Educational Resources Information Center

    Rugai, Joseph; Hamiliton-Ekeke, Joy-Telu

    2016-01-01

    In reviewing digital addiction, this paper recognized that digital technology has been useful in various spheres of life and the reach is undeniable, with an "average" user spending long hours on their phone or online daily. These hours increase as new applications are released by various technological companies. The demands of modern…

  14. A systematic review of the safety climate intervention literature: Past trends and future directions.

    PubMed

    Lee, Jin; Huang, Yueng-Hsiang; Cheung, Janelle H; Chen, Zhuo; Shaw, William S

    2018-04-26

    Safety climate represents the meaningfulness of safety and how safety is valued in an organization. The contributions of safety climate to organizational safety have been well documented. There is a dearth of empirical research, however, on specific safety climate interventions and their effectiveness. The present study aims at examining the trend of safety climate interventions and offering compiled information for designing and implementing evidence-based safety climate interventions. Our literature search yielded 384 titles that were inspected by three examiners. Using a stepwise process that allowed for assessment of interobserver agreement, 19 full articles were selected and reviewed. Results showed that 10 out of the 19 articles (52.6%) were based on a quasi-experimental pre- and postintervention design, whereas 42.1% (n = 8) studies were based on a mixed-design approach (including both between- and within-subject design). All interventions in these 19 studies involved either safety-/health-related communication or education/training. Improvement of safety leadership was also a common component of safety climate interventions. According to the socio-technical systems classification of intervention strategies, all studies were categorized as interventions focusing on improving organizational and managerial structure as well as the personnel subsystem; four of them also aimed at improving technological aspects of work, and five of them aimed at improving the physical work subsystem. In general, a vast majority of the studies (89.5%, n = 17) showed a statistically significant improvement in safety climate across their organizations postintervention. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  15. Panel Resource Management (PRM) Implementation and Effects within Safety Review Panel Settings and Dynamics

    NASA Technical Reports Server (NTRS)

    Taylor, Robert W.; Nash, Sally K.

    2007-01-01

    While technical training and advanced degree's assure proficiency at specific tasks within engineering disciplines, they fail to address the potential for communication breakdown and decision making errors familiar to multicultural environments where language barriers, intimidating personalities and interdisciplinary misconceptions exist. In an effort to minimize these pitfalls to effective panel review, NASA's lead safety engineers to the ISS Safety Review Panel (SRP), and Payload Safety Review Panel (PSRP) initiated training with their engineers, in conjunction with the panel chairs, and began a Panel Resource Management (PRM) program. The intent of this program focuses on the ability to reduce the barriers inhibiting effective participation from all panel attendees by bolstering participants confidence levels through increased communication skills, situational awareness, debriefing, and a better technical understanding of requirements and systems.

  16. Does classroom-based Crew Resource Management training improve patient safety culture? A systematic review

    PubMed Central

    de Bruijne, Martine C; Zwijnenberg, Nicolien C; Jansma, Elise P; van Dyck, Cathy; Wagner, Cordula

    2014-01-01

    Aim: To evaluate the evidence of the effectiveness of classroom-based Crew Resource Management training on safety culture by a systematic review of literature. Methods: Studies were identified in PubMed, Cochrane Library, PsycINFO, and Educational Resources Information Center up to 19 December 2012. The Methods Guide for Comparative Effectiveness Reviews was used to assess the risk of bias in the individual studies. Results: In total, 22 manuscripts were included for review. Training settings, study designs, and evaluation methods varied widely. Most studies reporting only a selection of culture dimensions found mainly positive results, whereas studies reporting all safety culture dimensions of the particular survey found mixed results. On average, studies were at moderate risk of bias. Conclusion: Evidence of the effectiveness of Crew Resource Management training in health care on safety culture is scarce and the validity of most studies is limited. The results underline the necessity of more valid study designs, preferably using triangulation methods. PMID:26770720

  17. Research priorities in occupational safety and health: a review.

    PubMed

    Iavicoli, Sergio; Rondinone, Bruna; Marinaccio, Alessandro; Fingerhut, Marilyn

    2006-01-01

    Changes in the world of work in the last few decades have markedly affected questions regarding occupational safety and health (OSH). Jobs in our economy continue to shift from manufacturing to services. Longer hours, shift work, reduced job security, temporary work are realities in the modern workplace, new chemicals, materials, processes are developed at an ever accelerating pace. The workforce is also changing. It will become older and more racially diverse and women are increasing. These changes present new challenges to protect worker safety and health and it was been indispensable to redefine priorities, by consulting all those involved in OSH. The present study therefore made a critical comparative analysis of the main published projects to identify research priorities in the OSH field, comparing methods, approaches and results. Comparison of the priority areas established in each of these studies is inherently difficult due to differences in socio-cultural backgrounds, in the methods employed to identify priority topics, and the many factors involved. However, it is clear that the Delphi technique is widely used as a reliable method, in that it covers a broad range of qualified witnesses, from a variety of backgrounds--such as trade union representatives and researchers--providing different viewpoints. It also takes account of the intrinsic features of OSH which--compared to other disciplines--involves multidisciplinary factors calling into play a range of scientific settings, such as toxicologists, molecular biologists, epidemiologists, occupational hygienists and occupational physicians. This analysis showed how important it is to reach consensus among all those operating in the OSH sector, in order to establish standard methods that can be applied in different contexts, and give results that can be validly compared.

  18. Effectiveness of health and safety in small enterprises: a systematic review of quantitative evaluations of interventions.

    PubMed

    Breslin, F Curtis; Kyle, Natasha; Bigelow, Philip; Irvin, Emma; Morassaei, Sara; MacEachen, Ellen; Mahood, Quenby; Couban, Rachel; Shannon, Harry; Amick, Benjamin C

    2010-06-01

    This systematic review was conducted to identify effective occupational health and safety interventions for small businesses. The review focused on peer-reviewed intervention studies conducted in small businesses with 100 or fewer employees, that were published in English and several other languages, and that were not limited by publication date. Multidisciplinary members of the review team identified relevant articles and assessed their quality. Studies assessed as medium or high quality had data extracted, which was then synthesized. Five studies were deemed of medium or high quality, and proceeded to data extraction and evidence synthesis. The types of interventions identified: a combination of training and safety audits; and a combination of engineering, training, safety audits, and a motivational component, showed a limited amount of evidence in improving safety outcomes. Overall, this evidence synthesis found a moderate level of evidence for intervention effectiveness, and found no evidence that any intervention had adverse effects. Even though there were few studies that adequately evaluated small business intervention, several studies demonstrate that well-designed evaluations are possible with small businesses. While stronger levels of evidence are required to make recommendations, these interventions noted above were associated with positive changes in safety-related attitudes and beliefs and workplace parties should be aware of them.

  19. Assessment of documentation requirements under DOE 5481. 1, Safety Analysis and Review System (SARS)

    SciTech Connect

    Browne, E.T.

    1981-03-01

    This report assesses the requirements of DOE Order 5481.1, Safety Analysis and Review System for DOE Operations (SARS) in regard to maintaining SARS documentation. Under SARS, all pertinent details of the entire safety analysis and review process for each DOE operation are to be traceable from the initial identification of a hazard. This report is intended to provide assistance in identifying the points in the SARS cycle at which documentation is required, what type of documentation is most appropriate, and where it ultimately should be maintained.

  20. Identification of a novel PSR as the substrate of an SR protein kinase in the true slime mold.

    PubMed

    Zhang, Yong-Xia; Xing, Miao; Fei, Xuan; Zhang, Jian-Hua; Tian, Sheng-Li; Li, Ming-Hua; Liu, Shi-De

    2011-03-01

    Here, a novel cDNA encoding a serine/arginine (SR)-rich protein, designated PSR, was isolated from the true slime mold Physarum polycephalum and expressed in Escherichia coli. The deduced amino acid (aa) sequence reveals that PSR contains RS repeats at its C-terminus, similar to the conventional PSRPK substrate ASF/SF2. To study the novel protein, we generated a variety of mutant constructs by PCR and site-directed mutagenesis. Our analysis indicated that the purified recombinant PSR was phosphorylated by PSRPK in vitro and the SR-rich domain (amino acids 460-469) in the PSR protein was required for phosphorylation. In addition, removal of the docking motif (amino acids 424-450) from PSR significantly reduced the overall catalytic efficiency of the phosphorylation reaction. We also found that the conserved ATP-binding region (62)LGWGHFSTVWLAIDEKNGGREVALK(86) and the serine/threonine protein kinases active-site signature (184)IIHTDLKPENVLL(196) of PSRPK played a crucial role in substrate phosphorylation and Lys(86) and Asp(188) were crucial for PSRPK phosphorylation of PSR. These results suggest that PSR is a novel SR-related protein that is phosphorylated by PSRPK.

  1. 7. Credit PSR. Interior of Building 4401, looking 200° (south ...

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

    7. Credit PSR. Interior of Building 4401, looking 200° (south southwest), showing original interior wooden construction of walls and roof trusses. Hangar is presently used for storage. - Edwards Air Force Base, North Base, Hangar No. 1, First & B Streets, Boron, Kern County, CA

  2. The integrated phenotype and plasticity of Cuphea PSR23: A semi-domesticated oilseed crop

    USDA-ARS?s Scientific Manuscript database

    Cuphea PSR23, a semi-domesticated potential oilseed crop, is a selection from an interspecific cross between the wild species Cuphea lanceolata and C. viscosissima. Understanding the extent to which its phenotype is integrated, by studying complex trait interactions and interdependencies, is critica...

  3. Dehulling of Cuphea PSR23 Seeds to Reduce Color of the Extracted Oil

    USDA-ARS?s Scientific Manuscript database

    Oil extracted from the seeds Cuphea PSR23, a semi-domesticated, high-capric acid hybrid from C. viscosissima x C. lanceolata, by screw-pressing contained 200-360 ppm of chlorophyll. A high amount of bleaching clay was needed during refining to remove the chlorophyll in the oil. In this paper, dehu...

  4. Credit PSR. View looks south southeast (160°) across top of ...

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

    Credit PSR. View looks south southeast (160°) across top of Imhoff Tank. Bare earth directly beyond tank demarks sewage canal which conducted wastes to a sewage lagoon at the edge of Rogers Dry Lake. Main Base at Edwards AFB appears across the lakebed - Edwards Air Force Base, North Base, Imhoff Tank, Southwest of E Street, Boron, Kern County, CA

  5. Credit PSR. View looks south (180°) across North Base Road ...

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

    Credit PSR. View looks south (180°) across North Base Road at foundations for Quarters "A", one arm of which appears at right. Bare earth at extreme left is entrance to parking lot between Quarters "A" and "B" - Edwards Air Force Base, North Base, Officers' Quarters B, North Base Road, Boron, Kern County, CA

  6. Credit PSR. View looks east southeast (118°) across foundations of ...

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

    Credit PSR. View looks east southeast (118°) across foundations of North Base Administration Building (originally numbered T-50) toward Building 4318 (Warehouse) and Building 4305 (Unicon Portable Hangar). Building 4401 (Hangar No. 1) appears in extreme left background - Edwards Air Force Base, North Base, Administration Building T-50, D Street, Boron, Kern County, CA

  7. Credit PSR. View looks west southwest (238°) at the north ...

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

    Credit PSR. View looks west southwest (238°) at the north and east elevations of the liner lab. Solid rocket motor casings receive specially formulated rubber insulating liners that protect the casings from the heat generated by burning solid motors - Jet Propulsion Laboratory Edwards Facility, Liner Laboratory, Edwards Air Force Base, Boron, Kern County, CA

  8. Credit PSR. View looks northeast (40°) across Imhoff Tank (Building ...

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

    Credit PSR. View looks northeast (40°) across Imhoff Tank (Building 4331) Imhoff Tank. This World War II wooden structure served as a sewage treatment facility for North Base - Edwards Air Force Base, North Base, Imhoff Tank, Southwest of E Street, Boron, Kern County, CA

  9. Identification of PSR1758-23 as a runaway pulsar from the supernova remnant W28

    NASA Technical Reports Server (NTRS)

    Frall, D. A.; Kulkarni, S. R.; Vasisht, G.

    1993-01-01

    New observations are presented which indicate that the large dispersion and scattering of the pulses from PSR1758-23 are caused by a dense screen of ionized material located along the line of sight. This reconciles the distances to the pulsar with that to SNR W28.

  10. 1. Credit PSR. View looks north northeast (18°) down typical ...

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

    1. Credit PSR. View looks north northeast (18°) down typical dust ditch paralleling First Street. Building 4401 (Hangar No. 1) appears at the extreme right of the view. Building 4456 (Fire House No. 4), Building 4444 (Communications Building), and Building 4505 appear in the background. - Edwards Air Force Base, North Base, Dust Ditch System, Traversing North Base, Boron, Kern County, CA

  11. Trends in HFE Methods and Tools and Their Applicability to Safety Reviews

    SciTech Connect

    O'Hara, J.M.; Plott, C.; Milanski, J.

    2009-09-30

    The U.S. Nuclear Regulatory Commission's (NRC) conducts human factors engineering (HFE) safety reviews of applicant submittals for new plants and for changes to existing plants. The reviews include the evaluation of the methods and tools (M&T) used by applicants as part of their HFE program. The technology used to perform HFE activities has been rapidly evolving, resulting in a whole new generation of HFE M&Ts. The objectives of this research were to identify the current trends in HFE methods and tools, determine their applicability to NRC safety reviews, and identify topics for which the NRC may need additional guidance tomore » support the NRC's safety reviews. We conducted a survey that identified over 100 new HFE M&Ts. The M&Ts were assessed to identify general trends. Seven trends were identified: Computer Applications for Performing Traditional Analyses, Computer-Aided Design, Integration of HFE Methods and Tools, Rapid Development Engineering, Analysis of Cognitive Tasks, Use of Virtual Environments and Visualizations, and Application of Human Performance Models. We assessed each trend to determine its applicability to the NRC's review by considering (1) whether the nuclear industry is making use of M&Ts for each trend, and (2) whether M&Ts reflecting the trend can be reviewed using the current design review guidance. We concluded that M&T trends that are applicable to the commercial nuclear industry and are expected to impact safety reviews may be considered for review guidance development. Three trends fell into this category: Analysis of Cognitive Tasks, Use of Virtual Environments and Visualizations, and Application of Human Performance Models. The other trends do not need to be addressed at this time.« less

  12. Reviewing methodologically disparate data: a practical guide for the patient safety research field.

    PubMed

    Brown, Katrina F; Long, Susannah J; Athanasiou, Thanos; Vincent, Charles A; Kroll, J Simon; Sevdalis, Nick

    2012-02-01

    This article addresses key questions frequently asked by researchers conducting systematic reviews in patient safety. This discipline is relatively young, and asks complex questions about complex aspects of health care delivery and experience, therefore its studies are typically methodologically heterogeneous, non-randomized and complex; but content rich and highly relevant to practice. Systematic reviews are increasingly necessary to drive forward practice and research in this area, but the data do not always lend themselves to 'standard' review methodologies. This accessible 'how-to' article demonstrates that data diversity need not preclude high-quality systematic reviews. It draws together information from published guidelines and experience within our multidisciplinary patient safety research group to provide entry-level advice for the clinician-researcher new to systematic reviewing, to non-biomedical research data or to both. It offers entry-level advice, illustrated with detailed practical examples, on defining a research question, creating a comprehensive search strategy, selecting articles for inclusion, assessing study quality, extracting data, synthesizing data and evaluating the impact of your review. The article concludes with a comment on the vital role of robust systematic reviews in the continuing advancement of the patient safety field. © 2010 Blackwell Publishing Ltd.

  13. Multimorbidity and Patient Safety Incidents in Primary Care: A Systematic Review and Meta-Analysis

    PubMed Central

    Panagioti, Maria; Stokes, Jonathan; Esmail, Aneez; Coventry, Peter; Cheraghi-Sohi, Sudeh; Alam, Rahul; Bower, Peter

    2015-01-01

    Background Multimorbidity is increasingly prevalent and represents a major challenge in primary care. Patients with multimorbidity are potentially more likely to experience safety incidents due to the complexity of their needs and frequency of their interactions with health services. However, rigorous syntheses of the link between patient safety incidents and multimorbidity are not available. This review examined the relationship between multimorbidity and patient safety incidents in primary care. Methods We followed our published protocol (PROSPERO registration number: CRD42014007434). Medline, Embase and CINAHL were searched up to May 2015. Study design and quality were assessed. Odds ratios (OR) and 95% confidence intervals (95% CIs) were calculated for the associations between multimorbidity and two categories of patient safety outcomes: ‘active patient safety incidents’ (such as adverse drug events and medical complications) and ‘precursors of safety incidents’ (such as prescription errors, medication non-adherence, poor quality of care and diagnostic errors). Meta-analyses using random effects models were undertaken. Results Eighty six relevant comparisons from 75 studies were included in the analysis. Meta-analysis demonstrated that physical-mental multimorbidity was associated with an increased risk for ‘active patient safety incidents’ (OR = 2.39, 95% CI = 1.40 to 3.38) and ‘precursors of safety incidents’ (OR = 1.69, 95% CI = 1.36 to 2.03). Physical multimorbidity was associated with an increased risk for active safety incidents (OR = 1.63, 95% CI = 1.45 to 1.80) but was not associated with precursors of safety incidents (OR = 1.02, 95% CI = 0.90 to 1.13). Statistical heterogeneity was high and the methodological quality of the studies was generally low. Conclusions The association between multimorbidity and patient safety is complex, and varies by type of multimorbidity and type of safety incident. Our analyses suggest that multimorbidity

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

    PubMed

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

    2014-11-01

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

  15. Bitter melon (Momordica charantia): a review of efficacy and safety.

    PubMed

    Basch, Ethan; Gabardi, Steven; Ulbricht, Catherine

    2003-02-15

    The pharmacology, clinical efficacy, adverse effects, drug interactions, and place in therapy of bitter melon are described. Bitter melon (Momordica charantia) is an alternative therapy that has primarily been used for lowering blood glucose levels in patients with diabetes mellitus. Components of bitter melon extract appear to have structural similarities to animal insulin. Antiviral and antineoplastic activities have also been reported in vitro. Four clinical trials found bitter melon juice, fruit, and dried powder to have a moderate hypoglycemic effect. These studies were small and were not randomized or double-blind, however. Reported adverse effects of bitter melon include hypoglycemic coma and convulsions in children, reduced fertility in mice, a favism-like syndrome, increases in gamma-glutamyltransferase and alkaline phosphatase levels in animals, and headaches. Bitter melon may have additive effects when taken with other glucose-lowering agents. Adequately powered, randomized, placebo-controlled trials are needed to properly assess safety and efficacy before bitter melon can be routinely recommended. Bitter melon may have hypoglycemic effects, but data are not sufficient to recommend its use in the absence of careful supervision and monitoring.

  16. Safety of Levetiracetam in Paediatrics: A Systematic Review

    PubMed Central

    Egunsola, Oluwaseun; Choonara, Imti; Sammons, Helen Mary

    2016-01-01

    Objective To identify adverse events (AEs) associated with Levetiracetam (LEV) in children. Methods Databases EMBASE (1974-February 2015) and Medline (1946-February 2015) were searched for articles in which paediatric patients (≤18 years) received LEV treatment for epilepsy. All studies with reports on safety were included. Studies involving adults, mixed age population (i.e. children and adults) in which the paediatric subpopulation was not sufficiently described, were excluded. A meta-analysis of the RCTs was carried out and association between the commonly reported AEs or treatment discontinuation and the type of regimen (polytherapy or monotherapy) was determined using Chi2 analysis. Results Sixty seven articles involving 3,174 paediatric patients were identified. A total of 1,913 AEs were reported across studies. The most common AEs were behavioural problems and somnolence, which accounted for 10.9% and 8.4% of all AEs in prospective studies. 21 prospective studies involving 1120 children stated the number of children experiencing AEs. 47% of these children experienced AEs. Significantly more children experienced AEs with polytherapy (64%) than monotherapy (22%) (p<0.001). Levetiracetam was discontinued in 4.5% of all children on polytherapy and 0.9% on monotherapy (p<0.001), the majority were due to behavioural problems. Conclusion Behavioural problems and somnolence were the most prevalent adverse events to LEV and the most common causes of treatment discontinuation. Children on polytherapy have a greater risk of adverse events than those receiving monotherapy. PMID:26930201

  17. Albendazole and Praziquantel: Review and Safety Monitoring in Korea

    PubMed Central

    2018-01-01

    Albendazole (ADZ) and praziquantel (PZQT) have been used as anthelmintics for over 30 years. Worldwide, hundreds of millions tablets are administered to people and livestock every year. ADZ is poorly orally absorbed (<5%), and its uptake is enhanced by high-fat meals, while PZQT is well absorbed (>75%) and uptake is enhanced by carbohydrate-rich meals. Both ADZ and PZQT are safe, but not recommended for children <2 years or for women in the first trimester of pregnancy. Serious adverse events occur following high dose and prolonged administration of these drugs for treatment of echinococcosis or neurocysticercosis, especially in patients with poor liver function. The adverse events may be induced by the drugs, or by the dead worms themselves. The Korea Institute of Drug Safety & Risk Management monitors drug-related adverse events in Korea, and its database included 256 probable or possible ADZ-associated events and 108 PZQT-associated events between 2006 and 2015. Such low incidence rates in Korea are due to the low single dose treatments of ADZ, and the short-term use of PZQT. The number of serious adverse events due to drug interaction induced by ADZ and PZQT were six and two, respectively. We conclude that ADZ and PZQT are generally safe drugs, but they must be used with caution in people with poor liver function or those being comedicated for gastroesophageal reflux disease. PMID:29637747

  18. Brominated flame retardants and seafood safety: a review.

    PubMed

    Cruz, Rebeca; Cunha, Sara C; Casal, Susana

    2015-04-01

    Brominated flame retardants (BFRs), frequently applied to industrial and household products to make them less flammable, are highly persistent in the environment and cause multi-organ toxicity in human and wildlife. Based on the review of BFRs presence in seafood published from 2004 to 2014, it is clear that such pollutants are not ideally controlled as the surveys are too restricted, legislation inexistent for some classes, the analytical methodologies diversified, and several factors as food processing and eating habits are generally overlooked. Indeed, while a seafood rich diet presents plenty of nutritional benefits, it can also represent a potential source of these environmental contaminants. Since recent studies have shown that dietary intake constitutes a main route of human exposure to BFRs, it is of major importance to review and enhance these features, since seafood constitutes a chief pathway for human exposure and biomagnification of priority environmental contaminants. In particular, more objective studies focused on the variability factors behind contamination levels, and subsequent human exposure, are necessary to support the necessity for more restricted legislation worldwide. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Revealing the X-Ray Emission Processes of Old Rotation-Powered Pulsars: XMM-Newton Observations of PSR B0950+08, PSR B0823+26 and PSR J2043+2740

    NASA Technical Reports Server (NTRS)

    Becker, Werner; Weisskopf, Martin C.; Tenant, Allyn F.; Jessmer, Axel; Zhang, Shiang N.

    2004-01-01

    We have completed part of a program to study the X-ray emission properties of old rotation-powered pulsars with XMM-Newton in order to probe and identify the origin of their X radiation. The X-ray emission from these old pulsars is largely dominated by non-thermal processes. None of the observed spectra required adding a thermal component consisting of either a hot polar cap or surface cooling emission to model the data. The energy spectrum of PSR B0950+08 is best described by a single power law of photon-index alpha = 1.93(sup +0.14)(sub -0.12). Three-sigma temperature upper limits for possible contributions from a heated polar cap or the whole neutron star surface are T(sup infinity)(sub pc) < 0.87 x 10(exp 6) K and T(sup infinity)(sub s) < 0.48 x 10(exp 6) K, respectively. We also find that the X-ray emission from PSR B0950+08 is pulsed with two peaks per rotation period. The phase separation between the two X-ray peaks is approx. 144 deg (maximum to maximum) which is similar to the pulse peak separation observed in the radio band at 1.4 GHz. The fraction of X-ray pulsed photons is approx. 30%. A phase resolved spectral analysis confirms the nonthermal nature of the pulsed emission and finds power law slopes of alpha = 2.4(sup +0.52)(sub -0.42) and alpha = 1.93(sup +0.29)(sub -0.24) for the pulse peaks P1 and P2, respectively. The spectral emission properties observed for PSR B0823+26 are similar to those of PSR B0950+08. Its energy spectrum is very well described by a single power law with photon-index alpha = 2.5(sup +0.52)(sub -0.24. Three-sigma temperature upper limits for thermal contributions from a hot polar cap or from the entire neutron star surface are T(sup infinity)(sub pc) < 1.17 x 10(exp 6) K and T(sup infinity)(sub s) < 0.5 x 10(exp 6) K, respectively. There is evidence for pulsed X-ray emission at the - 97% confidence level with a pulsed fraction of 49 +/- 22%. For PSR 52043+2740 we report the first detection of X-ray emission. A power law

  20. [Evidence-based effectiveness of road safety interventions: a literature review].

    PubMed

    Novoa, Ana M; Pérez, Katherine; Borrell, Carme

    2009-01-01

    Only road safety interventions with scientific evidence supporting their effectiveness should be implemented. The objective of this study was to identify and summarize the available evidence on the effectiveness of road safety interventions in reducing road traffic collisions, injuries and deaths. All literature reviews published in scientific journals that assessed the effectiveness of one or more road safety interventions and whose outcome measure was road traffic crashes, injuries or fatalities were included. An exhaustive search was performed in scientific literature databases. The interventions were classified according to the evidence of their effectiveness in reducing road traffic injuries (effective interventions, insufficient evidence of effectiveness, ineffective interventions) following the structure of the Haddon matrix. Fifty-four reviews were included. Effective interventions were found before, during and after the collision, and across all factors: a) the individual: the graduated licensing system (31% road traffic injury reduction); b) the vehicle: electronic stability control system (2 to 41% reduction); c) the infrastructure: area-wide traffic calming (0 to 20%), and d) the social environment: speed cameras (7 to 30%). Certain road safety interventions are ineffective, mostly road safety education, and others require further investigation. The most successful interventions are those that reduce or eliminate the hazard and do not depend on changes in road users' behavior or on their knowledge of road safety issues. Interventions based exclusively on education are ineffective in reducing road traffic injuries.

  1. A Systematic Review of the Use of Social Media for Food Safety Risk Communication.

    PubMed

    Overbey, Katie N; Jaykus, Lee-Ann; Chapman, Benjamin J

    2017-09-01

    This article covers the current published literature related to the use of social media in food safety and infectious disease communication. The aim was to analyze literature recommendations and draw conclusions about how best to utilize social media for food safety risk communication going forward. A systematic literature review was conducted, and 24 articles were included for analysis. The inclusion criteria were (i) original peer-reviewed articles and (ii) primary focus on communication through social media about food safety and/or infectious diseases. Studies were coded for themes about social media applications, benefits, limitations, and best practices. Trust and personal beliefs were important drivers of social media use. The wide reach, immediacy, and information gathering capacities of social media were frequently cited benefits. Suggestions for social media best practices were inconsistent among studies, and study designs were highly variable. More evidence-based suggestions are needed to better establish guidelines for social media use in food safety and infectious disease risk communication. The information gleaned from this review can be used to create effective messages for shaping food safety behaviors.

  2. Effects of digital countdown timer on intersection safety and efficiency: A systematic review.

    PubMed

    Fu, Chuanyun; Zhang, Yaping; Qi, Weiwei; Cheng, Shaowu

    2016-01-01

    To investigate the available evidence referring to the effectiveness of digital countdown timers (DCTs) in improving the safety and operational efficiency of signalized intersection. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement guidelines. Relevant literature was searched from electronic databases using key terms. Based on study selection and methodological quality assessment, 14 studies were included in the review. Findings of the studies were synthesized in a narrative analysis. Three types of DCT had different effects on intersection safety and operational efficiency. Green signal countdown timers (GSCTs) reduced red light violations, type I dilemma zone distributions, and rear-end collision likelihood but increased crossing after yellow onset and had mixed impacts on type II dilemma zone distributions and intersection capacity. In contrast, red signal countdown timers (RSCTs) increased intersection capacity, although their effectiveness in reducing red light violations dissipated over time. Likewise, continuous countdown timers (CCTs) significantly enhanced intersection capacity but had mixed influences on red light violations and crossing after yellow onset. Due to the limited and inconsistent evidence regarding DCTs' effects on intersection safety and efficiency, it is not sufficient to recommend any type of DCT to be installed at signalized intersections to improve safety and operational efficiency. Nevertheless, it is apparent that both RSCTs and CCTs enhance intersection capacity, though their impacts on intersection safety are unclear. Future studies need to further verify those anticipated safe and operational benefits of DCTs with enriched field observation data.

  3. Safety Review Panel (SRP) Special Topic Presentation on the Iodine Compatible Water Container (ICWC)

    NASA Technical Reports Server (NTRS)

    Thomas, Evan A.

    2008-01-01

    This viewgraph presentation reviews the safety requirements for the Iodine Compatible Water Container (ICWC). The topics include: 1) ICWC Team; 2) Purpose of presentation; 3) Background/Description of ICWC System; 4) Current status of ICWC Project; 5) HTV launch NCR Processing; 6) Tox 1 containment NCR processing; and 7) ISS on-orbit failure propagation and fault tolerance NCR processing.

  4. 49 CFR 659.25 - Annual review of system safety program plan and system security plan.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... system security plan. 659.25 Section 659.25 Transportation Other Regulations Relating to Transportation... and system security plan. (a) The oversight agency shall require the rail transit agency to conduct an annual review of its system safety program plan and system security plan. (b) In the event the rail...

  5. 76 FR 37375 - Meeting of the Public Safety Officer Medal of Valor Review Board

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-27

    ... INFORMATION: The Public Safety Officer Medal of Valor Review Board carries out those advisory functions... who wish to participate must register at least seven (7) days in advance of the meeting/conference... registration. Anyone requiring special accommodations should contact Mr. Joy at least seven (7) days in advance...

  6. 75 FR 30859 - Meeting of the Public Safety Officer Medal of Valor Review Board

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-02

    ... INFORMATION: The Public Safety Officer Medal of Valor Review Board carries out those advisory functions... participate must register at least seven (7) days in advance of the meeting/conference call by contacting Mr.... Anyone requiring special accommodations should contact Mr. Joy at least seven (7) days in advance of the...

  7. Systematic Review of Kinship Care Effects on Safety, Permanency, and Well-Being Outcomes

    ERIC Educational Resources Information Center

    Winokur, Marc A.; Holtan, Amy; Batchelder, Keri E.

    2018-01-01

    Objective: Children in out-of-home placements typically display more educational, behavioral, and psychological problems than do their peers. This systematic review evaluated the effect of kinship care placement compared to foster care placement on the safety, permanency, and well-being of children removed from the home for maltreatment. Methods:…

  8. 14 CFR 414.19 - Technical criteria for reviewing a safety approval application.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Technical criteria for reviewing a safety approval application. 414.19 Section 414.19 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL... regulations. (2) Government-developed or adopted standards. (3) Industry consensus performance-based criteria...

  9. A review of technology and safety aspects of erbium lasers in dentistry.

    PubMed

    Clarkson, D M

    2001-01-01

    This article reviews aspects of the probable mechanisms used by erbium dental lasers for cutting dentine and enamel, describes key issues of the risk of temperature elevation and speed of cutting relative to conventional techniques and looks at issues concerned with the safety of lasers.

  10. Interagency Nuclear Safety Review Panel: Biomedical and Environmental Effects Subpanel report for Galileo

    SciTech Connect

    Anspaugh, L.R.; Blanton, J.O.; Bollinger, L.J.

    1989-10-01

    This report of the Biomedical and Environmental Effects Subpanel (BEES) of the Interagency Nuclear Safety Review Panel (INSRP), for the Galileo space mission addresses the possible radiological consequences of postulated accidents that release radioactivity into the environment. This report presents estimates of the consequences and uncertainties given that the source term is released into the environment. 10 refs., 6 tabs.

  11. New graduate registered nurses' knowledge of patient safety and practice: A literature review.

    PubMed

    Murray, Melanie; Sundin, Deborah; Cope, Vicki

    2018-01-01

    To critically appraise available literature and summarise evidence pertaining to the patient safety knowledge and practices of new graduate registered nurses. Responsibility for patient safety should not be limited to the practice of the bedside nurses, rather the responsibility of all in the healthcare system. Previous research identified lapses in safety across the health care, more specifically with new practitioners. Understanding these gaps and what may be employed to counteract them is vital to ensuring patient safety. A focused review of research literature. The review used key terms and Boolean operators across a 5-year time frame in CINAHL, Medline, psycINFO and Google Scholar for research articles pertaining to the area of enquiry. Eighty-four articles met the inclusion criteria, 39 discarded due to irrelevant material and 45 articles were included in the literature review. This review acknowledges that nursing has different stages of knowledge and practice capabilities. A theory-practice gap for new graduate registered nurses exists, and transition to practice is a key learning period setting new nurses on the path to becoming expert practitioners. Within the literature, there was little to no acknowledgement of patient safety knowledge of the newly registered nurse. Issues raised in the 1970s remain a concern for today's new graduate registered nurses. Research has recognised several factors affecting transition from nursing student to new graduate registered nurse. These factors are leaving new practitioners open to potential errors and risking patient safety. Understanding the knowledge of a new graduate registered nurse upon entering clinical practice may assist in organisations providing appropriate clinical and theoretical support to these nurses during their transition. © 2017 John Wiley & Sons Ltd.

  12. Healthcare quality and safety: a review of policy, practice and research.

    PubMed

    Waring, Justin; Allen, Davina; Braithwaite, Jeffrey; Sandall, Jane

    2016-02-01

    Over the last two decades healthcare quality and safety have risen to the fore of health policy and research. This has largely been informed by theoretical and empirical ideas found in the fields of ergonomics and human factors. These have enabled significant advances in our understanding and management of quality and safety. However, a parallel and at time neglected sociological literature on clinical quality and safety is presented as offering additional, complementary, and at times critical insights on the problems of quality and safety. This review explores the development and contributions of both the mainstream and more sociological approaches to safety. It shows that where mainstream approaches often focus on the influence of human and local environment factors in shaping quality, a sociological perspective can deepen knowledge of the wider social, cultural and political factors that contextualise the clinical micro-system. It suggests these different perspectives can easily complement one another, offering a more developed and layered understanding of quality and safety. It also suggests that the sociological literature can bring to light important questions about the limits of the more mainstream approaches and ask critical questions about the role of social inequality, power and control in the framing of quality and safety. © 2015 Foundation for the Sociology of Health & Illness.

  13. Driving Safety after Spinal Surgery: A Systematic Review

    PubMed Central

    Alkhalili, Kenan; Hannallah, Jack; Ibeche, Bashar; Bajammal, Sohail; Baco, Abdul Moeen

    2017-01-01

    This study aimed to assess driving reaction times (DRTs) after spinal surgery to establish a timeframe for safe resumption of driving by the patient postoperatively. The MEDLINE and Google Scholar databases were analyzed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) Statement for clinical studies that investigated changes in DRTs following cervical and lumbar spinal surgery. Changes in DRTs and patients' clinical presentation, pathology, anatomical level affected, number of spinal levels involved, type of intervention, pain level, and driving skills were assessed. The literature search identified 12 studies that investigated postoperative DRTs. Six studies met the inclusion criteria; five studies assessed changes in DRT after lumbar spine surgery and two studies after cervical spina surgery. The spinal procedures were selective nerve root block, anterior cervical discectomy and fusion, and lumbar fusion and/ordecompression. DRTs exhibited variable responses to spinal surgery and depended on the patients' clinical presentation, spinal level involved, and type of procedure performed. The evidence regarding the patients' ability to resume safe driving after spinal surgery is scarce. Normalization of DRT or a return of DRT to pre-spinal intervention level is a widely accepted indicator for safe driving, with variable levels of statistical significance owing to multiple confounding factors. Considerations of the type of spinal intervention, pain level, opioid consumption, and cognitive function should be factored in the assessment of a patient's ability to safely resume driving. PMID:28443178

  14. Driving Safety after Spinal Surgery: A Systematic Review.

    PubMed

    Alhammoud, Abduljabbar; Alkhalili, Kenan; Hannallah, Jack; Ibeche, Bashar; Bajammal, Sohail; Baco, Abdul Moeen

    2017-04-01

    This study aimed to assess driving reaction times (DRTs) after spinal surgery to establish a timeframe for safe resumption of driving by the patient postoperatively. The MEDLINE and Google Scholar databases were analyzed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) Statement for clinical studies that investigated changes in DRTs following cervical and lumbar spinal surgery. Changes in DRTs and patients' clinical presentation, pathology, anatomical level affected, number of spinal levels involved, type of intervention, pain level, and driving skills were assessed. The literature search identified 12 studies that investigated postoperative DRTs. Six studies met the inclusion criteria; five studies assessed changes in DRT after lumbar spine surgery and two studies after cervical spina surgery. The spinal procedures were selective nerve root block, anterior cervical discectomy and fusion, and lumbar fusion and/ordecompression. DRTs exhibited variable responses to spinal surgery and depended on the patients' clinical presentation, spinal level involved, and type of procedure performed. The evidence regarding the patients' ability to resume safe driving after spinal surgery is scarce. Normalization of DRT or a return of DRT to pre-spinal intervention level is a widely accepted indicator for safe driving, with variable levels of statistical significance owing to multiple confounding factors. Considerations of the type of spinal intervention, pain level, opioid consumption, and cognitive function should be factored in the assessment of a patient's ability to safely resume driving.

  15. Efficacy and safety of dronedarone: a review of randomized trials.

    PubMed

    Christiansen, Christine Benn; Torp-Pedersen, Christian; Køber, Lars

    2010-01-01

    Dronedarone is developed for treatment of atrial fibrillation (AF) or flutter (AFL). It is a noniodinized amiodarone analogue and believed to be without the adverse effects of amiodarone. However, long-term adverse effects are not yet well investigated. This is a review of seven studies on dronedarone. DAFNE established an effective dose to be 400 mg b.i.d. ADONIS and EURIDIS showed significant prevention of AF/AFL recurrence hazard ratio (HR 0.78 and 0.73) compared to placebo. In ATHENA, cardiovascular death/hospitalization was significantly reduced (HR 0.76) in patients with AF and additional risk factors. ANDROMEDA was stopped because dronedarone increased early mortality (HR 2.13) in advanced heart failure (HF). ERATO found that dronedarone significantly reduced heart rate compared to placebo in patients with AF. DIONYSOS showed that amiodarone was superior to dronedarone to maintain sinus rhythm in patients with AF/AFL. Dronedarone is superior to placebo but less efficient than amiodarone in maintaining sinus rhythm in patients with a history of AF. In patients with AF and risk factors dronedarone reduces cardiovascular mortality and morbidity, but in patients with severe HF dronedarone significantly increases mortality.

  16. Safety.

    ERIC Educational Resources Information Center

    Education in Science, 1996

    1996-01-01

    Discusses safety issues in science, including: allergic reactions to peanuts used in experiments; explosions in lead/acid batteries; and inspection of pressure vessels, such as pressure cookers or model steam engines. (MKR)

  17. Improving the governance of patient safety in emergency care: a systematic review of interventions

    PubMed Central

    Hesselink, Gijs; Berben, Sivera; Beune, Thimpe

    2016-01-01

    Objectives To systematically review interventions that aim to improve the governance of patient safety within emergency care on effectiveness, reliability, validity and feasibility. Design A systematic review of the literature. Methods PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Database of Systematic Reviews and PsychInfo were searched for studies published between January 1990 and July 2014. We included studies evaluating interventions relevant for higher management to oversee and manage patient safety, in prehospital emergency medical service (EMS) organisations and hospital-based emergency departments (EDs). Two reviewers independently selected candidate studies, extracted data and assessed study quality. Studies were categorised according to study quality, setting, sample, intervention characteristics and findings. Results Of the 18 included studies, 13 (72%) were non-experimental. Nine studies (50%) reported data on the reliability and/or validity of the intervention. Eight studies (44%) reported on the feasibility of the intervention. Only 4 studies (22%) reported statistically significant effects. The use of a simulation-based training programme and well-designed incident reporting systems led to a statistically significant improvement of safety knowledge and attitudes by ED staff and an increase of incident reports within EDs, respectively. Conclusions Characteristics of the interventions included in this review (eg, anonymous incident reporting and validation of incident reports by an independent party) could provide useful input for the design of an effective tool to govern patient safety in EMS organisations and EDs. However, executives cannot rely on a robust set of evidence-based and feasible tools to govern patient safety within their emergency care organisation and in the chain of emergency care. Established strategies from other high-risk sectors need to be evaluated in emergency care settings, using an

  18. Patient safety in out-of-hours primary care: a review of patient records.

    PubMed

    Smits, Marleen; Huibers, Linda; Kerssemeijer, Brian; de Feijter, Eimert; Wensing, Michel; Giesen, Paul

    2010-12-10

    Most patients receive healthcare in primary care settings, but relatively little is known about patient safety. Out-of-hours contacts are of particular importance to patient safety. Our aim was to examine the incidence, types, causes, and consequences of patient safety incidents at general practice cooperatives for out-of-hours primary care and to examine which factors were associated with the occurrence of patient safety incidents. A retrospective study of 1,145 medical records concerning patient contacts with four general practice cooperatives. Reviewers identified records with evidence of a potential patient safety incident; a physician panel determined whether a patient safety incident had indeed occurred. In addition, the panel determined the type, causes, and consequences of the incidents. Factors associated with incidents were examined in a random coefficient logistic regression analysis. In 1,145 patient records, 27 patient safety incidents were identified, an incident rate of 2.4% (95% CI: 1.5% to 3.2%). The most frequent incident type was treatment (56%). All incidents had at least partly been caused by failures in clinical reasoning. The majority of incidents did not result in patient harm (70%). Eight incidents had consequences for the patient, such as additional interventions or hospitalisation. The panel assessed that most incidents were unlikely to result in patient harm in the long term (89%). Logistic regression analysis showed that age was significantly related to incident occurrence: the likelihood of an incident increased with 1.03 for each year increase in age (95% CI: 1.01 to 1.04). Patient safety incidents occur in out-of-hours primary care, but most do not result in harm to patients. As clinical reasoning played an important part in these incidents, a better understanding of clinical reasoning and guideline adherence at GP cooperatives could contribute to patient safety.

  19. Updating Human Factors Engineering Guidelines for Conducting Safety Reviews of Nuclear Power Plants

    SciTech Connect

    O, J.M.; Higgins, J.; Stephen Fleger - NRC

    The U.S. Nuclear Regulatory Commission (NRC) reviews the human factors engineering (HFE) programs of applicants for nuclear power plant construction permits, operating licenses, standard design certifications, and combined operating licenses. The purpose of these safety reviews is to help ensure that personnel performance and reliability are appropriately supported. Detailed design review procedures and guidance for the evaluations is provided in three key documents: the Standard Review Plan (NUREG-0800), the HFE Program Review Model (NUREG-0711), and the Human-System Interface Design Review Guidelines (NUREG-0700). These documents were last revised in 2007, 2004 and 2002, respectively. The NRC is committed to the periodicmore » update and improvement of the guidance to ensure that it remains a state-of-the-art design evaluation tool. To this end, the NRC is updating its guidance to stay current with recent research on human performance, advances in HFE methods and tools, and new technology being employed in plant and control room design. This paper describes the role of HFE guidelines in the safety review process and the content of the key HFE guidelines used. Then we will present the methodology used to develop HFE guidance and update these documents, and describe the current status of the update program.« less

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

    PubMed

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

    2017-09-01

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

  1. Identifying nontechnical skills associated with safety in the emergency department: a scoping review of the literature.

    PubMed

    Flowerdew, Lynsey; Brown, Ruth; Vincent, Charles; Woloshynowych, Maria

    2012-05-01

    Understanding the nontechnical skills specifically applicable to the emergency department (ED) is essential to facilitate training and more broadly consider interventions to reduce error. The aim of this scoping review is to first identify and then explore in depth the nontechnical skills linked to safety in the ED. The review was conducted in 2 stages. In stage 1, online databases were searched for published empirical studies linking nontechnical skills to safety and performance in the ED. Articles were analyzed to identify key ED nontechnical skills. In stage 2, these key skills were used to generate additional key words, which enabled a second search of the literature to be undertaken and expand on the evidence available for review. In stage 1, 11 articles were retrieved for data analysis and 9 core emergency medicine nontechnical skills were identified. These were communicating, managing workload, anticipating, situational awareness, supervising and providing feedback, leadership, maintaining standards, using assertiveness, and decisionmaking. In stage 2, a secondary search, using these 9 skills and related terms, uncovered a further 21 relevant articles. Therefore, 32 articles were used to describe the main nontechnical skills linked to safety in the ED. This article highlights the challenges of reviewing a topic for which the terms are not clearly defined in the literature. A novel methodological approach is described that provides a structured and transparent process for reviewing the literature in emerging areas of interest. A series of literature reviews focusing on individual nontechnical skills will provide a clearer understanding of how the skills identified contribute to safety in the ED. Copyright © 2011 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  2. Safety and efficacy of physical restraints for the elderly. Review of the evidence.

    PubMed Central

    Frank, C.; Hodgetts, G.; Puxty, J.

    1996-01-01

    OBJECTIVE: To critically review evidence on the safety and efficacy of physical restraints for the elderly and to provide family physicians with guidelines for rational use of restraints. DATA SOURCES: Articles cited on MEDLINE (from 1989 to November 1994) and Cinahl (from 1982 to 1994) under the MeSH heading "physical restraints." STUDY SELECTION: Articles that specifically dealt with the safety and efficacy of restraints and current patterns of use, including prevalence, risk factors, and indications, were selected. Eight original research articles were identified and critically appraised. DATA EXTRACTION: Data extracted concerned the negative sequelae of restraints and the association between restraint use and fall and injury rates. General data about current patterns of restraint use were related to safety and efficacy findings. DATA SYNTHESIS: No randomized, controlled trials of physical restraint use were found in the literature. A variety of study design, including retrospective chart review, prospective cohort studies, and case reports, found little evidence that restraints prevent injury. Some evidence suggested that restraints might increase risk of falls and injury. Restraint-reduction programs have not been shown to increase fall or injury rates. Numerous case reports document injuries or deaths resulting from restraint use or misuse. CONCLUSIONS: Although current evidence does not support the belief that restraints prevent falls and injuries and questions their safety, further prospective and controlled studies are needed to clarify these issues. Information from review and research articles was synthesized in this paper to produce guidelines for the safe and rational use of restraints. PMID:8969858

  3. The safety of serotonin-noradrenaline reuptake inhibitors (SNRIs) in pregnancy and breastfeeding: a comprehensive review.

