Leadership for safety: industrial experience.

PubMed

Flin, R; Yule, S

2004-12-01

The importance of leadership for effective safety management has been the focus of research attention in industry for a number of years, especially in energy and manufacturing sectors. In contrast, very little research into leadership and safety has been carried out in medical settings. A selective review of the industrial safety literature for leadership research with possible application in health care was undertaken. Emerging findings show the importance of participative, transformational styles for safety performance at all levels of management. Transactional styles with attention to monitoring and reinforcement of workers' safety behaviours have been shown to be effective at the supervisory level. Middle managers need to be involved in safety and foster open communication, while ensuring compliance with safety systems. They should allow supervisors a degree of autonomy for safety initiatives. Senior managers have a prime influence on the organisation's safety culture. They need to continuously demonstrate a visible commitment to safety, best indicated by the time they devote to safety matters.

Comparing two safety culture surveys: safety attitudes questionnaire and hospital survey on patient safety.

PubMed

Etchegaray, Jason M; Thomas, Eric J

2012-06-01

To examine the reliability and predictive validity of two patient safety culture surveys-Safety Attitudes Questionnaire (SAQ) and Hospital Survey on Patient Safety Culture (HSOPS)-when administered to the same participants. Also to determine the ability to convert HSOPS scores to SAQ scores. Employees working in intensive care units in 12 hospitals within a large hospital system in the southern United States were invited to anonymously complete both safety culture surveys electronically. All safety culture dimensions from both surveys (with the exception of HSOPS's Staffing) had adequate levels of reliability. Three of HSOPS's outcomes-frequency of event reporting, overall perceptions of patient safety, and overall patient safety grade-were significantly correlated with SAQ and HSOPS dimensions of culture at the individual level, with correlations ranging from r=0.41 to 0.65 for the SAQ dimensions and from r=0.22 to 0.72 for the HSOPS dimensions. Neither the SAQ dimensions nor the HSOPS dimensions predicted the fourth HSOPS outcome-number of events reported within the last 12 months. Regression analyses indicated that HSOPS safety culture dimensions were the best predictors of frequency of event reporting and overall perceptions of patient safety while SAQ and HSOPS dimensions both predicted patient safety grade. Unit-level analyses were not conducted because indices did not indicate that aggregation was appropriate. Scores were converted between the surveys, although much variance remained unexplained. Given that the SAQ and HSOPS had similar reliability and predictive validity, investigators and quality and safety leaders should consider survey length, content, sensitivity to change and the ability to benchmark when selecting a patient safety culture survey.

[Associations of occupational safety atmosphere and behaviors with unintentional injuries].

PubMed

Xiao, Ya-ni; Huang, Zhi-xiong; Huang, Shao-bin; Cao, Xiao-ou; Chen, Xia-ming; Liu, Xu-hua; Chen, Wei-qing

2012-07-01

To evaluate the associations of perception of safety atmosphere at workplace, occupational safety attitude and behaviors with occupational unintentional injury among manufacturing workers. A cross-sectional study was performed and a self-administered questionnaire was used to inquire socio-demographic characteristics, perceived safety atmosphere, occupational safety attitudes, occupational safety behaviors and occupational unintentional injuries among 10585 manufacturing workers selected from 46 enterprises in Guangdong. Structural equation modeling was applied to assess the relationship of the perception of safety atmosphere at workplace, occupational safety attitude, and occupational safety behaviors with occupational unintentional injury. Among 24 pathways supposed in structural equation model, 20 pathways (except for the attitude toward occupational safety, the attitude toward managers' support, the work posture and individual protection) were significantly related to the occupational unintentional injuries. The further analysis indicated that the perceived safety atmosphere might impact the occupational unintentional injuries by the attitude toward occupational safety and occupational safety behaviors. Workers' perception of safety atmosphere indirectly influenced on occupational unintentional injuries through occupational safety attitudes and occupational safety behaviors.

Safety outcomes in the United States: trends and challenges in measurement.

PubMed

Greenberg, Michael D; Haviland, Amelia M; Yu, Hao; Farley, Donna O

2009-04-01

To prepare Agency for Healthcare Research and Quality (AHRQ) for monitoring the impact of its own patient safety initiative, by exploring available outcomes data, assessing usability of measures, and estimating national trends in patient outcomes. Annual summary data on incidence of Joint Commission Sentinel Events, MEDMARX medication error events, and MDS measures of falls and pressure ulcers in nursing home residents. HCUP National Inpatient Sample (NIS) administrative claims data. Description and assessment of published summary data on selected safety measures. Analysis of selected Patient Safety Indicators (PSIs) and Utah–Missouri adverse event measures using HCUP NIS claims data (1994–2003). Interpretation of safety outcome trends requires close attention to the characteristics of underlying data sources and measures. Encounter-based measures have been affected by changes in definitions and ICD-9 coding, as well as by changes in the structure of administrative datasets like HCUP NIS. Historical trends are mixed for the safety outcome measures reviewed, with some measures showing improvement, others deterioration, and still others remaining fairly stable. Constructing national trends of safety outcomes is difficult because of limitations in available data sources and measures. Tracking growth in the adoption of safe practices could offer an important strategy for complementing existing safety measurement capabilities.