    PubMed

    Bellantuono, Cesario; Vargas, Marianna; Mandarelli, Gabriele; Nardi, Bernardo; Martini, Maria Giulia

    2015-05-01

    The present study provides a comprehensive review of the existing literature on the safety of serotonin-noradrenaline reuptake inhibitors (SNRIs) in pregnancy and lactation. Studies published in English, reporting the use of SNRIs in pregnant and/or breastfeeding women, were identified by searching MEDLINE/Pubmed, PsycINFO, and EMBASE. Twenty-nine studies were included in the review. Altogether, the initial evidence coming from the reviewed studies suggests a lack of association between SNRIs and an increased risk of major congenital malformations. Conversely, exposure to SNRIs seems to be significantly associated with an increased risk of some perinatal complications. No neonatal adverse events emerged, so far, in the few studies concerning the safety of SNRIs during breastfeeding. Available data suggest that venlafaxine is relatively safe during pregnancy, in particular as far as major malformations are concerned, whereas considering the small number of studies published, no definitive conclusions can be drawn on its safety during breastfeeding. Because of the few studies so far published, the safety of duloxetine during pregnancy and breastfeeding remains to be well established. Copyright © 2015 John Wiley & Sons, Ltd.

  4. The Spin-down of PSR J0821-4300 and PSR J1210-5226: Confirmation of Central Compact Objects as Anti-magnetars

    NASA Astrophysics Data System (ADS)

    Gotthelf, E. V.; Halpern, J. P.; Alford, J.

    2013-03-01

    Using XMM-Newton and Chandra, we measure period derivatives for the second and third known pulsars in the class of central compact objects (CCOs) in supernova remnants, proving that these young neutron stars have exceptionally weak dipole magnetic field components. For the 112 ms PSR J0821-4300 in Puppis A, \\dot{P} = (9.28 +/- 0.36) \\times 10^{-18}. Its proper motion, μ = 61 ± 9 mas yr-1, was also measured using Chandra. This contributes a kinematic term to the period derivative via the Shklovskii effect, which is subtracted from \\dot{P} to derive dipole Bs = 2.9 × 1010 G, a value similar to that of the first measured CCO, PSR J1852+0040 in Kes 79, which has Bs = 3.1 × 1010 G. Antipodal surface hot spots with different temperatures and areas are deduced from the X-ray spectrum and pulse profiles. Paradoxically, such nonuniform surface temperature appears to require strong crustal magnetic fields, probably toroidal or quadrupolar components much stronger than the external dipole. A spectral feature, consisting of either an emission line at ≈0.75 keV or an absorption line at ≈0.46 keV, is modulated in strength with the rotation. It may be due to a cyclotron process in a magnetic field on the surface that is slightly stronger than the dipole deduced from the spin-down. We also timed anew the 424 ms PSR J1210-5226, resolving previous ambiguities about its spin-down rate. Its \\dot{P} is (2.22 ± 0.02) × 10-17, corresponding to Bs = 9.8 × 1010 G. This is also compatible with a cyclotron resonance interpretation of its prominent absorption line at 0.7 keV and its harmonics. These results deepen the mystery of the origin and evolution of CCOs: Why are their numerous descendants not evident?

  5. Safety of licensed vaccines in HIV-infected persons: a systematic review protocol

    PubMed Central

    2014-01-01

    Background Safety of vaccines remains a cornerstone of building public trust on the use of these cost-effective and life-saving public health interventions. In some settings, particularly Sub-Saharan Africa, there is a high prevalence of HIV infection and a high burden of vaccine-preventable diseases. There is evidence suggesting that the immunity induced by some commonly used vaccines is not durable in HIV-infected persons, and therefore, repeated vaccination may be considered to ensure optimal vaccine-induced immunity in this population. However, some vaccines, particularly the live vaccines, may be unsafe in HIV-infected persons. There is lack of evidence on the safety profile of commonly used vaccines among HIV-infected persons. We are therefore conducting a systematic review to assess the safety profile of routine vaccines administered to HIV-infected persons. Methods/Design We will select studies conducted in any setting where licensed and effective vaccines were administered to HIV-infected persons. We will search for eligible studies in PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, Africa-Wide, PDQ-Evidence and CINAHL as well as reference lists of relevant publications. We will screen search outputs, select studies and extract data in duplicate, resolving discrepancies by discussion and consensus. Discussion Globally, immunisation is a major public health strategy to mitigate morbidity and mortality caused by various infectious disease-causing agents. In general, there are efforts to increase vaccination coverage worldwide, and for these efforts to be successful, safety of the vaccines is paramount, even among people living with HIV, who in some situations may require repeated vaccination. Results from this systematic review will be discussed in the context of the safety of routine vaccines among HIV-infected persons. From the safety perspective, we will also discuss whether repeat vaccination strategies may be

  6. Behavioral risk factors associated with listeriosis in the home: a review of consumer food safety studies.

    PubMed

    Evans, Ellen W; Redmond, Elizabeth C

    2014-03-01

    Listeria monocytogenes causes human listeriosis, which is associated with the highest hospitalization and mortality rates of all foodborne illnesses. In recent years, the incidence of listeriosis has doubled in Europe, almost exclusively among older adults (≥ 60 years of age). Food safety factors associated with increased risk of listeriosis include lack of adherence to "use by" dates and ineffective refrigerated storage of foods. Consequently, older adult consumers' implementation of safe food practices should be evaluated. This article is a review of consumer food safety cognitive and behavioral data relating to risk factors associated with listeriosis in the home as reported in 165 consumer food safety studies. Overall, only 41% of studies included assessment of consumer cognitive or behavioral data associated with listeriosis; of these studies 59% included data on safe refrigeration, 54% included data on storage time for opened ready-to-eat foods, and 49% included data on adherence to use-by dates. In most (83%) of the studies, survey-based data collection methods (questionnaires/interviews) were used; thus, the majority of findings were based on self-report (74%) and knowledge (44%). Observation (31%) and focus groups (12%) were less commonly used, resulting in a lack of actual behaviors and attitudinal data relating to listeriosis risk factors. Only 7% of studies included food safety data for older adults. Although older adults may fail to implement recommended practices, this review reveals a need for in-depth research to determine food safety attitudes and actual behaviors of older adults in conjunction with knowledge and selfreport of practices linked to increased risks of listeriosis. Such data combined with review findings would inform targeted food safety education to reduce risks associated with listeriosis in the home.

  7. Use of patient safety culture instruments in operating rooms: A systematic literature review.

    PubMed

    Zhao, Pujng; Li, Yaqin; Li, Zhi; Jia, Pengli; Zhang, Longhao; Zhang, Mingming

    2017-05-01

    To identify and qualitatively describe, in a literature review, how the instruments were used to evaluate patient safety culture in the operating rooms of published studies. Systematic searches of the literature were conducted using the major database including MEDLINE, EMbase, The Cochrane Library, and four Chinese databases including Chinese Biomedical Literature Database (CBM), Wanfang Data, Chinese Scientific Journal Database (VIP), and Chinese Journals Full-text Database (CNKI) for studies published up to March 2016. We summarized and analyzed the country scope, the instrument utilized in the study, the year when the instrument was used, and fields of operating rooms. Study populations, study settings, and the time span between baseline and follow-up phase were evaluated according to the study design. We identified 1025 references, of which 99 were obtained for full-text assessment; 47 of these studies were deemed relevant and included in the literature review. Most of the studies were from the USA. The most commonly used patient safety culture instrument was Safety Attitude Questionnaire. All identified instruments were used after 2002 and across many fields. Most included studies on patient safety culture were conducted in teaching hospitals or university hospitals. The study population in the cross-sectional studies was much more than that in the before-after studies. The time span between baseline and follow-up phase of before-after studies were almost over three months. Although patient safety culture is considered important in health care and patient safety, the number of studies in which patient safety culture has been estimated using the instruments in operating rooms, is fairly small. © 2017 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

  8. Critical review of controlled release packaging to improve food safety and quality.

    PubMed

    Chen, Xi; Chen, Mo; Xu, Chenyi; Yam, Kit L

    2018-03-19

    Controlled release packaging (CRP) is an innovative technology that uses the package to release active compounds in a controlled manner to improve safety and quality for a wide range of food products during storage. This paper provides a critical review of the uniqueness, design considerations, and research gaps of CRP, with a focus on the kinetics and mechanism of active compounds releasing from the package. Literature data and practical examples are presented to illustrate how CRP controls what active compounds to release, when and how to release, how much and how fast to release, in order to improve food safety and quality.

  9. Work zone safety analysis and modeling: a state-of-the-art review.

    PubMed

    Yang, Hong; Ozbay, Kaan; Ozturk, Ozgur; Xie, Kun

    2015-01-01

    Work zone safety is one of the top priorities for transportation agencies. In recent years, a considerable volume of research has sought to determine work zone crash characteristics and causal factors. Unlike other non-work zone-related safety studies (on both crash frequency and severity), there has not yet been a comprehensive review and assessment of methodological approaches for work zone safety. To address this deficit, this article aims to provide a comprehensive review of the existing extensive research efforts focused on work zone crash-related analysis and modeling, in the hopes of providing researchers and practitioners with a complete overview. Relevant literature published in the last 5 decades was retrieved from the National Work Zone Crash Information Clearinghouse and the Transport Research International Documentation database and other public digital libraries and search engines. Both peer-reviewed publications and research reports were obtained. Each study was carefully reviewed, and those that focused on either work zone crash data analysis or work zone safety modeling were identified. The most relevant studies are specifically examined and discussed in the article. The identified studies were carefully synthesized to understand the state of knowledge on work zone safety. Agreement and inconsistency regarding the characteristics of the work zone crashes discussed in the descriptive studies were summarized. Progress and issues about the current practices on work zone crash frequency and severity modeling are also explored and discussed. The challenges facing work zone safety research are then presented. The synthesis of the literature suggests that the presence of a work zone is likely to increase the crash rate. Crashes are not uniformly distributed within work zones and rear-end crashes are the most prevalent type of crashes in work zones. There was no across-the-board agreement among numerous papers reviewed on the relationship between work zone

  10. The Role of Fear Appeals in Improving Driver Safety: A Review of the Effectiveness of Fear-Arousing (Threat) Appeals in Road Safety Advertising

    ERIC Educational Resources Information Center

    Lewis, I.; Watson, B.; Tay, R.; White, K. M.

    2007-01-01

    This paper reviews theoretical and empirical evidence relating to the effectiveness of fear (threat) appeals in improving driver safety. The results of the review highlight the mixed and inconsistent findings that have been reported in the literature. While fear arousal appears important for attracting attention, its contribution to behaviour…

  11. Occupational health and safety issues affecting young workers: a literature review.

    PubMed

    Laberge, Marie; Ledoux, Elise

    2011-01-01

    Many overview articles, reports, book chapters and literature reviews have examined the health and safety of young workers. These sources discuss the relationships between the work conditions of young workers and the various indicators of accidents and occupational diseases. Breslin et al. [12,13] conducted two literature reviews of quantitative studies to determine which factors best predicted work accidents and occupational disorders in young people. The present article proposes a review of young people's occupational health and safety (OHS) factors (e.g., demographic, individual, professional, organizational, temporal and operational factors) in both qualitative and quantitative studies. Five types of problems were analyzed in greater depth, namely MSD symptoms, respiratory, allergy and toxicological problems, mental health and well-being, alcohol and drug consumption, and fatigue. This review likewise examines related dimensions that allow us to adopt a more global perspective on this subject by considering such elements as young people's values, their knowledge and attitudes, safety practices in companies, the safe integration of young people, and rehabilitation. A total of 189 scientific articles were selected on the basis of certain criteria. These articles came from refereed OHS journals published between 1994 and 2005.

  12. The relationship between patient safety climate and standard precaution adherence: a systematic review of the literature

    PubMed Central

    Hessels, Amanda; Larson, Elaine

    2015-01-01

    SUMMARY Standard precaution (SP) adherence is universally suboptimal, despite being a core component of healthcare-associated infection (HCAI) prevention and healthcare worker (HCW) safety. Emerging evidence suggests that patient safety climate (PSC) factors may improve HCW behaviours. Our aim was to examine the relationship between PSC and SP adherence by HCWs in acute care hospitals. A systematic review was conducted as guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Three electronic databases were comprehensively searched for literature published or available in English between 2000 and 2014. Seven of 888 articles identified were eligible for final inclusion in the review. Two reviewers independently assessed study quality using a validated quality tool. The seven articles were assigned quality scores ranging from 7 to 10 of 10 possible points. Five measured all aspects of SP and two solely measured needlestick and sharps handling. Three included a secondary outcome of HCW exposure; none included HCAIs. All reported a statistically significant relationship between better PSC and greater SP adherence and used data from self-report surveys including validated PSC measures or measures of management support and leadership. Although limited in number, studies were of high quality and confirmed that PSC and SP adherence were correlated, suggesting that efforts to improve PSC may enhance adherence to a core component of HCAI prevention and HCW safety. More clearly evident is the need for additional high-quality research. PMID:26549480

  13. Air Travel Safety in Postoperative Breast Cancer Patients: A Systematic Review.

    PubMed

    Co, Michael; Ng, Judy; Kwong, Ava

    2018-05-17

    Air travel has long been a dilemma in post-breast cancer surgery patients. Anecdotal reports have described adverse outcomes on surgical wound, implants, and lymphedema during air travel. This review aims to evaluate the best evidence from the literature concerning the air travel safety in breast cancer patients. A comprehensive review was performed of the Medline, Embase, CINAHL, and Cochrane databases using a predefined strategy. Retrieved studies were independently screened and rated for relevance. Data were extracted by 2 researchers. We reviewed the best evidence on air travel safety in postoperative breast cancer patients. Evidence was limited in the current literature to suggest adverse effects on postoperative mastectomy wounds and drains by high-altitude travel. Similarly, adverse effects on breast implants were limited to case reports and ex vivo experiments. A systematic review of 12 studies concluded that air travel is not associated with upper limb lymphedema after breast cancer surgery. Deep-vein thrombosis (DVT) is a known complication after air travel; in addition, malignancy itself is a known risk factor for DVT. Evidence of safety to continue tamoxifen during the period of air travel is lacking in the literature. Evidence to support the use of systemic DVT prophylaxis in general postoperative breast cancer patients is also limited. Best evidence from a large retrospective study suggested that mechanical antiembolism devices and early mobilization are the only measures required. Air travel is generally safe in patients after breast cancer surgery. Copyright © 2018. Published by Elsevier Inc.

  14. Why is patient safety so hard? A selective review of ethnographic studies.

    PubMed

    Dixon-Woods, Mary

    2010-01-01

    Ethnographic studies are valuable in studying patient safety. This is a narrative review of four reports of ethnographic studies of patient safety in UK hospitals conducted as part of the Patient Safety Research Programme. Three of these studies were undertaken in operating theatres and one in an A&E Department. The studies found that hospitals were rarely geared towards ensuring perfect performances. The coordination and mobilization of the large number of inter-dependent processes and resources needed to support the achievement of tasks was rarely optimal. This produced significant strain that staff learned to tolerate by developing various compensatory strategies. Teamwork and inter-professional communication did not always function sufficiently well to ensure that basic procedural information was shared or that the required sequence of events was planned. Staff did not always do the right things, for a wide range of different reasons, including contestations about what counted as the right thing. Structures of authority and accountability were not always clear or well-functioning. Patient safety incidents were usually not reported, though there were many different reasons for this. It can be concluded that securing patient safety is hard. There are multiple interacting influences on safety, and solutions need to be based on a sound understanding of the nature of the problems and which approaches are likely to be best suited to resolving them. Some solutions that appear attractive and straightforward are likely to founder. Addressing safety problems requires acknowledgement that patient safety is not simply a technical issue, but a site of organizational and professional politics.

  15. Confirmation of Earth-Mass Planets Orbiting the Millisecond Pulsar PSR B1257 + 12.

    PubMed

    Wolszczan, A

    1994-04-22

    The discovery of two Earth-mass planets orbiting an old ( approximately 10(9) years), rapidly spinning neutron star, the 6.2-millisecond radio pulsar PSR B1257+12, was announced in early 1992. It was soon pointed out that the approximately 3:2 ratio of the planets' orbital periods should lead to accurately predictable and possibly measurable gravitational perturbations of their orbits. The unambiguous detection of this effect, after 3 years of systematic timing observations of PSR B1257+12 with the 305-meter Arecibo radiotelescope, as well as the discovery of another, moon-mass object in orbit around the pulsar, constitutes irrefutable evidence that the first planetary system around a star other than the sun has been identified.

  16. High-energy emission from the eclipsing millisecond pulsar PSR 1957+20

    NASA Technical Reports Server (NTRS)

    Arons, Jonathan; Tavani, Marco

    1993-01-01

    The properties of the high-energy emission expected from the eclipsing millisecond pulsar system PSR 1957+20 are investigated. Emission is considered by both the relativistic shock produced by the pulsar wind in the nebula surrounding the binary and by the shock constraining the mass outflow from the companion star of PSR 1957+20. On the basis of the results of microscopic plasma physical models of relativistic shocks it is suggested that the high-energy radiation is produced in the range from X-rays to MeV gamma rays in the binary and in the range from 0.01 eV to about 40 keV in the nebula. Doppler boost of the emission in the radiating wind suggests the flux should vary on the orbital time scale, with the largest flux observed roughly coincident with the pulsar's radio eclipse.

  17. Discovery of a radio nebula around PSR J0855-4644

    NASA Astrophysics Data System (ADS)

    Maitra, C.; Roy, S.; Acero, F.; Gupta, Y.

    2018-06-01

    We report the discovery of a diffuse radio emission around PSR J0855-4644 using an upgraded GMRT (uGMRT) observation at 1.35 GHz. The radio emission is spatially coincident with the diffuse X-ray pulsar wind nebula (PWN) seen with XMM-Newton but is much larger in extent compared to the compact axisymmetric PWN seen with Chandra. The morphology of the emission, with a bright partial ring-like structure and two faint tail-like features strongly resembles a bow shock nebula, and indicates a velocity of 100 km s-1 through the ambient medium. We conclude that the emission is most likely to be associated with the radio PWN of PSR J0855-4644. From the integrated flux density, we estimate the energetics of the PWN.

  18. SAS-2 gamma-ray observations of PSR 1747-46. [radio pulsar

    NASA Technical Reports Server (NTRS)

    Thompson, D. J.; Fichtel, C. E.; Kniffen, D. A.; Ogelman, H. B.; Lamb, R. C.

    1976-01-01

    Evidence is reported for the observation of gamma-ray emission from the radio pulsar PSR 1747-46 by the gamma-ray telescope aboard SAS 2. The evidence is based on the presence of both an approximately 3-sigma enhancement of gamma rays at the pulsar's location and an approximately 4-sigma peak in the phase plot of 79 gamma-ray events whose phase was calculated from the pulsar's known period. The gamma-ray pulsation is found to appear at a phase lag of about 0.16 from that predicted by the radio observations. The pulsed gamma-ray fluxes above 35 MeV and 100 MeV are estimated, and it is shown that the gamma-ray pulse width is similar to the radio pulse width. It is concluded that PSR 1747-46 is a most likely candidate for pulsed gamma-ray emission.

  19. The 2017 Periastron Passage of PSR J2032+4127 in GeV Gamma rays

    NASA Astrophysics Data System (ADS)

    Johnson, Tyrel; Ray, Paul S.; Kerr, Matthew T.; Wood, Kent S.; Fermi Large Area Telescope Collaboration

    2018-01-01

    Pulsations from the 143 ms PSR J2032+4127 were discovered in 2008 using the Fermi Large Area Telescope (LAT) and subsequently detected in radio. Continued timing revealed it is in a wide and eccentric binary with the Be star MT91 213. With an orbital period of ~50 years, the periastron on 2017 November 13 is the only one we will observe in our lifetimes. By analogy with PSR B1259-63, a similar system, a GeV gamma-ray flare, from interactions of the Be star and pulsar winds, is expected near periastron. As part of a multi-wavelength campaign, we are continually monitoring the GeV emission from this system with the LAT. We will describe analysis and present preliminary results. Portions of this research performed at the US Naval Research Laboratory are sponsored by NASA DPR S-15633-Y and Fermi Guest Investigator Grant #16-Fermi10-0006.

  20. Overview and Status of the Los Alamos PSR Injection Upgrade Project

    NASA Astrophysics Data System (ADS)

    Fitzgerald, D. H.; Ahn, H.; Blind, B.; Borden, M. J.; Macek, R. J.; Neri, F.; Rose, C. R.; Thiessen, H. A.; Wilkinson, C. A.; Zumbro, M. V.

    1997-05-01

    An upgrade is in progress to the Los Alamos Proton Storage Ring (PSR) to allow direct injection of the H^- beam into the ring and provide a beam bump system to move the circulating beam off the stripper foil. The primary benefits of this upgrade are matching the transverse phase space of the injected beam to the PSR acceptance and reduction of foil hits by the circulating beam by a factor of ten. Foil thickness is optimized to minimize the combination of circulating-beam losses plus losses due to excited H^0 states produced at injection. An overall factor of four reduction in losses is expected. The project comprises extensive modifications of the injection line, the injection section of the ring, and the waste-beam transport line. We will discuss the goals of the project, present an overview of the technical design, and describe the status of the implementation plan.

  1. Research Note PSR B1929+10 and GSC 01060-01374 are not binary companions

    NASA Astrophysics Data System (ADS)

    Kouwenhoven, M. L. A.; van den Berg, M. C.

    2001-03-01

    We have observed the star GSC 01060-01374 to investigate whether it is in a binary with PSR B1929+10. Its spectral type is K4-6 and its luminosity class is III or II, therefore its distance is 2.4 kpc or higher. Since the dispersion measure distance of PSR B1929+10 is 0.17 kpc, we rule out the possibility that these two stars are associated in a binary. This poses further constraints on the lower limit of kick velocities in supernova explosions. Based on observations made with the William Herschel Telescope operated on the island of La Palma by the Isaac Newton Group in the Spanish Observatorio del Roque de los Muchachos of the Instituto de Astrofisica de Canarias.

  2. Time resolving beam position measurement and analysis of beam unstable movement in PSR

    NASA Astrophysics Data System (ADS)

    Aleksandrov, A. V.

    2000-11-01

    Precise measurement of beam centroid movement is very important for understanding the fast transverse instability in the Los Alamos Proton Storage Ring (PSR). Proton bunch in the PSR is long thus different parts of the bunch can have different betatron phase and move differently therefore time resolving position measurement is needed. Wide band strip line BPM can be adequate if proper processing algorithm is used. In this work we present the results of the analysis of unstable transverse beam motion using time resolving processing algorithm. Suggested algorithm allows to calculate transverse position of different parts of the beam on each turn, then beam centroid movement on successive turns can be developed in series of plane travelling waves in the beam frame of reference thus providing important information on instability development. Some general features of fast transverse instability, unknown before, are discovered.

  3. Development of thick, long-lived carbon stripper foils for PSR of LANL

    NASA Astrophysics Data System (ADS)

    Sugai, I.; Oyaizu, M.; Kawakami, H.; Ohmori, C.; Hattori, T.; Kawasaki, K.; Borden, M. J.; Macek, R. J.

    1995-02-01

    Thick carbon stripper foils (multi-layer thickness ≈ 200 μg/cm 2) have been developed for use with 800 MeV, H + ion beam in the Proton Storage Ring (PSR) at Los Alamos National Laboratory. Foils were prepared by means of the modified controlled ACDC arc discharge method (mCADAD). The lifetime measurements of the foils made by different methods were performed using an 800 MeV proton beam of up to 85 μA in the PSR, and a 3.2 MeV Ne + ion beam of 3 μA at Tokyo Institute of Technology. The foils made by the mCADAD method showed very long lifetimes, as compared to other foils tested, for both 800 MeV p and 3.2 MeV Ne + beam bombardments.

  4. A Spatially Resolved Plerionic X-Ray Nebula around PSR B0540-69.

    PubMed

    Gotthelf; Wang

    2000-04-01

    We present a high-resolution Chandra X-ray observation of PSR B0540-69, the Crab-like 50 ms pulsar in the Large Magellanic Cloud. We use phase-resolved imaging to decompose the extended X-ray emission, as expected of a synchrotron nebula, from the pointlike emission of the pulsar. The image of the pulsed X-ray emission shows a well-defined point-spread function of the observation, while the resolved nebula has a morphology and size remarkably similar to the Crab nebula, including evidence for a jetlike feature from PSR B0540-69. The patchy outer shell, which most likely represents the expanding blast wave of the supernova, is reminiscent of that seen in radio. Based on morphology, size, and energetics, there can be little doubt that SNR B0540-69 is an analogous system to the Crab but located in our neighboring galaxy.

  5. A Comprehensive Review of Spirit Drink Safety Standards and Regulations from an International Perspective.

    PubMed

    Pang, Xiao-Na; Li, Zhao-Jie; Chen, Jing-Yu; Gao, Li-Juan; Han, Bei-Zhong

    2017-03-01

    Standards and regulations related to spirit drinks have been established by different countries and international organizations to ensure the safety and quality of spirits. Here, we introduce the principles of food safety and quality standards for alcoholic beverages and then compare the key indicators used in the distinct standards of the Codex Alimentarius Commission, the European Union, the People's Republic of China, the United States, Canada, and Australia. We also discuss in detail the "maximum level" of the following main contaminants of spirit drinks: methanol, higher alcohols, ethyl carbamate, hydrocyanic acid, heavy metals, mycotoxins, phthalates, and aldehydes. Furthermore, the control measures used for potential hazards are introduced. Harmonization of the current requirements based on comprehensive scope analysis and the risk assessment approach will enhance both the trade and quality of distilled spirits. This review article provides valuable information that will enable producers, traders, governments, and researchers to increase their knowledge of spirit drink safety requirements, control measures, and research trends.

  6. NASA Post-Columbia Safety & Mission Assurance, Review and Assessment Initiatives

    NASA Astrophysics Data System (ADS)

    Newman, J. Steven; Wander, Stephen M.; Vecellio, Don; Miller, Andrew J.

    2005-12-01

    On February 1, 2003, NASA again experienced a tragic accident as the Space Shuttle Columbia broke apart upon reentry, resulting in the loss of seven astronauts. Several of the findings and observations of the Columbia Accident Investigation Board addressed the need to strengthen the safety and mission assurance function at NASA. This paper highlights key steps undertaken by the NASA Office of Safety and Mission Assurance (OSMA) to establish a stronger and more- robust safety and mission assurance function for NASA programs, projects, facilities and operations. This paper provides an overview of the interlocking OSMA Review and Assessment Division (RAD) institutional and programmatic processes designed to 1) educate, inform, and prepare for audits, 2) verify requirements flow-down, 3) verify process capability, 4) verify compliance with requirements, 5) support risk management decision making, 6) facilitate secure web- based collaboration, and 7) foster continual improvement and the use of lessons learned.

  7. Knowledge, attitudes and practices of food handlers in food safety: An integrative review.

    PubMed

    Zanin, Laís Mariano; da Cunha, Diogo Thimoteo; de Rosso, Veridiana Vera; Capriles, Vanessa Dias; Stedefeldt, Elke

    2017-10-01

    This study presents an overview of the relationship between knowledge, attitudes and practices (KAP) of food handlers with training in food safety, in addition to proposing reflections on the training of food handlers, considering its responsibility for food safety and health of consumers. The review was based on the integrative method. The descriptors used were: (food handler), (knowledge, attitudes and practice) and (training). Six databases were searched, 253 articles were consulted and 36 original articles were included. Fifty per cent of the articles pointed that there was no proper translation of knowledge into attitudes/practices or attitudes into practices after training. Knowledge, attitudes and practices of food handlers are important for identifying how efficient training in food safety is allowing prioritize actions in planning training. The evaluation of KAP is the first step to understand the food handler's point of view. After this evaluation other diagnostic strategies become necessary to enhance this understanding. Copyright © 2017. Published by Elsevier Ltd.

  8. PSR J1906+0722: an Elusive Gamma-Ray Pulsar

    DOE PAGES

    Clark, C. J.; Pletsch, H. J.; Wu, J.; ...

    2015-08-04

    Here, we report the discovery of PSR J1906+0722, a gamma-ray pulsar detected as part of a blind survey of unidentified Fermi Large Area Telescope (LAT) sources being carried out on the volunteer distributed computing system, Einstein@Home. This newly discovered pulsar previously appeared as the most significant remaining unidentified gamma-ray source without a known association in the second Fermi-LAT source catalog (2FGL) and was among the top 10 most significant unassociated sources in the recent third catalog (3FGL). PSR J1906+0722 is a young, energetic, isolated pulsar, with a spin frequency of 8.9 Hz, a characteristic age of 49 kyr, and spin-down powermore » $$1.0\\times {10}^{36}$$ erg s -1. In 2009 August it suffered one of the largest glitches detected from a gamma-ray pulsar ($${\\rm{\\Delta }}f/f\\approx 4.5\\times {10}^{-6}$$). Remaining undetected in dedicated radio follow-up observations, the pulsar is likely radio-quiet. An off-pulse analysis of the gamma-ray flux from the location of PSR J1906+0722 revealed the presence of an additional nearby source, which may be emission from the interaction between a neighboring supernova remnant and a molecular cloud. We discuss possible effects which may have hindered the detection of PSR J1906+0722 in previous searches and describe the methods by which these effects were mitigated in this survey. Lastly, we also demonstrate the use of advanced timing methods for estimating the positional, spin and glitch parameters of difficult-to-time pulsars such as this.« less

  9. 3. Credit PSR. This view looks south southwest (206°) at ...

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

    3. Credit PSR. This view looks south southwest (206°) at the north and east elevations. The large wing dominating this view contains a machine shop and other facilities used to build or maintain test equipment. A small gasoline facility for automobiles was formerly located near the east end of the building; it was removed in 1995. - Jet Propulsion Laboratory Edwards Facility, Administration & Shops Building, Edwards Air Force Base, Boron, Kern County, CA

  10. 2. Credit PSR. The Administration/Shops Building appears here as the ...

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

    2. Credit PSR. The Administration/Shops Building appears here as the camera looks east (84°). To the right in the view is the Guard House (Building 4279/E-80) which controls entry to the JPL facility. At left is a warehouse (Building 4287/E88). Overhead utility lines supply alternating current to the facility. - Jet Propulsion Laboratory Edwards Facility, Administration & Shops Building, Edwards Air Force Base, Boron, Kern County, CA

  11. Electron-cloud updated simulation results for the PSR, and recent results for the SNS

    NASA Astrophysics Data System (ADS)

    Pivi, M.; Furman, M. A.

    2002-05-01

    Recent simulation results for the main features of the electron cloud in the storage ring of the Spallation Neutron Source (SNS) at Oak Ridge, and updated results for the Proton Storage Ring (PSR) at Los Alamos are presented in this paper. A refined model for the secondary emission process including the so called true secondary, rediffused and backscattered electrons has recently been included in the electron-cloud code.

  12. Credit PSR. This view looks northeast (54°) at the open ...

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

    Credit PSR. This view looks northeast (54°) at the open burn unit as it is seen on approach from Circle Drive. The metal shed in front of the earth mound personnel shield contained controls for a stove that was formerly used to burn scrap propellants in the adjacent pit (see HAER photo CA163-V-1). Regulations changed to permit open pit burning of such materials - Jet Propulsion Laboratory Edwards Facility, Incinerator, Edwards Air Force Base, Boron, Kern County, CA

  13. Credit PSR. This photograph looks south southwest (200°) into the ...

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

    Credit PSR. This photograph looks south southwest (200°) into the burn pit. Scrap propellant was stored elsewhere until enough had accumulated to require a burn. The open burn unit is rated for 200 pounds (91 Kg) of class 1.1 propellants, or 1,000 pounds (454 Kg) of class 1.3 propellants. A maximum of 4 personnel were permitted on the grounds during a burn - Jet Propulsion Laboratory Edwards Facility, Incinerator, Edwards Air Force Base, Boron, Kern County, CA

  14. PSR J1906+0722: An Elusive Gamma-Ray Pulsar

    NASA Astrophysics Data System (ADS)

    Clark, C. J.; Pletsch, H. J.; Wu, J.; Guillemot, L.; Ackermann, M.; Allen, B.; de Angelis, A.; Aulbert, C.; Baldini, L.; Ballet, J.; Barbiellini, G.; Bastieri, D.; Bellazzini, R.; Bissaldi, E.; Bock, O.; Bonino, R.; Bottacini, E.; Brandt, T. J.; Bregeon, J.; Bruel, P.; Buson, S.; Caliandro, G. A.; Cameron, R. A.; Caragiulo, M.; Caraveo, P. A.; Cecchi, C.; Champion, D. J.; Charles, E.; Chekhtman, A.; Chiang, J.; Chiaro, G.; Ciprini, S.; Claus, R.; Cohen-Tanugi, J.; Cuéllar, A.; Cutini, S.; D'Ammando, F.; Desiante, R.; Drell, P. S.; Eggenstein, H. B.; Favuzzi, C.; Fehrmann, H.; Ferrara, E. C.; Focke, W. B.; Franckowiak, A.; Fusco, P.; Gargano, F.; Gasparrini, D.; Giglietto, N.; Giordano, F.; Glanzman, T.; Godfrey, G.; Grenier, I. A.; Grove, J. E.; Guiriec, S.; Harding, A. K.; Hays, E.; Hewitt, J. W.; Hill, A. B.; Horan, D.; Hou, X.; Jogler, T.; Johnson, A. S.; Jóhannesson, G.; Kramer, M.; Krauss, F.; Kuss, M.; Laffon, H.; Larsson, S.; Latronico, L.; Li, J.; Li, L.; Longo, F.; Loparco, F.; Lovellette, M. N.; Lubrano, P.; Machenschalk, B.; Manfreda, A.; Marelli, M.; Mayer, M.; Mazziotta, M. N.; Michelson, P. F.; Mizuno, T.; Monzani, M. E.; Morselli, A.; Moskalenko, I. V.; Murgia, S.; Nuss, E.; Ohsugi, T.; Orienti, M.; Orlando, E.; de Palma, F.; Paneque, D.; Pesce-Rollins, M.; Piron, F.; Pivato, G.; Rainò, S.; Rando, R.; Razzano, M.; Reimer, A.; Saz Parkinson, P. M.; Schaal, M.; Schulz, A.; Sgrò, C.; Siskind, E. J.; Spada, F.; Spandre, G.; Spinelli, P.; Suson, D. J.; Takahashi, H.; Thayer, J. B.; Tibaldo, L.; Torne, P.; Torres, D. F.; Tosti, G.; Troja, E.; Vianello, G.; Wood, K. S.; Wood, M.; Yassine, M.

    2015-08-01

    We report the discovery of PSR J1906+0722, a gamma-ray pulsar detected as part of a blind survey of unidentified Fermi Large Area Telescope (LAT) sources being carried out on the volunteer distributed computing system, Einstein@Home. This newly discovered pulsar previously appeared as the most significant remaining unidentified gamma-ray source without a known association in the second Fermi-LAT source catalog (2FGL) and was among the top 10 most significant unassociated sources in the recent third catalog (3FGL). PSR J1906+0722 is a young, energetic, isolated pulsar, with a spin frequency of 8.9 Hz, a characteristic age of 49 kyr, and spin-down power 1.0× {10}36 erg s-1. In 2009 August it suffered one of the largest glitches detected from a gamma-ray pulsar ({{Δ }}f/f≈ 4.5× {10}-6). Remaining undetected in dedicated radio follow-up observations, the pulsar is likely radio-quiet. An off-pulse analysis of the gamma-ray flux from the location of PSR J1906+0722 revealed the presence of an additional nearby source, which may be emission from the interaction between a neighboring supernova remnant and a molecular cloud. We discuss possible effects which may have hindered the detection of PSR J1906+0722 in previous searches and describe the methods by which these effects were mitigated in this survey. We also demonstrate the use of advanced timing methods for estimating the positional, spin and glitch parameters of difficult-to-time pulsars such as this.

  15. Review of quality assessment tools for the evaluation of pharmacoepidemiological safety studies

    PubMed Central

    Neyarapally, George A; Hammad, Tarek A; Pinheiro, Simone P; Iyasu, Solomon

    2012-01-01

    Objectives Pharmacoepidemiological studies are an important hypothesis-testing tool in the evaluation of postmarketing drug safety. Despite the potential to produce robust value-added data, interpretation of findings can be hindered due to well-recognised methodological limitations of these studies. Therefore, assessment of their quality is essential to evaluating their credibility. The objective of this review was to evaluate the suitability and relevance of available tools for the assessment of pharmacoepidemiological safety studies. Design We created an a priori assessment framework consisting of reporting elements (REs) and quality assessment attributes (QAAs). A comprehensive literature search identified distinct assessment tools and the prespecified elements and attributes were evaluated. Primary and secondary outcome measures The primary outcome measure was the percentage representation of each domain, RE and QAA for the quality assessment tools. Results A total of 61 tools were reviewed. Most tools were not designed to evaluate pharmacoepidemiological safety studies. More than 50% of the reviewed tools considered REs under the research aims, analytical approach, outcome definition and ascertainment, study population and exposure definition and ascertainment domains. REs under the discussion and interpretation, results and study team domains were considered in less than 40% of the tools. Except for the data source domain, quality attributes were considered in less than 50% of the tools. Conclusions Many tools failed to include critical assessment elements relevant to observational pharmacoepidemiological safety studies and did not distinguish between REs and QAAs. Further, there is a lack of considerations on the relative weights of different domains and elements. The development of a quality assessment tool would facilitate consistent, objective and evidence-based assessments of pharmacoepidemiological safety studies. PMID:23015600

  16. Cannabis for therapeutic purposes and public health and safety: a systematic and critical review.

    PubMed

    Sznitman, Sharon R; Zolotov, Yuval

    2015-01-01

    The use of Cannabis for Therapeutic Purposes (CTP) has recently become legal in many places. These policy and legal modifications may be related to changes in cannabis perceptions, availability and use and in the way cannabis is grown and sold. This may in turn have effects on public health and safety. To better understand the potential effects of CTP legalization on public health and safety, the current paper synthesizes and critically discusses the relevant literature. Twenty-eight studies were identified by a comprehensive search strategy, and their characteristics and main findings were systematically reviewed according to the following content themes: CTP and illegal cannabis use; CTP and other public health issues; CTP, crime and neighbourhood disadvantage. The research field is currently limited by a lack of theoretical and methodological rigorous studies. The review shows that the most prevalent theme of investigation so far has been the relation between CTP and illegal cannabis use. In addition, the literature review shows that there is an absence of evidence to support many common concerns related to detrimental public health and safety effects of CTP legalization. Although lack of evidence provides some reassurance that CTP legalization may not have posed a substantial threat to public health and safety, this conclusion needs to be examined in light of the limitations of studies conducted so far. Furthermore, as CTP policy continues to evolve, including incorporation of greater commercialization, it is possible that the full effects of CTP legalization have yet to take place. Ensuring study quality will allow future research to better investigate the complex role that CTP plays in relation to society at large, and public health and safety in particular. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Automated discovery of safety and efficacy concerns for joint & muscle pain relief treatments from online reviews.

    PubMed

    Adams, David Z; Gruss, Richard; Abrahams, Alan S

    2017-04-01

    Product issues can cost companies millions in lawsuits and have devastating effects on a firm's sales, image and goodwill, especially in the era of social media. The ability for a system to detect the presence of safety and efficacy (S&E) concerns early on could not only protect consumers from injuries due to safety hazards, but could also mitigate financial damage to the manufacturer. Prior studies in the field of automated defect discovery have found industry-specific techniques appropriate to the automotive, consumer electronics, home appliance, and toy industries, but have not investigated pain relief medicines and medical devices. In this study, we focus specifically on automated discovery of S&E concerns in over-the-counter (OTC) joint and muscle pain relief remedies and devices. We select a dataset of over 32,000 records for three categories of Joint & Muscle Pain Relief treatments from Amazon's online product reviews, and train "smoke word" dictionaries which we use to score holdout reviews, for the presence of safety and efficacy issues. We also score using conventional sentiment analysis techniques. Compared to traditional sentiment analysis techniques, we found that smoke term dictionaries were better suited to detect product concerns from online consumer reviews, and significantly outperformed the sentiment analysis techniques in uncovering both efficacy and safety concerns, across all product subcategories. Our research can be applied to the healthcare and pharmaceutical industry in order to detect safety and efficacy concerns, reducing risks that consumers face using these products. These findings can be highly beneficial to improving quality assurance and management in joint and muscle pain relief. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Explaining the food safety behaviours of food handlers using theories of behaviour change: a systematic review.

    PubMed

    Young, Ian; Thaivalappil, Abhinand; Greig, Judy; Meldrum, Richard; Waddell, Lisa

    2018-06-01

    Theories of behaviour change can explain the factors affecting food handlers' use of food safety practices. A systematic review was conducted on this topic to identify which theories have been applied in this area and to determine which theories are the most consistent predictors of food handlers' behaviours. Standard systematic review procedures were followed: comprehensive search strategy; relevance screening of abstracts; article characterization; data extraction; risk-of-bias assessment; and descriptive analysis. Among 19 relevant studies, the most commonly investigated theories were the Theory of Planned Behaviour (n = 9 studies) and Health Belief Model (n = 5). All investigated theories were useful to explain food handlers' behavioural intentions and behaviours related to food safety across different settings, and could serve as useful frameworks for future research and practice. However, there was wide variability in the predictive ability of the theories and their specific constructs, indicating theories should be adapted to the local context of application.

  19. Perspectives of The Interagency Nuclear Safety Review Panel (INSRP) on future nuclear powered space missions

    SciTech Connect

    Gray, L.B.; Pyatt, D.W.; Sholtis, J.A.

    1993-01-10

    The Interagency Nuclear Safety Review Panel (INSRP) has provided reviews of all nuclear powered spacecraft launched by the United States. The two most recent launches were Ulysses in 1990 and Galileo in 1989. One reactor was launched in 1965 (SNAP-10A). All other U.S. space missions have utilized radioisotopic thermoelectric generators (RTGs). There are several missions in the next few years that are to be nuclear powered, including one that would utilize the Topaz II reactor purchased from Russia. INSRP must realign itself to perform parallel safety assessments of a reactor powered space mission, which has not been done in aboutmore » thirty years, and RTG powered missions.« less

  20. Hospital Nurses' Work Environment Characteristics and Patient Safety Outcomes: A Literature Review.

    PubMed

    Lee, Seung Eun; Scott, Linda D

    2018-01-01

    This integrative literature review assesses the relationship between hospital nurses' work environment characteristics and patient safety outcomes and recommends directions for future research based on examination of the literature. Using an electronic search of five databases, 18 studies published in English between 1999 and 2016 were identified for review. All but one study used a cross-sectional design, and only four used a conceptual/theoretical framework to guide the research. No definition of work environment was provided in most studies. Differing variables and instruments were used to measure patient outcomes, and findings regarding the effects of work environment on patient outcomes were inconsistent. To clarify the relationship between nurses' work environment characteristics and patient safety outcomes, researchers should consider using a longitudinal study design, using a theoretical foundation, and providing clear operational definitions of concepts. Moreover, given the inconsistent findings of previous studies, they should choose their measurement methodologies with care.

  1. Proceedings of the Second NASA Aviation Safety Program Weather Accident Prevention Review

    NASA Technical Reports Server (NTRS)

    Martzaklis, K. Gus (Compiler)

    2003-01-01

    The Second NASA Aviation Safety Program (AvSP) Weather Accident Prevention (WxAP) Annual Project Review held June 5-7, 2001, in Cleveland, Ohio, presented the NASA technical plans and accomplishments to the aviation community. NASA-developed technologies presented included an Aviation Weather Information System with associated digital communications links, electronic atmospheric reporting technologies, forward-looking turbulence warning systems, and turbulence mitigation procedures. The meeting provided feedback and insight from the aviation community of diverse backgrounds and assisted NASA in steering its plans in the direction needed to meet the national safety goal of 80-percent reduction of aircraft accidents by 2007. The proceedings of the review are enclosed.

  2. A safety review of the medications used to treat atopic dermatitis.

    PubMed

    Shukla, Shweta; Feldman, Steven R; Strowd, Lindsay C

    2018-02-01

    Atopic dermatitis (AD) is a common disease in children and adults which causes severe physical discomfort and psychosocial distress. Recently novel therapies for AD have been FDA approved for use which creates the need to review the safety surrounding current FDA approved AD medications. Areas covered: Published clinical studies involving topical and oral FDA approved medications for AD are included in this review. Authors used PubMed research database to search for clinical trials involving AD patients. Expert opinion: AD is a common disease which currently has limited FDA approved medications. Given the chronicity of this disease, medications are needed which control disease while minimizing side effects to allow for long term use. Newer approved medications show promise but safety data is limited given their relatively new utilization for AD.

  3. FERMI LAT PULSED DETECTION OF PSR J0737-3039A IN THE DOUBLE PULSAR SYSTEM

    SciTech Connect

    Guillemot, L.; Kramer, M.; Johnson, T. J.

    2013-05-10

    We report the Fermi Large Area Telescope discovery of {gamma}-ray pulsations from the 22.7 ms pulsar A in the double pulsar system J0737-3039A/B. This is the first mildly recycled millisecond pulsar (MSP) detected in the GeV domain. The 2.7 s companion object PSR J0737-3039B is not detected in {gamma} rays. PSR J0737-3039A is a faint {gamma}-ray emitter, so that its spectral properties are only weakly constrained; however, its measured efficiency is typical of other MSPs. The two peaks of the {gamma}-ray light curve are separated by roughly half a rotation and are well offset from the radio and X-ray emission,more » suggesting that the GeV radiation originates in a distinct part of the magnetosphere from the other types of emission. From the modeling of the radio and the {gamma}-ray emission profiles and the analysis of radio polarization data, we constrain the magnetic inclination {alpha} and the viewing angle {zeta} to be close to 90 Degree-Sign , which is consistent with independent studies of the radio emission from PSR J0737-3039A. A small misalignment angle between the pulsar's spin axis and the system's orbital axis is therefore favored, supporting the hypothesis that pulsar B was formed in a nearly symmetric supernova explosion as has been discussed in the literature already.« less

  4. Orbital variability in the eclipsing pulsar binary PSR B1957+20

    NASA Technical Reports Server (NTRS)

    Arzoumanian, Z.; Fruchter, A. S.; Taylor, J. H.

    1994-01-01

    We have conducted timing observations of the eclipsing millisecond binary pulsar PSR B1957+20, extending the span of data on this pulsar to more than five years. During this time the orbital period of the system has varied by roughly Delta P(sub b)/P(sub b) = 1.6 x 10(exp -7), changing quardratically with time and displaying with time and displaying an orbital period second derivative of P(sub b) = (1.43 +/- 0.08) x 10(exp -18)/sec. The previous measurement of a large negative orbital period derivative reflected only the short-term behavior of the system during the early observations; the orbital period derivative is now positive. If, as we suspect, the PSR B1957+20 system is undergoing quasi-cyclic orbital period variations similar to those found in other close binaries such as Algol and RS CVn, then the 0.025 solar mass companion to PSR B1957+20 is most likely non-degenerate, convective, and magnetically active.

  5. Comparison of carbon and corrugated diamond stripper foils under operational conditions at the Los Alamos PSR

    NASA Astrophysics Data System (ADS)

    Spickermann, T.; Borden, M. J.; Macek, R. J.; Shaw, R. W.; Feigerle, C. S.; Sugai, I.

    2008-06-01

    To accumulate high-intensity proton pulses, the Los Alamos Proton Storage Ring (PSR) uses the charge-exchange injection method. H - ions merge with already circulating protons in a bending magnet, and then are stripped off their two electrons in a carbon stripper foil. The circulating protons continue to interact with the foil. Despite efforts to minimize the number of these foil hits, like "painting" of the vertical phase space, they cannot totally be eliminated. As a result, foil heating and probably also radiation damage limit the lifetime of these foils. In recent years, LANL has collaborated with KEK to improve the carbon foils in use at PSR, and these foils now last typically for about 2 months. Recently, an alternative in the form of corrugated diamond foils has been proposed for use at SNS. These foils have now been tested in PSR production for a year, and have already shown to be at least as enduring as the LANL/KEK carbon foils. Advantages of the diamond foil concept, as well as some noteworthy differences that we observed with respect to the LANL carbon foils, will be discussed here.

  6. Discovery of remarkable subpulse drifting pattern in PSR B0818-41

    NASA Astrophysics Data System (ADS)

    Bhattacharyya, B.; Gupta, Y.; Gil, J.; Sendyk, M.

    The study of pulsars showing systematic subpulse drift patterns provides important clues for understanding of pulsar emission mechanism. Pulsars with wide profiles provide extra insights because of the presence of multiple drift bands (e.g PSR B0826-34). We report the discovery of a remarkable subpulse drift pattern in a relatively less studied wide profile pulsar, PSR B0818-41, using the GMRT. We find simultaneous occurrence of three drift regions with two drift rates, an inner region with steeper apparent drift rate flanked on each side by a region of slower apparent drift rate. Furthermore, the two closely spaced drift regions always maintain a constant phase relationship. These unique drift properties seen for this pulsar is very rare. We interpret that the observed drift pattern is created by intersection of our line of sight (LOS) with two conal rings in a inner LOS (negative beta) geometry. We argue that the carousel rotation periodicity (P_4) and the number of sparks (N_sp) are the same for the rings and claim that P_4 is close to the measured P_3. Based on our analysis results and interpretations, we simulate the radiation from B0818-41. The simulations support our interpretations and reproduce the average profile and the observed drift pattern. The results of our study show that PSR B0818-41 is a powerful system to explore the pulsar radio emission mechanism, the implications of which are also discussed in our work.

  7. PSR J1755-2550: a young radio pulsar with a massive, compact companion

    NASA Astrophysics Data System (ADS)

    Ng, C.; Kruckow, M. U.; Tauris, T. M.; Lyne, A. G.; Freire, P. C. C.; Ridolfi, A.; Caiazzo, I.; Heyl, J.; Kramer, M.; Cameron, A. D.; Champion, D. J.; Stappers, B.

    2018-06-01

    Radio pulsars found in binary systems with short orbital periods are usually fast spinning as a consequence of recycling via mass transfer from their companion stars; this process is also thought to decrease the magnetic field of the neutron star being recycled. Here, we report on timing observations of the recently discovered binary PSR J1755-2550 and find that this pulsar is an exception: with a characteristic age of 2.1 Myr, it is relatively young; furthermore, with a spin period of 315 ms and a surface magnetic field strength at its poles of 0.88 × 1012 G, the pulsar shows no sign of having been recycled. Based on its timing and orbital characteristics, the pulsar either has a massive white dwarf (WD) or a neutron star (NS) companion. To distinguish between these two cases, we searched radio observations for a potential recycled pulsar companion and analysed archival optical data for a potential WD companion. Neither work returned conclusive detections. We apply population synthesis modelling and find that both solutions are roughly equally probable. Our population synthesis also predicts a minimum mass of 0.90 M⊙ for the companion star to PSR J1755-2550 and we simulate the systemic runaway velocities for the resulting WDNS systems which may merge and possibly produce Ca-rich supernovae. Whether PSR J1755-2550 hosts a WD or a NS companion star, it is certainly a member of a rare subpopulation of binary radio pulsars.

  8. Detection of long nulls in PSR B1706-16, a pulsar with large timing irregularities

    NASA Astrophysics Data System (ADS)

    Naidu, Arun; Joshi, Bhal Chandra; Manoharan, P. K.; Krishnakumar, M. A.

    2018-04-01

    Single pulse observations, characterizing in detail, the nulling behaviour of PSR B1706-16 are being reported for the first time in this paper. Our regular long duration monitoring of this pulsar reveals long nulls of 2-5 h with an overall nulling fraction of 31 ± 2 per cent. The pulsar shows two distinct phases of emission. It is usually in an active phase, characterized by pulsations interspersed with shorter nulls, with a nulling fraction of about 15 per cent, but it also rarely switches to an inactive phase, consisting of long nulls. The nulls in this pulsar are concurrent between 326.5 and 610 MHz. Profile mode changes accompanied by changes in fluctuation properties are seen in this pulsar, which switches from mode A before a null to mode B after the null. The distribution of null durations in this pulsar is bimodal. With its occasional long nulls, PSR B1706-16 joins the small group of intermediate nullers, which lie between the classical nullers and the intermittent pulsars. Similar to other intermediate nullers, PSR B1706-16 shows high timing noise, which could be due to its rare long nulls if one assumes that the slowdown rate during such nulls is different from that during the bursts.

  9. FERMI LAT Pulsed Detection of PSR J0737–3039A in the Double Pulsar System

    DOE PAGES

    Guillemot, L.; Kramer, M.; Johnson, T. J.; ...

    2013-04-25

    Here, we report the Fermi Large Area Telescope discovery of γ-ray pulsations from the 22.7 ms pulsar A in the double pulsar system J0737–3039A/B. This is the first mildly recycled millisecond pulsar (MSP) detected in the GeV domain. The 2.7 s companion object PSR J0737–3039B is not detected in γ rays. PSR J0737–3039A is a faint γ-ray emitter, so that its spectral properties are only weakly constrained; however, its measured efficiency is typical of other MSPs. The two peaks of the γ-ray light curve are separated by roughly half a rotation and are well offset from the radio and X-raymore » emission, suggesting that the GeV radiation originates in a distinct part of the magnetosphere from the other types of emission. From the modeling of the radio and the γ-ray emission profiles and the analysis of radio polarization data, we constrain the magnetic inclination α and the viewing angle ζ to be close to 90°, which is consistent with independent studies of the radio emission from PSR J0737–3039A. In conclusion, a small misalignment angle between the pulsar's spin axis and the system's orbital axis is therefore favored, supporting the hypothesis that pulsar B was formed in a nearly symmetric supernova explosion as has been discussed in the literature already.« less

  10. A CANDIDATE OPTICAL COUNTERPART TO THE MIDDLE AGED γ -RAY PULSAR PSR J1741–2054

    SciTech Connect

    Mignani, R. P.; Marelli, M.; Luca, A. De

    We carried out deep optical observations of the middle aged γ -ray pulsar PSR J1741−2054 with the Very Large Telescope (VLT). We identified two objects, of magnitudes m {sub v} = 23.10 ± 0.05 and m {sub v} = 25.32 ± 0.08, at positions consistent with the very accurate Chandra coordinates of the pulsar, the faintest of which is more likely to be its counterpart. From the VLT images we also detected the known bow-shock nebula around PSR J1741−2054. The nebula is displaced by ∼0.″9 (at the 3 σ confidence level) with respect to its position measured in archival data,more » showing that the shock propagates in the interstellar medium consistently with the pulsar proper motion. Finally, we could not find evidence of large-scale extended optical emission associated with the pulsar wind nebula detected by Chandra , down to a surface brightness limit of ∼28.1 mag arcsec{sup −2}. Future observations are needed to confirm the optical identification of PSR J1741−2054 and characterize the spectrum of its counterpart.« less

  11. Fermi LAT Pulsed Detection of PSR J0737-3039A in the Double Pulsar System

    NASA Technical Reports Server (NTRS)

    Guillemot, L.; Kramer, M.; Johnson, T. J.; Craig, H. A.; Romani, R. W.; Venter, C.; Harding, A. K.; Ferdman, R. D.; Stairs, I. H.; Kerr, M.

    2013-01-01

    We report the Fermi Large Area Telescope discovery of gamma-ray pulsations from the 22.7 ms pulsar A in the double pulsar system J0737-3039A/B. This is the first mildly recycled millisecond pulsar (MSP) detected in the GeV domain. The 2.7 s companion object PSR J0737-3039B is not detected in gamma rays. PSR J0737-3039A is a faint gamma-ray emitter, so that its spectral properties are only weakly constrained; however, its measured efficiency is typical of other MSPs. The two peaks of the gamma-ray light curve are separated by roughly half a rotation and are well offset from the radio and X-ray emission, suggesting that the GeV radiation originates in a distinct part of the magnetosphere from the other types of emission. From the modeling of the radio and the gamma-ray emission profiles and the analysis of radio polarization data, we constrain the magnetic inclination alpha and the viewing angle zeta to be close to 90 deg., which is consistent with independent studies of the radio emission from PSR J0737-3039A. A small misalignment angle between the pulsar's spin axis and the system's orbital axis is therefore favored, supporting the hypothesis that pulsar B was formed in a nearly symmetric supernova explosion as has been discussed in the literature already.

  12. Evaluation of Key Factors Impacting Feeding Safety in the Neonatal Intensive Care Unit: A Systematic Review.

    PubMed

    Matus, Bethany A; Bridges, Kayla M; Logomarsino, John V

    2018-06-21

    Individualized feeding care plans and safe handling of milk (human or formula) are critical in promoting growth, immune function, and neurodevelopment in the preterm infant. Feeding errors and disruptions or limitations to feeding processes in the neonatal intensive care unit (NICU) are associated with negative safety events. Feeding errors include contamination of milk and delivery of incorrect or expired milk and may result in adverse gastrointestinal illnesses. The purpose of this review was to evaluate the effect(s) of centralized milk preparation, use of trained technicians, use of bar code-scanning software, and collaboration between registered dietitians and registered nurses on feeding safety in the NICU. A systematic review of the literature was completed, and 12 articles were selected as relevant to search criteria. Study quality was evaluated using the Downs and Black scoring tool. An evaluation of human studies indicated that the use of centralized milk preparation, trained technicians, bar code-scanning software, and possible registered dietitian involvement decreased feeding-associated error in the NICU. A state-of-the-art NICU includes a centralized milk preparation area staffed by trained technicians, care supported by bar code-scanning software, and utilization of a registered dietitian to improve patient safety. These resources will provide nurses more time to focus on nursing-specific neonatal care. Further research is needed to evaluate the impact of factors related to feeding safety in the NICU as well as potential financial benefits of these quality improvement opportunities.

  13. Teamwork and patient safety in dynamic domains of healthcare: a review of the literature.

    PubMed

    Manser, T

    2009-02-01

    This review examines current research on teamwork in highly dynamic domains of healthcare such as operating rooms, intensive care, emergency medicine, or trauma and resuscitation teams with a focus on aspects relevant to the quality and safety of patient care. Evidence from three main areas of research supports the relationship between teamwork and patient safety: (1) Studies investigating the factors contributing to critical incidents and adverse events have shown that teamwork plays an important role in the causation and prevention of adverse events. (2) Research focusing on healthcare providers' perceptions of teamwork demonstrated that (a) staff's perceptions of teamwork and attitudes toward safety-relevant team behavior were related to the quality and safety of patient care and (b) perceptions of teamwork and leadership style are associated with staff well-being, which may impact clinician' ability to provide safe patient care. (3) Observational studies on teamwork behaviors related to high clinical performance have identified patterns of communication, coordination, and leadership that support effective teamwork. In recent years, research using diverse methodological approaches has led to significant progress in team research in healthcare. The challenge for future research is to further develop and validate instruments for team performance assessment and to develop sound theoretical models of team performance in dynamic medical domains integrating evidence from all three areas of team research identified in this review. This will help to improve team training efforts and aid the design of clinical work systems supporting effective teamwork and safe patient care.

  14. Evaluating the Impact of Radio Frequency Identification Retained Surgical Instruments Tracking on Patient Safety: Literature Review.

    PubMed

    Schnock, Kumiko O; Biggs, Bonnie; Fladger, Anne; Bates, David W; Rozenblum, Ronen

    2017-02-22

    Retained surgical instruments (RSI) are one of the most serious preventable complications in operating room settings, potentially leading to profound adverse effects for patients, as well as costly legal and financial consequences for hospitals. Safety measures to eliminate RSIs have been widely adopted in the United States and abroad, but despite widespread efforts, medical errors with RSI have not been eliminated. Through a systematic review of recent studies, we aimed to identify the impact of radio frequency identification (RFID) technology on reducing RSI errors and improving patient safety. A literature search on the effects of RFID technology on RSI error reduction was conducted in PubMed and CINAHL (2000-2016). Relevant articles were selected and reviewed by 4 researchers. After the literature search, 385 articles were identified and the full texts of the 88 articles were assessed for eligibility. Of these, 5 articles were included to evaluate the benefits and drawbacks of using RFID for preventing RSI-related errors. The use of RFID resulted in rapid detection of RSI through body tissue with high accuracy rates, reducing risk of counting errors and improving workflow. Based on the existing literature, RFID technology seems to have the potential to substantially improve patient safety by reducing RSI errors, although the body of evidence is currently limited. Better designed research studies are needed to get a clear understanding of this domain and to find new opportunities to use this technology and improve patient safety.

  15. Observaciones en la banda de radio de los alrededores de PSR J1646-4346 y PSR J1709-4428

    NASA Astrophysics Data System (ADS)

    Giacani, E.; Vieytes, M.

    It is generally accepted that most of the rotational energy loss of pulsars appears in the form of a relativistic wind of electron-positron pairs. Under certain conditions, the interaction between this wind and its surroundings is observable in the form of a pulsar wind nebula (PWN). At radio wavelenghts, there are at least two morphological types of PWN, depending on the source of confinement for the wind, but all of them present two unmistakable properties: a) high degree of polarization (>5%) and b) flat radio spectral index (0.0 <= α <= 0.3, where Snu∝ν-α). The existing sample of radio PWN is small. There are no more than seven confirmed PWN at radio wavelengths (the number is higher for X-ray PWN) which contain a known pulsar. We report on VLA high resolution observations of a region around the pulsars PSR J1645-4346 and PSR J1709-4428 at 1.4, 4.8 and 8.4 GHz. The pulsars appear surrounded by a synchrotron nebula. We argue on the basis of morphology, spectral index and polarization propierties that they are the synchrotron nebulae produced by the spin-down energy of the pulsar.

  16. Review Guidelines for Software Languages for use in Nuclear Power Plant Safety Systems

    DTIC Science & Technology

    1997-10-01

    desirable to segregate base classes from derived classes. Review is facilitated and safety is enhanced if project-specific guidance is provided on the... Segregate base from derived classes. In C++, it is desirable to segregate base classes from derived classes. 4.4.1.8 Minimizing Use of Literals...memory utilization. At the lowest level are base attributes, i.e., attributes xv NUREG/CR-6463 Rev. 1 sufficiently specific to define guidelines. An

  17. [Road safety measures and their effects on traffic injuries: a systematic review].

    PubMed

    Aguilera, Sandra Lúcia Vieira Ulinski; Moysés, Simone Tetú; Moysés, Samuel Jorge

    2014-10-01

    To identify and summarize the findings of studies describing interventions aimed at reducing road traffic injuries. An integrative systematic review without meta-analysis was performed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used to synthesize the findings of the articles reviewed. The keywords "traffic accidents", "review" and "public policy" were used in isolation or combined with boolean operator "And" to search PubMed, Web of Science, SciELO, and LILACS for the period between 2006 and 2011 RESULTS: Twenty-two studies were included in the systematic review. Of these, two described engineering strategies, two described other road safety policies, three described education strategies, and 15 described law enforcement policies. Law enforcement had the most effective immediate results. Engineering strategies proved important to promote a safe environment. Finally, education strategies had an informative role and served to support other strategies, but did not seem sufficient to promote cultural changes regarding road safety. Law enforcement seems to be the most effective strategy to change the behavior of drivers, especially regarding speed limits and drinking and driving.

  18. A Review of Safety and Design Requirements of the Artificial Pancreas.

    PubMed

    Blauw, Helga; Keith-Hynes, Patrick; Koops, Robin; DeVries, J Hans

    2016-11-01

    As clinical studies with artificial pancreas systems for automated blood glucose control in patients with type 1 diabetes move to unsupervised real-life settings, product development will be a focus of companies over the coming years. Directions or requirements regarding safety in the design of an artificial pancreas are, however, lacking. This review aims to provide an overview and discussion of safety and design requirements of the artificial pancreas. We performed a structured literature search based on three search components-type 1 diabetes, artificial pancreas, and safety or design-and extended the discussion with our own experiences in developing artificial pancreas systems. The main hazards of the artificial pancreas are over- and under-dosing of insulin and, in case of a bi-hormonal system, of glucagon or other hormones. For each component of an artificial pancreas and for the complete system we identified safety issues related to these hazards and proposed control measures. Prerequisites that enable the control algorithms to provide safe closed-loop control are accurate and reliable input of glucose values, assured hormone delivery and an efficient user interface. In addition, the system configuration has important implications for safety, as close cooperation and data exchange between the different components is essential.

  19. The economic burden of patient safety targets in acute care: a systematic review

    PubMed Central

    Mittmann, Nicole; Koo, Marika; Daneman, Nick; McDonald, Andrew; Baker, Michael; Matlow, Anne; Krahn, Murray; Shojania, Kaveh G; Etchells, Edward

    2012-01-01

    Background Our objective was to determine the quality of literature in costing of the economic burden of patient safety. Methods We selected 15 types of patient safety targets for our systematic review. We searched the literature published between 2000 and 2010 using the following terms: “costs and cost analysis,” “cost-effectiveness,” “cost,” and “financial management, hospital.” We appraised the methodologic quality of potentially relevant studies using standard economic methods. We recorded results in the original currency, adjusted for inflation, and then converted to 2010 US dollars for comparative purposes (2010 US$1.00 = 2010 €0.76). The quality of each costing study per patient safety target was also evaluated. Results We screened 1948 abstracts, and identified 158 potentially eligible studies, of which only 61 (39%) reported any costing methodology. In these 61 studies, we found wide estimates of the attributable costs of patient safety events ranging from $2830 to $10,074. In general hospital populations, the cost per case of hospital-acquired infection ranged from $2132 to $15,018. Nosocomial bloodstream infection was associated with costs ranging from $2604 to $22,414. Conclusion There are wide variations in the estimates of economic burden due to differences in study methods and methodologic quality. Greater attention to methodologic standards for economic evaluations in patient safety is needed. PMID:23097615

  20. Critical Review of Commercial Secondary Lithium-Ion Battery Safety Standards

    NASA Astrophysics Data System (ADS)

    Jones, Harry P.; Chapin, Thomas, J.; Tabaddor, Mahmod

    2010-09-01

    The development of Li-ion cells with greater energy density has lead to safety concerns that must be carefully assessed as Li-ion cells power a wide range of products from consumer electronics to electric vehicles to space applications. Documented field failures and product recalls for Li-ion cells, mostly for consumer electronic products, highlight the risk of fire, smoke, and even explosion. These failures have been attributed to the occurrence of internal short circuits and the subsequent thermal runaway that can lead to fire and explosion. As packaging for some applications include a large number of cells, the risk of failure is likely to be magnified. To address concerns about the safety of battery powered products, safety standards have been developed. This paper provides a review of various international safety standards specific to lithium-ion cells. This paper shows that though the standards are harmonized on a host of abuse conditions, most lack a test simulating internal short circuits. This paper describes some efforts to introduce internal short circuit tests into safety standards.

  1. Timing of Formal Phase Safety Reviews for Large-Scale Integrated Hazard Analysis

    NASA Technical Reports Server (NTRS)

    Massie, Michael J.; Morris, A. Terry

    2010-01-01

    Integrated hazard analysis (IHA) is a process used to identify and control unacceptable risk. As such, it does not occur in a vacuum. IHA approaches must be tailored to fit the system being analyzed. Physical, resource, organizational and temporal constraints on large-scale integrated systems impose additional direct or derived requirements on the IHA. The timing and interaction between engineering and safety organizations can provide either benefits or hindrances to the overall end product. The traditional approach for formal phase safety review timing and content, which generally works well for small- to moderate-scale systems, does not work well for very large-scale integrated systems. This paper proposes a modified approach to timing and content of formal phase safety reviews for IHA. Details of the tailoring process for IHA will describe how to avoid temporary disconnects in major milestone reviews and how to maintain a cohesive end-to-end integration story particularly for systems where the integrator inherently has little to no insight into lower level systems. The proposal has the advantage of allowing the hazard analysis development process to occur as technical data normally matures.

  2. Idaho National Laboratory Integrated Safety Management System FY 2016 Effectiveness Review and Declaration Report

    SciTech Connect

    Hunt, Farren J.

    Idaho National Laboratory’s (INL’s) Integrated Safety Management System (ISMS) effectiveness review of fiscal year (FY) 2016 shows that INL has integrated management programs and safety elements throughout the oversight and operational activities performed at INL. The significant maturity of Contractor Assurance System (CAS) processes, as demonstrated across INL’s management systems and periodic reporting through the Management Review Meeting process, over the past two years has provided INL with current real-time understanding and knowledge pertaining to the health of the institution. INL’s sustained excellence of the Integrated Safety and effective implementation of the Worker Safety and Health Program is also evidencedmore » by other external validations and key indicators. In particular, external validations include VPP, ISO 14001, DOELAP accreditation, and key Laboratory level indicators such as ORPS (number, event frequency and severity); injury/illness indicators such as Days Away, Restricted and Transfer (DART) case rate, back & shoulder metric and open reporting indicators, demonstrate a continuous positive trend and therefore improved operational performance over the last few years. These indicators are also reflective of the Laboratory’s overall organizational and safety culture improvement. Notably, there has also been a step change in ESH&Q Leadership actions that have been recognized both locally and complex-wide. Notwithstanding, Laboratory management continues to monitor and take action on lower level negative trends in numerous areas including: Conduct of Operations, Work Control, Work Site Analysis, Risk Assessment, LO/TO, Fire Protection, and Life Safety Systems, to mention a few. While the number of severe injury cases has decreased, as evidenced by the reduction in the DART case rate, the two hand injuries and the fire truck/ambulance accident were of particular concern. Aggressive actions continue in order to understand the causes

  3. High Frequency Radio Observations of the Reactivated Magnetar PSR J1622-4950

    NASA Astrophysics Data System (ADS)

    Pearlman, Aaron B.; Majid, Walid A.; Prince, Thomas A.; Horiuchi, Shinji; Kocz, Jonathon; Lazio, T. J. W.; Naudet, Charles J.

    2017-07-01

    Radio emission from the magnetar PSR J1622-4950 was recently reported to have resumed (Camilo et al., ATel #10346). We have carried out Target of Opportunity (ToO) radio observations of PSR J1622-4950 at S-band (2.3 GHz) and X-band (8.4 GHz) using the 70-m diameter Deep Space Network (DSN) radio dish (DSS-43) in Canberra, Australia. We report on our single polarization mode observations of PSR J1622-4950 spanning 5 hours on 23 May 2017 starting at 16:03:32 UTC. Pulsations were detected at a period of 4.327308(1) s. We measure a mean flux density of 3.8(8)/0.41(8) mJy at S/X-band, from which we derive a spectral index of -1.7(2). We note that PSR J1622-4950's spectral behavior is now consistent with the majority of pulsars, which have a mean spectral index of -1.8(2) (Maron et al. (2000)). The result by Maron et al. (2000) is used here because they included more high frequency pulsar spectra than other studies to characterize the underlying spectral index distribution over a wide frequency range. The mean flux density at S-band has now increased by an order of magnitude compared to previous flux density measurements by Scholz et al. (2017) during the magnetar's quiescent state. Furthermore, the spectral index has steepened compared to a nearly flat spectral index from flux density measurements between 1.4 and 24 GHz prior to the disappearance of the radio emission (Levin et al. (2010); Keith et al. (2011); Levin et al. (2012); Anderson et al. (2012); Scholz et al. (2017)). We are continuing to monitor changes in PSR J1622-4950's radio spectrum at both S-band and X-band. We thank the DSN (Deep Space Network) and Canberra Deep Space Communication Complex (CDSCC) teams for scheduling these observations.

  4. Frequency, Expected Effects, Obstacles, and Facilitators of Disclosure of Patient Safety Incidents: A Systematic Review

    PubMed Central

    2017-01-01

    Objectives We performed a systematic review to assess and aggregate the available evidence on the frequency, expected effects, obstacles, and facilitators of disclosure of patient safety incidents (DPSI). Methods We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for this systematic review and searched PubMed, Scopus, and the Cochrane Library for English articles published between 1990 and 2014. Two authors independently conducted the title screening and abstract review. Ninety-nine articles were selected for full-text reviews. One author extracted the data and another verified them. Results There was considerable variation in the reported frequency of DPSI among medical professionals. The main expected effects of DPSI were decreased intention of the general public to file medical lawsuits and punish medical professionals, increased credibility of medical professionals, increased intention of patients to revisit and recommend physicians or hospitals, higher ratings of quality of care, and alleviation of feelings of guilt among medical professionals. The obstacles to DPSI were fear of medical lawsuits and punishment, fear of a damaged professional reputation among colleagues and patients, diminished patient trust, the complexity of the situation, and the absence of a patient safety culture. However, the factors facilitating DPSI included the creation of a safe environment for reporting patient safety incidents, as well as guidelines and education for DPSI. Conclusions The reported frequency of the experience of the general public with DPSI was somewhat lower than the reported frequency of DPSI among medical professionals. Although we identified various expected effects of DPSI, more empirical evidence from real cases is required. PMID:28372351

  5. Efficacy, safety, and economics of bracing after spine surgery: a systematic review of the literature.

    PubMed

    Zhu, Mary P; Tetreault, Lindsay A; Sorefan-Mangou, Fatimah; Garwood, Philip; Wilson, Jefferson R

    2018-01-31

    Bracing is often used after spinal surgery to immobilize the spine, improve fusion, and relieve pain. However, controversy exists regarding the efficacy, necessity, and safety of various bracing techniques in the postsurgical setting. In this systematic review, we aimed to compare the effectiveness, safety, and cost-effectiveness of postoperative bracing versus no postoperative bracing after spinal surgery in patients with several common operative spinal pathologies. A systematic review was carried out to compare postoperative bracing and no postoperative bracing. A systematic search was conducted of MEDLINE, Embase, and the Cochrane Collaboration Library from 1970 to May 2017, supplemented by manual searching of the reference list of relevant studies and previously published reviews. Studies were included if they compared disability, quality of life, functional impairment, radiographic outcomes, cost-effectiveness, or complications between patients treated with postoperative bracing and patients not receiving any postoperative bracing. Each article was critically appraised independently by two reviewers, and the overall body of evidence was rated using guidelines outlined by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) Working Group. Of the 858 retrieved citations, 5 studies met the inclusion criteria and were included in this review, consisting of 4 randomized controlled trials and 1 prospective cohort study. Low to moderate evidence suggests that there are no significant differences in most measures of disability, pain, quality of life, functional impairment, radiographic outcomes, and safety between groups. Isolated studies reported statistically significant and inconsistent differences between groups with respect to Neck Disability Index at 6 weeks postoperatively or Short Form-36 Physical Component Score at 1.5, 3, 6, and 12 months postoperatively. Based on limited evidence, postoperative bracing does not result in improved

  6. Consumer food handling in the home: a review of food safety studies.

    PubMed

    Redmond, Elizabeth C; Griffith, Christopher J

    2003-01-01

    Epidemiological data from Europe, North America, Australia, and New Zealand indicate that a substantial proportion of foodborne disease is attributable to improper food preparation practices in consumers' homes. International concern about consumer food safety has prompted considerable research to evaluate domestic food-handling practices. The majority of consumer food safety studies in the last decade have been conducted in the United Kingdom and Northern Ireland (48%) and in the United States (42%). Surveys (questionnaires and interviews), the most frequent means of data collection, were used in 75% of the reviewed studies. Focus groups and observational studies have also been used. One consumer food safety study examined the relationship between pathogenic microbial contamination from raw chicken and observed food-handling behaviors, and the results of this study indicated extensive Campylobacter cross-contamination during food preparation sessions. Limited information about consumers' attitudes and intentions with regard to safe food-handling behaviors has been obtained, although a substantial amount of information about consumer knowledge and self-reported practices is available. Observation studies suggest that substantial numbers of consumers frequently implement unsafe food-handling practices. Knowledge, attitudes, intentions, and self-reported practices did not correspond to observed behaviors, suggesting that observational studies provide a more realistic indication of the food hygiene actions actually used in domestic food preparation. An improvement in consumer food-handling behavior is likely to reduce the risk and incidence of foodborne disease. The need for the development and implementation of food safety education strategies to improve specific food safety behaviors is reviewed in this paper.

  7. Health Information Technology in Healthcare Quality and Patient Safety: Literature Review.

    PubMed

    Feldman, Sue S; Buchalter, Scott; Hayes, Leslie W

    2018-06-04

    The area of healthcare quality and patient safety is starting to use health information technology to prevent reportable events, identify them before they become issues, and act on events that are thought to be unavoidable. As healthcare organizations begin to explore the use of health information technology in this realm, it is often unclear where fiscal and human efforts should be focused. The purpose of this study was to provide a foundation for understanding where to focus health information technology fiscal and human resources as well as expectations for the use of health information technology in healthcare quality and patient safety. A literature review was conducted to identify peer-reviewed publications reporting on the actual use of health information technology in healthcare quality and patient safety. Inductive thematic analysis with open coding was used to categorize a total of 41 studies. Three pre-set categories were used: prevention, identification, and action. Three additional categories were formed through coding: challenges, outcomes, and location. This study identifies five main categories across seven study settings. A majority of the studies used health IT for identification and prevention of healthcare quality and patient safety issues. In this realm, alerts, clinical decision support, and customized health IT solutions were most often implemented. Implementation, interface design, and culture were most often noted as challenges. This study provides valuable information as organizations determine where they stand to get the most "bang for their buck" relative to health IT for quality and patient safety. Knowing what implementations are being effectivity used by other organizations helps with fiscal and human resource planning as well as managing expectations relative to cost, scope, and outcomes. The findings from this scan of the literature suggest that having organizational champion leaders that can shepherd implementation, impact culture

  8. Systematic review: cardiovascular safety profile of 5-HT(4) agonists developed for gastrointestinal disorders.

    PubMed

    Tack, J; Camilleri, M; Chang, L; Chey, W D; Galligan, J J; Lacy, B E; Müller-Lissner, S; Quigley, E M M; Schuurkes, J; De Maeyer, J H; Stanghellini, V

    2012-04-01

    The nonselective 5-HT(4) receptor agonists, cisapride and tegaserod have been associated with cardiovascular adverse events (AEs). To perform a systematic review of the safety profile, particularly cardiovascular, of 5-HT(4) agonists developed for gastrointestinal disorders, and a nonsystematic summary of their pharmacology and clinical efficacy. Articles reporting data on cisapride, clebopride, prucalopride, mosapride, renzapride, tegaserod, TD-5108 (velusetrag) and ATI-7505 (naronapride) were identified through a systematic search of the Cochrane Library, Medline, Embase and Toxfile. Abstracts from UEGW 2006-2008 and DDW 2008-2010 were searched for these drug names, and pharmaceutical companies approached to provide unpublished data. Retrieved articles on pharmacokinetics, human pharmacodynamics and clinical data with these 5-HT(4) agonists, are reviewed and summarised nonsystematically. Articles relating to cardiac safety and tolerability of these agents, including any relevant case reports, are reported systematically. Two nonselective 5-HT(4) agonists had reports of cardiovascular AEs: cisapride (QT prolongation) and tegaserod (ischaemia). Interactions with, respectively, the hERG cardiac potassium channel and 5-HT(1) receptor subtypes have been suggested to account for these effects. No cardiovascular safety concerns were reported for the newer, selective 5-HT(4) agonists prucalopride, velusetrag, naronapride, or for nonselective 5-HT(4) agonists with no hERG or 5-HT(1) affinity (renzapride, clebopride, mosapride). 5-HT(4) agonists for GI disorders differ in chemical structure and selectivity for 5-HT(4) receptors. Selectivity for 5-HT(4) over non-5-HT(4) receptors may influence the agent's safety and overall risk-benefit profile. Based on available evidence, highly selective 5-HT(4) agonists may offer improved safety to treat patients with impaired GI motility. © 2012 Blackwell Publishing Ltd.

  9. Systematic review: cardiovascular safety profile of 5-HT4 agonists developed for gastrointestinal disorders

    PubMed Central

    Tack, J; Camilleri, M; Chang, L; Chey, W D; Galligan, J J; Lacy, B E; Müller-Lissner, S; Quigley, E M M; Schuurkes, J; Maeyer, J H; Stanghellini, V

    2012-01-01

    Summary Background The nonselective 5-HT4 receptor agonists, cisapride and tegaserod have been associated with cardiovascular adverse events (AEs). Aim To perform a systematic review of the safety profile, particularly cardiovascular, of 5-HT4 agonists developed for gastrointestinal disorders, and a nonsystematic summary of their pharmacology and clinical efficacy. Methods Articles reporting data on cisapride, clebopride, prucalopride, mosapride, renzapride, tegaserod, TD-5108 (velusetrag) and ATI-7505 (naronapride) were identified through a systematic search of the Cochrane Library, Medline, Embase and Toxfile. Abstracts from UEGW 2006–2008 and DDW 2008–2010 were searched for these drug names, and pharmaceutical companies approached to provide unpublished data. Results Retrieved articles on pharmacokinetics, human pharmacodynamics and clinical data with these 5-HT4 agonists, are reviewed and summarised nonsystematically. Articles relating to cardiac safety and tolerability of these agents, including any relevant case reports, are reported systematically. Two nonselective 5-HT4 agonists had reports of cardiovascular AEs: cisapride (QT prolongation) and tegaserod (ischaemia). Interactions with, respectively, the hERG cardiac potassium channel and 5-HT1 receptor subtypes have been suggested to account for these effects. No cardiovascular safety concerns were reported for the newer, selective 5-HT4 agonists prucalopride, velusetrag, naronapride, or for nonselective 5-HT4 agonists with no hERG or 5-HT1 affinity (renzapride, clebopride, mosapride). Conclusions 5-HT4 agonists for GI disorders differ in chemical structure and selectivity for 5-HT4 receptors. Selectivity for 5-HT4 over non-5-HT4 receptors may influence the agent's safety and overall risk–benefit profile. Based on available evidence, highly selective 5-HT4 agonists may offer improved safety to treat patients with impaired GI motility. PMID:22356640

  10. The Impact of System Factors on Quality and Safety in Arterial Surgery: A Systematic Review.

    PubMed

    Lear, R; Godfrey, A D; Riga, C; Norton, C; Vincent, C; Bicknell, C D

    2017-07-01

    A systems approach to patient safety proposes that a wide range of factors contribute to surgical outcome, yet the impact of team, work environment, and organisational factors, is not fully understood in arterial surgery. The aim of this systematic review is to summarize and discuss what is already known about the impact of system factors on quality and safety in arterial surgery. A systematic review of original research papers in English using MEDLINE, Embase, PsycINFO, and Cochrane databases, was performed according to PRISMA guidelines. Independent reviewers selected papers according to strict inclusion and exclusion criteria, and using predefined data fields, extracted relevant data on team, work environment, and organisational factors, and measures of quality and/or safety, in arterial procedures. Twelve papers met the selection criteria. Study endpoints were not consistent between papers, and most failed to report their clinical significance. A variety of tools were used to measure team skills in five papers; only one paper measured the relationship between team factors and patient outcomes. Two papers reported that equipment failures were common and had a significant impact on operating room efficiency. The influence of hospital characteristics on failure-to-rescue rates was tested in one large study, although their conclusions were limited to the American Medicare population. Five papers implemented changes in the patient pathway, but most studies failed to account for potential confounding variables. A small number of heterogenous studies have evaluated the relationship between system factors and quality or safety in arterial surgery. There is some evidence of an association between system factors and patient outcomes, but there is more work to be done to fully understand this relationship. Future research would benefit from consistency in definitions, the use of validated assessment tools, measurement of clinically relevant endpoints, and adherence to

  11. Critical review of the current literature on the safety of sucralose.

    PubMed

    Magnuson, Bernadene A; Roberts, Ashley; Nestmann, Earle R

    2017-08-01

    Sucralose is a non-caloric high intensity sweetener that is approved globally for use in foods and beverages. This review provides an updated summary of the literature addressing the safety of use of sucralose. Studies reviewed include chemical characterization and stability, toxicokinetics in animals and humans, assessment of genotoxicity, and animal and human feeding studies. Endpoints evaluated include effects on growth, development, reproduction, neurotoxicity, immunotoxicity, carcinogenicity and overall health status. Human clinical studies investigated potential effects of repeated consumption in individuals with diabetes. Recent studies on the safety of sucralose focused on carcinogenic potential and the effect of sucralose on the gut microflora are reviewed. Following the discovery of sweet taste receptors in the gut and studies investigating the activation of these receptors by sucralose lead to numerous human clinical studies assessing the effect of sucralose on overall glycemic control. Estimated daily intakes of sucralose in different population subgroups, including recent studies on children with special dietary needs, consistently find that the intakes of sucralose in all members of the population remain well below the acceptable daily intake. Collectively, critical review of the extensive database of research demonstrates that sucralose is safe for its intended use as a non-caloric sugar alternative. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness

    PubMed Central

    Doyle, Cathal; Lennox, Laura; Bell, Derek

    2013-01-01

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

  13. Do safety checklists improve teamwork and communication in the operating room? A systematic review.

    PubMed

    Russ, Stephanie; Rout, Shantanu; Sevdalis, Nick; Moorthy, Krishna; Darzi, Ara; Vincent, Charles

    2013-12-01

    The aim of this systematic review was to assess the impact of surgical safety checklists on the quality of teamwork and communication in the operating room (OR). Safety checklists have been shown to impact positively on patient morbidity and mortality following surgery, but it is unclear whether this clinical improvement is related to an improvement in OR teamwork and communication. A systematic search strategy of MEDLINE, EMBASE, PsycINFO, Google Scholar, and the Cochrane Database for Systematic Reviews was undertaken to obtain relevant articles. After de-duplication and the addition of limits, 315 articles were screened for inclusion by 2 researchers and all articles meeting a set of prespecified inclusion criteria were retained. Information regarding the type of checklist, study design, assessment tools used, outcomes, and study limitations was extracted. Twenty articles formed the basis of this systematic review. All articles described an empirical study relating to a case-specific safety checklist for surgery as the primary intervention, with some measure of change/improvement in teamwork and/or communication relating to its use. The methods for assessing teamwork and communication varied greatly, including surveys, observations, interviews, and 360° assessments. The evidence suggests that safety checklists improve the perceived quality of OR teamwork and communication and reduce observable errors relating to poor team skills. This is likely to function through establishing an open platform for communication at the start of a procedure: encouraging the sharing of critical case-related information, promoting team coordination and decision making, flagging knowledge gaps, and enhancing team cohesion. However, the evidence would also suggest that when used suboptimally or when individuals have not bought in to the process, checklists may conversely have a negative impact on the function of the team. Safety checklists are beneficial for OR teamwork and

  14. A systematic review of occupational health and safety interventions with economic analyses.

    PubMed

    Tompa, Emile; Dolinschi, Roman; de Oliveira, Claire; Irvin, Emma

    2009-09-01

    We reviewed the occupational health and safety intervention literature to synthesize evidence on financial merits of such interventions. A literature search included journal databases, existing systematic reviews, and studies identified by content experts. Studies meeting inclusion criteria were assessed for quality. Evidence was synthesized within industry-intervention type clusters. We found strong evidence that ergonomic and other musculoskeletal injury prevention interventions in manufacturing and warehousing are worth undertaking in terms of their financial merits. We also found strong evidence that multisector disability management interventions are worth undertaking. While the economic evaluation of interventions in this literature warrants further expansion, we found a sufficient number of studies to identify strong, moderate, and limited evidence in certain industry-intervention clusters. The review also provided insights into how the methodological quality of economic evaluations in this literature could be improved.

  15. The Evaluation of Land Ecological Safety of Chengchao Iron Mine Based on PSR and MEM

    NASA Astrophysics Data System (ADS)

    Jin, Xiangdong; Chen, Yong

    2018-01-01

    Land ecological security is of vital importance to local security and sustainable development of mining activities. The study has analyzed the potential causal chains between the land ecological security of Iron Mine mining environment, mine resource and the social-economic background. On the base of Pressure-State-Response model, the paper set up a matter element evaluation model of land ecological security, and applies it in Chengchao iron mine. The evaluation result proves to be effective in land ecological evaluation.

  16. Safety of regular formoterol or salmeterol in children with asthma: an overview of Cochrane reviews

    PubMed Central

    Cates, Christopher J; Oleszczuk, Marta; Stovold, Elizabeth; Wieland, L. Susan

    2014-01-01

    Background Two large surveillance studies in adults with asthma have found an increased risk of asthma-related mortality in those who took regular salmeterol as monotherapy in comparison to placebo or regular salbutamol. No similar sized surveillance studies have been carried out in children with asthma, and we remain uncertain about the comparative safety of regular combination therapy with either formoterol or salmeterol in children with asthma. Objectives We have used the paediatric trial results from Cochrane systematic reviews to assess the safety of regular formoterol or salmeterol, either as monotherapy or as combination therapy, in children with asthma. Methods We included Cochrane reviews relating to the safety of regular formoterol and salmeterol from a search of the Cochrane Database of Systematic Reviews conducted in May 2012, and ran updated searches for each of the reviews. These were independently assessed. All the reviews were assessed for quality using the AMSTAR tool. We extracted the data relating to children from each review and from new trials found in the updated searches (including risks of bias, study characteristics, serious adverse event outcomes, and control arm event rates). The safety of regular formoterol and salmeterol were assessed directly from the paediatric trials in the Cochrane reviews of monotherapy and combination therapy with each product. Then monotherapy was indirectly compared to combination therapy by looking at the differences between the pooled trial results for monotherapy and the pooled results for combination therapy. The comparative safety of formoterol and salmeterol was assessed using direct evidence from trials that randomised children to each treatment; this was combined with the result of an indirect comparison of the combination therapy trials, which represents the difference between the pooled results of each product when randomised against inhaled corticosteroids alone. Main results We identified six high

  17. Scoping Review of Research on the Effectiveness of Food-Safety Education Interventions Directed at Consumers.

    PubMed

    Sivaramalingam, Bhairavi; Young, Ian; Pham, Mai T; Waddell, Lisa; Greig, Judy; Mascarenhas, Mariola; Papadopoulos, Andrew

    2015-07-01

    Improper food handling by consumers at home is a major cause of foodborne illness. Therefore, effective education strategies are essential to change consumers' food safety attitudes and behaviors. The purpose of this scoping review was to identify and characterize primary literature examining the effectiveness of consumer food-safety education interventions. Ten bibliographic databases were searched using a comprehensive search strategy. Citations were identified; two reviewers screened them for relevance and characterized relevant articles. To ensure results would be applicable to end users, stakeholders were engaged to provide input on the review scope, methods, and results. We identified 246 relevant articles, of which 150 were quantitative, 66 qualitative, and 30 mixed-method research studies. Most studies (64.2%) were published in the United States, using an uncontrolled before-and-after study design (31.3%), and investigated the effectiveness of community-based training sessions and workshops (52.0%). Research gaps were found in the number of randomized controlled studies conducted, academic- and school-based courses and curricula investigated, and interventions targeting high-risk populations (e.g., pregnant women, those who are immunocompromised) and using new media channels (e.g., social media). Key opportunities to enhance the utility of future primary research investigating consumer food-safety interventions include the following: using studies based on behavior-change theories and formative research; engaging the target population in the research; using validated instruments to measures outcomes; and reporting intervention characteristics and outcomes completely. Results of this review can be used to prioritize future primary research and decision-making in this area.

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

    PubMed Central

    Packer, Mark

    2016-01-01

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

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

    PubMed

    Packer, Mark

    2016-01-01

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

  20. Spinal cord stimulation: a review of the safety literature and proposal for perioperative evaluation and management.

    PubMed

    Walsh, Kevin M; Machado, Andre G; Krishnaney, Ajit A

    2015-08-01

    There is currently no consensus on appropriate perioperative management of patients with spinal cord stimulator implants. Magnetic resonance imaging (MRI) is considered safe under strict labeling conditions. Electrocautery is generally not recommended in these patients but sometimes used despite known risks. The aim was to discuss the perioperative evaluation and management of patients with spinal cord stimulator implants. A literature review, summary of device labeling, and editorial were performed, regarding the safety of spinal cord stimulator devices in the perioperative setting. A literature review was performed, and the labeling of each Food and Drug Administration (FDA)-approved spinal cord stimulation system was reviewed. The literature review was performed using PubMed and the FDA website (www.fda.gov). Magnetic resonance imaging safety recommendations vary between the models. Certain systems allow for MRI of the brain to be performed, and only one system allows for MRI of the body to be performed, both under strict labeling conditions. Before an MRI is performed, it is imperative to ascertain that the system is intact, without any lead breaks or low impedances, as these can result in heating of the spinal cord stimulation (SCS) and injury to the patient. Monopolar electrocautery is generally not recommended for patients with SCS; however, in some circumstances, it is used when deemed required by the surgeon. When cautery is necessary, bipolar electrocautery is recommended. Modern electrocautery units are to be used with caution as there remains a risk of thermal injury to the tissue in contact with the SCS. As with MRI, electrocautery usage in patients with SCS systems with suspected breaks or abnormal impedances is unsafe and may cause injury to the patient. Spinal cord stimulation is increasingly used in patients with pain of spinal origin, particularly to manage postlaminectomy syndrome. Knowledge of the safety concerns of SCS and appropriate

  1. Occupational Health and Safety in Ethiopia: A review of Situational Analysis and Needs Assessment

    PubMed Central

    Kumie, Abera; Amera, Tadesse; Berhane, Kiros; Samet, Jonathan; Hundal, Nuvjote; G/Michael, Fitsum; Gilliland, Frank

    2017-01-01

    Background The current rapid economic development has brought changes in workplaces in developing countries, including Ethiopia. The organization of occupational health and safety services is not yet resilient enough to handle the growing demands for workers’ health in the context of industrialization. There is limited information on the gaps and needs of occupational health services in workplaces in Ethiopia. Objectives The present review article describes the existing profile of occupational safety and health services in Ethiopia and identifies the current gaps and needs in the services. Methods Secondary data sources were reviewed using a structured checklist to explore the status of occupational safety, health services and related morbidity. Local literature was consulted in order to describe the type and prevalence of work related hazards, patterns of industries and of workforce. Published articles were searched in Google, Google scholar, PUBMED, and HINARI databases. Relevant heads of stakeholder organizations and experts were interviewed to verify the gaps that were synthesized using desk review. Results Ethiopia is an agrarian country that is industrializing rapidly with a focus on construction, manufacturing, mining, and road infrastructure. An estimated work force of about two million is currently engaged in the public and private sectors. Males constitute the majority of this workforce. Most of the workforce has basic primary education. Commonly observed hazards in the workplace include occupational noise and dust of various types in manufacturing sectors and chemical exposures in the flower industry. Injury in both the agriculture and the manufacturing sectors is another workplace hazard commonly observed in the country. A lack of information made assessing workplace exposures in detail difficult. The prevalence of noise exposure was found to be high with the potential to seriously impact hearing capacity. Exposure to dust in textile and cement

  2. Occupational Health and Safety in Ethiopia: A review of Situational Analysis and Needs Assessment.

    PubMed

    Kumie, Abera; Amera, Tadesse; Berhane, Kiros; Samet, Jonathan; Hundal, Nuvjote; G/Michael, Fitsum; Gilliland, Frank

    2016-01-01

    The current rapid economic development has brought changes in workplaces in developing countries, including Ethiopia. The organization of occupational health and safety services is not yet resilient enough to handle the growing demands for workers' health in the context of industrialization. There is limited information on the gaps and needs of occupational health services in workplaces in Ethiopia. The present review article describes the existing profile of occupational safety and health services in Ethiopia and identifies the current gaps and needs in the services. Secondary data sources were reviewed using a structured checklist to explore the status of occupational safety, health services and related morbidity. Local literature was consulted in order to describe the type and prevalence of work related hazards, patterns of industries and of workforce. Published articles were searched in Google, Google scholar, PUBMED, and HINARI databases. Relevant heads of stakeholder organizations and experts were interviewed to verify the gaps that were synthesized using desk review. Ethiopia is an agrarian country that is industrializing rapidly with a focus on construction, manufacturing, mining, and road infrastructure. An estimated work force of about two million is currently engaged in the public and private sectors. Males constitute the majority of this workforce. Most of the workforce has basic primary education. Commonly observed hazards in the workplace include occupational noise and dust of various types in manufacturing sectors and chemical exposures in the flower industry. Injury in both the agriculture and the manufacturing sectors is another workplace hazard commonly observed in the country. A lack of information made assessing workplace exposures in detail difficult. The prevalence of noise exposure was found to be high with the potential to seriously impact hearing capacity. Exposure to dust in textile and cement factories greatly exceeded international

  3. A Review of Numerical Simulation and Analytical Modeling for Medical Devices Safety in MRI

    PubMed Central

    Kabil, J.; Belguerras, L.; Trattnig, S.; Pasquier, C.; Missoffe, A.

    2016-01-01

    Summary Objectives To review past and present challenges and ongoing trends in numerical simulation for MRI (Magnetic Resonance Imaging) safety evaluation of medical devices. Methods A wide literature review on numerical and analytical simulation on simple or complex medical devices in MRI electromagnetic fields shows the evolutions through time and a growing concern for MRI safety over the years. Major issues and achievements are described, as well as current trends and perspectives in this research field. Results Numerical simulation of medical devices is constantly evolving, supported by calculation methods now well-established. Implants with simple geometry can often be simulated in a computational human model, but one issue remaining today is the experimental validation of these human models. A great concern is to assess RF heating on implants too complex to be traditionally simulated, like pacemaker leads. Thus, ongoing researches focus on alternative hybrids methods, both numerical and experimental, with for example a transfer function method. For the static field and gradient fields, analytical models can be used for dimensioning simple implants shapes, but limited for complex geometries that cannot be studied with simplifying assumptions. Conclusions Numerical simulation is an essential tool for MRI safety testing of medical devices. The main issues remain the accuracy of simulations compared to real life and the studies of complex devices; but as the research field is constantly evolving, some promising ideas are now under investigation to take up the challenges. PMID:27830244

  4. A Review of the Efficacy, Safety, and Clinical Implications of Naturally Derived Dietary Supplements for Dyslipidemia.

    PubMed

    Thaipitakwong, Thanchanit; Aramwit, Pornanong

    2017-02-01

    Dyslipidemia is recognized as a major cause of cardiovascular disease. A number of evidence-based guidelines recommend conventional synthetic drugs as standard therapy for dyslipidemia in clinical practice. However, antihyperlipidemic drugs have some serious side effects. Naturally derived dietary supplements are becoming attractive as an alternative strategy because of their high efficacy and safety, as supported by numerous data. Moreover, they could be considered an initial treatment for dyslipidemia. The aims of this literature review were to demonstrate the efficacy, safety, and clinical implications of dietary supplements for treating dyslipidemia. We reviewed the literature, including data from in vitro, in vivo, and human studies, and clinical guideline recommendations. We classified dietary supplements by their proposed mechanisms of action on lipid metabolism and also collected daily dosage recommendations, interactions with concurrent drugs and/or foods, dosage forms, and examples of commercially available products. Various types of naturally derived dietary supplements exhibit lipid-improving properties. Efficacy and safety are acceptable; however, their use in clinical practice will require further well-designed investigations and the support of scientific data.

  5. Long-acting atypical injectable antipsychotics in the treatment of schizophrenia: safety and tolerability review.

    PubMed

    Cañas, Fernando; Möller, Hans-Jürgen

    2010-09-01

    Although atypical antipsychotics have beneficial efficacy and tolerance, non-adherence and partial adherence remain in patients treated for schizophrenia. Long-acting injectable or depot atypical antipsychotics offer better medication adherence and tolerability advantages. Currently, two drugs are available for the treatment of schizophrenia, risperidone long-acting injectable (RLAI) and olanzapine pamoate (OP). Short- and long-term safety and tolerability data on RLAI and OP from January 2006 through September 2009 were reviewed by performing Medline and PubMed searches, reviewing abstracts and poster presentations, and viewing available material from the FDA and European Medicines Agency. RLAI and OP show good short- and long-term safety when treating patients with schizophrenia, with uncommon discontinuation due to adverse effects. RLAI and OP data show rare problems with injection site reactions and patients exposed to injectable treatments prefer to continue injections. Infrequent but serious post-injection delirium sedation syndrome occurred after 1% of OP injections. Weight gain was generally higher among patients treated with OP versus RLAI. Healthcare providers, patients and family members should be made aware of the safety and benefits of long-acting injectable atypical antipsychotics in order to diminish the unnecessary restrictions of these therapies for patients with schizophrenia.

  6. A Systematic Review of Community Health Workers' Role in Occupational Safety and Health Research.

    PubMed

    Swanberg, Jennifer E; Nichols, Helen M; Clouser, Jessica M; Check, Pietra; Edwards, Lori; Bush, Ashley M; Padilla, Yancy; Betz, Gail

    2018-03-03

    We systematically reviewed the literature to describe how community health workers (CHWs) are involved in occupational health and safety research and to identify areas for future research and research practice strategies. We searched five electronic databases from July 2015 through July 2016. Inclusion criteria were as follows: (1) study took place in the United States, (2) published as a full peer-review manuscript in English, (3) conducted occupational health and safety research, and (4) CHWs were involved in the research. The majority of 17 included studies took place in the agriculture industry (76%). CHWs were often involved in study implementation/design and research participant contact. Rationale for CHW involvement in research was due to local connections/acceptance, existing knowledge/skills, communication ability, and access to participants. Barriers to CHW involvement in research included competing demands on CHWs, recruitment and training difficulties, problems about research rigor and issues with proper data collection. Involving CHWs in occupational health and safety research has potential for improving inclusion of diverse, vulnerable and geographically isolated populations. Further research is needed to assess the challenges and opportunities of involving CHWs in this research and to develop evidence-based training strategies to teach CHWs to be lay-health researchers.

  7. Electronic Nicotine Delivery Systems (“E-Cigarettes”): Review of Safety and Smoking Cessation Efficacy

    PubMed Central

    Harrell, Paul Truman; Simmons, Vani Nath; Correa, John Bernard; Padhya, Tapan Ashvin; Brandon, Thomas Henry

    2015-01-01

    Background and Objectives Cigarette smoking is common among cancer patients and is associated with negative outcomes. Electronic nicotine delivery systems (“e-cigarettes”) are rapidly growing in popularity and use, but there is limited information on their safety or effectiveness in helping individuals quit smoking. Data Sources The authors searched PubMed, Web of Science, and additional sources for published empirical data on safety and use of electronic cigarettes as an aid to quit smoking. Review Methods We conducted a structured search of the current literature up to and including November 2013. Results E-cigarettes currently vary widely in their contents and are sometimes inconsistent with labeling. Compared to tobacco cigarettes, available evidence suggests that e-cigarettes are often substantially lower in toxic content, cytotoxicity, associated adverse effects, and secondhand toxicity exposure. Data on the use of e-cigarettes for quitting smoking is suggestive, but ultimately inconclusive. Conclusions Clinicians are advised to be aware that the use of e-cigarettes, especially among cigarette smokers, is growing rapidly. These devices are unregulated, of unknown safety, and of uncertain benefit in quitting smoking. Implications for Practice In the absence of further data or regulation, oncologists are advised to discuss the known and unknown safety and efficacy information on e-cigarettes with interested patients, and to encourage patients to first try FDA-approved pharmacotherapies for smoking cessation. PMID:24898072

  8. Physical Activity and Safety From Crime Among Adults: A Systematic Review.

    PubMed

    da Silva, Inacio C; Payne, Valerie L; Hino, Adriano Akira; Varela, Andrea Ramirez; Reis, Rodrigo S; Ekelund, Ulf; Hallal, Pedro C

    2016-06-01

    The aim of this study was to review the evidence to date on the association between physical activity and safety from crime. Articles with adult populations of 500+ participants investigating the association between physical activity and safety from crime were included. A methodological quality assessment was conducted using an adapted version of the Downs and Black checklist. The literature search identified 15,864 articles. After assessment of titles, abstracts and full-texts, 89 articles were included. Most articles (84.3%) were derived from high-income countries and only 3 prospective articles were identified. Articles presented high methodological quality. In 38 articles (42.7%), at least one statistically significant association in the expected direction was reported (ie, safety from crime was positively associated with physical activity). Nine articles (10.1%) found an association in the unexpected direction and 42 (47.2%) did not find statistically significant associations. The results did not change when we analyzed articles separately by sex, age, type of measurement, or domains of physical activity evaluated. The current evidence, mostly based on cross-sectional studies, suggests a lack of association between physical activity and safety from crime. Prospective studies and natural experiments are needed, particularly in areas with wide crime variability.

  9. The U.S. commercial air tour industry: a review of aviation safety concerns.

    PubMed

    Ballard, Sarah-Blythe

    2014-02-01

    The U.S. Title 14 Code of Federal Regulations defines commercial air tours as "flight[s] conducted for compensation or hire in an airplane or helicopter where a purpose of the flight is sightseeing." The incidence of air tour crashes in the United States is disproportionately high relative to similar commercial aviation operations, and air tours operating under Part 91 governance crash significantly more than those governed by Part 135. This paper reviews the government and industry response to four specific areas of air tour safety concern: surveillance of flight operations, pilot factors, regulatory standardization, and maintenance quality assurance. It concludes that the government and industry have successfully addressed many of these tenet issues, most notably by: advancing the operations surveillance infrastructure through implementation of en route, ground-based, and technological surveillance methods; developing Aeronautical Decision Making and cue-based training programs for air tour pilots; consolidating federal air tour regulations under Part 136; and developing public-private partnerships for raising maintenance operating standards and improving quality assurance programs. However, opportunities remain to improve air tour safety by: increasing the number and efficiency of flight surveillance programs; addressing pilot fatigue with more restrictive flight hour limitations for air tour pilots; ensuring widespread uptake of maintenance quality assurance programs, especially among high-risk operators not currently affiliated with private air tour safety programs; and eliminating the 25-mile exception allowing Part 91 operators to conduct commercial air tours without the safety oversight required of Part 135 operators.

  10. A review of the effect of traffic and weather characteristics on road safety.

    PubMed

    Theofilatos, Athanasios; Yannis, George

    2014-11-01

    Taking into consideration the increasing availability of real-time traffic data and stimulated by the importance of proactive safety management, this paper attempts to provide a review of the effect of traffic and weather characteristics on road safety, identify the gaps and discuss the needs for further research. Despite the existence of generally mixed evidence on the effect of traffic parameters, a few patterns can be observed. For instance, traffic flow seems to have a non-linear relationship with accident rates, even though some studies suggest linear relationship with accidents. On the other hand, increased speed limits have found to have a straightforward positive relationship with accident occurrence. Regarding weather effects, the effect of precipitation is quite consistent and leads generally to increased accident frequency but does not seem to have a consistent effect on severity. The impact of other weather parameters on safety, such as visibility, wind speed and temperature is not found straightforward so far. The increasing use of real-time data not only makes easier to identify the safety impact of traffic and weather characteristics, but most importantly makes possible the identification of their combined effect. The more systematic use of these real-time data may address several of the research gaps identified in this research. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. ASCERTAINMENT OF ON-ROAD SAFETY ERRORS BASED ON VIDEO REVIEW

    PubMed Central

    Dawson, Jeffrey D.; Uc, Ergun Y.; Anderson, Steven W.; Dastrup, Elizabeth; Johnson, Amy M.; Rizzo, Matthew

    2011-01-01

    Summary Using an instrumented vehicle, we have studied several aspects of the on-road performance of healthy and diseased elderly drivers. One goal from such studies is to ascertain the type and frequency of driving safety errors. Because the judgment of such errors is somewhat subjective, we applied a taxonomy system of 15 general safety error categories and 76 specific safety error types. We also employed and trained professional driving instructors to review the video data of the on-road drives. In this report, we illustrate our rating system on a group of 111 drivers, ages 65 to 89. These drivers made errors in 13 of the 15 error categories, comprising 42 of the 76 error types. A mean (SD) of 35.8 (12.8) safety errors per drive were noted, with 2.1 (1.7) of them being judged as serious. Our methodology may be useful in applications such as intervention studies, and in longitudinal studies of changes in driving abilities in patients with declining cognitive ability. PMID:24273753

  12. Immobilization of Hg(II) in water with polysulfide-rubber (PSR) polymer-coated activated carbon.

    PubMed

    Kim, Eun-Ah; Seyfferth, Angelia L; Fendorf, Scott; Luthy, Richard G

    2011-01-01

    An effective mercury removal method using polymer-coated activated carbon was studied for possible use in water treatment. In order to increase the affinity of activated carbon for mercury, a sulfur-rich compound, polysulfide-rubber (PSR) polymer, was effectively coated onto the activated carbon. The polymer was synthesized by condensation polymerization between sodium tetrasulfide and 1,2-dichloroethane in water. PSR-mercury interactions and Hg-S bonding were elucidated from x-ray photoelectron spectroscopy, and Fourier transform infra-red spectroscopy analyses. The sulfur loading levels were controlled by the polymer dose during the coating process and the total surface area of the activated carbon was maintained for the sulfur loading less than 2 wt%. Sorption kinetic studies showed that PSR-coated activated carbon facilitates fast reaction by providing a greater reactive surface area than PSR alone. High sulfur loading on activated carbon enhanced mercury adsorption contributing to a three orders of magnitude reduction in mercury concentration. μ-X-ray absorption near edge spectroscopic analyses of the mercury bound to activated carbon and to PSR on activated carbon suggests the chemical bond with mercury on the surface is a combination of Hg-Cl and Hg-S interaction. The pH effect on mercury removal and adsorption isotherm results indicate competition between protons and mercury for binding to sulfur at low pH. Copyright © 2010. Published by Elsevier Ltd.

  13. A role for the regulator PsrA in the polyhydroxyalkanoate metabolism of Pseudomonas putida KT2440.

    PubMed

    Fonseca, Pilar; de la Peña, Fernando; Prieto, María Auxiliadora

    2014-11-01

    Pseudomonas putida KT2440 is a Gram-negative bacterium capable of producing medium-chain-length-polyhydroxyalkanoates (mcl-PHA). When fatty acids are used as growth and polymer precursors, the biosynthesis is linked to fatty acid metabolism via ß-oxidation route. In the close-related Pseudomonas aeruginosa, the transcriptional repressor PsrA regulates the ß-oxidation, but little is known about the regulatory system in P. putida. To analyze the effect of the absence of psrA gene on the growth and PHA production in P. putida, a set of different carbon sources were assayed in the wild type strain and in a generated psrA deficient strain (KT40P). The growth rates were in all cases, lower for the mutant. The amount of PHA produced by the mutant strain is lower than the wild type. Moreover, the monomeric composition seems to be different among the strains, as there is enrichment in monomers with shorter carbon length in the mutant strain. To understand the role of the psrA gene on the metabolism of fatty acids, we have determined the expression profile of several genes related to fatty acid metabolism in the wild type and in the mutant strain. The results indicated that PsrA mostly negatively regulate genes related to fatty acid metabolism. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Intra-particle migration of mercury in granular polysulfide-rubber-coated activated carbon (PSR-AC)

    PubMed Central

    Kim, Eun-Ah; Masue-Slowey, Yoko; Fendorf, Scott; Luthy, Richard G.

    2011-01-01

    The depth profile of mercuric ion after the reaction with polysulfide-rubber-coated activated carbon (PSR-AC) was investigated using micro-x-ray fluorescence (μ-XRF) imaging techniques and mathematical modeling. The μ-XRF results revealed that mercury was concentrated at 0~100 μm from the exterior of the particle after three months of treatment with PSR-AC in 10 ppm HgCl2 aqueous solution. The μ-X-ray absorption near edge spectroscopic (μ-XANES) analyses indicated HgS as a major mercury species, and suggested that the intra-particle mercury transport involved a chemical reaction with PSR polymer. An intra-particle mass transfer model was developed based on either a Langmuir sorption isotherm with liquid phase diffusion (Langmuir model) or a kinetic sorption with surface diffusion (kinetic sorption model). The Langmuir model predicted the general trend of mercury diffusion, although at a slower rate than observed from the μ-XRF map. A kinetic sorption model suggested faster mercury transport, which overestimated the movement of mercuric ions through an exchange reaction between the fast and slow reaction sites. Both μ-XRF and mathematical modeling results suggest mercury removal occurs not only at the outer surface of the PSR-AC particle but also at some interior regions due to a large PSR surface area within an AC particle. PMID:22133913

  15. Description and Yield of Current Quality and Safety Review in Selected US Academic Emergency Departments.

    PubMed

    Griffey, Richard Thomas; Schneider, Ryan M; Sharp, Brian R; Pothof, Jeffrey J; Hodkins, Sheridan; Capp, Roberta; Wiler, Jennifer L; Sreshta, Neil; Sather, John E; Sampson, Christopher S; Powell, Jonathan T; Groner, Kathryn Y; Adler, Lee M

    2017-06-29

    Quality and safety review for performance improvement is important for systems of care and is required for US academic emergency departments (EDs). Assessment of the impact of patient safety initiatives in the context of increasing burdens of quality measurement compels standardized, meaningful, high-yield approaches for performance review. Limited data describe how quality and safety reviews are currently conducted and how well they perform in detecting patient harm and areas for improvement. We hypothesized that decades-old approaches used in many academic EDs are inefficient and low yield for identifying patient harm. We conducted a prospective observational study to evaluate the efficiency and yield of current quality review processes at five academic EDs for a 12-month period. Sites provided descriptions of their current practice and collected summary data on the number and severity of events identified in their reviews and the referral sources that led to their capture. Categories of common referral sources were established at the beginning of the study. Sites used the Institute for Healthcare Improvement's definition in defining an adverse event and a modified National Coordinating Council for Medication Error Reporting and Prevention (MERP) Index for grading severity of events. Participating sites had similar processes for quality review, including a two-level review process, monthly reviews and conferences, similar screening criteria, and a grading system for evaluating cases. In 60 months of data collection, we reviewed a total of 4735 cases and identified 381 events. This included 287 near-misses, errors/events (MERP A-I) and 94 adverse events (AEs) (MERP E-I). The overall AE rate (event rate with harm) was 1.99 (95% confidence interval = 1.62%-2.43%), ranging from 1.24% to 3.47% across sites. The overall rate of quality concerns (events without harm) was 6.06% (5.42%-6.78%), ranging from 2.96% to 10.95% across sites. Seventy-two-hour returns were the

  16. The structure and emerging trends of construction safety management research: a bibliometric review.

    PubMed

    Liang, Huakang; Zhang, Shoujian; Su, Yikun

    2018-03-29

    Recently, construction safety management (CSM) practices and systems have become important topics for stakeholders to take care of human resources. However, few studies have attempted to map the global research on CSM. A comprehensive bibliometric review was conducted in this study based on multiple methods. In total, 1172 CSM-related papers from the Web of Science Core Collection database were examined. The analyses focused on publication year, country-institute, publication source, author and research topics. The results indicated that the USA, China, Australia and the UK took leading positions in CSM research. Two branches of journals were identified, namely the branch of engineering science and that of safety science and social science. Additionally, seven themes together with 28 specific topics were detected to allow researchers to track the main structure and temporal evolution of CSM research. Finally, the main research trends and potential research directions were discussed to guide the future research.

  17. Safety classification of herbal medicines used among pregnant women in Asian countries: a systematic review.

    PubMed

    Ahmed, Mansoor; Hwang, Jung Hye; Choi, Soojeung; Han, Dongwoon

    2017-11-14

    High prevalence of herbal medicines used in pregnancy and the lack of information on their safety is a public concern. Despite this, no significant research has been done regarding potential adverse effects of using herbal medicines during pregnancy, especially among developing Asian countries. Cross-sectional studies were searched up to year 2016 on PubMed/Medline and EMBASE, the data were extracted and quality of studies was assessed using the quality appraisal tool. The findings are reported in accordance to the PRISMA checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Classification on safety of identified herbal medicines was done based on current scientific literature. This study included eight cross-sectional studies (2729 participants) from seven different Asian countries, of which 1283 (47.01%) women used one or more herbal medicines during pregnancy. Peppermint (22.8%), aniseed (14.7%), olibanum (12.9%), flixweed seed (12.2%) and ginger (11.5%) were the most frequently used herbal medicines. Out of the 33 identified herbal medicines, 13 were classified as safe to use, five as use with caution, eight were potentially harmful to use in pregnancy and information on seven herbal medicines was not available in the current literature. Several herbal medicines identified in this review were classified to be potentially harmful or the information regarding safety in pregnancy was missing. It is recommended that contraindicated herbal medicines should be avoided and other herbals should be taken under supervision of a qualified health care practitioner. The classification regarding safety of herbal medicines in pregnancy can be utilized to create awareness on prevention of adverse effects.

  18. Safety of vaccines used for routine immunization of U.S. children: a systematic review.

    PubMed

    Maglione, Margaret A; Das, Lopamudra; Raaen, Laura; Smith, Alexandria; Chari, Ramya; Newberry, Sydne; Shanman, Roberta; Perry, Tanja; Goetz, Matthew Bidwell; Gidengil, Courtney

    2014-08-01

    Concerns about vaccine safety have led some parents to decline recommended vaccination of their children, leading to the resurgence of diseases. Reassurance of vaccine safety remains critical for population health. This study systematically reviewed the literature on the safety of routine vaccines recommended for children in the United States. Data sources included PubMed, Advisory Committee on Immunization Practices statements, package inserts, existing reviews, manufacturer information packets, and the 2011 Institute of Medicine consensus report on vaccine safety. We augmented the Institute of Medicine report with more recent studies and increased the scope to include more vaccines. Only studies that used active surveillance and had a control mechanism were included. Formulations not used in the United States were excluded. Adverse events and patient and vaccine characteristics were abstracted. Adverse event collection and reporting was evaluated by using the McHarm scale. We were unable to pool results. Strength of evidence was rated as high, moderate, low, or insufficient. Of 20 478 titles identified, 67 were included. Strength of evidence was high for measles/mumps/rubella (MMR) vaccine and febrile seizures; the varicella vaccine was associated with complications in immunodeficient individuals. There is strong evidence that MMR vaccine is not associated with autism. There is moderate evidence that rotavirus vaccines are associated with intussusception. Limitations of the study include that the majority of studies did not investigate or identify risk factors for AEs; and the severity of AEs was inconsistently reported. We found evidence that some vaccines are associated with serious AEs; however, these events are extremely rare and must be weighed against the protective benefits that vaccines provide. Copyright © 2014 by the American Academy of Pediatrics.

  19. Efficacy and safety of biosimilar insulins compared to their reference products: A systematic review.

    PubMed

    Tieu, Carolyn; Lucas, Eleanor J; DePaola, Mindi; Rosman, Lori; Alexander, G Caleb

    2018-01-01

    For nearly a century, no generic form of insulin has been available in the United States. However, the first biosimilar insulin, Basaglar, was approved by the U.S. Food and Drug Administration in 2015, and subsequently Admelog and Lusduna in 2017. To summarize the scientific evidence comparing the safety, efficacy, pharmacokinetics, and pharmacodynamics of biosimilar and reference insulin products. We conducted a systematic review using PubMed, Cochrane, Embase, Latin America and Caribbean Health Sciences, South Asian Database of Controlled Clinical Trials, and IndiaMED from their inception through January 14, 2018. We included randomized controlled trials (RCTs) comparing safety, clinical efficacy, pharmacokinetics and pharmacodynamics of any biosimilar insulin with a reference product in adults regardless of sample size and location. Two researchers independently reviewed all titles, abstracts and text; extracted data; and performed quality assessments. Efficacy, safety, pharmacokinetics, and pharmacodynamics of biosimilar and reference insulin products. Of 6945 articles screened, 11 studies were included in the data synthesis. LY2963016, Basalog, Basalin, and MK-1293 were compared to Lantus while SAR342434 was compared to Humalog. Three trials enrolled healthy volunteers, five enrolled type 1 diabetics, and two enrolled type 2 diabetics. One study enrolled both healthy and type 1 diabetics. Of the eleven studies, six examined pharmacokinetic and/or pharmacodynamic parameters and five examined clinical efficacy and immunogenicity. All studies included adverse events. All PK and/or PD studies showed that comparable parameters of biosimilar and reference products were within the pre-specified equivalence margins. Clinical studies suggested similar clinical efficacy and immunogenicity. Adverse events were similar between the groups across all studies. Few published studies have compared biosimilar and reference insulins, though those that did suggest that the

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

    PubMed Central

    Stavropoulou, Charitini; Doherty, Carole; Tosey, Paul

    2015-01-01

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

  1. The role of hospital managers in quality and patient safety: a systematic review

    PubMed Central

    Parand, Anam; Dopson, Sue; Renz, Anna; Vincent, Charles

    2014-01-01

    Objectives To review the empirical literature to identify the activities, time spent and engagement of hospital managers in quality of care. Design A systematic review of the literature. Methods A search was carried out on the databases MEDLINE, PSYCHINFO, EMBASE, HMIC. The search strategy covered three facets: management, quality of care and the hospital setting comprising medical subject headings and key terms. Reviewers screened 15 447 titles/abstracts and 423 full texts were checked against inclusion criteria. Data extraction and quality assessment were performed on 19 included articles. Results The majority of studies were set in the USA and investigated Board/senior level management. The most common research designs were interviews and surveys on the perceptions of managerial quality and safety practices. Managerial activities comprised strategy, culture and data-centred activities, such as driving improvement culture and promotion of quality, strategy/goal setting and providing feedback. Significant positive associations with quality included compensation attached to quality, using quality improvement measures and having a Board quality committee. However, there is an inconsistency and inadequate employment of these conditions and actions across the sample hospitals. Conclusions There is some evidence that managers’ time spent and work can influence quality and safety clinical outcomes, processes and performance. However, there is a dearth of empirical studies, further weakened by a lack of objective outcome measures and little examination of actual actions undertaken. We present a model to summarise the conditions and activities that affect quality performance. PMID:25192876

  2. Safety and Efficacy Profile of Commercial Veterinary Vaccines against Rift Valley Fever: A Review Study

    PubMed Central

    2016-01-01

    Rift Valley Fever (RVF) is an infectious illness with serious clinical manifestations and health consequences in humans as well as a wide range of domestic ruminants. This review provides significant information about the prevention options of RVF along with the safety-efficacy profile of commercial vaccines and some of RVF vaccination strategies. Information presented in this paper was obtained through a systematic investigation of published data about RVF vaccines. Like other viral diseases, the prevention of RVF relies heavily on immunization of susceptible herds with safe and cost-effective vaccine that is able to confer long-term protective immunity. Several strains of RVF vaccines have been developed and are available in commercial production including Formalin-Inactivated vaccine, live attenuated Smithburn vaccine, and the most recent Clone13. Although Formalin-Inactivated vaccine and live attenuated Smithburn vaccine are immunogenic and widely used in prevention programs, they proved to be accompanied by significant concerns. Despite Clone13 vaccine being suggested as safe in pregnant ewes and as highly immunogenic along with its potential for differentiating infected from vaccinated animals (DIVA), a recent study raised concerns about the safety of the vaccine during the first trimester of gestation. Accordingly, RVF vaccines that are currently available in the market to a significant extent do not fulfill the requirements of safety, potency, and DIVA. These adverse effects stressed the need for developing new vaccines with an excellent safety profile to bridge the gap in safety and immunity. Bringing RVF vaccine candidates to local markets besides the absence of validated serological test for DIVA remain the major challenges of RVF control. PMID:27689098

  3. Risk management systems for health care and safety development on transplantation: a review and a proposal.

    PubMed

    Pretagostini, R; Gabbrielli, F; Fiaschetti, P; Oliveti, A; Cenci, S; Peritore, D; Stabile, D

    2010-05-01

    Starting from the report on medical errors published in 1999 by the US Institute of Medicine, a number of different approaches to risk management have been developed for maximum risk reduction in health care activities. The health care authorities in many countries have focused attention on patient safety, employing action research programs that are based on quite different principles. We performed a systematic Medline research of the literature since 1999. The following key words were used, also combining boolean operators and medical subheading terms: "adverse event," "risk management," "error," and "governance." Studies published in the last 5 years were particularly classified in various groups: risk management in health care systems; safety in specific hospital activities; and health care institutions' official documents. Methods of action researches have been analysed and their characteristics compared. Their suitability for safety development in donation, retrieval, and transplantation processes were discussed in the reality of the Italian transplant network. Some action researches and studies were dedicated to entire national healthcare systems, whereas others focused on specific risks. Many research programs have undergone critical review in the literature. Retrospective analysis has centered on so-called sentinel events to particularly analyze only a minor portion of the organizational phenomena, which can be the origin of an adverse event, an incident, or an error. Sentinel events give useful information if they are studied in highly engineered and standardized organizations like laboratories or tissue establishments, but they show several limits in the analysis of organ donation, retrieval, and transplantation processes, which are characterized by prevailing human factors, with high intrinsic risk and variability. Thus, they are poorly effective to deliver sure elements to base safety management improvement programs, especially regarding

  4. The patient safety culture: a systematic review by characteristics of Hospital Survey on Patient Safety Culture dimensions.

    PubMed

    Reis, Cláudia Tartaglia; Paiva, Sofia Guerra; Sousa, Paulo

    2018-05-08

    To learn the weaknesses and strengths of safety culture as expressed by the dimensions measured by the Hospital Survey on Patient Safety Culture (HSOPSC) at hospitals in the various cultural contexts. The aim of this study was to identify studies that have used the HSOPSC to collect data on safety culture at hospitals; to survey their findings in the safety culture dimensions and possible contributions to improving the quality and safety of hospital care. Medline (via PubMed), Web of Science and Scopus were searched from 2005 to July 2016 in English, Portuguese and Spanish. Studies were identified using specific search terms and inclusion criteria. A total of 33 articles, reporting on 21 countries, was included. Scores were extracted by patient safety culture dimensions assessed by the HSOPSC. The quality of the studies was evaluated by the STROBE Statement. The dimensions that proved strongest were 'Teamwork within units' and 'Organisational learning-continuous improvement'. Particularly weak dimensions were 'Non-punitive response to error', 'Staffing', 'Handoffs and transitions' and 'Teamwork across units'. The studies revealed a predominance of hospital organisational cultures that were underdeveloped or weak as regards patient safety. For them to be effective, safety culture evaluation should be tied to strategies designed to develop safety culture hospital-wide.

  5. Idaho National Laboratory Integrated Safety Management System FY 2013 Effectiveness Review and Declaration Report

    SciTech Connect

    Hunt, Farren

    2013-12-01

    Idaho National Laboratory (INL) performed an Annual Effectiveness Review of the Integrated Safety Management System (ISMS), per 48 Code of Federal Regulations (CFR) 970.5223 1, “Integration of Environment, Safety and Health into Work Planning and Execution.” The annual review assessed Integrated Safety Management (ISM) effectiveness, provided feedback to maintain system integrity, and identified target areas for focused improvements and assessments for Fiscal Year (FY) 2014. Results of the FY 2013 annual effectiveness review demonstrate that the INL’s ISMS program is “Effective” and continually improving and shows signs of being significantly strengthened. Although there have been unacceptable serious events in themore » past, there has also been significant attention, dedication, and resources focused on improvement, lessons learned and future prevention. BEA’s strategy of focusing on these improvements includes extensive action and improvement plans that include PLN 4030, “INL Sustained Operational Improvement Plan, PLN 4058, “MFC Strategic Excellence Plan,” PLN 4141, “ATR Sustained Excellence Plan,” and PLN 4145, “Radiological Control Road to Excellence,” and the development of LWP 20000, “Conduct of Research.” As a result of these action plans, coupled with other assurance activities and metrics, significant improvement in operational performance, organizational competence, management oversight and a reduction in the number of operational events is being realized. In short, the realization of the fifth core function of ISMS (feedback and continuous improvement) and the associated benefits are apparent.« less

  6. Safety and efficacy of tinea pedis and onychomycosis treatment in people with diabetes: a systematic review.

    PubMed

    Matricciani, Lisa; Talbot, Kerwin; Jones, Sara

    2011-12-04

    Effective treatment of tinea pedis and onychomycosis is crucial for patients with diabetes as these infections may lead to foot ulcers and secondary bacterial infections resulting in eventual lower limb amputation. Although numerous studies have assessed the effectiveness of antifungal drug and treatment regimens, most exclude patients with diabetes and examine otherwise healthy individuals. While these studies are useful, results cannot necessarily be extrapolated to patients with diabetes. The purpose of this study was to therefore identify the best evidence-based treatment interventions for tinea pedis or onychomycosis in people with diabetes. The question for this systemic review was: 'what evidence is there for the safety and/or efficacy of all treatment interventions for adults with tinea pedis and/or onychomycosis in people with diabetes'? A systematic literature search of four electronic databases (Scopus, EbscoHost, Ovid, Web of Science) was undertaken (6/1/11). The primary outcome measure for safety was self-reported adverse events likely to be drug-related, while the primary outcome measures assessed for 'efficacy' were mycological, clinical and complete cure. The systematic review identified six studies that examined the safety and/or efficacy of treatment interventions for onychomycosis in people with diabetes. No studies were identified that examined treatment for tinea pedis. Of the studies identified, two were randomised controlled trials (RCTs) and four were case series. Based on the best available evidence identified, it can be suggested that oral terbinafine is as safe and effective as oral itraconazole therapy for the treatment of onychomycosis in people with diabetes. However, efficacy results were found to be poor. This review indicates that there is good evidence (Level II) to suggest oral terbinafine is as safe and effective as itraconazole therapy for the treatment of onychomycosis in people with diabetes. Further research is needed to

  7. Efficacy and safety of Suanzaoren decoction for primary insomnia: a systematic review of randomized controlled trials

    PubMed Central

    2013-01-01

    Background Insomnia is a widespread human health problem, but there currently are the limitations of conventional therapies available. Suanzaoren decoction (SZRD) is a well known classic Chinese herbal prescription for insomnia and has been treating people’s insomnia for more than thousand years. The objective of this study was to evaluate the efficacy and safety of SZRD for insomnia. Methods A systematic literature search was performed for 6 databases up to July of 2012 to identify randomized control trials (RCTs) involving SZRD for insomniac patients. The methodological quality of RCTs was assessed independently using the Cochrane Handbook for Systematic Reviews of Interventions. Results Twelve RCTs with total of 1376 adult participants were identified. The methodological quality of all included trials are no more than 3/8 score. Majority of the RCTs concluded that SZRD was more significantly effective than benzodiazepines for treating insomnia. Despite these positive outcomes, there were many methodological shortcomings in the studies reviewed, including insufficient information about randomization generation and absence of allocation concealment, lack of blinding and no placebo control, absence of intention-to-treat analysis and lack of follow-ups, selective publishing and reporting, and small number of sample sizes. A number of clinical heterogeneity such as diagnosis, intervention, control, and outcome measures were also reviewed. Only 3 trials reported adverse events, whereas the other 9 trials did not provide the safety information. Conclusions Despite the apparent reported positive findings, there is insufficient evidence to support efficacy of SZRD for insomnia due to the poor methodological quality and the small number of trials of the included studies. SZRD seems generally safe, but is insufficient evidence to make conclusions on the safety because fewer studies reported the adverse events. Further large sample-size and well-designed RCTs are needed

  8. Efficacy and safety data of subsequent entry biologics pertinent to nephrology practice: a systematic review.

    PubMed

    Marin, Judith Genevieve; Leung, Marianna; Lo, Clifford; Tsao, Nicole W; Martinusen, Daniel J

    2014-01-01

    Subsequent entry biologics (SEBs) may soon be a reality in Canadian nephrology practice. Understanding the worldwide experience with these agents will be valuable to Canadian clinicians. To compare the efficacy and safety data between SEBs used in nephrology practice and their reference biologic. Systematic review. Ovid MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Database of Abstracts of Review of Effects, Cochrane Central Register of Controlled Trials. Adult patients with chronic kidney disease (CKD). Our systematic review follows the process outlined by Cochrane Reviews. For efficacy data, all randomized controlled trials (RCTs), quasi-RCTs and observational trials in nephrology practice were included. For safety data, case series, case reports, review articles in nephrology practice and pharmacovigilance programs were included as well. Only epoetin SEBs trials were published in the literature. Ten studies involving three different epoetin SEBs (epoetin zeta, HX575 and epoetin theta) were included. The mean epoetin dose used did not differ significantly between the SEBs and the reference product. For epoetin zeta and epoetin theta, the mean hemoglobin levels achieved in the studies were similar between the SEBs and the reference epoetin. The HX 575 studies reported a mean absolute change in hemoglobin within the predefined equivalence margin, when compared with the reference biologic. In terms of safety data, 2 cases of pure-red-cell aplasia were linked to the subcutaneous administration of HX 575. Otherwise, the rate of adverse drug reactions was similar when epoetin SEBs were compared with the reference biologic. Our analysis is limited by the paucity of information available on SEB use in nephrology with the exception of epoetin SEBs. Methodological flaw was found in one of the epoetin zeta studies which accounted for 45% of pooled results. Little clinical difference was found between epoetin SEBs and the reference product. Although not deemed

  9. Integrating natural language processing expertise with patient safety event review committees to improve the analysis of medication events.

    PubMed

    Fong, Allan; Harriott, Nicole; Walters, Donna M; Foley, Hanan; Morrissey, Richard; Ratwani, Raj R

    2017-08-01

    Many healthcare providers have implemented patient safety event reporting systems to better understand and improve patient safety. Reviewing and analyzing these reports is often time consuming and resource intensive because of both the quantity of reports and length of free-text descriptions in the reports. Natural language processing (NLP) experts collaborated with clinical experts on a patient safety committee to assist in the identification and analysis of medication related patient safety events. Different NLP algorithmic approaches were developed to identify four types of medication related patient safety events and the models were compared. Well performing NLP models were generated to categorize medication related events into pharmacy delivery delays, dispensing errors, Pyxis discrepancies, and prescriber errors with receiver operating characteristic areas under the curve of 0.96, 0.87, 0.96, and 0.81 respectively. We also found that modeling the brief without the resolution text generally improved model performance. These models were integrated into a dashboard visualization to support the patient safety committee review process. We demonstrate the capabilities of various NLP models and the use of two text inclusion strategies at categorizing medication related patient safety events. The NLP models and visualization could be used to improve the efficiency of patient safety event data review and analysis. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Evaluated community fire safety interventions in the United States: a review of current literature.

    PubMed

    Ta, Van M; Frattaroli, Shannon; Bergen, Gwendolyn; Gielen, Andrea Carlson

    2006-06-01

    The purpose of the study was to assess the state of fire prevention research, provide an updated synthesis of evaluated fire prevention programs, and discuss the role of fire fighters and data systems in prevention efforts. The review included all evaluations of U.S. based fire prevention interventions published between January 1998 and September 2004 and any earlier articles about U.S. fire prevention interventions not included in two prior review articles. We retrieved information from each identified study including evaluation findings, involvement of fire service personnel and use of existing data systems. We identified twelve articles: seven reported on smoke alarm interventions, three on multi-faceted programs, and two other programs. Five programs involved fire service personnel in the design, implementation, and/or evaluation, and three used existing data systems. Studies reviewed suggest that canvassing and smoke alarm installations are the most effective means of distributing alarms and increasing the functional status of distributed alarms. The functionality of smoke alarms, an issue noted in earlier reviews, remains a problem. Programs involving partnerships with fire departments have indicated success in preventing fires and deaths, improving smoke alarm ownership and functional status, and improving children's fire safety knowledge. Using existing data systems to target and to evaluate interventions was effective. In the years since prior reviews, some improvements in the rigor of evaluation designs have been made, but there is still a need for high quality evaluations that will inform fire injury prevention efforts.

  11. Orbital variability of the PSR J2051-0827 binary system

    NASA Astrophysics Data System (ADS)

    Doroshenko, O.; Löhmer, O.; Kramer, M.; Jessner, A.; Wielebinski, R.; Lyne, A. G.; Lange, Ch.

    2001-11-01

    We have carried out high-precision timing measurements of the binary millisecond pulsar PSR J2051-0827 with the Effelsberg 100-m radio telescope of the Max-Planck-Institut für Radioastronomie and with the Lovell 76-m radio telescope at Jodrell Bank. The 6.5-yrs radio timing measurements have revealed a significant secular variation of the projected semi-major axis of the pulsar at a rate of dot xequiv d(a1 sin i)/dt = (-0.23+/- 0.03)x 10-12, which is probably caused by the Newtonian spin-orbit coupling in this binary system leading to a precession of the orbital plane. The required misalignment of the spin and orbital angular momenta of the companion are evidence for an asymmetric supernova explosion. We have also confirmed that the orbital period is currently decreasing at a rate of dot Pb=(-15.5 +/- 0.8)x 10-12 s s-1 and have measured second and third orbital period derivatives d2Pb/dt2=(+2.1 +/- 0.3)x 10-20: s-1 and d3Pb/dt3 =(3.6 +/- 0.6)x 10-28: s-2, which indicate a quasi-cyclic orbital period variation similar to those found in another eclipsing pulsar system, PSR B1957+20. The observed variation of the orbital parameters constrains the maximal value of the companion radius to Rc: max ~ 0.06: Rsun and implies that the companion is underfilling its Roche lobe by 50%. The derived variation in the quadrupole moment of the companion is probably caused by tidal dissipation similar to the mechanism proposed for PSR B1957+20. We conclude that the companion is at least partially non-degenerate, convective and magnetically active.

  12. Discovery of gamma-ray pulsations from the transitional redback PSR J1227-4853

    DOE PAGES

    Johnson, Tyrel J.; Ray, Paul S.; Roy, Jayanta; ...

    2015-06-10

    Here, the 1.69 ms spin period of PSR J1227–4853 was recently discovered in radio observations of the low-mass X-ray binary XSS J12270–4859 following the announcement of a possible transition to a rotation-powered millisecond pulsar state, inferred from decreases in optical, X-ray, and gamma-ray flux from the source. We report the detection of significant (5σ) gamma-ray pulsations after the transition, at the known spin period, using ~1 year of data from the Large Area Telescope (LAT) on board the Fermi Gamma-ray Space Telescope. The gamma-ray light curve of PSR J1227–4853 can be fit by one broad peak, which occurs at nearlymore » the same phase as the main peak in the 1.4 GHz radio profile. The partial alignment of light-curve peaks in different wavebands suggests that at least some of the radio emission may originate at high altitude in the pulsar magnetosphere, in extended regions co-located with the gamma-ray emission site. We folded the LAT data at the orbital period, both pre- and post-transition, but find no evidence for significant modulation of the gamma-ray flux. Analysis of the gamma-ray flux over the mission suggests an approximate transition time of 2012 November 30. Continued study of the pulsed emission and monitoring of PSR J1227–4853, and other known redback systems, for subsequent flux changes will increase our knowledge of the pulsar emission mechanism and transitioning systems.« less

  13. 14 CFR Appendix B to Part 415 - Safety Review Document Outline

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ....0Flight Safety (§ 415.115) 4.1Initial Flight Safety Analysis 4.1.1Flight Safety Sub-Analyses, Methods, and... Analysis Data 4.2Radionuclide Data (where applicable) 4.3Flight Safety Plan 4.3.1Flight Safety Personnel 4... Safety (§ 415.117) 5.1Ground Safety Analysis Report 5.2Ground Safety Plan 6.0Launch Plans (§ 415.119 and...

  14. 14 CFR Appendix B to Part 415 - Safety Review Document Outline

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ....0Flight Safety (§ 415.115) 4.1Initial Flight Safety Analysis 4.1.1Flight Safety Sub-Analyses, Methods, and... Analysis Data 4.2Radionuclide Data (where applicable) 4.3Flight Safety Plan 4.3.1Flight Safety Personnel 4... Safety (§ 415.117) 5.1Ground Safety Analysis Report 5.2Ground Safety Plan 6.0Launch Plans (§ 415.119 and...

  15. Evolution of International Space Station Program Safety Review Processes and Tools

    NASA Technical Reports Server (NTRS)

    Ratterman, Christian D.; Green, Collin; Guibert, Matt R.; McCracken, Kristle I.; Sang, Anthony C.; Sharpe, Matthew D.; Tollinger, Irene V.

    2013-01-01

    The International Space Station Program at NASA is constantly seeking to improve the processes and systems that support safe space operations. To that end, the ISS Program decided to upgrade their Safety and Hazard data systems with 3 goals: make safety and hazard data more accessible; better support the interconnection of different types of safety data; and increase the efficiency (and compliance) of safety-related processes. These goals are accomplished by moving data into a web-based structured data system that includes strong process support and supports integration with other information systems. Along with the data systems, ISS is evolving its submission requirements and safety process requirements to support the improved model. In contrast to existing operations (where paper processes and electronic file repositories are used for safety data management) the web-based solution provides the program with dramatically faster access to records, the ability to search for and reference specific data within records, reduced workload for hazard updates and approval, and process support including digital signatures and controlled record workflow. In addition, integration with other key data systems provides assistance with assessments of flight readiness, more efficient review and approval of operational controls and better tracking of international safety certifications. This approach will also provide new opportunities to streamline the sharing of data with ISS international partners while maintaining compliance with applicable laws and respecting restrictions on proprietary data. One goal of this paper is to outline the approach taken by the ISS Progrm to determine requirements for the new system and to devise a practical and efficient implementation strategy. From conception through implementation, ISS and NASA partners utilized a user-centered software development approach focused on user research and iterative design methods. The user-centered approach used on

  16. Credit PSR. View looks north northeast (20°) at the concrete ...

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

    Credit PSR. View looks north northeast (20°) at the concrete pad which forms the top of the sump pump facility. In the background stand Building 4303 (Air Compressor Building), Building 4307 (Supply and Equipment Warehouse) at left, Building 4305 (Unicon Portable Hangar) at center, and Building 4306 (Boiler House) at right. Sign marking Building 4302 was made from a disused road sign from somewhere on Edwards AFB - Edwards Air Force Base, North Base, Sump Pump, East of Second Street, Boron, Kern County, CA

  17. Nature and evolution of the eclipsing millisecond binary pulsar PSR1957 + 20

    NASA Technical Reports Server (NTRS)

    Kluzniak, W.; Ruderman, M.; Shaham, J.; Tavani, M.

    1988-01-01

    A model in which a millisecond pulsar may be able to evaporate a very light companion by a particular component of its energetic radiation is applied to the recently discovered 1.6-ms pulsar PSR1957 + 20. Pulsar turn-on in the very low-mass X-ray binary follows a stage of mass transfer dominated by an evaporative wind from the surface of the companion. The wind is driven by a large MeV gamma-ray flux powered by an accretion dynamo. That source of radiation ceases when it is replaced by that from the millisecond pulsar, which has been spun up by accretion.

  18. Gamma-ray emission from PSR J0007+7303 using seven year

    SciTech Connect

    Li, Jian; Torres, Diego F.; de Oña Wilhelmi, Emma

    We report on a detailed analysis of the bright gamma-ray pulsar (PSR) J0007+7303, based on more than seven years of Fermi Large Area Telescope Pass 8 data. We also confirm that PSR J0007+7303 is significantly detected as a point source also during the off-peak phases with a test statistic value of 262 (~16σ). In the description of the off-peak spectrum of PSR J0007+7303, a power law with an exponential cutoff at 2.7 ± 1.2 ± 1.3 GeV (the first/second uncertainties correspond to statistical/systematic errors) is preferred over a single power law at a level of 3.5σ. The possible existence ofmore » a cutoff hints at a magnetospheric origin of the emission. In addition, no extended gamma-ray emission is detected that is compatible with either the supernova remnant (CTA 1) or the very high-energy (>100 GeV) pulsar wind nebula. A flux upper limit of 6.5 × 10 -12 erg cm -2 s -1 in the energy range 10–300 GeV is reported, for an extended source assuming the morphology of the VERITAS detection. During on-peak phases, a sub-exponential cutoff is significantly preferred (~11σ) for representing the spectral energy distribution, in both the phase-averaged and phase-resolved spectra. Furthermore, three glitches are detected during the observation period and we found no flux variability at the time of the glitches or in the long-term behavior. We also report the discovery of a previously unknown gamma-ray source in the vicinity of PSR J0007+7303, Fermi J0020+7328, which we associate with the z = 1.781 quasar S5 0016+73. A concurrent analysis of this source is needed to correctly characterize the behavior of CTA 1 and it is also presented in the paper.« less

  19. Gamma-ray emission from PSR J0007+7303 using seven year

    DOE PAGES

    Li, Jian; Torres, Diego F.; de Oña Wilhelmi, Emma; ...

    2016-10-24

    We report on a detailed analysis of the bright gamma-ray pulsar (PSR) J0007+7303, based on more than seven years of Fermi Large Area Telescope Pass 8 data. We also confirm that PSR J0007+7303 is significantly detected as a point source also during the off-peak phases with a test statistic value of 262 (~16σ). In the description of the off-peak spectrum of PSR J0007+7303, a power law with an exponential cutoff at 2.7 ± 1.2 ± 1.3 GeV (the first/second uncertainties correspond to statistical/systematic errors) is preferred over a single power law at a level of 3.5σ. The possible existence ofmore » a cutoff hints at a magnetospheric origin of the emission. In addition, no extended gamma-ray emission is detected that is compatible with either the supernova remnant (CTA 1) or the very high-energy (>100 GeV) pulsar wind nebula. A flux upper limit of 6.5 × 10 -12 erg cm -2 s -1 in the energy range 10–300 GeV is reported, for an extended source assuming the morphology of the VERITAS detection. During on-peak phases, a sub-exponential cutoff is significantly preferred (~11σ) for representing the spectral energy distribution, in both the phase-averaged and phase-resolved spectra. Furthermore, three glitches are detected during the observation period and we found no flux variability at the time of the glitches or in the long-term behavior. We also report the discovery of a previously unknown gamma-ray source in the vicinity of PSR J0007+7303, Fermi J0020+7328, which we associate with the z = 1.781 quasar S5 0016+73. A concurrent analysis of this source is needed to correctly characterize the behavior of CTA 1 and it is also presented in the paper.« less

  20. Simultaneous X-ray and radio observations of the radio-mode-switching pulsar PSR B1822-09

    NASA Astrophysics Data System (ADS)

    Hermsen, W.; Kuiper, L.; Hessels, J. W. T.; Mitra, D.; Rankin, J. M.; Stappers, B. W.; Wright, G. A. E.; Basu, R.; Szary, A.; van Leeuwen, J.

    2017-04-01

    We report on simultaneous X-ray and radio observations of the radio-mode-switching pulsar PSR B1822-09 with ESA's XMM-Newton and the Westerbork Synthesis Radio Telescope, Giant Metrewave Radio Telescope and Lovell radio telescopes. PSR B1822-09 switches between a radio-bright and radio-quiet mode, and we discovered a relationship between the durations of its modes and a known underlying radio-modulation time-scale within the modes. We discovered X-ray (energies 0.2-1.4 keV) pulsations with a broad sinusoidal pulse, slightly lagging the radio main pulse in phase by 0.094 ± 0.017, with an energy-dependent pulsed fraction varying from ˜0.15 at 0.3 keV to ˜0.6 at 1 keV. No evidence is found for simultaneous X-ray and radio mode switching. The total X-ray spectrum consists of a cool component (T ˜0.96 × 106 K, hotspot radius R ˜2.0 km) and a hot component (T ˜2.2 × 106 K, R ˜100 m). The hot component can be ascribed to the pulsed emission and the cool component to the unpulsed emission. The high-energy characteristics of PSR B1822-09 resemble those of middle-aged pulsars such as PSR B0656+14, PSR B1055-52 and Geminga, including an indication for pulsed high-energy gamma-ray emission in Fermi Large Area Telescope data. Explanations for the high pulsed fraction seem to require different temperatures at the two poles of this orthogonal rotator, or magnetic anisotropic beaming effects in its strong magnetic field. In our X-ray skymap, we found a harder source at only 5.1 ± 0.5 arcsec from PSR B1822-09, which might be a pulsar wind nebula.

  1. Safety of allergen immunotherapy: a review of premedication and dose adjustment.

    PubMed

    Morris, A Erika; Marshall, Gailen D

    2012-03-01

    From the first allergen immunotherapy proposed in the early 1900s to the present day, numerous studies have proven the efficacy of allergen immunotherapy for the treatment of allergic rhinitis, allergic conjunctivitis, allergic asthma and stinging insect hypersensitivity. The major risk, however small, with allergen immunotherapy is anaphylaxis. There has been considerable interest and debate regarding risk factors for immunotherapy reactions (local and systemic) and interventions to reduce the occurrence of these reactions. One of these interventions that is especially debated regards dose adjustment for various reasons, but in particular for local reactions. In this review, we discuss the safety of immunotherapy and provide a comprehensive review of the literature regarding immunotherapy schedules and doses.

  2. First NASA Aviation Safety Program Weather Accident Prevention Project Annual Review

    NASA Technical Reports Server (NTRS)

    Colantonio, Ron

    2000-01-01

    The goal of this Annual Review was to present NASA plans and accomplishments that will impact the national aviation safety goal. NASA's WxAP Project focuses on developing the following products: (1) Aviation Weather Information (AWIN) technologies (displays, sensors, pilot decision tools, communication links, etc.); (2) Electronic Pilot Reporting (E-PIREPS) technologies; (3) Enhanced weather products with associated hazard metrics; (4) Forward looking turbulence sensor technologies (radar, lidar, etc.); (5) Turbulence mitigation control system designs; Attendees included personnel from various NASA Centers, FAA, National Weather Service, DoD, airlines, aircraft and pilot associations, industry, aircraft manufacturers and academia. Attendees participated in discussion sessions aimed at collecting aviation user community feedback on NASA plans and R&D activities. This CD is a compilation of most of the presentations presented at this Review.

  3. Occupational safety and health management in the construction industry: a review.

    PubMed

    Jaafar, Mohd Hafiidz; Arifin, Kadir; Aiyub, Kadaruddin; Razman, Muhammad Rizal; Ishak, Muhammad Izzuddin Syakir; Samsurijan, Mohamad Shaharudin

    2017-09-11

    The construction industry plays a significant role in contributing to the economy and development globally. During the process of construction, various hazards coupled with the unique nature of the industry contribute to high fatality rates. This review refers to previous published studies and related Malaysian legislation documents. Four main elements consisting of human, worksite, management and external elements which cause occupational accidents and illnesses were identified. External and management elements are the underlying causes contributing to occupational safety and health (OSH), while human and worksite elements are more apparent causes of occupational accidents and illnesses. An effective OSH management approach is required to contain all hazards at construction sites. An approach to OSH management constructed by elements of policy, process, personnel and incentive developed in previous work is explored. Changes to the sub-elements according to previous studies and the related Malaysian legislation are also covered in this review.

  4. Safety and tolerability of new-generation anti-obesity medications: a narrative review.

    PubMed

    Patel, Dhiren K; Stanford, Fatima Cody

    2018-03-01

    The prevalence of obesity and associated comorbidities is rising. Despite their weight-loss efficacy, new generation anti-obesity medications are only prescribed to a minority of adults with obesity, possibly, which in part may be due to safety concerns. This review presents detailed safety profiles for orlistat, phentermine/topiramate, lorcaserin, naltrexone/bupropion and liraglutide 3.0 mg, and discusses the associated risk-benefit profiles. Two anti-obesity medications presented safety issues that warranted further discussion; phentermine/topiramate (fetal toxicity) and liraglutide 3.0 mg (risk of gallstone disease and mild, acute pancreatitis), whereas the adverse events associated with orlistat, lorcaserin, and naltrexone/bupropion were mostly transient tolerability issues. The difficulties surrounding the objective determination of risk-benefit for anti-obesity medications is discussed. The need for more long-term data, thorough patient assessment, individualization of pharmacological interventions and adherence to stopping rules to maximize risk-benefit are highlighted. Overall, the majority of new generation anti-obesity medications present encouraging tolerability profiles; however, in some cases a lack of long-term clinical trials confounds the accurate determination of risk-benefit.

  5. Methylphenidate dose optimization for ADHD treatment: review of safety, efficacy, and clinical necessity

    PubMed Central

    Huss, Michael; Duhan, Praveen; Gandhi, Preetam; Chen, Chien-Wei; Spannhuth, Carsten; Kumar, Vinod

    2017-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a chronic psychiatric disorder characterized by hyperactivity and/or inattention and is often associated with a substantial impact on psychosocial functioning. Methylphenidate (MPH), a central nervous system stimulant, is commonly used for pharmacological treatment of adults and children with ADHD. Current practice guidelines recommend optimizing MPH dosage to individual patient needs; however, the clinical benefits of individual dose optimization compared with fixed-dose regimens remain unclear. Here we review the available literature on MPH dose optimization from clinical trials and real-world experience on ADHD management. In addition, we report safety and efficacy data from the largest MPH modified-release long-acting Phase III clinical trial conducted to examine benefits of dose optimization in adults with ADHD. Overall, MPH is an effective ADHD treatment with a good safety profile; data suggest that dose optimization may enhance the safety and efficacy of treatment. Further research is required to establish the extent to which short-term clinical benefits of MPH dose optimization translate into improved long-term outcomes for patients with ADHD. PMID:28740389

  6. Methylphenidate dose optimization for ADHD treatment: review of safety, efficacy, and clinical necessity.

    PubMed

    Huss, Michael; Duhan, Praveen; Gandhi, Preetam; Chen, Chien-Wei; Spannhuth, Carsten; Kumar, Vinod

    2017-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a chronic psychiatric disorder characterized by hyperactivity and/or inattention and is often associated with a substantial impact on psychosocial functioning. Methylphenidate (MPH), a central nervous system stimulant, is commonly used for pharmacological treatment of adults and children with ADHD. Current practice guidelines recommend optimizing MPH dosage to individual patient needs; however, the clinical benefits of individual dose optimization compared with fixed-dose regimens remain unclear. Here we review the available literature on MPH dose optimization from clinical trials and real-world experience on ADHD management. In addition, we report safety and efficacy data from the largest MPH modified-release long-acting Phase III clinical trial conducted to examine benefits of dose optimization in adults with ADHD. Overall, MPH is an effective ADHD treatment with a good safety profile; data suggest that dose optimization may enhance the safety and efficacy of treatment. Further research is required to establish the extent to which short-term clinical benefits of MPH dose optimization translate into improved long-term outcomes for patients with ADHD.

  7. A brief review of the occurrence, use, and safety of food-related nanomaterials.

    PubMed

    Magnuson, Bernadene A; Jonaitis, Tomas S; Card, Jeffrey W

    2011-08-01

    Nanotechnology and nanomaterials have tremendous potential to enhance the food supply through novel applications, including nutrient and bioactive absorption and delivery systems; ingredient functionality; improved colors and flavors; microbial, allergen, and contaminant detection and control; and food packaging properties and performance. To determine the current state of knowledge regarding the safety of these potential uses of nanomaterials, an appraisal of the published literature on the safety of food-related nanomaterials was undertaken. A method of assessment of reliability of toxicology studies was developed to conduct this appraisal. The review of the toxicology literature on oral exposure to food-related nanomaterials found that the number of studies is limited. Exposure to nanomaterials in the human food chain may occur not only through intentional uses in food manufacturing, but also via uses in agricultural production and carry over from use in other industries. Although a number of analytical methods are useful in physicochemical characterization of manufactured nanomaterials, new methods may be needed to more fully detect and characterize nanomaterials incorporated into foods and in other media. There is a need for additional toxicology studies of sufficient quality and duration on different types of nanomaterials to further our understanding of the characteristics of nanomaterials that affect safety of oral exposure resulting from use in various food applications. © 2011 Institute of Food Technologists®

  8. Safety of tumescent and laser-assisted liposuction: review of the literature.

    PubMed

    Tierney, Emily P; Kouba, David J; Hanke, C William

    2011-12-01

    Tumescent liposuction (TL) allows the removal of large volumes of fat with minimal blood loss or postoperative morbidity, excellent cosmesis, and a remarkable safety profile. To review the literature on the safety of tumescent liposuction, liposuction under general anesthesia and laser-assisted liposuction. Aggregate safety data on liposuction under tumescent anesthesia reveals over 100,000 body areas treated with liposuction. There were no serious complications of death, emboli, hypovolemic shock, perforation of thorax or peritoneum, thrombophlebitis, seizures, or toxic reactions to drugs. In contrast, in the plastic surgery literature, liposuction under general anesthesia was associated with complications of deep venous thrombosis or pulmonary embolus, abdominal or other organ perforation, infection, and bleeding. Most recently, survey data in the European literature analyzed data showed 72 cases of severe complications from liposuction, including 23 deaths in a 5-year period from 1998 to 2002. The most frequent complications were bacterial infections such as necrotizing fasciitis, gas gangrene, and different forms of sepsis. Further causes of lethal outcome were hemorrhages, perforation of abdominal viscera, and pulmonary embolism. Tumescent local anesthesia utilizing lidocaine with epinephrine allows the removal of large volumes of fat with minimal associated blood loss and postoperative morbidity.

  9. The safety of escitalopram during pregnancy and breastfeeding: a comprehensive review.

    PubMed

    Bellantuono, Cesario; Bozzi, Francesca; Orsolini, Laura; Catena-Dell'Osso, Mario

    2012-11-01

    Escitalopram (ESC) is considered one of the most effective selective serotonin reuptake inhibitors for the treatment of major depression. However, little is known on its potential risk of inducing major malformations (MMs) and perinatal complications (PCs). Hence, aim of the present study is to provide a comprehensive review of the available literature on the safety profile of ESC during pregnancy and breastfeeding. MEDLINE and PubMed databases were searched for English language articles by using the following keywords: escitalopram, selective serotonin reuptake inhibitors, major malformations, perinatal complications, pregnancy, and breastfeeding. Although some cases of MMs have been reported after maternal exposure to ESC during early pregnancy, the rate of these adverse events is substantially in the range of those reported in unexposed women. On the contrary, exposure to ESC seems to be significantly associated with some PCs. No adverse effects have been reported in the few studies evaluating its safety during breastfeeding. The available data seem to support the notion that ESC might be considered safe during pregnancy, in particular as far as MMs is concerned. However, similar to other selective serotonin reuptake inhibitors, it could be associated with an increased risk of PCs. Given the paucity of the studies published so far, no definitive conclusions can be drawn on its safety profile during breastfeeding. Copyright © 2012 John Wiley & Sons, Ltd.

  10. Immunogenicity, effectiveness and safety of combined hepatitis A and B vaccine: a systematic literature review.

    PubMed

    Bakker, Marina; Bunge, Eveline M; Marano, Cinzia; de Ridder, Marc; De Moerlooze, Laurence

    2016-07-01

    Hepatitis A and B are two of the most common vaccine-preventable diseases and vaccination for Hepatitis A virus (HAV) and hepatitis B virus (HBV) is recommended for those at risk of contracting HAV and/or HBV through their occupation, travel or lifestyle. To describe the vaccine efficacy, immunogenicity, effectiveness and safety of the combined vaccine against hepatitis A and hepatitis B. A systematic review of the literature published between 1990 and 2015. Anti-HAV seropositivity rates ranged from 96.2% to 100% and anti-HBs seroprotection rates from 82% to 100%. Antibodies persisted up to 15 years and geometric mean concentration (GMC) remained above the seropositivity cut-off value for both. Anti-HAV and anti-HBs immune responses were lower in less immunocompetent individuals one month after completion of the immunization schedule. The safety profiles of Twinrix(TM) and monovalent hepatitis A and B vaccines were similar. The vaccine offers satisfactory long-term immunogenicity rates, expected duration of protection and safety profile similar to the monovalent hepatitis A or B vaccines.

  11. Review of Occupational Health and Safety Organization in Expanding Economies: The Case of Southern Africa.

    PubMed

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

    2015-01-01

    Globally, access to occupational health and safety (OHS) by workers has remained at very low levels. The organization and implementation of OHS in South Africa, Zimbabwe, Zambia, and Botswana has remained at suboptimal levels. Inadequacy of human resource capital, training, and education in the field of OHS has had a major negative impact on the improvement of worker access to such services in expanding economies. South Africa, Zimbabwe, Zambia, and Botswana have expanding economies with active mining and agricultural activities that pose health and safety risks to the working population. A literature review and country systems inquiry on the organization of OHS services in the 4 countries was carried out. Because of the infancy and underdevelopment of OHS in southern Africa, literature on the status of this topic is limited. In the 4 countries under review, OHS services are a function shared either wholly or partially by 3 ministries, namely Health, Labor, and Mining. Other ministries, such as Environment and Agriculture, carry small fragments of OHS function. The 4 countries are at different stages of OHS legislative frameworks that guide the practice of health and safety in the workplace. Inadequacies in human resource capital and expertise in occupational health and safety are noted major constraints in the implementation and compliance to health and safety initiatives in the work place. South Africa has a more mature system than Zimbabwe, Zambia, and Botswana. Lack of specialized training in occupational health services, such as occupational medicine specialization for physicians, has been a major drawback in Zimbabwe, Zambia, and Botswana. The full adoption and success of OHS systems in Southern Africa remains constrained. Training and education in OHS, especially in occupational medicine, will enhance the development and maturation of occupational health in southern Africa. Capacitating primary health services with basic occupational health knowledge would

  12. Comparison of case note review methods for evaluating quality and safety in health care.

    PubMed

    Hutchinson, A; Coster, J E; Cooper, K L; McIntosh, A; Walters, S J; Bath, P A; Pearson, M; Young, T A; Rantell, K; Campbell, M J; Ratcliffe, J

    2010-02-01

    To determine which of two methods of case note review--holistic (implicit) and criterion-based (explicit)--provides the most useful and reliable information for quality and safety of care, and the level of agreement within and between groups of health-care professionals when they use the two methods to review the same record. To explore the process-outcome relationship between holistic and criterion-based quality-of-care measures and hospital-level outcome indicators. Case notes of patients at randomly selected hospitals in England. In the first part of the study, retrospective multiple reviews of 684 case notes were undertaken at nine acute hospitals using both holistic and criterion-based review methods. Quality-of-care measures included evidence-based review criteria and a quality-of-care rating scale. Textual commentary on the quality of care was provided as a component of holistic review. Review teams comprised combinations of: doctors (n = 16), specialist nurses (n = 10) and clinically trained audit staff (n = 3) and non-clinical audit staff (n = 9). In the second part of the study, process (quality and safety) of care data were collected from the case notes of 1565 people with either chronic obstructive pulmonary disease (COPD) or heart failure in 20 hospitals. Doctors collected criterion-based data from case notes and used implicit review methods to derive textual comments on the quality of care provided and score the care overall. Data were analysed for intrarater consistency, inter-rater reliability between pairs of staff using intraclass correlation coefficients (ICCs) and completeness of criterion data capture, and comparisons were made within and between staff groups and between review methods. To explore the process-outcome relationship, a range of publicly available health-care indicator data were used as proxy outcomes in a multilevel analysis. Overall, 1473 holistic and 1389 criterion-based reviews were undertaken in the first part of the study

  13. Shift and night work and long working hours--a systematic review of safety implications.

    PubMed

    Wagstaff, Anthony Sverre; Sigstad Lie, Jenny-Anne

    2011-05-01

    In order to devise effective preventive strategies, it is important to study workplace stressors that might increase the risk of workplace accidents - both affecting workers themselves as well as causing harm to third-parties. The aim of this report is to provide a systematic, updated overview and scientific review of empirical research regarding accidents in relation to long work hours and shift work, primarily based on epidemiological studies. The search for articles was part of a large review study on the effects of work hours on various health outcomes, safety, and performance. The search strategy included 5 international scientific databases, and nearly 7000 articles were initially identified using our search string. Following the application of inclusion and exclusion criteria, 443 publications were found and evaluated using a pre-defined scoring system. Of these, 43 concerned safety and accidents but only 14 were considered to be of high quality (total score 2 or 3 on a scale from 0-3) and therefore used for this study. Both shift work and long working hours present a substantial and well-documented detrimental effect on safety - all the studies that are included in this review have one or more significant findings in this respect. The trends are quite coherent although the increases in accident rates are mostly from 50% to 100%. In epidemiological terms, this may be seen as rather small differences. The use of such data is therefore only of importance if the accident incidence is high or if accidents may have large effects. The findings are most relevant to safety-critical activities such as the transport and health sectors. Work periods >8 hours carry an increased risk of accidents that cumulates, so that the increased risk of accidents at around 12 hours is twice the risk at 8 hours. Shift work including nights carries a substantial increased risk of accidents, whereas "pure" night work may bring some protection against this effect due to

  14. 77 FR 43811 - Submission for OMB Review; Comment Request-Safety Standards for Full-Size Baby Cribs and Non-Full...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-26

    ... CONSUMER PRODUCT SAFETY COMMISSION Submission for OMB Review; Comment Request--Safety Standards for Full-Size Baby Cribs and Non-Full-Size Baby Cribs; Compliance Form AGENCY: Consumer Product Safety Commission. ACTION: Notice. SUMMARY: The Consumer Product Safety Commission (CPSC or Commission) announces...

  15. Safety of repetitive transcranial magnetic stimulation in patients with epilepsy: A systematic review.

    PubMed

    Pereira, Luisa Santos; Müller, Vanessa Teixeira; da Mota Gomes, Marleide; Rotenberg, Alexander; Fregni, Felipe

    2016-04-01

    Approximately one-third of patients with epilepsy remain with pharmacologically intractable seizures. An emerging therapeutic modality for seizure suppression is repetitive transcranial magnetic stimulation (rTMS). Despite being considered a safe technique, rTMS carries the risk of inducing seizures, among other milder adverse events, and thus, its safety in the population with epilepsy should be continuously assessed. We performed an updated systematic review on the safety and tolerability of rTMS in patients with epilepsy, similar to a previous report published in 2007 (Bae EH, Schrader LM, Machii K, Alonso-Alonso M, Riviello JJ, Pascual-Leone A, Rotenberg A. Safety and tolerability of repetitive transcranial magnetic stimulation in patients with epilepsy: a review of the literature. Epilepsy Behav. 2007; 10 (4): 521-8), and estimated the risk of seizures and other adverse events during or shortly after rTMS application. We searched the literature for reports of rTMS being applied on patients with epilepsy, with no time or language restrictions, and obtained studies published from January 1990 to August 2015. A total of 46 publications were identified, of which 16 were new studies published after the previous safety review of 2007. We noted the total number of subjects with epilepsy undergoing rTMS, medication usage, incidence of adverse events, and rTMS protocol parameters: frequency, intensity, total number of stimuli, train duration, intertrain intervals, coil type, and stimulation site. Our main data analysis included separate calculations for crude per subject risk of seizure and other adverse events, as well as risk per 1000 stimuli. We also performed an exploratory, secondary analysis on the risk of seizure and other adverse events according to the type of coil used (figure-of-8 or circular), stimulation frequency (≤ 1 Hz or > 1 Hz), pulse intensity in terms of motor threshold (<100% or ≥ 100%), and number of stimuli per session (< 500 or ≥ 500

  16. Efficacy and Safety of Gabapentin in the Treatment of Chronic Cough: A Systematic Review.

    PubMed

    Shi, Guanglin; Shen, Qin; Zhang, Caixin; Ma, Jun; Mohammed, Anaz; Zhao, Huan

    2018-06-19

    Despite recent clinical guidelines, the optimal therapeutic strategy for the management of refractory chronic cough is still a challenge. The present systematic review was designed to assess the evidence for efficacy and safety of gabapentin in the treatment of chronic cough. A systematic search of PubMed, Embase, Cochrane Library databases, and publications cited in bibliographies was performed. Articles were searched by two reviewers with a priori criteria for study selection. Seven relevant articles were identified, including two randomized controlled trials, one prospective case-series designed with consecutive patients, one retrospective case series of consecutive patients, one retrospective case series with unknown consecutive status, and two case reports comprising six and two patients, respectively. Improvements were detected in cough-specific quality of life (Leicester Cough Questionnaire score) and cough severity (visual analogue scale score) following gabapentin treatment in randomized controlled trials. The results of prospective case-series showed that the rate of overall improvement of cough and sensory neuropathy with gabapentin was 68%. Gabapentin treatment of patients with chronic cough showed superior efficacy and a good safety record compared with placebo or standard medications. Additional randomized and controlled trials are needed. Copyright©2018. The Korean Academy of Tuberculosis and Respiratory Diseases.

  17. Efficacy and safety of miconazole for oral candidiasis: a systematic review and meta-analysis.

    PubMed

    Zhang, L-W; Fu, J-Y; Hua, H; Yan, Z-M

    2016-04-01

    The objective of this study is to assess the efficacy and safety of miconazole for treating oral candidiasis. Twelve electronic databases were searched for randomized controlled trials evaluating treatments for oral candidiasis and complemented by hand searching. The clinical and mycological outcomes, as well as adverse effects, were set as the primary outcome criteria. Seventeen trials were included in this review. Most studies were considered to have a high or moderate level of bias. Miconazole was more effective than nystatin for thrush. For HIV-infected patients, there was no significant difference in the efficacy between miconazole and other antifungals. For denture wearers, microwave therapy was significantly better than miconazole. No significant difference was found in the safety evaluation between miconazole and other treatments. The relapse rate of miconazole oral gel may be lower than that of other formulations. This systematic review and meta-analysis indicated that miconazole may be an optional choice for thrush. Microwave therapy could be an effective adjunct treatment for denture stomatitis. Miconazole oral gel may be more effective than other formulations with regard to long-term results. However, future studies that are adequately powered, large-scale, and well-designed are needed to provide higher-quality evidence for the management of oral candidiasis. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Review of the efficacy and safety of transanal irrigation for neurogenic bowel dysfunction.

    PubMed

    Emmanuel, A

    2010-09-01

    Neurogenic bowel dysfunction (NBD) is a common occurrence after spinal cord injury (SCI) and in patients with spina bifida or multiple sclerosis. The impact of NBD on well-being is considerable, affecting both physical and psychological aspects of quality of life. Transanal irrigation (TAI) of the colon promotes the evacuation of faeces by introducing water into the colon and rectum through a catheter inserted into the anus. Regular and controlled evacuation in this manner aims at preventing both constipation and faecal soiling. The aim of this study was to review current evidence for the efficacy and safety of TAI in patients with NBD. A literature search was conducted in PubMed. All identified papers were assessed for relevance based on the title and abstract; this yielded 23 studies that were considered to be of direct relevance to the topic of the review. A multicentre, randomized, controlled trial has supported observational reports in demonstrating that TAI offers significant benefits over conservative bowel management in patients with SCI, in terms of managing constipation and faecal incontinence, reducing NBD symptoms and improving quality of life. Among other populations with NBD, TAI shows the greatest promise in children with spina bifida; however, further investigation is required. The overall safety profile of TAI is good, with few, and rare, adverse effects. Building on the positive data reported for patients with SCI, continued evaluation in the clinical trial setting is required to further define the utility of TAI in other populations with NBD.

  19. Safety Profile of the Newest Antiepileptic Drugs: A Curated Literature Review.

    PubMed

    Palleria, Caterina; Cozza, Giuseppe; Khengar, Rajeshree; Libri, Vincenzo; De Sarro, Giovambattista

    2017-01-01

    Despite the introduction of new antiepileptic drugs (AEDs), the quality of life and therapeutic response for patients with epilepsy remain unsatisfactory. In addition, whilst several antiepileptic drugs (AEDs) have been approved and consequently marketed in recent years, little is known about their long-term safety and tolerability. Availability of the newest AEDs, characterized by improved pharmacokinetic profiles, has positively impacted the treatment approach for patients with partial seizures in clinical practice. However, the main cause of treatment failure is still poor patient compliance due to the occurrence of adverse drug reactions (ADRs) that lead to treatment withdrawal in about 25% of cases before achieving maximal efficacy, and is associated with increasing health care costs. In this Review, we conducted an online database search using Medline, PubMed, Embase, and the Cochrane Online Library to review the available studies highlighting the clinical relevance of side effects, pharmacological interactions, safety and tolerability of the newest AEDs: Brivaracetam (BRV), Cannabidiol (CBD), Eslicarbazepine acetate (ESL), Lacosamide (LCM), and Perampanel (PER). The principal benefit of the newest AEDs, in addition to reduced frequency and seizure severity, is the low number and severity of ADRs reported compared to more historic drugs. Early detection of ADRs could lead to an improvement in patients' quality of life, therefore it is important to monitor ADRs and to adequately perform post marketing surveillance in the clinical practice setting. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  20. A review of the efficacy and safety of canagliflozin in elderly patients with type 2 diabetes.

    PubMed

    Elmore, Lindsey K; Baggett, Sara; Kyle, Jeffrey A; Skelley, Jessica W

    2014-01-01

    To review the efficacy and safety of canagliflozin (CAN) in elderly patients with type 2 diabetes mellitus (T2DM). Studies were identified using PubMed, International Pharmaceutical Abstracts, MEDLINE, Academic Search Premier, SCOPUS, and Google Scholar from 2011 to August 2013. The following key words were reviewed: canagliflozin, canagliflozin elderly, canagliflozin geriatrics, dapagliflozin, sodium glucose cotransporter 2 (SGLT2) inhibitors, and SGLT2 receptor inhibitors. Articles evaluating CAN for diabetes that were published in English and used human subjects were selected. Fifteen clinical trials were identified and evaluated. Of 15 identified articles, 2 articles, 2 published posters, and unpublished information from the manufacturer were chosen based on the mean age of the study subjects. Evidence that elderly patients with T2DM have less A1C reduction with CAN is presented; the benefit on A1C is significant. Systolic blood pressure (SBP) and body weight reduction in the elderly were consistent with younger patients. Adverse effects such as increased urinary frequency, genital mycotic infections, and urinary tract infections may discourage the use of CAN in the elderly patient. Treatment with CAN improves A1C levels, reduces SBP and body weight, and is overall well tolerated in older subjects with T2DM. Risks and benefits of treatment with CAN should be assessed in geriatric patients on a case-by-case basis. Safety in elderly patients was consistent with that of other phase 3 trials in the general population. Additional longterm cardiovascular studies are needed.

  1. Review of clinical trials evaluating safety and efficacy of milk thistle (Silybum marianum [L.] Gaertn.).

    PubMed

    Tamayo, Carmen; Diamond, Suzanne

    2007-06-01

    Milk thistle extracts have been used as traditional herbal remedies for almost 2000 years. The extracts are still widely used to protect the liver against toxins and to control chronic liver diseases. Recent experimental and clinical studies suggest that milk thistle extracts also have anticancer, antidiabetic, and cardioprotective effects. This article reviews clinical trials of milk thistle conducted in the past 5 years including pharmacokinetic and toxicity studies, herb-drug interactions, and other safety issues. Several trials have studied the effects of milk thistle for patients with liver diseases, cancer, hepatitis C, HIV, diabetes, and hypercholesterolemia. Promising results have been reported in the protective effect of milk thistle in certain types of cancer, and ongoing trials will provide more evidence about this effect. In addition, new established doses and improvement on the quality and standardization of this herb will provide the much-awaited evidence about the efficacy of milk thistle in the treatment of liver diseases. Milk thistle extracts are known to be safe and well tolerated, and toxic or adverse effects observed in the reviewed clinical trials seem to be minimal. The future of milk thistle research is promising, and high-quality randomized clinical trials on milk thistle versus placebo may be needed to further demonstrate the safety and efficacy of this herb.

  2. A review on leadership of head nurses and patient safety and quality of care.

    PubMed

    Verschueren, Marc; Kips, Johan; Euwema, Martin

    2013-01-01

    The purpose of the study was to explore in literature what different leadership styles and behaviors of head nurses have a positive influence on the outcomes of patient safety or quality of care. We reviewed the literature from January 2000 until September 2011. We searched Pubmed, Embase, Cinahl, Psychlit, and Econlit. We found 10 studies addressing the relationship between head nurse leadership and safety and quality. A wide array of styles and practices were associated with different patient outcomes. Transformational leadership was the most used concept in the studies. A trend can be observed over these studies suggesting that a trustful relationship between the head nurse and subordinates is an important driving force for the achievement of positive patient outcomes. Furthermore, the effects of these trustful relationships seem to be amplified by supporting mechanisms, often objective conditions like clinical pathways and, especially, staffing level. This study offers an up-to-date review of the limited number of studies on the relationship between nurse leadership and patient outcomes. Although mostly transformational leadership was found to be responsible for positive associations with outcomes, also contingent reward had positive influence on outcomes. We formulated some comments on the predominance of the transformational leadership concept and suggested the application of complexity theory and political leadership for the current context of care. We formulated some implications for practice and further research, mainly the need for more systematic empirical and cross cultural studies and the urgent need for the development of a validated set of nurse-sensitive patient outcome indicators.

  3. Safety and efficacy of pharmacologic thromboprophylaxis following blunt head injury: a systematic review.

    PubMed

    Reeves, Fairleigh; Batty, Lachlan; Pitt, Veronica; Chau, Marisa; Pattuwage, Loyal; Gruen, Russell L

    2013-10-01

    Patients with blunt head injury are at high risk of venous thromboembolism. However, pharmacologic thromboprophylaxis (PTP) may cause progression of intracranial hemorrhage, and clinicians must often weigh up the risks and benefits. This review aimed to determine whether adding PTP to mechanical prophylaxis confers net benefit or harm and the optimal timing, dose, and agent for PTP in patients with blunt head injury. We searched MEDLINE, EMBASE, The Cochrane Library Central Register of Controlled Trials (CENTRAL), and www.clinicaltrials.gov on April 24, 2013, to identify controlled studies and ongoing trials that assessed the efficacy or safety of thromboprophylaxis interventions in the early management of head-injured patients. Studies were classified based on types of interventions and comparisons, and the quality of included studies was assessed using Cochrane risk-of-bias tool and the Newcastle-Ottawa Quality Assessment Scale. We intended to undertake a meta-analysis if studies were sufficiently similar. Sixteen studies met the inclusion criteria, including four randomized controlled trials. At least two randomized controlled trials were at high risk of bias owing to inadequate randomization and concealment of allocation, and observational studies were potentially confounded by substantial differences between comparison groups. Heterogeneity of included studies precluded meta-analysis. Results were mixed, with some studies supporting and others refuting addition of PTP to mechanical interventions. Little evidence was available about dose or choice of agent. The safety and efficacy of early PTP in patients without early progression of hemorrhage is unclear. There is currently insufficient evidence to guide thromboprophylaxis in patients with blunt head injury. Standardized definitions and outcome measurements would facilitate comparison of outcomes across future studies. Studies in mixed populations should report head-injured specific subgroup data. Future

  4. Safety and performance benefits of arginine supplements for military personnel: a systematic review.

    PubMed

    Brooks, James R; Oketch-Rabah, Hellen; Low Dog, Tieraona; Gorecki, Dennis K J; Barrett, Marilyn L; Cantilena, Louis; Chung, Mei; Costello, Rebecca B; Dwyer, Johanna; Hardy, Mary L; Jordan, Scott A; Maughan, Ronald J; Marles, Robin J; Osterberg, Robert E; Rodda, Bruce E; Wolfe, Robert R; Zuniga, Jorge M; Valerio, Luis G; Jones, Donnamaria; Deuster, Patricia; Giancaspro, Gabriel I; Sarma, Nandakumara D

    2016-11-01

    Dietary supplements are widely used by military personnel and civilians for promotion of health. The objective of this evidence-based review was to examine whether supplementation with l-arginine, in combination with caffeine and/or creatine, is safe and whether it enhances athletic performance or improves recovery from exhaustion for military personnel. Information from clinical trials and adverse event reports were collected from 17 databases and 5 adverse event report portals. Studies and reports were included if they evaluated the safety and the putative outcomes of enhanced performance or improved recovery from exhaustion associated with the intake of arginine alone or in combination with caffeine and/or creatine in healthy adults aged 19 to 50 years. Information related to population, intervention, comparator, and outcomes was abstracted. Of the 2687 articles screened, 62 articles meeting the inclusion criteria were analyzed. Strength of evidence was assessed in terms of risk of bias, consistency, directness, and precision. Most studies had few participants and suggested risk of bias that could negatively affect the results. l-Arginine supplementation provided little enhancement of athletic performance or improvements in recovery. Short-term supplementation with arginine may result in adverse gastrointestinal and cardiovascular effects. No information about the effects of arginine on the performance of military personnel was available. The available information does not support the use of l-arginine, either alone or in combination with caffeine, creatine, or both, to enhance athletic performance or improve recovery from exhaustion. Given the information gaps, an evidence-based review to assess the safety or effectiveness of multi-ingredient dietary supplements was not feasible, and therefore the development of a computational model-based approach to predict the safety of multi-ingredient dietary supplements is recommended. © The Author(s) 2016. Published by

  5. Safety and efficacy of autologous cell therapy in critical limb ischemia: a systematic review.

    PubMed

    Benoit, Eric; O'Donnell, Thomas F; Patel, Amit N

    2013-01-01

    Researchers have accumulated a decade of experience with autologous cell therapy in the treatment of critical limb ischemia (CLI). We conducted a systematic review of clinical trials in the literature to determine the safety and efficacy of cell therapy in CLI. We searched the literature for clinical trials of autologous cell therapy in CLI, including observational series of five or more patients to accrue a large pool of patients for safety analysis. Safety analysis included evaluation of death, cancer, unregulated angiogenesis, and procedural adverse events such as bleeding. Efficacy analysis included the clinical endpoints amputation and death as well as functional and surrogate endpoints. We identified 45 clinical trials, including seven RCTs, and 1,272 patients who received cell therapy. The overall adverse event rate was low (4.2%). Cell therapy patients did not have a higher mortality rate than control patients and demonstrated no increase in cancer incidence when analyzed against population rates. With regard to efficacy, cell therapy patients had a significantly lower amputation rate than control patients (OR 0.36, p = 0.0004). Cell therapy also demonstrated efficacy in a variety of functional and surrogate outcomes. Clinical trials differed in the proportion of patients with risk factors for clinical outcomes, and these influenced rates of amputation and death. Cell therapy presents a favorable safety profile with a low adverse event rate and no increase in severe events such as mortality and cancer and treatment with cell therapy decreases the risk of amputation. Cell therapy has a positive benefit-to-risk ratio in CLI and may be a valuable treatment option, particularly for those challenging patients who cannot undergo arterial reconstruction.

  6. Impact of irradiation on the safety and quality of poultry and meat products: a review.

    PubMed

    O'Bryan, Corliss A; Crandall, Philip G; Ricke, Steven C; Olson, Dennis G

    2008-05-01

    For more than 100 years research on food irradiation has demonstrated that radiation will make food safer and improve the shelf life of irradiated foods. Using the current food safety technology, we may have reached the point of diminishing returns even though recent figures from the CDC show a significant drop in the number of foodborne illnesses. However, too many people continue to get sick and die from eating contaminated food. New and under utilized technologies such as food irradiation need to be re-examined to achieve new levels of safety for the food supply. Effects of irradiation on the safety and quality of meat and poultry are discussed. Irradiation control of the principle microbial pathogens including viruses, the differences among at-risk sub-populations, factors affecting the diminished rate of improvement in food safety and published D values for irradiating raw meat and poultry are presented. Currently permitted levels of irradiation are probably not sufficient to control pathogenic viruses. Typical gram-negative spoilage organisms are very sensitive to irradiation. Their destruction leads to a significant increase in the acceptable shelf life. In addition, the destruction of these normal spoilage organisms did not provide a competitive growth advantage for irradiation injured food pathogens. Another of the main focuses of this review is a detailed compilation of the effects of most of the food additives that have been proposed to minimize the negative quality effect of irradiation. Most of the antimicrobials and antioxidants used singly or in combination produced an increased lethality of irradiation and a decrease in oxidation by-products. Combinations of dosage, temperature, dietary and direct additives, storage temperature and packaging atmosphere can produce meats that the average consumer will find indistinguishable from non-irradiated meats. A discussion of the production of unique radiological by-products is also included.

  7. Herpes zoster vaccine live: A 10 year review of post-marketing safety experience.

    PubMed

    Willis, English D; Woodward, Meredith; Brown, Elizabeth; Popmihajlov, Zoran; Saddier, Patricia; Annunziato, Paula W; Halsey, Neal A; Gershon, Anne A

    2017-12-19

    Zoster vaccine is a single dose live, attenuated vaccine (ZVL) indicated for individuals ≥50 years-old for the prevention of herpes zoster (HZ). Safety data from clinical trials and post-licensure studies provided reassurance that ZVL is generally safe and well tolerated. The objective of this review was to provide worldwide post-marketing safety information following 10 years of use and >34 million doses distributed. All post-marketing adverse experience (AE) reports received worldwide between 02-May-2006 and 01-May-2016 from healthcare professionals following vaccination with ZVL and submitted to the MSD AE global safety database, were analyzed. A total of 23,556 AE reports, 93% non-serious, were reported. Local injection site reactions (ISRs), with a median time-to-onset of 2 days, were the most frequently reported AEs followed by HZ. The majority of HZ reports were reported within 2 weeks of vaccination and considered, based on time-to-onset, pathogenesis of HZ, and data from clinical trials, to be caused by wild-type varicella-zoster virus (VZV). HZ confirmed by PCR analysis to be VZV Oka/Merck vaccine-strain was identified in an immunocompetent individual 8 months postvaccination and in 4 immunocompromised individuals. Disseminated HZ was reported very rarely (<1%) with 38% occurring in immunocompromised individuals. All reports of disseminated HZ confirmed by PCR as VZV Oka/Merck vaccine-strain were in individuals with immunosuppressive conditions and/or therapy at the time of vaccination. The safety profile of ZVL, following 10 years of post-marketing use, was favorable and consistent with that observed in clinical trials and post-licensure studies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. The U.S. Commercial Air Tour Industry: A Review of Aviation Safety Concerns

    PubMed Central

    Ballard, Sarah-Blythe

    2016-01-01

    The U.S. Title 14 Code of Federal Regulations defines commercial air tours as “flight[s] conducted for compensation or hire in an airplane or helicopter where a purpose of the flight is sightseeing.” The incidence of air tour crashes in the United States is disproportionately high relative to similar commercial aviation operations, and air tours operating under Part 91 governance crash significantly more than those governed by Part 135. This paper reviews the government and industry response to four specific areas of air tour safety concern: surveillance of flight operations, pilot factors, regulatory standardization, and maintenance quality assurance. It concludes that the government and industry have successfully addressed many of these tenet issues, most notably by: advancing the operations surveillance infrastructure through implementation of en route, ground-based, and technological surveillance methods; developing Aeronautical Decision Making and cue-based training programs for air tour pilots; consolidating federal air tour regulations under Part 136; and developing public-private partnerships for raising maintenance operating standards and improving quality assurance programs. However, opportunities remain to improve air tour safety by: increasing the number and efficiency of flight surveillance programs; addressing pilot fatigue with more restrictive flight hour limitations for air tour pilots; ensuring widespread uptake of maintenance quality assurance programs, especially among high-risk operators not currently affiliated with private air tour safety programs; and eliminating the 25-mile exception allowing Part 91 operators to conduct commercial air tours without the safety oversight required of Part 135 operators. PMID:24597160

  9. Herpes zoster vaccine live: A 10 year review of post-marketing safety experience

    PubMed Central

    Willis, English D.; Woodward, Meredith; Brown, Elizabeth; Popmihajlov, Zoran; Saddier, Patricia; Annunziato, Paula W.; Halsey, Neal A.; Gershon, Anne A.

    2017-01-01

    Background Zoster vaccine is a single dose live, attenuated vaccine (ZVL) indicated for individuals ≥50 years-old for the prevention of herpes zoster (HZ). Safety data from clinical trials and post-licensure studies provided reassurance that ZVL is generally safe and well tolerated. The objective of this review was to provide worldwide post-marketing safety information following 10 years of use and >34 million doses distributed. Methods All post-marketing adverse experience (AE) reports received worldwide between 02-May-2006 and 01-May-2016 from healthcare professionals following vaccination with ZVL and submitted to the MSD AE global safety database, were analyzed. Results A total of 23,556 AE reports, 93% non-serious, were reported. Local injection site reactions (ISRs), with a median time-to-onset of 2 days, were the most frequently reported AEs followed by HZ. The majority of HZ reports were reported within 2 weeks of vaccination and considered, based on time-to-onset, pathogenesis of HZ, and data from clinical trials, to be caused by wild-type varicella-zoster virus (VZV). HZ confirmed by PCR analysis to be VZV Oka/Merck vaccine-strain was identified in an immunocompetent individual 8 months postvaccination and in 4 immunocompromised individuals. Disseminated HZ was reported very rarely (<1%) with 38% occurring in immunocompromised individuals. All reports of disseminated HZ confirmed by PCR as VZV Oka/Merck vaccine-strain were in individuals with immunosuppressive conditions and/or therapy at the time of vaccination. Conclusions The safety profile of ZVL, following 10 years of post-marketing use, was favorable and consistent with that observed in clinical trials and post-licensure studies. PMID:29174682

  10. How effective is drug testing as a workplace safety strategy? A systematic review of the evidence.

    PubMed

    Pidd, Ken; Roche, Ann M

    2014-10-01

    The growing prevalence of workplace drug testing and the narrow scope of previous reviews of the evidence base necessitate a comprehensive review of research concerning the efficacy of drug testing as a workplace strategy. A systematic qualitative review of relevant research published between January 1990 and January 2013 was undertaken. Inclusion criteria were studies that evaluated the effectiveness of drug testing in deterring employee drug use or reducing workplace accident or injury rates. Methodological adequacy was assessed using a published assessment tool specifically designed to assess the quality of intervention studies. A total of 23 studies were reviewed and assessed, six of which reported on the effectiveness of testing in reducing employee drug use and 17 which reported on occupational accident or injury rates. No studies involved randomised control trials. Only one study was assessed as demonstrating strong methodological rigour. That study found random alcohol testing reduced fatal accidents in the transport industry. The majority of studies reviewed contained methodological weaknesses including; inappropriate study design, limited sample representativeness, the use of ecological data to evaluate individual behaviour change and failure to adequately control for potentially confounding variables. This latter finding is consistent with previous reviews and indicates the evidence base for the effectiveness of testing in improving workplace safety is at best tenuous. Better dissemination of the current evidence in relation to workplace drug testing is required to support evidence-informed policy and practice. There is also a pressing need for more methodologically rigorous research to evaluate the efficacy and utility of drug testing. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. The outcomes of recent patient safety education interventions for trainee physicians and medical students: a systematic review

    PubMed Central

    Kirkman, Matthew A; Sevdalis, Nick; Arora, Sonal; Baker, Paul; Vincent, Charles; Ahmed, Maria

    2015-01-01

    Objective To systematically review the latest evidence for patient safety education for physicians in training and medical students, updating, extending and improving on a previous systematic review on this topic. Design A systematic review. Data sources Embase, Ovid Medline and PsycINFO databases. Study selection Studies including an evaluation of patient safety training interventions delivered to trainees/residents and medical students published between January 2009 and May 2014. Data extraction The review was performed using a structured data capture tool. Thematic analysis also identified factors influencing successful implementation of interventions. Results We identified 26 studies reporting patient safety interventions: 11 involving students and 15 involving trainees/residents. Common educational content included a general overview of patient safety, root cause/systems-based analysis, communication and teamwork skills, and quality improvement principles and methodologies. The majority of courses were well received by learners, and improved patient safety knowledge, skills and attitudes. Moreover, some interventions were shown to result in positive behaviours, notably subsequent engagement in quality improvement projects. No studies demonstrated patient benefit. Availability of expert faculty, competing curricular/service demands and institutional culture were important factors affecting implementation. Conclusions There is an increasing trend for developing educational interventions in patient safety delivered to trainees/residents and medical students. However, significant methodological shortcomings remain and additional evidence of impact on patient outcomes is needed. While there is some evidence of enhanced efforts to promote sustainability of such interventions, further work is needed to encourage their wider adoption and spread. PMID:25995240

  12. A Microglitch in the Millisecond Pulsar PSR B1821-24 in M28

    NASA Astrophysics Data System (ADS)

    Cognard, Ismaël; Backer, Donald C.

    2004-09-01

    We report on the observation of a very small glitch observed for the first time in a millisecond pulsar, PSR B1821-24, located in the globular cluster M28. Timing observations were mainly conducted with the Nançay radio telescope (France), and confirmation comes from the 140 ft radio telescope at Green Bank and the new Green Bank Telescope data. This event is characterized by a rotation frequency step of 3 nHz, or 10-11 in fractional frequency change, along with a short duration limited to a few days or a week. A marginally significant frequency derivative step was also found. This glitch follows the main characteristics of those in the slow-period pulsars but is 2 orders of magnitude smaller than the smallest ever recorded. Such an event must be very rare for millisecond pulsars since no other glitches have been detected when the cumulated number of years of millisecond pulsar timing observations up to 2001 is around 500 for all these objects. However, pulsar PSR B1821-24 is one of the youngest among the old recycled ones, and there is likely a correlation between age, or a related parameter, and timing noise. While this event happens on a much smaller scale, the required adjustment of the star to a new equilibrium figure as it spins down is a likely common cause for all glitches.

  13. PSR J1838-0537: DISCOVERY OF A YOUNG, ENERGETIC GAMMA-RAY PULSAR

    SciTech Connect

    Pletsch, H. J.; Allen, B.; Aulbert, C.

    2012-08-10

    We report the discovery of PSR J1838-0537, a gamma-ray pulsar found through a blind search of data from the Fermi Large Area Telescope (LAT). The pulsar has a spin frequency of 6.9 Hz and a frequency derivative of -2.2 Multiplication-Sign 10{sup -11} Hz s{sup -1}, implying a young characteristic age of 4970 yr and a large spin-down power of 5.9 Multiplication-Sign 10{sup 36} erg s{sup -1}. Follow-up observations with radio telescopes detected no pulsations; thus PSR J1838-0537 appears radio-quiet as viewed from Earth. In 2009 September the pulsar suffered the largest glitch so far seen in any gamma-ray-only pulsar, causingmore » a relative increase in spin frequency of about 5.5 Multiplication-Sign 10{sup -6}. After the glitch, during a putative recovery period, the timing analysis is complicated by the sparsity of the LAT photon data, the weakness of the pulsations, and the reduction in average exposure from a coincidental, contemporaneous change in LAT's sky-survey observing pattern. The pulsar's sky position is coincident with the spatially extended TeV source HESS J1841-055 detected by the High Energy Stereoscopic System (H.E.S.S.). The inferred energetics suggest that HESS J1841-055 contains a pulsar wind nebula powered by the pulsar.« less

  14. Large Magneto-ionic Variations toward the Galactic Center Magnetar, PSR J1745-2900

    NASA Astrophysics Data System (ADS)

    Desvignes, G.; Eatough, R. P.; Pen, U. L.; Lee, K. J.; Mao, S. A.; Karuppusamy, R.; Schnitzeler, D. H. F. M.; Falcke, H.; Kramer, M.; Wucknitz, O.; Spitler, L. G.; Torne, P.; Liu, K.; Bower, G. C.; Cognard, I.; Lyne, A. G.; Stappers, B. W.

    2018-01-01

    Polarized radio emission from PSR J1745‑2900 has already been used to investigate the strength of the magnetic field in the Galactic center (GC), close to Sagittarius A*. Here we report how persistent radio emission from this magnetar, for over four years since its discovery, has revealed large changes in the observed Faraday rotation measure (RM), by up to 3500 rad m‑2 (a 5% fractional change). From simultaneous analysis of the dispersion measure, we determine that these fluctuations are dominated by variations in either the projected magnetic field or the free electron content within the GC, along the changing line of sight to the rapidly moving magnetar. From a structure function analysis of RM variations, and a recent epoch of rapid change of RM, we determine a minimum scale of magneto-ionic fluctuations of size ∼2 au at the GC distance, inferring PSR J1745‑2900 is just ∼0.1 pc behind an additional scattering screen.

  15. X-rays from radio pulsars - The detection of PSR 1055-52

    NASA Technical Reports Server (NTRS)

    Cheng, A. F.; Helfand, D. J.

    1983-01-01

    The short-period pulsar PSR 1055-52 has been detected as a soft X-ray source in the course of an Einstein Observatory survey of radio pulsars. Its X-ray to radio luminosity ratio is about 10,000, although the X-rays are not modulated at the neutron star's rotation frequency. High spatial resolution observations suggest that a significant fraction of the emission comes from an extended region surrounding the pulsar. Several possible scenarios for the origin of both point and extended X-ray emission from isolated neutron stars are investigated: radiation from the hot stellar surface, from hot polar caps, and from an optically thick atmosphere, as well as from a circumstellar nebula emitting thermal bremsstrahlung or synchrotron radiation. It is concluded that the spatial, spectral, and temporal characteristics of this source are most consistent with a model in which relativistic particles generated by the pulsar are radiating synchrotron X-rays in the surrounding magnetic field; i.e., that PSR 1055 is embedded in a mini-Crab nebula. Observational tests of this hypothesis are suggested, and the implications of this result for pulsar evolution are briefly discussed.

  16. X-rays from radio pulsars: the detection of PSR 1055-52

    SciTech Connect

    Cheng, A.F.; Helfand, D.J.

    The short-period pulsar PSR 1055-52 has been detected as a soft X-ray source in the course of an Einstein Observatory survey of radio pulsars. Its X-ray to radio luminosity ratio is approx.10/sup 4/, although the X-rays are not modulated at the neutron star's rotation frequency. We present high spatial resolution observations which suggest that a significant fraction of the emission comes from an extended region surrounding the pulsar. We investigate several possible scenarios for the origin of both point and extended X-ray emission from isolated neutron stars: radiation from the hot stellar surface, from hot polar caps, and from anmore » optically thick atmosphere, as well as from a circumstellar nebula emitting thermal bremsstrahlung or synchrotron radiation. We conclude that the spatial, spectral, and temporal characteristic of this source are most consistent with a model in which relativistic particles generated by the pulsar are radiating synchrotron X-rays in the surrounding magnetic field; i.e., that PSR 1055 is embedded in a mini-Crab nebula. Observational tests of this hypothesis are suggested, and the implications of this result for pulsar evolution are briefly discussed.« less

  17. Spin-down Evolution and Radio Disappearance of the Magnetar PSR J1622-4950

    NASA Astrophysics Data System (ADS)

    Scholz, P.; Camilo, F.; Sarkissian, J.; Reynolds, J. E.; Levin, L.; Bailes, M.; Burgay, M.; Johnston, S.; Kramer, M.; Possenti, A.

    2017-06-01

    We report on 2.4 yr of radio timing measurements of the magnetar PSR J1622-4950 using the Parkes Observatory, between 2011 November and 2014 March. During this period the torque on the neutron star (inferred from the rotational frequency derivative) varied greatly, though much less erratically than during the 2 yr following its discovery in 2009. During the last year of our measurements the frequency derivative decreased in magnitude monotonically by 20%, to a value of -1.3 × 10-13 s-2, a factor of 8 smaller than when it was discovered. The flux density continued to vary greatly during our monitoring through 2014 March, reaching a relatively steady low level after late 2012. The pulse profile varied secularly on a similar timescale as the flux density and torque. A relatively rapid transition in all three properties was evident in early 2013. After PSR J1622-4950 was detected in all of our 87 observations up to 2014 March, we did not detect the magnetar in our resumed monitoring starting in 2015 January and have not detected it in any of the 30 observations conducted through 2016 September.

  18. Spin-down Evolution and Radio Disappearance of the Magnetar PSR J1622–4950

    SciTech Connect

    Scholz, P.; Camilo, F.; Sarkissian, J.

    2017-06-01

    We report on 2.4 yr of radio timing measurements of the magnetar PSR J1622−4950 using the Parkes Observatory, between 2011 November and 2014 March. During this period the torque on the neutron star (inferred from the rotational frequency derivative) varied greatly, though much less erratically than during the 2 yr following its discovery in 2009. During the last year of our measurements the frequency derivative decreased in magnitude monotonically by 20%, to a value of −1.3 × 10{sup −13} s{sup −2}, a factor of 8 smaller than when it was discovered. The flux density continued to vary greatly during ourmore » monitoring through 2014 March, reaching a relatively steady low level after late 2012. The pulse profile varied secularly on a similar timescale as the flux density and torque. A relatively rapid transition in all three properties was evident in early 2013. After PSR J1622−4950 was detected in all of our 87 observations up to 2014 March, we did not detect the magnetar in our resumed monitoring starting in 2015 January and have not detected it in any of the 30 observations conducted through 2016 September.« less

  19. Gravitational wave emission by the high braking index pulsar PSR J1640-4631

    SciTech Connect

    De Araujo, José C.N.; Coelho, Jaziel G.; Costa, Cesar A., E-mail: jcarlos.dearaujo@inpe.br, E-mail: jaziel.coelho@inpe.br, E-mail: cesar.costa@inpe.br

    Recently, a braking index for the pulsar PSR J1640-4631 has been measured. With a braking index of n = 3.15 ± 0.03, this pulsar has the highest braking index ever measured. As it is well known, a pure magnetic dipole brake yields n = 3, whereas a pure gravitational wave (GW) brake yields n = 5. Therefore, each of these mechanisms alone can not account for the braking index found for PSR J1640-4631. Here we consider in detail that such a braking index could be accounted for if the spindown model combines magnetic dipole and GW brakes. Then, we brieflymore » discuss the detectability of this pulsar by aLIGO and the planned Einstein Telescope. In particular, we show that the amplitude of the GW that comes from our model is around a factor four lower than the amplitude modeled exclusively by GW energy loss. Another interesting outcome of our modeling is that it is possible to obtain the ellipticity from the braking index and other pulsar parameters.« less

  20. Fermi Large Area Telescope observations of PSR J1836+5925

    DOE PAGES

    Abdo, A. A.; Ackermann, M.; Ajello, M.; ...

    2010-03-11

    The discovery of the γ-ray pulsar PSR J1836+5925, powering the formerly unidentified EGRET source 3EG J1835+5918, was one of the early accomplishments of the Fermi Large Area Telescope (LAT). Sitting 25° off the Galactic plane, PSR J1836+5925 is a 173 ms pulsar with a characteristic age of 1.8 million years, a spindown luminosity of 1.1 × 10 34 erg s –1, and a large off-peak (OP) emission component, making it quite unusual among the known γ-ray pulsar population. We present an analysis of one year of LAT data, including an updated timing solution, detailed spectral results, and a long-term lightmore » curve showing no indication of variability. No evidence for a surrounding pulsar wind nebula is seen and the spectral characteristics of the OP emission indicate it is likely magnetospheric. Finally, analysis of recent XMM-Newton observations of the X-ray counterpart yields a detailed characterization of its spectrum, which, like Geminga, is consistent with that of a neutron star showing evidence for both magnetospheric and thermal emission.« less

  1. PSR J1838–0537: Discovery of a young, energetic gamma-ray pulsar

    DOE PAGES

    Pletsch, H. J.; Guillemot, L.; Allen, B.; ...

    2012-07-27

    Here, we report the discovery of PSR J1838–0537, a gamma-ray pulsar found through a blind search of data from the Fermi Large Area Telescope (LAT). The pulsar has a spin frequency of 6.9 Hz and a frequency derivative of –2.2 × 10 –11 Hz s–1, implying a young characteristic age of 4970 yr and a large spin-down power of 5.9 × 1036 erg s–1. Follow-up observations with radio telescopes detected no pulsations; thus PSR J1838–0537 appears radio-quiet as viewed from Earth. In 2009 September the pulsar suffered the largest glitch so far seen in any gamma-ray-only pulsar, causing a relativemore » increase in spin frequency of about 5.5 × 10–6. After the glitch, during a putative recovery period, the timing analysis is complicated by the sparsity of the LAT photon data, the weakness of the pulsations, and the reduction in average exposure from a coincidental, contemporaneous change in LAT's sky-survey observing pattern. Furthermore, the pulsar's sky position is coincident with the spatially extended TeV source HESS J1841–055 detected by the High Energy Stereoscopic System (H.E.S.S.). Finally, the inferred energetics suggest that HESS J1841–055 contains a pulsar wind nebula powered by the pulsar.« less

  2. PSR J1740-3052: a pulsar with a massive companion

    NASA Astrophysics Data System (ADS)

    Stairs, I. H.; Manchester, R. N.; Lyne, A. G.; Kaspi, V. M.; Camilo, F.; Bell, J. F.; D'Amico, N.; Kramer, M.; Crawford, F.; Morris, D. J.; Possenti, A.; McKay, N. P. F.; Lumsden, S. L.; Tacconi-Garman, L. E.; Cannon, R. D.; Hambly, N. C.; Wood, P. R.

    2001-08-01

    We report on the discovery of a binary pulsar, PSR J1740-3052, during the Parkes multibeam survey. Timing observations of the 570-ms pulsar at Jodrell Bank and Parkes show that it is young, with a characteristic age of 350kyr, and is in a 231-d, highly eccentric orbit with a companion whose mass exceeds 11Msolar. An accurate position for the pulsar was obtained using the Australia Telescope Compact Array. Near-infrared 2.2-μm observations made with the telescopes at the Siding Spring observatory reveal a late-type star coincident with the pulsar position. However, we do not believe that this star is the companion of the pulsar, because a typical star of this spectral type and required mass would extend beyond the orbit of the pulsar. Furthermore, the measured advance of periastron of the pulsar suggests a more compact companion, for example, a main-sequence star with radius only a few times that of the Sun. Such a companion is also more consistent with the small dispersion measure variations seen near periastron. Although we cannot conclusively rule out a black hole companion, we believe that the companion is probably an early B star, making the system similar to the binary PSR J0045-7319.

  3. Assessing secondary soil salinization risk based on the PSR sustainability framework.

    PubMed

    Zhou, De; Lin, Zhulu; Liu, Liming; Zimmermann, David

    2013-10-15

    Risk assessment of secondary soil salinization, which is caused in part by the way people manage the land, is an essential challenge to agricultural sustainability. The objective of our study was to develop a soil salinity risk assessment methodology by selecting a consistent set of risk factors based on the conceptual Pressure-State-Response (PSR) sustainability framework and incorporating the grey relational analysis and the Analytic Hierarchy Process methods. The proposed salinity risk assessment methodology was demonstrated through a case study of developing composite risk index maps for the Yinchuan Plain, a major irrigation agriculture district in northwest China. Fourteen risk factors were selected in terms of the three PSR criteria: pressure, state, and response. The results showed that the salinity risk in the Yinchuan Plain was strongly influenced by the subsoil and groundwater salinity, land use, distance to irrigation canals, and depth to groundwater. To maintain agricultural sustainability in the Yinchuan Plain, a suite of remedial and preventative actions were proposed to manage soil salinity risk in the regions that are affected by salinity at different levels and by different salinization processes. The weight sensitivity analysis results also showed that the overall salinity risk of the Yinchuan Plain would increase or decrease as the weights for pressure or response risk factors increased, signifying the importance of human activities on secondary soil salinization. Ideally, the proposed methodology will help us develop more consistent management tools for risk assessment and management and for control of secondary soil salinization. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Multifrequency behaviour of the anomalous events of PSR J0922+0638

    NASA Astrophysics Data System (ADS)

    Shaifullah, G.; Tiburzi, C.; Osłowski, S.; Verbiest, J. P. W.; Szary, A.; Künsemöller, J.; Horneffer, A.; Anderson, J.; Kramer, M.; Schwarz, D. J.; Mann, G.; Steinmetz, M.; Vocks, C.

    2018-06-01

    PSR J0922+0638 (B0919+06) shows unexplained anomalous variations in the on-pulse phase, where the pulse appears to episodically move to an earlier longitude for a few tens of rotations before reverting to the usual phase for approximately several hundred to more than a thousand rotations. These events, where the pulse moves in phase by up to 5°, have been previously detected in observations from ˜300 to 2000 MHz. We present simultaneous observations from the Effelsberg 100-m radio telescope at 1350 MHz and the Bornim (Potsdam) station of the LOw Frequency ARray at 150 MHz. Our observations present the first evidence for an absence of the anomalous phase-shifting behaviour at 150 MHz. Instead, the observed intensity at the usual pulse-phase typically decreases, often showing a pseudo-nulling feature corresponding to the times when phase shifts are observed at 1350 MHz. The presence of weak emission at the usual pulse-phase supports the theory that these shifts may result from processes similar to the `profile-absorption' expected to operate for PSR J0814+7429 (B0809+74). A possible mechanism for this could be intrinsic variations of the emission within the pulsar's beam combined with absorption by expanding shells of electrons in the line of sight.

  5. THE EINSTEIN-HOME SEARCH FOR RADIO PULSARS AND PSR J2007+2722 DISCOVERY

    SciTech Connect

    Allen, B.; Knispel, B.; Aulbert, C.

    Einstein-Home aggregates the computer power of hundreds of thousands of volunteers from 193 countries, to search for new neutron stars using data from electromagnetic and gravitational-wave detectors. This paper presents a detailed description of the search for new radio pulsars using Pulsar ALFA survey data from the Arecibo Observatory. The enormous computing power allows this search to cover a new region of parameter space; it can detect pulsars in binary systems with orbital periods as short as 11 minutes. We also describe the first Einstein-Home discovery, the 40.8 Hz isolated pulsar PSR J2007+2722, and provide a full timing model. PSRmore » J2007+2722's pulse profile is remarkably wide with emission over almost the entire spin period. This neutron star is most likely a disrupted recycled pulsar, about as old as its characteristic spin-down age of 404 Myr. However, there is a small chance that it was born recently, with a low magnetic field. If so, upper limits on the X-ray flux suggest but cannot prove that PSR J2007+2722 is at least {approx}100 kyr old. In the future, we expect that the massive computing power provided by volunteers should enable many additional radio pulsar discoveries.« less

  6. Effectiveness of occupational safety and health training for migrant farmworkers: a scoping review.

    PubMed

    Caffaro, F; Micheletti Cremasco, M; Bagagiolo, G; Vigoroso, L; Cavallo, E

    2018-04-24

    Migrant farmworkers report higher rates of work-related illnesses, injuries and fatalities compared with local workers. Language and cultural barriers represent a relevant source of risk, which can be reduced by means of targeted training interventions. However, very little evidence is available about the effectiveness of Occupational Safety and Health (OSH) training programmes addressing migrant farmworkers. We carried out a scoping review. Currently available literature about the effectiveness of OSH training for migrant farmworkers-in terms of improvements in at least one of the following: safety knowledge, behaviours, attitudes and beliefs and health outcomes-was searched from four databases: PubMed, PsycINFO, Scopus and Web of Science. The screening was performed independently by two authors, and any disagreement was resolved through discussion until consensus was achieved. Once the articles eligible for inclusion were selected, the objectives, design, sample and setting, interventions and findings of each study were recorded. No quality assessment tool for publications considered by this study has been used because a scoping review does not aim for critical appraisal. Twenty-nine publications met the inclusion criteria. Of these, nine cross-sectional studies discussed the effectiveness of training activities in terms of whether participating in any programme had or did not have a significant effect on the dependent variables, when training was considered along with other sociodemographic factors. In the majority of these studies, training appeared to have low or no effect on the dependent variables considered. Twenty mainly within-subject experimental studies addressed the effectiveness of specific training methods, reporting significant improvements especially for interventions based on a participatory approach. Training could greatly contribute to an effective attainment of OSH information, but the present review shows that more evidence is needed to guide

  7. Safety of Running Two Rooms: A Systematic Review and Meta-Analysis of Overlapping Neurosurgical Procedures.

    PubMed

    Self, D Mitchell; Ilyas, Adeel; Stetler, William R

    2018-04-27

    Overlapping surgery, a long-standing practice within academic neurosurgery centers nationwide, has recently come under scrutiny from the government and media as potentially harmful to patients. Therefore, the objective of this systematic review and meta-analysis is to determine the safety of overlapping neurosurgical procedures. The authors performed a systematic review and meta-analysis in accordance with PRISMA guidelines. A review of PubMed and Medline databases was undertaken with the search phrase "overlapping surgery AND neurosurgery AND outcomes." Data regarding patient demographics, type of neurosurgical procedure, and outcomes and complications were extracted from each study. The principle summary measure was odds ratio (OR) of the association of overlapping versus non-overlapping surgery with outcomes. The literature search yielded a total of 36 studies, of which 5 studies met inclusion criteria and were included in this study. These studies included a total of 25,764 patients undergoing neurosurgical procedures. Overlapping surgery was associated with an increased likelihood of being discharged home (OR = 1.32; 95% CI 1.20 to 1.44; P < 0.001) and a reduced 30-day unexpected return to the operating room (OR = 0.79; 95% CI 0.72 to 0.87; P < 0.001). Overlapping surgery did not significantly affect OR of length of surgery, 30-day mortality, or 30-day readmission. Overlapping neurosurgical procedures were not associated with worse patient outcomes. Additional, prospective studies are needed to further assess the safety overlapping procedures. Copyright © 2018. Published by Elsevier Inc.

  8. Patient Safety and Quality Improvement in Otolaryngology Education: A Systematic Review.

    PubMed

    Gettelfinger, John D; Paulk, P Barrett; Schmalbach, Cecelia E

    2017-06-01

    Objective The breadth and depth of patient safety/quality improvement (PS/QI) research dedicated to otolaryngology-head and neck surgery (OHNS) education remains unknown. This systematic review aims to define this scope and to identify knowledge gaps as well as potential areas of future study to improved PS/QI education and training in OHNS. Data Sources A computerized Ovid/Medline database search was conducted (January 1, 1965, to May 15, 2015). Similar computerized searches were conducted using Cochrane Database, PubMed, and Google Scholar. Review Methods The study protocol was developed a priori using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles were classified by year, subspecialty, Institute of Medicine (IOM) Crossing the Chasm categories, and World Health Organization (WHO) subclass. Results Computerized searches yielded 8743 eligible articles, 267 (3.4%) of which met otolaryngology PS/QI inclusion criteria; 51 (19%) were dedicated to resident/fellow education and training. Simulation studies (39%) and performance/competency evaluation (23.5%) were the most common focus. Most projects involved general otolaryngology (47%), rhinology (18%), and otology (16%). Classification by the IOM included effective care (45%), safety/effective care (41%), and effective and efficient care (7.8%). Most research fell into the WHO category of "identifying solutions" (61%). Conclusion Nineteen percent of OHNS PS/QI articles are dedicated to education, the majority of which are simulation and focus on effective care. Knowledges gaps for future research include facial plastics PS/QI and the WHO category of "studies translating evidence into safer care."

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

    PubMed Central

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

    2012-01-01

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

  10. Efficacy and safety of biologic therapies for systemic lupus erythematosus treatment: systematic review and meta-analysis.

    PubMed

    Borba, Helena Hiemisch Lobo; Wiens, Astrid; de Souza, Thais Teles; Correr, Cassyano Januário; Pontarolo, Roberto

    2014-04-01

    The objectives of this study were to evaluate the efficacy, safety, and tolerability of biologic drugs compared with placebo for systemic lupus erythematosus (SLE) treatment. A systematic review evaluating the efficacy and safety of biologic therapies compared with placebo in adult SLE patients treatment was performed. Data from studies performed before September 2013 were collected from several databases (MEDLINE, Cochrane Library, SCIELO, Scopus, and International Pharmaceutical Abstracts). Study eligibility criteria included randomized, double-blind, placebo-controlled trials; regarding treatment with biologic agents in SLE adult patients; and published in English, German, Portuguese, and Spanish. Extracted data were statistically analyzed in a meta-analysis using the Review Manager (RevMan) 5.1 software. Efficacy outcomes included the SELENA-SLEDAI (Safety of Estrogens in Lupus Erythematosus National Assessment version of the SLE Disease Activity Index) score, the SRI (Systemic Lupus Erythematosus Responder Index), normalization of low C3 (<90 mg/dL), anti-double-stranded DNA positive to negative, and no new BILAG (British Isles Lupus Assessment Group index) 1A or 2B flares. Data on safety profile included adverse events, serious and severe adverse events, death, malignancy, infections, and infusion reactions. We also evaluated withdrawals from treatment due to lack of efficacy or adverse events. Thirteen randomized placebo-controlled trials met the criteria for data extraction for systematic review. A meta-analysis regarding the efficacy and safety of belimumab compared with placebo involving four of these trials was undertaken and the remainder contributed to a meta-analysis of the safety of biologic agents. In addition, two trials allowed the performance of a meta-analysis regarding the efficacy and safety of rituximab compared with placebo. Belimumab was more effective than placebo in most evaluated outcomes. No significant differences in the safety and

  11. Safety and efficacy of tinea pedis and onychomycosis treatment in people with diabetes: a systematic review

    PubMed Central

    2011-01-01

    Background Effective treatment of tinea pedis and onychomycosis is crucial for patients with diabetes as these infections may lead to foot ulcers and secondary bacterial infections resulting in eventual lower limb amputation. Although numerous studies have assessed the effectiveness of antifungal drug and treatment regimens, most exclude patients with diabetes and examine otherwise healthy individuals. While these studies are useful, results cannot necessarily be extrapolated to patients with diabetes. The purpose of this study was to therefore identify the best evidence-based treatment interventions for tinea pedis or onychomycosis in people with diabetes. Methods The question for this systemic review was: 'what evidence is there for the safety and/or efficacy of all treatment interventions for adults with tinea pedis and/or onychomycosis in people with diabetes'? A systematic literature search of four electronic databases (Scopus, EbscoHost, Ovid, Web of Science) was undertaken (6/1/11). The primary outcome measure for safety was self-reported adverse events likely to be drug-related, while the primary outcome measures assessed for 'efficacy' were mycological, clinical and complete cure. Results The systematic review identified six studies that examined the safety and/or efficacy of treatment interventions for onychomycosis in people with diabetes. No studies were identified that examined treatment for tinea pedis. Of the studies identified, two were randomised controlled trials (RCTs) and four were case series. Based on the best available evidence identified, it can be suggested that oral terbinafine is as safe and effective as oral itraconazole therapy for the treatment of onychomycosis in people with diabetes. However, efficacy results were found to be poor. Conclusions This review indicates that there is good evidence (Level II) to suggest oral terbinafine is as safe and effective as itraconazole therapy for the treatment of onychomycosis in people with

  12. US policies to enhance older driver safety: a systematic review of the literature.

    PubMed

    Dugan, Elizabeth; Barton, Kelli N; Coyle, Caitlin; Lee, Chae Man

    2013-01-01

    The purpose of this study was to conduct a systematic review of the literature related to state policies concerning older drivers and to draw policy conclusions about which policies appear to work to reduce older driver crashes and to identify areas needed for further research. Specific policies examined in this paper concern medical reporting and medical review, license renewal processes, and driver testing. A study was included in the systematic review if it met the following criteria: published in English between 1991and January 2013; included data on human subjects aged 65 and older residing in the United States; included information on at least one policy related to older drivers; and had a transportation-related outcome variable (e.g., crash, fatality, renewal). A total of 29 studies met inclusion criteria. Twenty-two studies investigated license renewal and seven articles examined medical reporting. In-person license renewal requirements were associated with reduced risk for fatal crashes. Restricted licenses were associated with reduced number of miles driven per week. More intensive renewal requirements and being the subject of a medical report to the licensing authority was associated with delicensure. Given the importance of driving to mobility, quality of life, and public safety, more research is needed.

  13. The efficacy and safety of herbal medicines used in the treatment of hyperlipidemia; a systematic review.

    PubMed

    Hasani-Ranjbar, Shirin; Nayebi, Neda; Moradi, Leila; Mehri, Avin; Larijani, Bagher; Abdollahi, Mohammad

    2010-01-01

    This review focuses on the efficacy and safety of effective herbal medicines in the management of hyperlipidemia in human. PubMed, Scopus, Google Scholar, Web of Science, and IranMedex databases were searched up to 11th May 2010. The search terms were "hyperlipidemia" and ("herbal medicine" or "medicine traditional", "extract plant") without narrowing or limiting search elements. All of the human studies on the effects of herbs with the key outcome of change in lipid profiles were included. Fifty three relevant clinical trials were reviewed for efficacy of plants. This study showed significant decrease in total cholesterol and LDL cholesterol after treatment with Daming capsule (DMC), chunghyul-dan, Glycyrrhiza glabra, garlic powder (Allicor), black tea, green tea, soy drink enriched with plant sterols, licorice, Satureja khuzestanica, Monascus purpureus Went rice, Fenugreek, Commiphora mukul (guggul), Achillea wilhelmsii C. Koch, Ningzhi capsule (NZC), cherry, compositie salviae dropping pill (CSDP), shanzha xiaozhi capsule, Ba-wei-wan (hachimijiogan), rhubarb stalk, Silybum marianum, Rheum Ribes and Jingmingdan granule (primrose oil). Conflicting data exist for red yeast rice, garlic and guggul. No significant adverse effect or mortality were observed except in studies with DMC, guggul, and Terminalia belerica, Terminalia chebula, Emblica officinalis, ginger, and garlic powder (Allium sativum). Amongst reviewed studies, 22 natural products were found effective in the treatment of hyperlipidemia that deserve further works to isolate and characterization of their constituents to reach novel therapeutic and more effective agents.

  14. A systematic literature review of the effectiveness of occupational health and safety regulatory enforcement.

    PubMed

    Tompa, Emile; Kalcevich, Christina; Foley, Michael; McLeod, Chris; Hogg-Johnson, Sheilah; Cullen, Kim; MacEachen, Ellen; Mahood, Quenby; Irvin, Emma

    2016-11-01

    We aimed to determine the strength of evidence on the effectiveness of legislative and regulatory policy levers in creating incentives for organizations to improve occupational health and safety processes and outcomes. A systematic review was undertaken to assess the strength of evidence on the effectiveness of specific policy levers using a "best-evidence" synthesis approach. A structured literature search identified 11,947 citations from 13 peer-reviewed literature databases. Forty-three studies were retained for synthesis. Strong evidence was identified for three out of nine clusters. There is strong evidence that several OHS policy levers are effective in terms of reducing injuries and/or increasing compliance with legislation. This study adds to the evidence on OHS regulatory effectiveness from an earlier review. In addition to new evidence supporting previous study findings, it included new categories of evidence-compliance as an outcome, nature of enforcement, awareness campaigns, and smoke-free workplace legislation. Am. J. Ind. Med. 59:919-933, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  15. PSR J2032+4127/MT91 213 on approach to periastron: X-ray & optical monitoring

    NASA Astrophysics Data System (ADS)

    Coe, M. J.; Steele, I. A.; Ho, W. C. G.; Stappers, B.; Lyne, A. G.; Halpern, J. P.; Ray, P. S.; Johnson, T. L.; Ng, C.-Y.; Kerr, M.

    2017-11-01

    Swift XRT monitoring of the 50 year binary system PSR J2032+4127/MT91 213 shows a dramatic decrease in the X-ray flux as the system is in the final stages of approach to periastron (13 November 2017).

  16. VizieR Online Data Catalog: PSR J1023+0038 & XSS J12270-4859 VRi polarimetry (Baglio+, 2016)

    NASA Astrophysics Data System (ADS)

    Baglio, M. C.; D'Avanzo, P.; Campana, S.; Coti Zelati, F.; Covino, S.; Russell, D. M.

    2016-05-01

    The systems PSR J1023+0038 and XSS J12270-4859 were observed in quiescence on 8 and 9 February 2015 (respectively) with the ESO New Technology Telescope (NTT) located at La Silla (Chile), equipped with the EFOSC2 camera in polarimetric mode, using the B, V, R, i filters. (6 data files).

  17. The High Time Resolution Universe Pulsar Survey - XIII. PSR J1757-1854, the most accelerated binary pulsar

    NASA Astrophysics Data System (ADS)

    Cameron, A. D.; Champion, D. J.; Kramer, M.; Bailes, M.; Barr, E. D.; Bassa, C. G.; Bhandari, S.; Bhat, N. D. R.; Burgay, M.; Burke-Spolaor, S.; Eatough, R. P.; Flynn, C. M. L.; Freire, P. C. C.; Jameson, A.; Johnston, S.; Karuppusamy, R.; Keith, M. J.; Levin, L.; Lorimer, D. R.; Lyne, A. G.; McLaughlin, M. A.; Ng, C.; Petroff, E.; Possenti, A.; Ridolfi, A.; Stappers, B. W.; van Straten, W.; Tauris, T. M.; Tiburzi, C.; Wex, N.

    2018-03-01

    We report the discovery of PSR J1757-1854, a 21.5-ms pulsar in a highly-eccentric, 4.4-h orbit with a neutron star (NS) companion. PSR J1757-1854 exhibits some of the most extreme relativistic parameters of any known pulsar, including the strongest relativistic effects due to gravitational-wave damping, with a merger time of 76 Myr. Following a 1.6-yr timing campaign, we have measured five post-Keplerian parameters, yielding the two component masses (mp = 1.3384(9) M⊙ and mc = 1.3946(9) M⊙) plus three tests of general relativity, which the theory passes. The larger mass of the NS companion provides important clues regarding the binary formation of PSR J1757-1854. With simulations suggesting 3-σ measurements of both the contribution of Lense-Thirring precession to the rate of change of the semimajor axis and the relativistic deformation of the orbit within ˜7-9 yr, PSR J1757-1854 stands out as a unique laboratory for new tests of gravitational theories.

  18. Index to Nuclear Safety. A technical progress review by chronology, permuted title, and author. Vol. 11, No. 1--Vol. 17, No. 6

    SciTech Connect

    Cottrell, W.B.; Klein, A.

    1977-02-23

    This index to Nuclear Safety covers articles in Nuclear Safety Vol. 11, No. 1 (Jan.-Feb. 1970), through Vol. 17, No. 6 (Nov.-Dec. 1976). The index includes a chronological list of articles (including abstract) followed by KWIC and Author Indexes. Nuclear Safety, a bimonthly technical progress review prepared by the Nuclear Safety Information Center, covers all safety aspects of nuclear power reactors and associated facilities. The index lists over 350 technical articles in the last six years of publication.

  19. Whole blood pathogen reduction technology and blood safety in sub-Saharan Africa: A systematic review with regional discussion

    PubMed Central

    Agbor, Gabriel; Asongalem, Emmanuel; Tagny, Claude; Asonganyi, Tazoacha

    2016-01-01

    Background Despite vast improvements in transfusion services in sub-Saharan Africa over the last decade, there remain serious concerns on the safety and adequacy of the blood supply across the region. Objective This review paper ascertains the role of pathogen reduction technology (PRT) in improving blood safety and supply adequacy in the region. Method The state of blood safety in sub-Saharan Africa was reviewed. Meetings, seminars and correspondence were undertaken with key clinicians, scientists and professional bodies in the region, including the World Health Organization’s Regional Office for Africa, to examine the suitability of PRT for improving the safety of whole blood transfusion, a prevalent transfusion format in the region. Results Existing literature suggests that combining PRT with current blood safety measures (such as serology) would improve the safety and adequacy of the blood supply for transfusions in sub-Saharan Africa. This was echoed by the findings of the stakeholder meetings. Conclusion Following a detailed appraisal of two leading PRT systems, the Mirasol® PRT System and the Cerus S-303 System, we suggest that companies conduct comprehensive toxicological evaluation of the agents used for PRT and publish this in the scientific literature. We also recommend that the safety and efficacy of these technologies should be established in a randomised clinical trial conducted in sub-Saharan Africa. PMID:28879109

  20. Safety of Tamsulosin: A Systematic Review of Randomized Trials with a Focus on Women and Children.

    PubMed

    Kaplan, Steven A; Chughtai, Bilal I

    2018-05-08

    Although tamsulosin is indicated for the treatment of the signs and symptoms of benign prostatic hyperplasia (BPH), it has also been assessed in clinical studies for other conditions/symptoms and in other populations such as women and children. In this systematic review of randomized studies, the overall safety of tamsulosin was assessed, focusing on these understudied populations. Literature searches were conducted using Embase, Medline, and PubMed (inception-December 2015). A study was included if patients were randomized to receive treatment with any dose of tamsulosin capsules, tablets, or an oral controlled absorption system and numerical safety results were reported. Overall, 160 articles involving 46,072 participants met the inclusion criteria. Of these, four studies included women only and three included children. The mean [standard deviation (SD)] age ranged from 7.3 (4.2) to 76.8 (7.1) years. The studies (n; %) evaluated healthy subjects (18; 11%) or patients with lower urinary tract symptoms/BPH (90; 56%), ureteral stones/renal colic (42; 26%), prostatitis (4; 3%), or other conditions (6; 4%). Patients discontinued tamsulosin primarily because of adverse events (AEs) or insufficient response. AEs in women and children were abdominal pain, asthenia, constipation, dizziness, dry mouth, drowsiness, dyspepsia, headache, incontinence, nasal congestion, nausea, orthostatic hypotension, and somnolence. Due to heterogeneity across studies, statistical analysis could not be conducted. No unexpected AEs were observed in an all-comers population treated with tamsulosin for various conditions/symptoms. The overall safety profile in women and children seemed to be generally consistent with the profile in men, the indicated population.

  1. Biological Response Modifiers in Rheumatoid Arthritis: Systematic Review and Meta-analysis of Safety

    PubMed Central

    Tank, Nitishkumar D.; Karelia, Bharti N.; Vegada, Bhavisha N.

    2017-01-01

    Objective: To analyze available evidence on the safety of different biological response modifiers which are used for a treatment of rheumatoid arthritis (RA). Materials and Methods: We searched systematically for randomized controlled clinical trials on treatment of RA with different biological response modifiers, followed by a systematic review with meta-analysis. Trials were searched from MEDLINE and Cochrane Library databases. The following safety parameters reported in the selected trials were analyzed: number of patients suffering any adverse event (AE), withdrawal due to AEs, serious AE (SAEs), infections, serious infections, infusion reactions, injection site reactions, malignancies, and overall mortality. Undesired effects were estimated using combined relative risks (RR) and number needed to harm (NNH). Heterogeneity was evaluated by Cochrane's Q and I2 statistics. Results: According to inclusion criteria, a total of 43 trials (20,504 patients) were included in this study. A total number of AEs were found more with abatacept (RR: 1.05, NNH: 21.93). Withdrawal due to AEs was found with all biologicals, highest with anakinra (RR: 3.48, NNH: 15.70). Patients receiving newer tumor necrosis factor-alpha inhibitors, golimumab, were more likely to develop SAEs (RR: 2.44, NNH: 12.72) and infection (RR: 1.25, NNH: 10.09), and in certolizumab, serious infections (RR: 2.95, NNH: 37.31) were found more. Infusion reaction develops more with rituximab (RR: 1.52, NNH: 8.47). Etanercept showed the highest risk to develop infusion site reaction (RR: 5.33, NNH: 4.65). Biologicals showed no difference to their control counterparts in malignancy and mortality risk. Conclusion: This meta-analysis helps to clarify some frequently encountered and unanswered safety questions of different biological response modifiers, a new class of drugs, in the clinical care of RA patients. PMID:29081616

  2. Systematic review: the safety of vedolizumab for the treatment of inflammatory bowel disease.

    PubMed

    Bye, W A; Jairath, V; Travis, S P L

    2017-07-01

    Vedolizumab specifically recognises the α4β7 integrin and selectively blocks gut lymphocyte trafficking: potentially, it offers gut-specific immunosuppression. To review the safety of vedolizumab and summarise post-marketing data to assess if any safety concerns that differ from registration trials have emerged. A systematic bibliographic search identified six registration trials and nine cohort studies. Integrated data from registration trials included 2830 vedolizumab-exposed patients (4811 person-years exposure [PYs]) and 513 placebo patients. This reported lower exposure-adjusted incidence rates of infection (63.5/100 PYs; 95% CI: 59.6-67.3) and serious adverse events (20.0/100 PYs; 95% CI: 18.5-21.5) compared to placebo (82.9/100 PYs; 95% CI: 68.3-97.5) and (28.3/100 PYs 95% CI: 20.6-35.9) respectively. Higher, but statistically insignificant rates of enteric infections occurred in vedolizumab-exposed patients (7.4/100 PYs; 95% CI: 6.6-8.3) compared to placebo (6.7 PYs; 95% CI: 3.2-10.1). Six post-marketing cohort studies (1049 patients, 403 PYs) demonstrated rates of infection of 8% (82/1049); enteric infection of 2% (21/1049) and adverse events of 16% (166/1049). Multivariate analysis in one cohort study suggested increased risk of surgical site infection with perioperative VDZ. Human experience in pregnancy is limited. Post-marketing data confirm the excellent safety of vedolizumab observed in registration trials. The signal of post-operative complications should be interpreted with caution, but warrants further study. Although comparative studies are needed, Vedolizumab may be a safe alternative in patients who best avoid systematic immunosuppression, including those pre-disposed to infection, malignancy or the elderly. © 2017 John Wiley & Sons Ltd.

  3. Review article: safety aspects of anesthesia in under-resourced locations.

    PubMed

    Enright, Angela

    2013-02-01

    Improving patient safety during anesthesia and surgery is the focus of much effort worldwide. Major advances have occurred since the 1980s, especially in economically advantaged areas. This paper is a review of some of the challenges that face those who work in resource-poor areas of the world. There is a shortage of trained anesthesia providers, both physician and non-physician, and this is particularly acute outside urban areas. Anesthesia is still sometimes delivered by unqualified people, which results in expected high rates of morbidity and mortality. Residency training programs in low-income countries ought to increase their output as anesthesiologists must be available to supervise non-physician providers. All groups require continuing medical education. In addition, increased efforts are needed to recruit trainees into the specialty of anesthesia and to retain them locally. There is a well-recognized shortage of resources for anesthesia. Consequently, concerted efforts are necessary to ensure reliable supplies of drugs, and attention should be paid to the procurement of anesthesia equipment appropriate for the location. Biomedical support must also be developed. Lifebox is a charitable foundation dedicated to supplying pulse oximeters to low- and middle-income countries. Adoption of the World Health Organization's Surgical Safety Checklist could further reduce morbidity and mortality. Much time, effort, planning, and resources are required to ensure that anesthesia in low-income areas can reach internationally accepted standards. Such investment in anesthesia would result in wider access to surgical and obstetrical care, and the quality and safety of that care would be much improved.

  4. Implementing technology to improve medication safety in healthcare facilities: a literature review.

    PubMed

    Hidle, Unn

    Medication errors remain one of the most common causes of patient injuries in the United States, with detrimental outcomes including adverse reactions and even death. By developing a better understanding of why and how medication errors occur, preventative measures may be implemented including technological advances. In this literature review, potential methods of reducing medication errors were explored. Furthermore, technology tools available for medication orders and administration are described, including advantages and disadvantages of each system. It was found that technology can be an excellent aid in improving safety of medication administration. However, computer technology cannot replace human intellect and intuition. Nurses should be involved when implementing any new computerized system in order to obtain the most appropriate and user-friendly structure.

  5. CYD-TDV dengue vaccine: systematic review and meta-analysis of efficacy, immunogenicity and safety.

    PubMed

    Godói, Isabella Piassi; Lemos, Livia Lovato Pires; de Araújo, Vânia Eloisa; Bonoto, Braúlio Cesar; Godman, Brian; Guerra Júnior, Augusto Afonso

    2017-03-01

    Dengue virus (DENV) is a serious global health problem. CYD-TDC (Dengvaxia ® ) was the first vaccine to gain regulatory approval to try and address this problem. Summarize all available evidence on the immunogenicity, efficacy and safety of the CYD-TDV dengue vaccine. Meta-analysis and systematic review. The best and worst immunogenicity results were for DENV4 and DENV1, respectively. Vaccine efficacy of 60% was derived from studies with participants aged 2-16 years old, with DENV4 and DENV2 presenting the best and worst results, respectively. Erythema and swelling were more frequent with CYD-TDV. No differences were detected for systemic adverse events. CYD-TDV showed moderate efficacy in children and adolescents. From the immunogenicity results in adults, we can expect satisfactory efficacy from vaccination in this population.

  6. Efficacy and Safety of Medicinal Plants or Related Natural Products for Fibromyalgia: A Systematic Review

    PubMed Central

    de Souza Nascimento, Simone; DeSantana, Josimari Melo; Ribeiro, Êurica Adélia Nogueira; da Silva, Daniel Lira; Araújo-Júnior, João Xavier; da Silva Almeida, Jackson Roberto Guedes; Bonjardim, Leonardo Rigoldi; de Souza Araújo, Adriano Antunes; Quintans-Júnior, Lucindo José

    2013-01-01

    To assess the effects of medicinal plants (MPs) or related natural products (RNPs) on fibromyalgia (FM) patients, we evaluate the possible benefits and advantages of MP or RNP for the treatment of FM based on eight randomized placebo-controlled trials (RCTs) involving 475 patients. The methodological quality of all studies included was determined according to JADAD and “Risk of Bias” with the criteria in the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. Evidence suggests significant benefits of MP or RNP in sleep disruption, pain, depression, joint stiffness, anxiety, physical function, and quality of life. Our results demonstrated that MP or RNP had significant effects on improving the symptoms of FM compared to conventional drug or placebo; longer tests are required to determine the duration of the treatment and characterize the long-term safety of using MP, thus suggesting effective alternative therapies in the treatment of pain with minimized side effects. PMID:23861696

  7. The safety review and approval process for space nuclear power sources

    SciTech Connect

    Bennett, G.L.

    1991-01-01

    Over the past 30 yr. the U.S. Government has evolved a process for the safety review and launch approval of nuclear power sources (NPSs) proposed for launch into space. This process, which involves a number of governmental agencies, ensures that the various postulated accident scenarios are considered, that the responses of the NPSs to the accident environments are assessed, and that appropriate elements of the Federal Government are involved in the launch approval. This process has worked very well in the successful launches of 37 radioisotope thermoelectric generators and 1 reactor by the United States since 1961. Particular attention willmore » be focused on the recent launch of the Galileo spacecraft. 19 refs., 12 figs., 4 tabs.« less

  8. Trespassing on the tracks: a review of railway pedestrian safety research.

    PubMed

    Lobb, Brenda

    2006-01-01

    Train-pedestrian collisions have been shown to be the leading cause of fatality in train-related accidents worldwide, yet there is remarkably little research in this area. In this paper, the major types of railway transportation accident research are briefly highlighted to indicate the general context of research concerning train-pedestrian collisions, which are then reviewed. Themes emerging from the diverse research are identified, the various strategies that have been proposed for prevention of railway pedestrian accidents are discussed, and the empirical evidence for their efficacy examined in the light of the much more extensive literature on road pedestrian accidents. Finally, it is proposed that application of current theory in behavioral and cognitive psychology may usefully inform future research in transportation safety.

  9. Efficacy and Safety of Tranexamic Acid in Melasma: A Meta-analysis and Systematic Review.

    PubMed

    Kim, Hyun Jung; Moon, Seok Hoon; Cho, Sang Hyun; Lee, Jeong Deuk; Kim, Hei Sung

    2017-07-06

    Tranexamic acid is a novel treatment option for melasma; however, there is no consensus on its use. This systematic review searched major databases for relevant publications to March 2016. Eleven studies with 667 participants were included. Pooled data from tranexamic acid-only observational studies with pre- and post-treatment Melasma Area and Severity Index (MASI) showed a decrease of 1.60 in MASI (95% confidence interval (CI), 1.20-2.00; p<0.001) after treat-ment with tranexamic acid. The addition of tranexamic acid to routine treatment modalities resulted in a further decrease in MASI of 0.94 (95% CI 0.10-1.79; p = 0.03). Side-effects were minor, with a few cases reporting hypo-menorrhoea, mild abdominal discomfort, and transient skin irritation. These results support the efficacy and safety of tranexamic acid, either alone or as an adjuvant to routine treatment modalities for melasma.

  10. Efficacy and safety of herbal medicines in treating gastric ulcer: A review

    PubMed Central

    Bi, Wei-Ping; Man, Hui-Bin; Man, Mao-Qiang

    2014-01-01

    Gastric ulcer is a common disorder of the digestive system. Current therapeutic regimens largely rely on Western medicine. However, numerous studies have demonstrated that herbal medicines can effectively treat gastric ulcer in humans and various animal models via divergent mechanisms. This review updates the efficacy and safety of herbal medicines in treating gastric ulcer, and the mechanisms of their action in humans and animal models. Studies have demonstrated that the efficacy of herbal medicines is comparable or superior to that of drugs such as omeprazole or cimetidine in humans and animal models, and herbal medicines display fewer adverse effects. The mechanisms by which herbal medicines benefit gastric ulcer include stimulation of mucous cell proliferation, anti-oxidation, and inhibition of gastric acid secretion and H(+)/K(+)-ATPase activity. Some herbal medicines also exhibit antimicrobial properties. Utilization of herbal medicines could be a valuable alternative to treat gastric ulcer in humans effectively, with few adverse effects. PMID:25493014

  11. Botanical medicine and cancer: a review of the safety and efficacy.

    PubMed

    Boon, Heather; Wong, Jacqueline

    2004-12-01

    It is currently estimated that > 50% of all patients diagnosed with cancer explore complementary and alternative medicine - especially herbal medicine. We conducted a comprehensive review to assess the safety and efficacy of herbal medicines commonly used by patients in an attempt to: prevent cancer; treat cancer; and treat adverse effects associated with conventional cancer treatments. Current evidence suggests that Asian ginseng, garlic, green tea, tomatoes and soy intake as part of the diet may be useful in preventing various cancers; additional research is needed in order to determine the efficacy of essiac, evening primrose oil, mistletoe, reishi, shiitake and turmeric as cancer treatments; and ginger may be effective in treating chemotherapy-induced nausea and vomiting.

  12. Efficacy and safety of herbal medicines in treating gastric ulcer: a review.

    PubMed

    Bi, Wei-Ping; Man, Hui-Bin; Man, Mao-Qiang

    2014-12-07

    Gastric ulcer is a common disorder of the digestive system. Current therapeutic regimens largely rely on Western medicine. However, numerous studies have demonstrated that herbal medicines can effectively treat gastric ulcer in humans and various animal models via divergent mechanisms. This review updates the efficacy and safety of herbal medicines in treating gastric ulcer, and the mechanisms of their action in humans and animal models. Studies have demonstrated that the efficacy of herbal medicines is comparable or superior to that of drugs such as omeprazole or cimetidine in humans and animal models, and herbal medicines display fewer adverse effects. The mechanisms by which herbal medicines benefit gastric ulcer include stimulation of mucous cell proliferation, anti-oxidation, and inhibition of gastric acid secretion and H(+)/K(+)-ATPase activity. Some herbal medicines also exhibit antimicrobial properties. Utilization of herbal medicines could be a valuable alternative to treat gastric ulcer in humans effectively, with few adverse effects.

  13. A review of the iStent® trabecular micro-bypass stent: safety and efficacy

    PubMed Central

    Wellik, Sarah R; Dale, Elizabeth A

    2015-01-01

    There is a significant demand for procedures that can effectively treat glaucoma with low risk and good visual outcomes. To fill this void, procedures termed “minimally invasive glaucoma surgery”, are gaining in popularity. This review will focus on the safety and efficacy of one such minimally invasive glaucoma surgery procedure, the trabecular micro-bypass stent. This stent is intended to lower intraocular pressure by directly cannulating Schlemm’s canal and thereby enhancing aqueous outflow. Recent randomized controlled trials and case series have demonstrated the micro-bypass stent to be a relatively safe procedure, with limited complications and no serious adverse sequelae. The most common complication across all studies was stent obstruction or malposition, which generally did not result in any adverse outcome in vision or pressure control. In addition, increased rates of hypotony, choroidal hemorrhage, or infection were not seen with the micro-bypass stent in comparison to cataract surgery alone. PMID:25931808

  14. Review article: the role of practice guidelines and evidence-based medicine in perioperative patient safety.

    PubMed

    Crosby, Edward

    2013-02-01

    The purpose of this narrative review is to discuss the impact of clinical practice guidelines on the outcomes of care and patient safety. The care provided to patients has a high degree of variability, including some care that is discordant with available evidence. This inconsistency has implications for patient safety as some patients receive care that is unlikely beneficial yet may be harmful, while others are denied care that would clearly be helpful. The medical literature is expanding at an alarming rate; its quality and reliability is often poor; study methodology is frequently suboptimal, and reversal is common, even among frequently cited articles. For decades, specialty societies and other agencies have been providing clinical practice guidelines to assist physicians with the integration of evidence into clinical decision-making. Implementation of guidelines has been variable, and their goals are often not achieved due to failed uptake and application. The reasons for this shortcoming are complex and some explanations are valid. Many guidelines have not been evidence-based and many have been methodologically unsound. Physician autonomy likely also plays an important role in guideline uptake; an updated concept of autonomy that embraces appropriate guidelines is long overdue. Under certain conditions, guidelines can add value to care and improve outcomes; they need to be evidence-based, methodologically sound, and appropriately applied to patients and clinical scenarios. Simply summarizing evidence in a guideline is an inadequate process. To achieve the benefit of guidelines, implementation strategies need to be robust.

  15. Systematic review of the prevention incentives of insurance and regulatory mechanisms for occupational health and safety.

    PubMed

    Tompa, Emile; Trevithick, Scott; McLeod, Chris

    2007-04-01

    The objective of this study was to determine the strength of evidence on the effectiveness of two policy levers-the experience rating of workers' compensation insurance and the enforcement of occupational health and safety regulation-in creating incentives for firms to focus on health and safety issues. An extensive systematic literature review was undertaken in an effort to capture both published and grey literature studies on the topic. Studies that met specific subject-matter and methods criteria underwent a quality assessment. A qualitative approach to evidence synthesis, known as "best-evidence" synthesis, was used. This method ranks the strength of evidence on a particular topic on the basis of the number, quality, and consistency of studies on the topic. There was moderate evidence that the degree of experience rating reduces injuries, limited to mixed evidence that inspections offer general and specific deterrence and that citations and penalties aid general deterrence, and strong evidence that actual citations and penalties reduce injuries. Although experience rating is a key policy lever of those providing workers' compensation insurance, there is much to be learned about its merits. Few studies have concerned the topic, and most have used crude proxy measures or exploited natural experiments. There have been many more studies on the merits of regulation enforcement, even though here too measures were often crude. Nonetheless, this synthesis indicates that general deterrence is less effective in reducing injury incidence and severity, whereas specific deterrence with regard to citations and penalties does indeed have an impact.

  16. Cleaning and asthma: A systematic review and approach for effective safety assessment.

    PubMed

    Vincent, Melissa J; Parker, Ann; Maier, Andrew

    2017-11-01

    Research indicates a correlative relationship between asthma and use of consumer cleaning products. We conduct a systematic review of epidemiological literature on persons who use or are exposed to cleaning products, both in occupational and domestic settings, and risk of asthma or asthma-like symptoms to improve understanding of the causal relationship between exposure and asthma. A scoring method for assessing study reliability is presented. Although research indicates an association between asthma and the use of cleaning products, no study robustly investigates exposure to cleaning products or ingredients along with asthma risk. This limits determination of causal relationships between asthma and specific products or ingredients in chemical safety assessment. These limitations, and a lack of robust animal models for toxicological assessment of asthma, create the need for a weight-of-evidence (WoE) approach to examine an ingredient or product's asthmatic potential. This proposed WoE method organizes diverse lines of data (i.e., asthma, sensitization, and irritation information) through a systematic, hierarchical framework that provides qualitatively categorized conclusions using hazard bands to predict a specific product or ingredient's potential for asthma induction. This work provides a method for prioritizing chemicals as a first step for quantitative and scenario-specific safety assessments based on their potential for inducing asthmatic effects. Acetic acid is used as a case study to test this framework. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  17. Shelf life and safety concerns of bakery products--a review.

    PubMed

    Smith, James P; Daifas, Daphne Phillips; El-Khoury, Wassim; Koukoutsis, John; El-Khoury, Anis

    2004-01-01

    Bakery products are an important part of a balanced diet and, today, a wide variety of such products can be found on supermarket shelves. This includes unsweetened goods (bread, rolls, buns, crumpets, muffins and bagels), sweet goods (pancakes, doughnuts, waffles and cookies) and filled goods (fruit and meat pies, sausage rolls, pastries, sandwiches, cream cakes, pizza and quiche). However, bakery products, like many processed foods, are subject to physical, chemical and microbiological spoilage. While physical and chemical spoilage limits the shelf life of low and intermediate moisture bakery products, microbiological spoilage by bacteria, yeast and molds is the concern in high moisture products i.e., products with a water activity (a(w)) > 0.85. Furthermore, several bakery products also have been implicated infoodborne illnesses involving Salmonella spp., Listeria monoctyogenes and Bacillus cereus, while Clostridium botulinum is a concern in high moisture bakery products packaged under modified atmospheres. This extensive review is divided into two parts. Part I focuses on the spoilage concerns of low, intermediate and high moisture bakery products while Part II focuses on the safety concerns of high moisture bakery products only. In both parts, traditional and novel methods of food preservation that can be used by the bakery industry to extend the shelf life and enhance the safety of products are discussed in detail.

  18. Safety of therapeutic methylphenidate in adults: a systematic review of the evidence.

    PubMed

    Godfrey, J

    2009-03-01

    Attention deficit hyperactivity disorder (ADHD) often persists into adulthood. Stimulant drugs, including methylphenidate, have showed efficacy in trials for ADHD in adults. Adult psychiatrists are likely to encounter increasing numbers of adult patients who may benefit from methylphenidate. A systematic review of the literature was made to examine the evidence on the safety of methylphenidate, when used therapeutically in adults. Twenty-six placebo-controlled trials were found, in which 811 adults received methylphenidate for ADHD and other conditions. In the short term, methylphenidate was well tolerated and no serious side effects were observed. There is little information on the long-term safety of methylphenidate in adults, although the number of serious adverse effects reported to regulatory authorities has, so far, been low. Methylphenidate is associated with a modest rise in blood pressure and heart rate. Surveys of stimulant use in US universities show that misuse of prescribed medication, for recreation or to enhance study, is fairly common although the level of harm that arises from this practice is unclear.

  19. Efficacy and safety of ketamine in bipolar depression: A systematic review.

    PubMed

    Alberich, Susana; Martínez-Cengotitabengoa, Mónica; López, Purificación; Zorrilla, Iñaki; Núñez, Nuria; Vieta, Eduard; González-Pinto, Ana

    The depression is the most prevalent state throughout the life of the bipolar patient. Ketamine has been shown to be an effective and rapid treatment for depression. The objective of the present work is to perform a systematic review on the efficacy and safety of ketamine as treatment of bipolar depression, as well as its different patterns of administration. The search found 10 relevant manuscripts that met the inclusion criteria: one clinical trial, 5 cohort studies, and 4 case reports. Intravenous infusion was used in 60% of the studies. According to data, ketamine seems to be an effective and safe treatment for bipolar depression, although the length of its effect is short. Adverse effects observed generally occurred at the time of infusion, and tended to completely disappear within 1-2h. Therefore, more studies are necessary to explore new patterns of administration, as well as on its safety and adverse effects. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. A systematic review of the safety of kava extract in the treatment of anxiety.

    PubMed

    Stevinson, Clare; Huntley, Alyson; Ernst, Edzard

    2002-01-01

    This paper systematically reviews the clinical evidence relating to the safety of extracts of the herbal anxiolytic kava (Piper methysticum). Literature searches were conducted in four electronic databases and the reference lists of all papers located were checked for further relevant publications. Information was also sought from the spontaneous reporting schemes of the WHO and national drug safety bodies and ten manufacturers of kava preparations were contacted. Data from short-term post-marketing surveillance studies and clinical trials suggest that adverse events are, in general, rare, mild and reversible. However, published case reports indicate that serious adverse events are possible including dermatological reactions, neurological complications and, of greatest concern, liver damage. Spontaneous reporting schemes also suggest that the most common adverse events are mild, but that serious ones occur. Controlled trials suggest that kava extracts do not impair cognitive performance and vigilance or potentiate the effects of central nervous system depressants. However, a possible interaction with benzodiazepines has been reported. It is concluded that when taken as a short-term monotherapy at recommended doses, kava extracts appear to be well tolerated by most users. Serious adverse events have been reported and further research is required to determine the nature and frequency of such events.

  1. The effectiveness and safety of Iranian herbal medicines for treatment of premenstrual syndrome: A systematic review

    PubMed Central

    Maleki-Saghooni, Nahid; Karimi, Fatemeh Zahra; Behboodi Moghadam, Zahra; Mirzaii Najmabadi, Khadigeh

    2018-01-01

    Objective: Premenstrual syndrome (PMS) is one of the most common problems among women of reproductive age. The popularity of complementary/alternative therapies has grown in recent years, and these treatments have been more commonly used by women (48.9%) than men (37.8%). The aim of this systematic review was to assess effectiveness and safety of Iranian herbal medicines for treatment of premenstrual syndrome. Methods: PubMed, Scopus, Cochrane, and Google Scholar were searched along with SID, Magiran and Irandoc up to Dec 2017. Inclusion criteria consist of Iranian, published, randomized controlled trials (RCTs) using Iranian herbal medicine for treatment of reproductive age women with PMS. Eventually Eighteen RCTs met the inclusion criteria. Results: Overall, studies have shown that Vitex agnuscastus, Hypericum perforatum, Matricaria chamomilla, saffron, Curcumin, Melissa officinalis, Zataria multiflora, Wheat Germ Extract, Echinophora platyloba, Foeniculum vulgare, Valerian root extract, Citrus sinensis, Zingiber officinale and Flax seed might alleviate symptoms of PMS. Conclusion: This research demonstrated efficacy and safety of Iranian herbal medicines in alleviating PMS. Therefore, herbal medicine can be regarded as an alternative treatment for women suffering from PMS. PMID:29632841

  2. Systematic review of reusable versus disposable laparoscopic instruments: costs and safety.

    PubMed

    Siu, Joey; Hill, Andrew G; MacCormick, Andrew D

    2017-01-01

    The quality of instruments and surgical expertise in minimally invasive surgery has developed markedly in the last two decades. Attention is now being turned to ways to allow surgeons to adopt more cost-effective and environmental-friendly approaches. This review explores current evidence on the cost and environmental impact of reusable versus single-use instruments. In addition, we aim to compare their quality, functionality and associated clinical outcomes. The Medline and EMBASE databases were searched for relevant literature from January 2000 to May 2015. Subject headings were Equipment Reuse/, Disposable Equipment/, Cholecystectomy/, Laparoscopic/, Laparoscopy/, Surgical Instruments/, Medical Waste Disposal/, Waste Management/, Medical Waste/, Environmental Sustainability/ and Sterilization/. There are few objective comparative analyses between single-use versus reusable instruments. Current evidence suggests that limiting use of disposal instruments to necessity may hold both economical and environmental advantages. Theoretical advantages of single-use instruments in quality, safety, sterility, ease of use and importantly patient outcomes have rarely been examined. Cost-saving methods, environmental-friendly methods, global operative costs, hidden costs, sterilization methods and quality assurance systems vary greatly between studies making it difficult to gain an overview of the comparison between single-use and reusable instruments. Further examination of cost comparisons between disposable and reusable instruments is necessary while externalized environmental costs, instrument function and safety are also important to consider in future studies. © 2016 Royal Australasian College of Surgeons.

  3. Efficacy and safety of local steroids for urethra strictures: a systematic review and meta-analysis.

    PubMed

    Zhang, Kaile; Qi, Er; Zhang, Yumeng; Sa, Yinglong; Fu, Qiang

    2014-08-01

    Local steroids have been used as an adjuvant therapy to patients undergoing internal urethrotomy (IU) in treating urethral strictures. Whether this technique is effective and safe is still controversial. The aim of this study is to determine the efficacy and safety of local steroids as applied with the IU procedure. A systematic review of the literature was performed by searching Medline, Embase, Cochrane Library Databases, and the Web of Science. We included only prospective randomized, controlled trials that compared the efficacy and safety between IU procedures with applied local steroids and those without. Eight studies were found eligible for further analysis. In total, 203 patients undergoing IU were treated with steroid injection or catheter lubrication. Time to recurrence is statistically significant (mean: 10.14 and 5.07 months, P<0.00001).The number of patients with recurrent stricture formation significantly decreased at different follow-up time points (P=0.05).No statistically significant differences were found between the recurrence rates, adverse effects, and success rates of second IUs in patients with applied local steroids and those without. The use of local steroids with IU seems to prolong time to stricture recurrence but does not seem to affect the high stricture recurrence rate following IU. When local steroids are applied with complementary intention, the disease control outcomes are encouraging. Further robust comparative effectiveness studies are now required.

  4. A review of the efficacy and safety of oral antidiabetic drugs

    PubMed Central

    Stein, Stephanie Aleskow; Lamos, Elizabeth Mary; Davis, Stephen N

    2014-01-01

    Introduction Additional oral antidiabetic agents to metformin, sulfonylureas (SU) and thiazolidinediones (TZD) are approved for the treatment of type 2 diabetes. Areas covered The efficacy and safety of metformin, SUs, TZDs, dipeptidyl peptidase-IV (DPP-4) inhibitors, meglitinide analogs, α-glucosidase inhibitors (AGIs), bile-acid sequestrants (BAS) and bromocriptine will be reviewed. Expert opinion Several new oral agents have been approved for type 2 diabetes management in recent years. It is important to understand the efficacy and safety of these medications in addition to the older agents to best maximize oral drug therapy for diabetes. Of the recently introduced oral hypoglycemic/antihyperglycemic agents, the DPP-4 inhibitors are moderately efficacious compared with mainstay treatment with metformin with a low side-effect profile and have good efficacy in combination with other oral agents and insulin. They are a recommended alternative when metformin use is limited by gastrointestinal (GI) side effects or when SU treatment results in significant hypoglycemia or weight gain. Meglitinide analogs are limited by their frequent dosing, expense and hypoglycemia (repaglinide > nateglinide), while AGIs are also limited by their dosing schedule and GI side-effect profile. BAS and bromocriptine have the lowest efficacy with regard to HbA1c reduction, also are plagued by GI adverse reactions, but have a low risk of hypoglycemia. PMID:23241069

  5. Applications of hyperspectral imaging in chicken meat safety and quality detection and evaluation: a review.

    PubMed

    Xiong, Zhenjie; Xie, Anguo; Sun, Da-Wen; Zeng, Xin-An; Liu, Dan

    2015-01-01

    Currently, the issue of food safety and quality is a great public concern. In order to satisfy the demands of consumers and obtain superior food qualities, non-destructive and fast methods are required for quality evaluation. As one of these methods, hyperspectral imaging (HSI) technique has emerged as a smart and promising analytical tool for quality evaluation purposes and has attracted much interest in non-destructive analysis of different food products. With the main advantage of combining both spectroscopy technique and imaging technique, HSI technique shows a convinced attitude to detect and evaluate chicken meat quality objectively. Moreover, developing a quality evaluation system based on HSI technology would bring economic benefits to the chicken meat industry. Therefore, in recent years, many studies have been conducted on using HSI technology for the safety and quality detection and evaluation of chicken meat. The aim of this review is thus to give a detailed overview about HSI and focus on the recently developed methods exerted in HSI technology developed for microbiological spoilage detection and quality classification of chicken meat. Moreover, the usefulness of HSI technique for detecting fecal contamination and bone fragments of chicken carcasses are presented. Finally, some viewpoints on its future research and applicability in the modern poultry industry are proposed.

  6. Early Botulinum Toxin Injections in Infants With Musculoskeletal Disorders: A Systematic Review of Safety and Effectiveness.

    PubMed

    Bourseul, Jean-Sébastien; Molina, Anais; Lintanf, Mael; Houx, Laetitia; Chaléat-Valayer, Emmanuelle; Pons, Christelle; Brochard, Sylvain

    2018-06-01

    To report current evidence regarding the safety of intramuscular botulinum toxin injection (BTI) in children with orthopedic- and neurologic-related musculoskeletal disorders >2 years of age. PubMed, Cochrane Library, and ScienceDirect, Google Scholar, and Web of Science. Two reviewers independently selected studies based on predetermined inclusion criteria. Data relating to the aim were extracted. Methodologic quality was graded independently by 2 reviewers using the Physiotherapy Evidence Database scale for randomized controlled trials (RCTs) and the Downs and Black evaluation tool for non-RCTs. Level of evidence was determined using the modified Sackett scale. Data of 473 infants were analyzed. Fifty-five infants had cerebral palsy, 112 had obstetric brachial plexus palsy, 257 had clubfoot, and 44 had congenital torticollis. No studies reported any severe adverse event that could be attributed to the BTI. The rate of mild to moderate adverse events reported varied from 5% to 25%. Results regarding efficacy were preliminary, dependent on the pathology, and limited by the small number of studies and their low levels of evidence. BTI is already widely used as an early treatment for this age group. The safety profile of BTI in infants appears similar to that of older children and risks appear more related to the severity of the pathology and the location of the injections than to the toxin itself. Regarding effectiveness, other studies with higher levels of evidence should be carried out for each specific pathology. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  7. The safety of urban cycle tracks: a review of the literature.

    PubMed

    Thomas, Beth; DeRobertis, Michelle

    2013-03-01

    Cycling has to be a safe activity, and perceived as such, if bicycle trips by all populations are to increase and the public health benefits are to be realized. A key characteristic of developed countries with a high cycling mode share is their provision of cycle tracks--separated bikeways along city streets--on major routes. This literature review therefore sought to examine studies of cycle tracks from different countries in order elucidate the safety of these facilities relative to cycling in the street and to point to areas where further research is needed. The review indicates that one-way cycle tracks are generally safer at intersections than two-way and that, when effective intersection treatments are employed, constructing cycle tracks on busy streets reduces collisions and injuries. The evidence also suggests that, when controlling for exposure and including all collision types, building one-way cycle tracks reduces injury severity even when such intersection treatments are not employed. However, the extent of this effect has not been well examined, as very few studies both look at severity and control for exposure. Future studies of the safety of cycle tracks and associated intersection treatments should focus foremost on examining injury severity, while controlling for exposure. In the U.S., where the obesity epidemic and its health consequences and costs are well documented, the benefits of increased cycling should be a focus of research and policy development in order to provide the infrastructure needed to attract people to cycling while minimizing injuries. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. COMPARATIVE EFFECTIVENESS AND SAFETY BETWEEN AMPHOTERICIN B LIPID-FORMULATIONS: A SYSTEMATIC REVIEW.

    PubMed

    Grazziotin, Luiza Raquel; Moreira, Leila Beltrami; Ferreira, Maria Angelica Pires

    2018-06-13

    It is not yet established the advantages between amphotericin B lipid complex (ABLC) and liposomal (L-AmB) in patients with invasive fungal infections refractory to usual doses of conventional AmB (d-AmB), previous renal impairment, or unacceptable d-AmB renal toxicity. This systematic review aims to compare ABLC and L-AmB effectiveness and safety outcomes in these subgroups of patients. The search was performed on Medline, Cochrane Library, EMBASE, and LILACS databases. treatment comparing L-AmB with ABLC; patients who had (i) refractory infection after being treated with d-AmB, (ii) previous renal impairment, or (iii) unacceptable d-AmB toxicity. Two investigators independently screened the search results, assessed trial quality, and extracted data. A total of 1,054 articles were identified in the literature. Among those, eleven were selected for full-text reading and five met the inclusion criteria. The five articles included reported on four separate observational studies. Overall, no significant difference was found in clinical relevant outcomes as new-onset dialysis, length of hospital stay, or mortality when comparing both lipid formulations. The studies reported a trend toward lower nephrotoxicity in patients treated with L-AmB. However, the results were imprecise and heterogeneous and the studies presented important methodological biases. The studies included in this systematic review pointed toward less nephrotoxicity events in the L-AmB group. However, due to low quality of evidence and no statistically significant differences in other clinical relevant outcomes, there is no definitive evidence of overall superiority in effectiveness or safety outcomes regarding one lipid formulation or another in this population subgroup.

  9. Navigation in the electronic health record: A review of the safety and usability literature.

    PubMed

    Roman, Lisette C; Ancker, Jessica S; Johnson, Stephen B; Senathirajah, Yalini

    2017-03-01

    Inefficient navigation in electronic health records has been shown to increase users' cognitive load, which may increase potential for errors, reduce efficiency, and increase fatigue. However, navigation has received insufficient recognition and attention in the electronic health record (EHR) literature as an independent construct and contributor to overall usability. Our aims in this literature review were to (1) assess the prevalence of navigation-related topics within the EHR usability and safety research literature, (2) categorize types of navigation actions within the EHR, (3) capture relationships between these navigation actions and usability principles, and (4) collect terms and concepts related to EHR navigation. Our goal was to improve access to navigation-related research in usability. We applied scoping literature review search methods with the assistance of a reference librarian to identify articles published since 1996 that reported evaluation of the usability or safety of an EHR user interface via user test, analytic methods, or inspection methods. The 4336 references collected from MEDLINE, EMBASE, Engineering Village, and expert referrals were de-duplicated and screened for relevance, and navigation-related concepts were abstracted from the 21 articles eligible for review using a standard abstraction form. Of the 21 eligible articles, 20 (95%) mentioned navigation in results and discussion of usability evaluations. Navigation between pages of the EHR was the more frequently documented type of navigation (86%) compared to navigation within a single page (14%). Navigation actions (e.g., scrolling through a medication list) were frequently linked to specific usability heuristic violations, among which flexibility and efficiency of use, recognition rather than recall, and error prevention were most common. Discussion of navigation was prevalent in results across all types of evaluation methods among the articles reviewed. Navigating between multiple

  10. The End of Accretion: The X-Ray Binary/Millisecond Pulsar Transition Object PSR J1023+0038

    NASA Astrophysics Data System (ADS)

    Archibald, Anne

    2015-04-01

    Millisecond radio pulsars (MSRPs), those spinning hundreds of times per second, have long been understood to be old pulsars that have been spun up by the accretion of matter from a companion in a low-mass X-ray binary (LMXB) phase. Yet the details of this transformation, particularly the end of the accretion process and the birth of a radio pulsar, remain mysterious. I will describe the discovery and detailed study of the first object known to transition between MSRP and LMXB states, PSR J1023+0038. By dint of a multiwavelength campaign of observations in the RMSP state, we are able to measure all the key system parameters and show the existence of an X-ray shock close to the pulsar-facing side of the companion. Since the discovery of PSR J1023+0038, two more objects (XSS J12270-4859 and M28I) have been found to make the same transition, and the study of these transitioning objects has become an active field of research. Most interestingly, PSR J1023+0038 has transitioned back into an LMXB state, with an active accretion disk and a puzzling increase in gamma-ray flux. Our detailed picture of the system allows us to test models of accretion against the phenomena we observe in PSR J1023+0038, and in fact these observations challenge current models: in spite of the low luminosity of the system (and low inferred accretion rate) some material is penetrating the centrifugal barrier and falling on the neutron-star surface. Key evidence for explaining this puzzling behaviour will come when PSR J1023+0038 returns to an MSRP state and we are able to compare pulsar timing models from after the LMXB state with those we obtained in this work.

  11. Broadband pulsations from PSR B1821–24: Implications for emission models and the pulsar population of M28

    SciTech Connect

    Johnson, T. J.; Guillemot, L.; Freire, P. C. C.

    2013-12-01

    We report a 5.4σ detection of pulsed gamma rays from PSR B1821–24 in the globular cluster M28 using ∼44 months of Fermi Large Area Telescope (LAT) data that have been reprocessed with improved instrument calibration constants. We constructed a phase-coherent ephemeris, with post-fit residual rms of 3 μs, using radio data spanning ∼23.2 yr, enabling measurements of the multi-wavelength light-curve properties of PSR B1821–24 at the milliperiod level. We fold RXTE observations of PSR B1821–24 from 1996 to 2007 and discuss implications on the emission zones. The gamma-ray light curve consists of two peaks separated by 0.41 ± 0.02 inmore » phase, with the first gamma-ray peak lagging behind the first radio peak by 0.05 ± 0.02 in phase, consistent with the phase of giant radio pulses. We observe significant emission in the off-peak interval of PSR B1821–24 with a best-fit LAT position inconsistent with the core of M28. We do not detect significant gamma-ray pulsations at the spin or orbital periods from any other known pulsar in M28, and we place limits on the number of energetic pulsars in the cluster. The derived gamma-ray efficiency, ∼2%, is typical of other gamma-ray pulsars with comparable spin-down power, suggesting that the measured spin-down rate (2.2 × 10{sup 36} erg s{sup –1}) is not appreciably distorted by acceleration in the cluster potential. This confirms PSR B1821–24 as the second very energetic millisecond pulsar in a globular cluster and raises the question of whether these represent a separate class of objects that only form in regions of very high stellar density.« less

  12. Polymerase spiral reaction (PSR): a novel, visual isothermal amplification method for detection of canine parvovirus 2 genomic DNA.

    PubMed

    Gupta, Vikas; Chakravarti, Soumendu; Chander, Vishal; Majumder, Saurabh; Bhat, Shabir Ahmad; Gupta, Vivek Kumar; Nandi, Sukdeb

    2017-07-01

    Canine parvovirus-2 (CPV-2), which is ubiquitously distributed worldwide, causes severe and often fatal gastroenteritis in dogs. Accurate, differential and rapid diagnosis of canine parvoviral enteritis remains a challenge for clinicians. A recently developed isothermal amplification technique, polymerase spiral reaction (PSR), was optimized for the first time for a viral pathogen with reference recombinant plasmid standards from different CPV-2 antigenic variants (CPV-2, CPV-2a, CPV-2b and CPV-2c) and subsequently validated using clinical samples. Addition of chromogenic substrate SYBR Green I after the completion of the reaction resulted in bright green fluorescence in positive samples, while negative samples and a no-template control remained orange. These results were further substantiated through visualization of a laddering pattern of the PSR-amplified product in an agarose gel in positive cases and the absence of this pattern in no-template control and negative samples. The PSR assay was found to be highly specific, as it did not react with other putative canine pathogens (canine adenovirus 1 and canine distemper virus). The sensitivity of the newly developed PSR technique was compared with that of conventional PCR, real-time PCR and LAMP, using a serial tenfold dilution of canine parvovirus DNA. The detection limit of PSR was found to be at the femtogram level, which is comparable with that of real-time PCR and LAMP, which are ten times more sensitive than conventional PCR. The assay was validated using 90 clinical samples, of which 54 were found positive, while only 45 samples were positive in conventional PCR. This novel assay, which is fully compliant with the 'ASSURED' concept for disease diagnosis, provides a simple, rapid, specific, sensitive and cost-effective method for diagnosis of canine parvoviral enteritis in veterinary clinics.

  13. Broadband pulsations from PSR B1821-24: Implications for emission models and the pulsar population of M28

    DOE PAGES

    Johnson, Tyrel J.; Guillemot, L.; Kerr, M.; ...

    2013-11-11

    Here, we report a 5.4σ detection of pulsed gamma rays from PSR B1821–24 in the globular cluster M28 using ~44 months of Fermi Large Area Telescope (LAT) data that have been reprocessed with improved instrument calibration constants. We constructed a phase-coherent ephemeris, with post-fit residual rms of 3 μs, using radio data spanning ~23.2 yr, enabling measurements of the multi-wavelength light-curve properties of PSR B1821–24 at the milliperiod level. We fold RXTE observations of PSR B1821–24 from 1996 to 2007 and discuss implications on the emission zones. The gamma-ray light curve consists of two peaks separated by 0.41 ± 0.02more » in phase, with the first gamma-ray peak lagging behind the first radio peak by 0.05 ± 0.02 in phase, consistent with the phase of giant radio pulses. We observe significant emission in the off-peak interval of PSR B1821–24 with a best-fit LAT position inconsistent with the core of M28. We do not detect significant gamma-ray pulsations at the spin or orbital periods from any other known pulsar in M28, and we place limits on the number of energetic pulsars in the cluster. The derived gamma-ray efficiency, ~2%, is typical of other gamma-ray pulsars with comparable spin-down power, suggesting that the measured spin-down rate (2.2 × 10 36 erg s –1) is not appreciably distorted by acceleration in the cluster potential. This confirms PSR B1821–24 as the second very energetic millisecond pulsar in a globular cluster and raises the question of whether these represent a separate class of objects that only form in regions of very high stellar density.« less

  14. Spectroscopy of the Inner Companion of the Pulsar PSR J0337+1715

    NASA Astrophysics Data System (ADS)

    Kaplan, David L.; van Kerkwijk, Marten H.; Koester, Detlev; Stairs, Ingrid H.; Ransom, Scott M.; Archibald, Anne M.; Hessels, Jason W. T.; Boyles, Jason

    2014-03-01

    The hierarchical triple system PSR J0337+1715 offers an unprecedented laboratory to study secular evolution of interacting systems and to explore the complicated mass-transfer history that forms millisecond pulsars and helium-core white dwarfs. The latter in particular, however, requires knowledge of the properties of the individual components of the system. Here we present precise optical spectroscopy of the inner companion in the PSR J0337+1715 system. We confirm it as a hot, low-gravity DA white dwarf with T eff = 15, 800 ± 100 K and log10(g) = 5.82 ± 0.05. We also measure an inner mass ratio of 0.1364 ± 0.0015, entirely consistent with that inferred from pulsar timing, and a systemic radial velocity of 29.7 ± 0.3 km s-1. Combined with the mass (0.19751 M ⊙) determined from pulsar timing, our measurement of the surface gravity implies a radius of 0.091 ± 0.005 R ⊙ combined further with the effective temperature and extinction, the photometry implies a distance of 1300 ± 80 pc. The high temperature of the companion is somewhat puzzling: with current models, it likely requires a recent period of unstable hydrogen burning, and suggests a surprisingly short lifetime for objects at this phase in their evolution. We discuss the implications of these measurements in the context of understanding the PSR J0337+1715 system, as well as of low-mass white dwarfs in general. Based on observations obtained under Program GN-2012B-Q-43 at the Gemini Observatory, which is operated by the Association of Universities for Research in Astronomy, Inc., under a cooperative agreement with the NSF on behalf of the Gemini partnership: the National Science Foundation (United States), the National Research Council (Canada), CONICYT (Chile), the Australian Research Council (Australia), Ministério da Ciência, Tecnologia e Inovação (Brazil) and Ministerio de Ciencia, Tecnología e Innovación Productiva (Argentina).

  15. Speaking up for patient safety by hospital-based health care professionals: a literature review

    PubMed Central

    2014-01-01

    Background Speaking up is important for patient safety, but often, health care professionals hesitate to voice concerns. Understanding the influencing factors can help to improve speaking-up behaviour and team communication. This review focused on health care professionals’ speaking-up behaviour for patient safety and aimed at (1) assessing the effectiveness of speaking up, (2) evaluating the effectiveness of speaking-up training, (3) identifying the factors influencing speaking-up behaviour, and (4) developing a model for speaking-up behaviour. Methods Five databases (PubMed, MEDLINE, CINAHL, Web of Science, and the Cochrane Library) were searched for English articles describing health care professionals’ speaking-up behaviour as well as those evaluating the relationship between speaking up and patient safety. Influencing factors were identified and then integrated into a model of voicing behaviour. Results In total, 26 studies were identified in 27 articles. Some indicated that hesitancy to speak up can be an important contributing factor in communication errors and that training can improve speaking-up behaviour. Many influencing factors were found: (1) the motivation to speak up, such as the perceived risk for patients, and the ambiguity or clarity of the clinical situation; (2) contextual factors, such as hospital administrative support, interdisciplinary policy-making, team work and relationship between other team members, and attitude of leaders/superiors; (3) individual factors, such as job satisfaction, responsibility toward patients, responsibility as professionals, confidence based on experience, communication skills, and educational background; (4) the perceived efficacy of speaking up, such as lack of impact and personal control; (5) the perceived safety of speaking up, such as fear for the responses of others and conflict and concerns over appearing incompetent; and (6) tactics and targets, such as collecting facts, showing positive intent, and

  16. Safety Analysis of Panax Ginseng in Randomized Clinical Trials: A Systematic Review

    PubMed Central

    Kim, Young-Sook; Woo, Jung-Yoon; Han, Chang-Kyun; Chang, Il-Moo

    2015-01-01

    Background: Panax ginseng C.A. Meyer is one of the most frequently used herbs in the world. The roots of Panax ginseng have been used as a traditional tonic and medicine for thousands of years in Korea and China. Today, ginseng root is used as a dietary supplement and complementary medicine and for adjuvant therapeutics worldwide. The efficacy of ginseng has been studied in a wide range of basic research and clinical studies. However, it has been reported that the results from clinical studies are conflicting, and they depend on the parameters of the protocol design including the conditions of the participants and the types of ginseng used such as red ginseng, white ginseng, fermented ginseng and cultured ginseng. Meanwhile, in addition to clinical efficacy, the safety of ginseng is a highly important matter for customers. With globally increasing demand for Panax ginseng as a dietary supplement or complementary medicine, it is necessary to provide information on its safe use to customers to improve their health conditions. Although the safety of Panax ginseng in pre-clinical studies is well known, the evaluation of safety in clinical studies has so far been insufficient. This systematic review was conducted to assess the safety of ginseng in randomized controlled clinical trials (RCT) over the last 10 years. We chose the last 10 years because many clinical trials have been conducted in the past 10 years, and it will help to understand the recent trends in RCTs of ginseng. Methods: Articles on ginseng studies were searched with keywords in MEDLINE and four other Korean online database sites. Studies with ginseng as a monopreparation were selected while studies with single administration, preparations combined with other herbs or drug combinations were excluded from the selected studies. Data from the selected studies meeting the criteria were extracted and reviewed in terms of study design, condition and number of participants, type of ginseng, dosage, duration

  17. A systematic review of safety data reporting in clinical trials of vaccines against malaria, tuberculosis, and human immunodeficiency virus.

    PubMed

    Tamminga, Cindy; Kavanaugh, Michael; Fedders, Charlotte; Maiolatesi, Santina; Abraham, Neethu; Bonhoeffer, Jan; Heininger, Ulrich; Vasquez, Carlos S; Moorthy, Vasee S; Epstein, Judith E; Richie, Thomas L

    2013-08-02

    Malaria, tuberculosis (TB) and human immunodeficiency virus (HIV) are diseases with devastating effects on global public health, especially in the developing world. Clinical trials of candidate vaccines for these diseases are being conducted at an accelerating rate, and require accurate and consistent methods for safety data collection and reporting. We performed a systematic review of publications describing the safety results from clinical trials of malaria, TB and HIV vaccines, to ascertain the nature and consistency of safety data collection and reporting. The target for the review was pre-licensure trials for malaria, TB and HIV vaccines published in English from 2000 to 2009. Search strategies were customized for each of the databases utilized (MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews and the Database of Reviews and Effects). Data extracted included age of trial participants, vaccine platform, route and method of vaccine administration, duration of participant follow-up, reporting of laboratory abnormalities, and the type, case definitions, severity, reporting methods and internal reporting consistency of adverse events. Of 2278 publications screened, 124 were eligible for inclusion (malaria: 66, TB: 9, HIV: 49). Safety data reporting was found to be highly variable among publications and often incomplete: overall, 269 overlapping terms were used to describe specific adverse events. 17% of publications did not mention fever. Descriptions of severity or degree of relatedness to immunization of adverse events were frequently omitted. 26% (32/124) of publications failed to report data on serious adverse events. The review demonstrated lack of standardized safety data reporting in trials for vaccines against malaria, TB and HIV. Standardization of safety data collection and reporting should be encouraged to improve data quality and comparability. The search strategy missed studies published in languages other than English and excluded studies

  18. 14 CFR Appendix B of Part 415 - Safety Review Document Outline

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Performed by Certified Personnel 4.0Flight Safety (§ 415.115) 4.1Initial Flight Safety Analysis 4.1.1Flight Safety Sub-Analyses, Methods, and Assumptions 4.1.2Sample Calculation and Products 4.1.3 Launch Specific Updates and Final Flight Safety Analysis Data 4.2Radionuclide Data (where applicable) 4.3Flight Safety...

  19. 14 CFR Appendix B of Part 415 - Safety Review Document Outline

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Performed by Certified Personnel 4.0Flight Safety (§ 415.115) 4.1Initial Flight Safety Analysis 4.1.1Flight Safety Sub-Analyses, Methods, and Assumptions 4.1.2Sample Calculation and Products 4.1.3 Launch Specific Updates and Final Flight Safety Analysis Data 4.2Radionuclide Data (where applicable) 4.3Flight Safety...

  20. 14 CFR Appendix B of Part 415 - Safety Review Document Outline

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Performed by Certified Personnel 4.0Flight Safety (§ 415.115) 4.1Initial Flight Safety Analysis 4.1.1Flight Safety Sub-Analyses, Methods, and Assumptions 4.1.2Sample Calculation and Products 4.1.3 Launch Specific Updates and Final Flight Safety Analysis Data 4.2Radionuclide Data (where applicable) 4.3Flight Safety...

  1. A status review of photovoltaic power conversion equipment reliability, safety, and quality assurance protocols

    SciTech Connect

    Hacke, Peter; Lokanath, Sumanth; Williams, Paul

    Data indicate that the inverter is the element of the photovoltaic plant that has the highest number of service calls and the greatest operation and maintenance cost burden. This paper describes the projects and relevant background needed in developing design qualification standards that would serve to establish a minimum level of reliability, along with a review of photovoltaic inverter quality and safety standards, most of which are in their infancy. We compare stresses and levels for accelerated testing of inverters proposed in the standard drafts, and those proposed by manufacturers and purchasers of inverters. We also review bases for themore » methods, stress types, and stress levels for durability testing of key inverter components. Many of the test protocols appear to need more comprehensive inclusion of stress factors existing in the natural environment such as wind driven rain, dust, and grid disturbances. Further understanding of how temperature, humidity ingress, and voltage bias affect the inverters and their components is also required. We provide data indicating inconsistent quality of the inverters and the durability of components leading to greater cost for the photovoltaic plant operator. Accordingly, the recommendation for data collection within quality standards for obtaining cost of ownership metrics is made. Design validation testing using realistic operation, environmental, and connection conditions, including under end-use field conditions with feedback for continuous improvement is recommended for inclusion within a quality standard.« less

  2. A systematic review of the effectiveness of occupational health and safety training.

    PubMed

    Robson, Lynda S; Stephenson, Carol M; Schulte, Paul A; Amick, Benjamin C; Irvin, Emma L; Eggerth, Donald E; Chan, Stella; Bielecky, Amber R; Wang, Anna M; Heidotting, Terri L; Peters, Robert H; Clarke, Judith A; Cullen, Kimberley; Rotunda, Cathy J; Grubb, Paula L

    2012-05-01

    Training is regarded as an important component of occupational health and safety (OHS) programs. This paper primarily addresses whether OHS training has a beneficial effect on workers. The paper also examines whether higher engagement OHS training has a greater effect than lower engagement training. Ten bibliographic databases were searched for pre-post randomized trial studies published in journals between 1996 and November 2007. Training interventions were included if they were delivered to workers and were concerned with primary prevention of occupational illness or injury. The methodological quality of each relevant study was assessed and data was extracted. The impacts of OHS training in each study were summarized by calculating the standardized mean differences. The strength of the evidence on training's effectiveness was assessed for (i) knowledge, (ii) attitudes and beliefs, (iIi) behaviors, and (iv) health using the US Centers for Disease Control and Prevention's Guide to Community Preventive Services, a qualitative evidence synthesis method. Twenty-two studies met the relevance criteria of the review. They involved a variety of study populations, occupational hazards, and types of training. Strong evidence was found for the effectiveness of training on worker OHS behaviors, but insufficient evidence was found of its effectiveness on health (ie, symptoms, injuries, illnesses). The review team recommends that workplaces continue to deliver OHS training to employees because training positively affects worker practices. However, large impacts of training on health cannot be expected, based on research evidence.

  3. Improving the safety of aging road users: a mini-review.

    PubMed

    Boot, Walter R; Stothart, Cary; Charness, Neil

    2014-01-01

    Older drivers are at greatest risk for injury or death as a result of a car crash. In this mini-review, we outline the normative age-related changes to perceptual, cognitive, and motor abilities that contribute to increased crash risk and decreased comfort with driving, and highlight specific driving scenarios and conditions that are particularly challenging for aging road users. Adopting a person-environment fit framework, we discuss how the roadway environment can be modified to better match the abilities of the aging driver. We also review evidence for the efficacy of training interventions that aim to change the abilities and strategies of the aging driver to better match the demands of the driving environment. Evidence suggests that specific changes to the roadway and driver training strategies can bring the abilities of the older driver back into alignment with the demands of the driving task. A focus on both approaches will help ensure the safety of all road users as the number of aging drivers greatly increases over the next few decades.

  4. A systematic review of the psychological literature on interruption and its patient safety implications.

    PubMed

    Li, Simon Y W; Magrabi, Farah; Coiera, Enrico

    2012-01-01

    To understand the complex effects of interruption in healthcare. As interruptions have been well studied in other domains, the authors undertook a systematic review of experimental studies in psychology and human-computer interaction to identify the task types and variables influencing interruption effects. 63 studies were identified from 812 articles retrieved by systematic searches. On the basis of interruption profiles for generic tasks, it was found that clinical tasks can be distinguished into three broad types: procedural, problem-solving, and decision-making. Twelve experimental variables that influence interruption effects were identified. Of these, six are the most important, based on the number of studies and because of their centrality to interruption effects, including working memory load, interruption position, similarity, modality, handling strategies, and practice effect. The variables are explained by three main theoretical frameworks: the activation-based goal memory model, prospective memory, and multiple resource theory. This review provides a useful starting point for a more comprehensive examination of interruptions potentially leading to an improved understanding about the impact of this phenomenon on patient safety and task efficiency. The authors provide some recommendations to counter interruption effects. The effects of interruption are the outcome of a complex set of variables and should not be considered as uniformly predictable or bad. The task types, variables, and theories should help us better to identify which clinical tasks and contexts are most susceptible and assist in the design of information systems and processes that are resilient to interruption.

  5. A Review on Internet of Things for Defense and Public Safety

    PubMed Central

    Fraga-Lamas, Paula; Fernández-Caramés, Tiago M.; Suárez-Albela, Manuel; Castedo, Luis; González-López, Miguel

    2016-01-01

    The Internet of Things (IoT) is undeniably transforming the way that organizations communicate and organize everyday businesses and industrial procedures. Its adoption has proven well suited for sectors that manage a large number of assets and coordinate complex and distributed processes. This survey analyzes the great potential for applying IoT technologies (i.e., data-driven applications or embedded automation and intelligent adaptive systems) to revolutionize modern warfare and provide benefits similar to those in industry. It identifies scenarios where Defense and Public Safety (PS) could leverage better commercial IoT capabilities to deliver greater survivability to the warfighter or first responders, while reducing costs and increasing operation efficiency and effectiveness. This article reviews the main tactical requirements and the architecture, examining gaps and shortcomings in existing IoT systems across the military field and mission-critical scenarios. The review characterizes the open challenges for a broad deployment and presents a research roadmap for enabling an affordable IoT for defense and PS. PMID:27782052

  6. A systematic review of the literature on safety measures to prevent railway suicides and trespassing accidents.

    PubMed

    Havârneanu, Grigore M; Burkhardt, Jean-Marie; Paran, Françoise

    2015-08-01

    This review covers a central aspect in railway safety which is the prevention of suicides and trespassing accidents. The paper attempts to answer the following research question: 'What measures are available to reduce railway suicide and trespass, and what is the evidence for their effectiveness?' The review is based on 139 relevant publications, ranging from 1978 to 2014. The analysis aimed to identify the past and current trend in the prevention practice by looking both quantitatively and qualitatively at the recommended measures. According to the results, there has been a constant focus on suicide prevention, and only relatively recent interest in trespass countermeasures. The content analysis revealed 19 main preventative categories which include more than 100 specific measures. We identified 16 common categories against railway suicide and trespass, and 3 categories of specific measures to prevent suicide. There are only 22 studies which provide empirical support for the effectiveness of measures. Actual combinations of measures are barely evaluated, but several challenges emerge from the literature. The discussion focuses on the need for a unified approach to suicide and trespass prevention, and on the importance to consider the effect mechanism of the measures in order to design better interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. A status review of photovoltaic power conversion equipment reliability, safety, and quality assurance protocols

    DOE PAGES

    Hacke, Peter; Lokanath, Sumanth; Williams, Paul; ...

    2017-10-10

    Data indicate that the inverter is the element of the photovoltaic plant that has the highest number of service calls and the greatest operation and maintenance cost burden. This paper describes the projects and relevant background needed in developing design qualification standards that would serve to establish a minimum level of reliability, along with a review of photovoltaic inverter quality and safety standards, most of which are in their infancy. We compare stresses and levels for accelerated testing of inverters proposed in the standard drafts, and those proposed by manufacturers and purchasers of inverters. We also review bases for themore » methods, stress types, and stress levels for durability testing of key inverter components. Many of the test protocols appear to need more comprehensive inclusion of stress factors existing in the natural environment such as wind driven rain, dust, and grid disturbances. Further understanding of how temperature, humidity ingress, and voltage bias affect the inverters and their components is also required. We provide data indicating inconsistent quality of the inverters and the durability of components leading to greater cost for the photovoltaic plant operator. Accordingly, the recommendation for data collection within quality standards for obtaining cost of ownership metrics is made. Design validation testing using realistic operation, environmental, and connection conditions, including under end-use field conditions with feedback for continuous improvement is recommended for inclusion within a quality standard.« less

  8. Selection of Surrogate Bacteria for Use in Food Safety Challenge Studies: A Review.

    PubMed

    Hu, Mengyi; Gurtler, Joshua B

    2017-09-01

    Nonpathogenic surrogate bacteria are prevalently used in a variety of food challenge studies in place of foodborne pathogens such as Listeria monocytogenes, Salmonella, Escherichia coli O157:H7, and Clostridium botulinum because of safety and sanitary concerns. Surrogate bacteria should have growth characteristics and/or inactivation kinetics similar to those of target pathogens under given conditions in challenge studies. It is of great importance to carefully select and validate potential surrogate bacteria when verifying microbial inactivation processes. A validated surrogate responds similar to the targeted pathogen when tested for inactivation kinetics, growth parameters, or survivability under given conditions in agreement with appropriate statistical analyses. However, a considerable number of food studies involving putative surrogate bacteria lack convincing validation sources or adequate validation processes. Most of the validation information for surrogates in these studies is anecdotal and has been collected from previous publications but may not be sufficient for given conditions in the study at hand. This review is limited to an overview of select studies and discussion of the general criteria and approaches for selecting potential surrogate bacteria under given conditions. The review also includes a list of documented bacterial pathogen surrogates and their corresponding food products and treatments to provide guidance for future studies.

  9. Improving the Safety of Aging Road Users – A Mini-Review

    PubMed Central

    Boot, Walter R.; Stothart, Cary; Charness, Neil

    2014-01-01

    Older drivers are at greatest risk for injury or death as a result of a car crash. In this mini-review we outline the normative age-related changes to perceptual, cognitive, and motor abilities that contribute to increased crash risk and decreased comfort with driving, and highlight specific driving scenarios and conditions that are particularly challenging for aging road users. Adopting a person-environment fit framework, we discuss how the roadway environment can be modified to better match the abilities of the aging driver. We also review evidence for the efficacy of training interventions intent on changing the abilities and strategies of the aging driver to better match the demands of the driving environment. Evidence suggests that specific changes to the roadway and driver training strategies can bring the abilities of the older driver back into alignment with the demands of the driving task. A focus on both approaches will help ensure the safety of all road users as the number of aging road users greatly increases over the next few decades. PMID:23989044

  10. A Review on Internet of Things for Defense and Public Safety.

    PubMed

    Fraga-Lamas, Paula; Fernández-Caramés, Tiago M; Suárez-Albela, Manuel; Castedo, Luis; González-López, Miguel

    2016-10-05

    The Internet of Things (IoT) is undeniably transforming the way that organizations communicate and organize everyday businesses and industrial procedures. Its adoption has proven well suited for sectors that manage a large number of assets and coordinate complex and distributed processes. This survey analyzes the great potential for applying IoT technologies (i.e., data-driven applications or embedded automation and intelligent adaptive systems) to revolutionize modern warfare and provide benefits similar to those in industry. It identifies scenarios where Defense and Public Safety (PS) could leverage better commercial IoT capabilities to deliver greater survivability to the warfighter or first responders, while reducing costs and increasing operation efficiency and effectiveness. This article reviews the main tactical requirements and the architecture, examining gaps and shortcomings in existing IoT systems across the military field and mission-critical scenarios. The review characterizes the open challenges for a broad deployment and presents a research roadmap for enabling an affordable IoT for defense and PS.

  11. Efficacy and safety of immunomodulatory drugs in patients with anterior uveitis: A systematic literature review.

    PubMed

    Gómez-Gómez, Alejandro; Loza, Estíbaliz; Rosario, Maria Piedad; Espinosa, Gerard; Morales, José M García Ruiz de; Herreras, Jose M; Muñoz-Fernández, Santiago; Cordero-Coma, Miguel

    2017-10-01

    To assess the efficacy and safety of immunomodulatory drugs in patients with noninfectious anterior uveitis (AU). Systematic review of studies were retrieved from Medline (1961 to March 2016), Embase (1961 to March 2016), and Cochrane Library (up to March 2016), and a complementary hand search was also performed. The selection criteria were as follows: (population) noninfectious AU patients, adults; (intervention) immunomodulatory drugs (any dose, regimen, route of administration, duration of treatment); (outcome) control of inflammation, steroid-sparing effect, AU flares, adverse events, and so on; (study design) systematic literature reviews, randomized controlled trials, and observational studies. The study quality was assessed using the Jadad scale and according to The Oxford Centre for Evidence-based Medicine (update 2009). We included 13 studies of moderate-poor quality, with a mean duration from 5 months to 20 years, and number of AU patients ranging from 9 to 274. Patient's demographic and clinical characteristics were very heterogeneous. In most cases, uveitis anatomic classification criteria and outcomes definitions were unclear. Some of the studies only included AU patients with a systemic disease associated, mostly spondyloarthritis, others, mixed populations (idiopathic and systemic disease associated patients), and in some articles this data is not described. We found that methotrexate, cyclosporine A, azathioprine, adalimumab, and golimumab might prevent AU flares, improve ocular inflammation and visual acuity, and decrease systemic steroids doses. Although there is a lack of robust evidence, methotrexate, cyclosporine A, azathioprine, adalimumab, and golimumab might be effective in AU patients.

  12. The X-Ray Counterpart to LAT PSR J2021+4026 and Its Interesting Spectrum

    NASA Technical Reports Server (NTRS)

    Weisskopf, Martin C.; Becker, W.; Carraminana, A.; De Luca, A.; Dormandy, M.; Harding, A.; Kanbach, G.; O'Dell, S. L.; Parkinson, P. Saz; Ray, P.; hide

    2011-01-01

    We report on the likely identification of the X-ray counterpart to LAT PSR J2021+4026, using the Chandra X-Ray Observatory ACIS-S3 and timing analysis of Large Area telescope (LAT) data from the Fermi satellite. The X-ray source that lies closest (10 arcsec) to the position determined from the Fermi-LAT timing solution has no cataloged infrared-to-visible counterpart and we have set an upper limit to its optical I and R band emission. The source exhibits a X-ray spectrum which is different when compared to Geminga and CTA 1, and this may have implications for the evolutionary track of radio-quiet gamma-ray pulsars.

  13. A search for X-ray emission from a nearby pulsar - PSR 1929 + 10

    NASA Technical Reports Server (NTRS)

    Alpar, A.; Brinkmann, W.; Oegelman, H.; Kiziloglu, U.; Pines, D.

    1987-01-01

    Observations of the radio pulsar PSR 1929 + 10 with the Exosat observatory are reported. A 2 sigma upper limit of 0.0005 cts/s was obtained in the 0.04-2.4 keV range, which translates into a luminosity upper limit of 2 x 10 to the 29th erg/s for a power-law source with photon number index 1-3, and a luminosity upper limit of 10 to the 30th erg/s corresponding to a temperature of 190,000 K for a blackbody with radius 10 km. The implications of these upper limits for various models and their compatibility with the positive detection of this source by the Einstein Observatory are discussed.

  14. X-Ray Observations of High-Energy Pulsars: PSR B1951+32 and Geminga

    NASA Astrophysics Data System (ADS)

    Ho, Cheng

    Observations at frequencies across a wide range of electromagnetic spectra are key to the understanding of the origin and mechanisms of high-energy emissions from pulsars. We propose to observe the high-energy pulsars PSR B1951+32 and Geminga with XTE. These two sources emit X-rays at low enough count rate that we can acquire high resolution timing and spectral data, allowing us to perform detailed analysis on the ground. Staring integration of 10 ksec for each source is requested. Data obtained in these observations, together with those from ROSAT, GRO and a planned project for optical counterpart study at Los Alamos, will provide crucial information to advance high-energy pulsar research.

  15. Origin of Magnetar-Scale Crustal Field in PSR J1852+0040 and 'Frozen' Magnetars

    NASA Astrophysics Data System (ADS)

    Popov, S. B.

    2013-08-01

    We discuss the origin of strong crustal magnetic field in one of central compact objects (CCOs)-a neutron star PSR J1852+0040 in the supernova remnant Kes 79. Taking into account its relatively long present day spin period we conclude that the field could not be generated via a dynamo mechanism. If this neutron star indeed is a magnetar with field submerged during a strong fall-back episode, then it argues against the dynamo field origin in magnetars. Otherwise, Kes 79 is not a close relative of normal magnetars. A discovery of an anti-magnetar with a millisecond period and strong crustal field identifiable, for example, due to large pulse fraction, would be the proof of the dynamo field origin. Existence of such sources is in correspondence with the present standard picture of neutron star unification. However, the fraction of magnetars with submerged fields can be small-few percent of the total number of CCOs.

  16. Spitzer MIPS Limits on Asteroidal Dust in the Pulsar Planetary System PSR B1257+12

    NASA Technical Reports Server (NTRS)

    Bryden, G.; Beichman, C. A.; Rieke, G. H.; Stansberry, J. A.; Stapelfeldt, K. R.; Trilling, D. E.; Turner, N. J.; Wolszczan, A.

    2006-01-01

    With the MIPS camera on Spitzer, we have searched for far-infrared emission from dust in the planetary system orbiting pulsar PSR B1257+12. With accuracies of 0.05 mJy at 24 microns and 1.5 mJy at 70 microns, photometric measurements find no evidence for emission at these wavelengths. These observations place new upper limits on the luminosity of dust with temperatures between 20 and 1000 K. They are particularly sensitive to dust temperatures of 100-200 K, for which they limit the dust luminosity to below 3 x 10(exp -5) of the pulsar's spin-down luminosity, 3 orders of magnitude better than previous limits. Despite these improved constraints on dust emission, an asteroid belt similar to the solar system's cannot be ruled out.

  17. On the existence of planets around the pulsar PSR B0329+54

    NASA Astrophysics Data System (ADS)

    Starovoit, E. D.; Rodin, A. E.

    2017-11-01

    Results of timing measurements of the pulsar PSR B0329+54 obtained in 1968-2012 using the Big Scanning Antenna of the Pushchino Radio Astronomy Observatory (at 102 and 111 MHz), the DSS 13 and DSS 14 telescopes of the Jet Propulsion Laboratory (2388 MHz), and the 64 m telescope of the Kalyazin Radio Astronomy Observatory (610 MHz) are presented. The astrometric and rotational parameters of the pulsar are derived at a new epoch. Periodic variations in the barycentric timing residuals have been found, which can be explained by the presence of a planet orbiting the pulsar, with an orbital period P 1 = 27.8 yr, mass m c sin i = 2 M ⨁, and orbital semi-major axis a = 10.26 AU. The results of this study do not confirm existence of a proposed second planet with orbital period P 2 = 3 yr.

  18. Credit PSR. View looking north northeast (12°) across surface remains ...

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

    Credit PSR. View looking north northeast (12°) across surface remains of North Base swimming pool. The southeast edge of the pool appearing in the foreground may seem to be a sidewalk to the casual observer; the wavy inside edge of this walk matches the pool side visible in historic construction photos (See HAER photo CA-170-Q-2). The telephone pole in the midground of the view is inside the pool proper. Building 4312 (Liquid Oxygen Repair Facility) appears in left background, Building 4456 (Fire House No. 4) in middle background, and Building 4444 (Communications Building) in right background - Edwards Air Force Base, North Base, Swimming Pool, Second Street, Boron, Kern County, CA

  19. High-energy variability of the Pulsar binary PSR J1311-3430

    NASA Astrophysics Data System (ADS)

    An, Hongjun; Fermi-LAT Collaboration

    2018-01-01

    We present analysis results of high-energy observations of the extreme mass-ratio black-widow millisecond pulsar binary PSR J1311-3430. Our studies in the UV, X-ray, and gamma-ray bands confirm the orbital modulation in the gamma-ray band as suggested previously. In addition, we find that the modulation is stronger in the high-energy band. In the lower-energy UV and X-ray bands, we detect flares which were observed previously and attributed to magnetic activities. We find that the optical flares are associated with the X-ray flares, suggesting common origin. We explore possible connections of the variabilities with the intrabinary shock (IBS) and magnetic activity on the low mass companion.

  20. Burn injury models of care: A review of quality and cultural safety for care of Indigenous children.

    PubMed

    Fraser, Sarah; Grant, Julian; Mackean, Tamara; Hunter, Kate; Holland, Andrew J A; Clapham, Kathleen; Teague, Warwick J; Ivers, Rebecca Q

    2018-05-01

    Safety and quality in the systematic management of burn care is important to ensure optimal outcomes. It is not clear if or how burn injury models of care uphold these qualities, or if they provide a space for culturally safe healthcare for Indigenous peoples, especially for children. This review is a critique of publically available models of care analysing their ability to facilitate safe, high-quality burn care for Indigenous children. Models of care were identified and mapped against cultural safety principles in healthcare, and against the National Health and Medical Research Council standard for clinical practice guidelines. An initial search and appraisal of tools was conducted to assess suitability of the tools in providing a mechanism to address quality and cultural safety. From the 53 documents found, 6 were eligible for review. Aspects of cultural safety were addressed in the models, but not explicitly, and were recorded very differently across all models. There was also limited or no cultural consultation documented in the models of care reviewed. Quality in the documents against National Health and Medical Research Council guidelines was evident; however, description or application of quality measures was inconsistent and incomplete. Gaps concerning safety and quality in the documented care pathways for Indigenous peoples' who sustain a burn injury and require burn care highlight the need for investigation and reform of current practices. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  1. Analysis of roadside inspection data and its relationship to accident and safety/compliance review data and reviews of previous and ongoing research in these areas

    DOT National Transportation Integrated Search

    1993-01-01

    The main objective of the present study is to analyze roadside inspection data and its relationship to safety/compliance review and accident data. Data used for this analysis is provided by the Office of Motor Carriers and includes a sample of larger...

  2. Safety and efficacy of encapsulated fecal microbiota transplantation for recurrent Clostridium difficile infection: a systematic review.

    PubMed

    Iqbal, Umair; Anwar, Hafsa; Karim, Muhammad A

    2018-07-01

    Fecal microbial transplantation (FMT) has been shown to be effective for the treatment of recurrent clostridium difficile infection (CDI). The efficacy and safety of freeze-dried encapsulated FMT for the treatment of recurrent CDI is unclear. We performed a systematic review to evaluate and analyze the current evidence in this respect. A systematic literature search was performed using the PubMed, Embase, and Medline databases until December 2017 to identify all original studies that investigated the role of administration of encapsulated FMT in recurrent CDI. The study included patients of all ages. Two independent reviewers extracted data and assessed the quality of publications; a third investigator resolved any discrepancies. A total of six studies, five case series and one randomized-controlled trial, were included in this review. Overall, 341 patients completed treatment with encapsulated FMT. Only three major adverse events were reported and no deaths occurred directly related to FMT. In all, 285 patients responded to the first treatment, with no recurrence during the specified follow-up period set to meet the primary endpoint. Forty-two patients underwent a second treatment, with resolution of symptoms in 28 patients. At least five patients were reported to undergo a third treatment, with resolution in three of them. Only one patient was reported to have received four treatments without long-term resolution of symptoms. Low-quality to moderate-quality evidence showed that encapsulated FMT is safe and cost-effective for the treatment and prevention of recurrent CDI. Its efficacy is not inferior to FMT performed through the nonoral route. Randomized-controlled trials are necessary to compare its efficacy with oral antimicrobial drugs and also to evaluate the potential adverse effects associated with the treatment.

  3. Applicability and feasibility of systematic review for performing evidence-based risk assessment in food and feed safety.

    PubMed

    Aiassa, E; Higgins, J P T; Frampton, G K; Greiner, M; Afonso, A; Amzal, B; Deeks, J; Dorne, J-L; Glanville, J; Lövei, G L; Nienstedt, K; O'connor, A M; Pullin, A S; Rajić, A; Verloo, D

    2015-01-01

    Food and feed safety risk assessment uses multi-parameter models to evaluate the likelihood of adverse events associated with exposure to hazards in human health, plant health, animal health, animal welfare, and the environment. Systematic review and meta-analysis are established methods for answering questions in health care, and can be implemented to minimize biases in food and feed safety risk assessment. However, no methodological frameworks exist for refining risk assessment multi-parameter models into questions suitable for systematic review, and use of meta-analysis to estimate all parameters required by a risk model may not be always feasible. This paper describes novel approaches for determining question suitability and for prioritizing questions for systematic review in this area. Risk assessment questions that aim to estimate a parameter are likely to be suitable for systematic review. Such questions can be structured by their "key elements" [e.g., for intervention questions, the population(s), intervention(s), comparator(s), and outcome(s)]. Prioritization of questions to be addressed by systematic review relies on the likely impact and related uncertainty of individual parameters in the risk model. This approach to planning and prioritizing systematic review seems to have useful implications for producing evidence-based food and feed safety risk assessment.

  4. Reconciling Optical and Radio Observations of the Binary Millisecond Pulsar PSR J1640+2224

    NASA Astrophysics Data System (ADS)

    Vigeland, Sarah J.; Deller, Adam T.; Kaplan, David L.; Istrate, Alina G.; Stappers, Benjamin W.; Tauris, Thomas M.

    2018-03-01

    Previous optical and radio observations of the binary millisecond pulsar PSR J1640+2224 have come to inconsistent conclusions about the identity of its companion, with some observations suggesting that the companion is a low-mass helium-core (He-core) white dwarf (WD), while others indicate that it is most likely a high-mass carbon–oxygen (CO) WD. Binary evolution models predict PSR J1640+2224 most likely formed in a low-mass X-ray binary based on the pulsar’s short spin period and long-period, low-eccentricity orbit, in which case its companion should be a He-core WD with mass about 0.35–0.39 M ⊙, depending on metallicity. If instead it is a CO WD, it would suggest that the system has an unusual formation history. In this paper we present the first astrometric parallax measurement for this system from observations made with the Very Long Baseline Array (VLBA), from which we determine the distance to be {1520}-150+170 {pc}. We use this distance and a reanalysis of archival optical observations originally taken in 1995 with the Wide Field Planetary Camera 2 on the Hubble Space Telescope (HST) to measure the WD’s mass. We also incorporate improvements in calibration, extinction model, and WD cooling models. We find that the existing observations are not sufficient to tightly constrain the companion mass, but we conclude the WD mass is >0.4 M ⊙ with >90% confidence. The limiting factor in our analysis is the low signal-to-noise ratio of the original HST observations.

  5. Revealing two radio-active galactic nuclei extremely near PSR J0437-4715

    NASA Astrophysics Data System (ADS)

    Li, Zhixuan; Yang, Jun; An, Tao; Paragi, Zsolt; Deller, Adam; Reynolds, Cormac; Hong, Xiaoyu; Wang, Jiancheng; Ding, Hao; Xia, Bo; Yan, Zhen; Guo, Li

    2018-05-01

    Newton's gravitational constant G may vary with time at an extremely low level. The time variability of G will affect the orbital motion of a millisecond pulsar in a binary system and cause a tiny difference between the orbital period-dependent measurement of the kinematic distance and the direct measurement of the annual parallax distance. PSR J0437-4715 is the nearest millisecond pulsar and the brightest at radio wavelengths. To explore the feasibility of achieving a parallax distance accuracy of one light-year, comparable to the recent timing result, with the technique of differential astrometry, we searched for compact radio sources quite close to PSR J0437-4715. Using existing data from the Very Large Array and the Australia Telescope Compact Array, we detected two sources with flat spectra, relatively stable flux densities of 0.9 and 1.0 mJy at 8.4 GHz and separations of 13 and 45 arcsec. With a network consisting of the Long Baseline Array and the Kunming 40-m radio telescope, we found that both sources have a point-like structure and a brightness temperature of ≥107 K. According to these radio inputs and the absence of counterparts in other bands, we argue that they are most likely the compact radio cores of extragalactic active galactic nuclei, rather than Galactic radio stars. The finding of these two radio active galactic nuclei will enable us to achieve a sub-pc distance accuracy with in-beam phase-referencing very-long-baseline interferometric observations and provide one of the most stringent constraints on the time variability of G in the near future.

  6. The Glitches and Rotational History of the Highly Energetic Young Pulsar PSR J0537–6910

    NASA Astrophysics Data System (ADS)

    Ferdman, R. D.; Archibald, R. F.; Gourgouliatos, K. N.; Kaspi, V. M.

    2018-01-01

    We present a timing and glitch analysis of the young X-ray pulsar PSR J0537‑6910, located within the Large Magellanic Cloud, using 13 yr of data from the now-decommissioned Rossi X-ray Timing Explorer. Rotating with a spin period of 16 ms, PSR J0537‑6910 is the fastest-spinning and most energetic young pulsar known. It also displays the highest glitch activity of any known pulsar. We have found 42 glitches over the data span, corresponding to a glitch rate of 3.2 yr‑1, with an overall glitch activity rate of 8.8× {10}-7 {{yr}}-1. The high glitch frequency has allowed us to study the glitch behavior in ways that are inaccessible in other pulsars. We observe a strong linear correlation between spin frequency glitch magnitude and wait time to the following glitch. We also find that the post-glitch spin-down recovery is well described by a single two-component model fit to all glitches for which we have adequate input data. This consists of an exponential amplitude A=(7.6+/- 1.0)× {10}-14 {{{s}}}-2, decay timescale τ ={27}-6+7 {day}s, and linear slope m=(4.1+/- 0.4)× {10}-16 {{{s}}}-2 {{day}}-1. The latter slope corresponds to a second frequency derivative \\ddot{ν }=(4.7+/- 0.5)× {10}-22 {{{s}}}-3, from which we find an implied braking index n=7.4+/- 0.8. We also present a maximum likelihood technique for searching for periods in event-time data, which we used to both confirm previously published values and determine rotation frequencies in later observations. We discuss the implied constraints on glitch models from the observed behavior of this system, which we argue cannot be fully explained in the context of existing theories.

  7. Limits on the mass, velocity and orbit of PSR J1933-6211

    NASA Astrophysics Data System (ADS)

    Graikou, E.; Verbiest, J. P. W.; Osłowski, S.; Champion, D. J.; Tauris, T. M.; Jankowski, F.; Kramer, M.

    2017-11-01

    We present a high-precision timing analysis of PSR J1933-6211, a millisecond pulsar with a 3.5 ms spin period and a white dwarf (WD) companion, using data from the Parkes radio telescope. Since we have accurately measured the polarization properties of this pulsar, we have applied the matrix template matching approach in which the times of arrival are measured using full polarimetric information. We achieved a weighted root-mean-square timing residuals of the timing residuals of 1.23 μs, 15.5 per cent improvement compared to the total intensity timing analysis. After studying the scintillation properties of this pulsar, we put constraints on the inclination angle of the system. Based on these measurements and on χ2 mapping we put a 2σ upper limit on the companion mass (0.44 M⊙). Since this mass limit cannot reveal the nature of the companion, we further investigate the possibility of the companion to be a He WD. Applying the orbital period-mass relation for such WDs, we conclude that the mass of a He WD companion would be about 0.26±0.01 M⊙, which combined with the measured mass function and orbital inclination limits, would lead to a light pulsar mass ≤ 1.0 M⊙. This result seems unlikely based on current neutron star formation models and we therefore conclude that PSR J1933-6211 most likely has a CO WD companion, which allows for a solution with a more massive pulsar.

  8. Identification and description of randomized controlled trials and systematic reviews on patient safety published in medical journals.

    PubMed

    Barajas-Nava, Leticia Andrea; Calvache, José Andrés; López-Alcalde, Jesús; Solà, Ivan; Cosp, Xavier Bonfill

    2013-06-01

    To identify and describe randomized controlled trials (RCTs) and systematic reviews (SRs) on patient safety published from 1973 onward. We handsearched a total of 12 medical journals published in English with contents related to patient safety to identify RCTs and SRs published between 1973 and the end of 2010. The results obtained from this search were complemented with an additional search in MEDLINE. The documents were classified by area of specialty or service in which the intervention was applied, level of preventive action, and type of patient safety incident, the latter in accordance with the International Classification for Patient Safety proposed by the World Health Organization (WHO). The main features of the identified studies are also described. A total of 787 issues of 12 journals published between 1973 and 2010 were handsearched. This procedure yielded 10,162 references, of which, 131 corresponded to RCTs and 127 to SRs. A parallel MEDLINE search identified only about two-thirds of these articles. Of all the studies identified, 83 RCTs and 64 SRs addressed interventions related to patient safety. The types of incident related to patient safety that were included most often in RCTs involved the clinical process, and for SRs, those related to resources/organizational management. On average, only 3.5 RCTs and 3.4 SRs were published per year, many of which had significant deficiencies in the reported information, such as, for instance, a lack of details on the methodology used. The number of RCTs and SRs on patient safety published in specialized journals is scarce. No studies on interventions to improve the safety of the handling of blood and derivatives, infections related to health care, nutrition, or infrastructure were identified as a result of our search. Handsearching plays a key role in the identification of all the clinical trials that could be included in SRs on patient safety interventions. Knowing the content of RCTs and SRs published on

  9. Boiling eXperiment Facility (BXF) Fluid Toxicity Technical Interchange Meeting (TIM) with the Payload Safety Review Panel (PSRP)

    NASA Technical Reports Server (NTRS)

    Sheredy, William A.

    2012-01-01

    A Technical Interchange meeting was held between the payload developers for the Boiling eXperiment Facility (BXF) and the NASA Safety Review Panel concerning operational anomaly that resulted in overheating one of the fluid heaters, shorted a 24VDC power supply and generated Perfluoroisobutylene (PFiB) from Perfluorohexane.

  10. Background for Community-Level Work on Physical Health and Safety in Adolescence: Reviewing the Literature on Contributing Factors.

    ERIC Educational Resources Information Center

    Hatcher, Juliet L.; Scarpa, Juliet

    Although adolescence is characterized by general good health, this developmental stage is a key time for promoting a healthy lifestyle and preventing health-compromising behaviors and injuries. This paper presents a selective review of research into factors predicting health and safety behavior patterns and injury occurrence, focusing on…

  11. Behavioral Self-Monitoring of Safety and Productivity in the Workplace: A Methodological Primer and Quantitative Literature Review

    ERIC Educational Resources Information Center

    Olson, Ryan; Winchester, Jamey

    2008-01-01

    Workplace applications of behavioral self-monitoring (BSM) methods have been studied periodically for over 35 years, yet the literature has never been systematically reviewed. Recent occupational safety interventions including BSM resulted in relatively large behavior changes. Moreover, BSM methods are functional for addressing a broad range of…

  12. Spent Nuclear Fuel (SNF) project Integrated Safety Management System phase I and II Verification Review Plan

    SciTech Connect

    CARTER, R.P.

    1999-11-19

    The U.S. Department of Energy (DOE) commits to accomplishing its mission safely. To ensure this objective is met, DOE issued DOE P 450.4, Safety Management System Policy, and incorporated safety management into the DOE Acquisition Regulations ([DEAR] 48 CFR 970.5204-2 and 90.5204-78). Integrated Safety Management (ISM) requires contractors to integrate safety into management and work practices at all levels so that missions are achieved while protecting the public, the worker, and the environment. The contractor is required to describe the Integrated Safety Management System (ISMS) to be used to implement the safety performance objective.

  13. Enhancing the role of case-oriented peer review to improve quality and safety in radiation oncology: Executive summary

    PubMed Central

    Marks, Lawrence B.; Adams, Robert D.; Pawlicki, Todd; Blumberg, Albert L.; Hoopes, David; Brundage, Michael D.; Fraass, Benedick A.

    2013-01-01

    This report is part of a series of white papers commissioned for the American Society for Radiation Oncology (ASTRO) Board of Directors as part of ASTRO's Target Safely Campaign, focusing on the role of peer review as an important component of a broad safety/quality assurance (QA) program. Peer review is one of the most effective means for assuring the quality of qualitative, and potentially controversial, patient-specific decisions in radiation oncology. This report summarizes many of the areas throughout radiation therapy that may benefit from the application of peer review. Each radiation oncology facility should evaluate the issues raised and develop improved ways to apply the concept of peer review to its individual process and workflow. This might consist of a daily multidisciplinary (eg, physicians, dosimetrists, physicists, therapists) meeting to review patients being considered for, or undergoing planning for, radiation therapy (eg, intention to treat and target delineation), as well as meetings to review patients already under treatment (eg, adequacy of image guidance). This report is intended to clarify and broaden the understanding of radiation oncology professionals regarding the meaning, roles, benefits, and targets for peer review as a routine quality assurance tool. It is hoped that this work will be a catalyst for further investigation, development, and study of the efficacy of peer review techniques and how these efforts can help improve the safety and quality of our treatments. PMID:24175002

  14. Efficacy and safety of artemisinin combination therapy (ACT) for non-falciparum malaria: a systematic review.

    PubMed

    Visser, Benjamin J; Wieten, Rosanne W; Kroon, Daniëlle; Nagel, Ingeborg M; Bélard, Sabine; van Vugt, Michèle; Grobusch, Martin P

    2014-11-26

    Artemisinin combination therapy (ACT) is recommended as first-line treatment for uncomplicated Plasmodium falciparum malaria, whereas chloroquine is still commonly used for the treatment of non-falciparum species (Plasmodium vivax, Plasmodium ovale and Plasmodium malariae). A more simplified, more uniform treatment approach across all malaria species is worthwhile to be considered both in endemic areas and for malaria as an imported condition alike. A PROSPERO-registered systematic review to determine the efficacy and safety of ACT for the treatment of non-falciparum malaria was conducted, following PRISMA guidelines. Without language restrictions, Medline/PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, LILACS, Biosis Previews and the African Index Medicus were searched for studies published up to November 2014. The literature search identified 986 reports; 40 publications were found eligible for inclusion, all of them on non-falciparum malaria in endemic areas. Most evidence was available for P. vivax (n = 35). Five clinical trials in total were identified evaluating ACT for P. ovale, P. malariae and Plasmodium knowlesi. Most ACT presentations have high efficacy against P. vivax parasites; artemisinin-based combinations have shorter parasite and fever clearance times compared to chloroquine. ACT is as effective as chloroquine in preventing recurrent parasitaemia before day 28. Artemisinin-based combinations with long half-lives show significantly fewer recurrent parasitaemia up to day 63. The limited evidence available supports both the use of chloroquine and an ACT for P. ovale and P. malariae. ACT seems to be preferable for optimal treatment of P. knowlesi. ACT is at least equivalent to chloroquine in effectively treating non-falciparum malaria. These findings may facilitate development of simplified protocols for treating all forms of malaria with ACT, including returning travellers. Obtaining comprehensive efficacy and

  15. Genetically modified foods: safety, risks and public concerns-a review.

    PubMed

    Bawa, A S; Anilakumar, K R

    2013-12-01

    Genetic modification is a special set of gene technology that alters the genetic machinery of such living organisms as animals, plants or microorganisms. Combining genes from different organisms is known as recombinant DNA technology and the resulting organism is said to be 'Genetically modified (GM)', 'Genetically engineered' or 'Transgenic'. The principal transgenic crops grown commercially in field are herbicide and insecticide resistant soybeans, corn, cotton and canola. Other crops grown commercially and/or field-tested are sweet potato resistant to a virus that could destroy most of the African harvest, rice with increased iron and vitamins that may alleviate chronic malnutrition in Asian countries and a variety of plants that are able to survive weather extremes. There are bananas that produce human vaccines against infectious diseases such as hepatitis B, fish that mature more quickly, fruit and nut trees that yield years earlier and plants that produce new plastics with unique properties. Technologies for genetically modifying foods offer dramatic promise for meeting some areas of greatest challenge for the 21st century. Like all new technologies, they also pose some risks, both known and unknown. Controversies and public concern surrounding GM foods and crops commonly focus on human and environmental safety, labelling and consumer choice, intellectual property rights, ethics, food security, poverty reduction and environmental conservation. With this new technology on gene manipulation what are the risks of "tampering with Mother Nature"?, what effects will this have on the environment?, what are the health concerns that consumers should be aware of? and is recombinant technology really beneficial? This review will also address some major concerns about the safety, environmental and ecological risks and health hazards involved with GM foods and recombinant technology.

  16. Review of the regulation and safety assessment of food substances in various countries and jurisdictions

    PubMed Central

    Magnuson, Bernadene; Munro, Ian; Abbot, Peter; Baldwin, Nigel; Lopez-Garcia, Rebeca; Ly, Karen; McGirr, Larry; Roberts, Ashley; Socolovsky, Susan

    2013-01-01

    This review compares the regulations, definitions and approval processes for substances intentionally added to or unintentionally present in human food in the following specific countries/jurisdictions: Argentina, Australia, Brazil, Canada, China, the European Union, Japan, Mexico, New Zealand, and the United States. This includes direct food additives, food ingredients, flavouring agents, food enzymes and/or processing aids, food contact materials, novel foods, and nanoscale materials for food applications. The regulatory authority of each target jurisdiction/country uses its own regulatory framework and although the definitions, regulations and approval processes may vary among all target countries, in general there are many similarities. In all cases, the main purpose of each authority is to establish a regulatory framework and maintain/enforce regulations to ensure that food consumed and sold within its respective countries is safe. There is a move towards harmonisation of food regulations, as illustrated by Australia and New Zealand and by Mercosur. The European Union has also established regulations, which are applicable for all member states, to establish a common authorisation procedure for direct food additives, flavourings and enzymes. Although the path for approval of different categories of food additives varies from jurisdiction to jurisdiction, there are many commonalities in terms of the data requirements and considerations for assessment of the safety of use of food additives, including the use of positive lists of approved substances, pre-market approval, and a separation between science and policy decisions. The principles applied are largely reflective of the early work by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) committees and JECFA assessments of the safety of food additives for human and animal foods. PMID:23781843

  17. Review of the regulation and safety assessment of food substances in various countries and jurisdictions.

    PubMed

    Magnuson, Bernadene; Munro, Ian; Abbot, Peter; Baldwin, Nigel; Lopez-Garcia, Rebeca; Ly, Karen; McGirr, Larry; Roberts, Ashley; Socolovsky, Susan

    2013-01-01

    This review compares the regulations, definitions and approval processes for substances intentionally added to or unintentionally present in human food in the following specific countries/jurisdictions: Argentina, Australia, Brazil, Canada, China, the European Union, Japan, Mexico, New Zealand, and the United States. This includes direct food additives, food ingredients, flavouring agents, food enzymes and/or processing aids, food contact materials, novel foods, and nanoscale materials for food applications. The regulatory authority of each target jurisdiction/country uses its own regulatory framework and although the definitions, regulations and approval processes may vary among all target countries, in general there are many similarities. In all cases, the main purpose of each authority is to establish a regulatory framework and maintain/enforce regulations to ensure that food consumed and sold within its respective countries is safe. There is a move towards harmonisation of food regulations, as illustrated by Australia and New Zealand and by Mercosur. The European Union has also established regulations, which are applicable for all member states, to establish a common authorisation procedure for direct food additives, flavourings and enzymes. Although the path for approval of different categories of food additives varies from jurisdiction to jurisdiction, there are many commonalities in terms of the data requirements and considerations for assessment of the safety of use of food additives, including the use of positive lists of approved substances, pre-market approval, and a separation between science and policy decisions. The principles applied are largely reflective of the early work by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) committees and JECFA assessments of the safety of food additives for human and animal foods.

  18. Review of endoscopic radiofrequency in biliopancreatic tumours with emphasis on clinical benefits, controversies and safety

    PubMed Central

    Alvarez-Sánchez, María-Victoria; Napoléon, Bertrand

    2016-01-01

    Most pancreatic cancers and extrahepatic cholangiocarcinomas are unresectable at the time of diagnosis, and even in case of a resectable cancer, for elderly or patients with coexistent comorbidities, surgery is not an option. Current treatment alternatives in these scenarios are very limited. Biliary stenting with self-expanding metal stents (SEMS) is the mainstay palliative treatment of biliary obstruction due to unresectable pancreatic cancer or cholangiocarcinoma. Nevertheless, more than 50% of SEMS become occluded after 6 mo due to tumour over- and ingrowth, leading to hospital readmissions and reinterventions that significantly impair quality of life. Regimes of chemotherapy or chemoradiotherapy also provide minimal survival benefits. Therefore, novel therapies are eagerly awaited. Radiofrequency (RF) energy causes coagulative necrosis leading to local destruction of the accessed malignant tissue and has an established role in the treatment of malignancies in several solid organs, especially liver cancers. However, pancreatic and extrahepatic biliary cancers are not easily accessed by a percutaneous route, making the procedure dangerous. Over the past five years, the development of dedicated devices compatible with endoscopic instruments has offered a minimally invasive option for RF energy delivery in biliopancreatic cancers. Emerging experience with endoscopic RF ablation (RFA) in this setting has been reported in the literature, but little is known about its feasibility, efficacy and safety. A literature review makes it clear that RFA in biliopancreatic tumours is feasible with high rates of technical success and acceptable safety profile. Although available data suggest a benefit of survival with RFA, there is not enough evidence to draw a firm conclusion about its efficacy. For this reason, prospective randomized trials comparing RFA with standard palliative treatments with quality-of-life and survival endpoints are required. Anecdotal reports have also

  19. The development of neural stimulators: a review of preclinical safety and efficacy studies.

    PubMed

    Shepherd, Robert K; Villalobos, Joel; Burns, Owen; Nayagam, David

    2018-05-14

    Given the rapid expansion of the field of neural stimulation and the rigorous regulatory approval requirements required before these devices can be applied clinically, it is important that there is clarity around conducting preclinical safety and efficacy studies required for the development of this technology. The present review examines basic design principles associated with the development of a safe neural stimulator and describes the suite of preclinical safety studies that need to be considered when taking a device to clinical trial. Neural stimulators are active implantable devices that provide therapeutic intervention, sensory feedback or improved motor control via electrical stimulation of neural or neuro-muscular tissue in response to trauma or disease. Because of their complexity, regulatory bodies classify these devices in the highest risk category (Class III), and they are therefore required to go through a rigorous regulatory approval process before progressing to market. The successful development of these devices is achieved through close collaboration across disciplines including engineers, scientists and a surgical/clinical team, and the adherence to clear design principles. Preclinical studies form one of several key components in the development pathway from concept to product release of neural stimulators. Importantly, these studies provide iterative feedback in order to optimise the final design of the device. Key components of any preclinical evaluation include: in vitro studies that are focussed on device reliability and include accelerated testing under highly controlled environments; in vivo studies using animal models of the disease or injury in order to assess safety and, given an appropriate animal model, the efficacy of the technology under both passive and electrically active conditions; and human cadaver and ex vivo studies designed to ensure the device's form factor conforms to human anatomy, to optimise the surgical approach and to

  20. Simultaneous X-ray and radio observations of the radio-mode-switching pulsar PSR B1822$-$09

    DOE PAGES

    Hermsen, W.; Kuiper, L.; Hessels, J. W. T.; ...

    2016-12-05

    Here, we report on simultaneous X-ray and radio observations of the radio-mode-switching pulsar PSR B1822–09 with ESA's XMM–Newton and the Westerbork Synthesis Radio Telescope, Giant Metrewave Radio Telescope and Lovell radio telescopes. PSR B1822–09 switches between a radio-bright and radio-quiet mode, and we discovered a relationship between the durations of its modes and a known underlying radio-modulation time-scale within the modes. We discovered X-ray (energies 0.2–1.4 keV) pulsations with a broad sinusoidal pulse, slightly lagging the radio main pulse in phase by 0.094 ± 0.017, with an energy-dependent pulsed fraction varying from ~0.15 at 0.3 keV to ~0.6 at 1more » keV. No evidence is found for simultaneous X-ray and radio mode switching. The total X-ray spectrum consists of a cool component (T ~0.96 × 10 6 K, hotspot radius R ~2.0 km) and a hot component (T ~2.2 × 10 6 K, R ~100 m). The hot component can be ascribed to the pulsed emission and the cool component to the unpulsed emission. The high-energy characteristics of PSR B1822–09 resemble those of middle-aged pulsars such as PSR B0656+14, PSR B1055–52 and Geminga, including an indication for pulsed high-energy gamma-ray emission in Fermi Large Area Telescope data. Explanations for the high pulsed fraction seem to require different temperatures at the two poles of this orthogonal rotator, or magnetic anisotropic beaming effects in its strong magnetic field. In our X-ray skymap, we found a harder source at only 5.1 ± 0.5 arcsec from PSR B1822–09, which might be a pulsar wind nebula.« less