Leadership for safety: industrial experience

PubMed Central

Flin, R; Yule, S

2004-01-01

The importance of leadership for effective safety management has been the focus of research attention in industry for a number of years, especially in energy and manufacturing sectors. In contrast, very little research into leadership and safety has been carried out in medical settings. A selective review of the industrial safety literature for leadership research with possible application in health care was undertaken. Emerging findings show the importance of participative, transformational styles for safety performance at all levels of management. Transactional styles with attention to monitoring and reinforcement of workers' safety behaviours have been shown to be effective at the supervisory level. Middle managers need to be involved in safety and foster open communication, while ensuring compliance with safety systems. They should allow supervisors a degree of autonomy for safety initiatives. Senior managers have a prime influence on the organisation's safety culture. They need to continuously demonstrate a visible commitment to safety, best indicated by the time they devote to safety matters. PMID:15576692

Selected Indicators of Adolescent Violence & Safety at School.

ERIC Educational Resources Information Center

Mikow, Victoria A.

Fights, weapons, and stolen or intentionally damaged property are common concerns of most schools in North Carolina. The results of this survey indicate that 27 percent of all 9th-12th grade students reported carrying a weapon (gun, knife, club) within the month prior to this survey. A significant percentage of students do not feel safe at school…

The Influence of Safety, Efficacy, and Medical Condition Severity on Natural versus Synthetic Drug Preference.

PubMed

Meier, Brian P; Lappas, Courtney M

2016-11-01

Research indicates that there is a preference for natural v. synthetic products, but the influence of this preference on drug choice in the medical domain is largely unknown. We present 5 studies in which participants were asked to consider a hypothetical situation in which they had a medical issue requiring pharmacological therapy. Participants ( N = 1223) were asked to select a natural, plant-derived, or synthetic drug. In studies 1a and 1b, approximately 79% of participants selected the natural v. synthetic drug, even though the safety and efficacy of the drugs were identical. Furthermore, participants rated the natural drug as safer than the synthetic drug, and as that difference increased, the odds of choosing the natural over synthetic drug increased. In studies 2 and 3, approximately 20% of participants selected the natural drug even when they were informed that it was less safe (study 2) or less effective (study 3) than the synthetic drug. Finally, in study 4, approximately 65% of participants chose a natural over synthetic drug regardless of the severity of a specific medical condition (mild v. severe hypertension), and this choice was predicted by perceived safety and efficacy differences. Overall, these data indicate that there is a bias for natural over synthetic drugs. This bias could have implications for drug choice and usage. © The Author(s) 2015.

The impact of red light cameras on safety in Arizona.

PubMed

Shin, Kangwon; Washington, Simon

2007-11-01

Red light cameras (RLCs) have been used in a number of US cities to yield a demonstrable reduction in red light violations; however, evaluating their impact on safety (crashes) has been relatively more difficult. Accurately estimating the safety impacts of RLCs is challenging for several reasons. First, many safety related factors are uncontrolled and/or confounded during the periods of observation. Second, "spillover" effects caused by drivers reacting to non-RLC equipped intersections and approaches can make the selection of comparison sites difficult. Third, sites selected for RLC installation may not be selected randomly, and as a result may suffer from the regression to the mean bias. Finally, crash severity and resulting costs need to be considered in order to fully understand the safety impacts of RLCs. Recognizing these challenges, a study was conducted to estimate the safety impacts of RLCs on traffic crashes at signalized intersections in the cities of Phoenix and Scottsdale, Arizona. Twenty-four RLC equipped intersections in both cities are examined in detail and conclusions are drawn. Four different evaluation methodologies were employed to cope with the technical challenges described in this paper and to assess the sensitivity of results based on analytical assumptions. The evaluation results indicated that both Phoenix and Scottsdale are operating cost-effective installations of RLCs: however, the variability in RLC effectiveness within jurisdictions is larger in Phoenix. Consistent with findings in other regions, angle and left-turn crashes are reduced in general, while rear-end crashes tend to increase as a result of RLCs.

The comparison of road safety survey answers between web-panel and face-to-face; Dutch results of SARTRE-4 survey.

PubMed

Goldenbeld, C; de Craen, S

2013-09-01

In the Netherlands, a comparison of an online and a face-to-face sample of car drivers was made to study differences on a number of selected questions from the SARTRE-4 road safety survey. Contrary to expectations, there was no indication that online respondents were more likely to come from higher educated or more privileged social groups. Confirming earlier research, the results indicated that online respondents were less inclined to give socially desirable answers and were less inclined to use more extreme ratings in their opinions about measures. Contrary to expectations, face-to-face respondents did not tend to give more positive answers in judgment of road safety measures. Weighting to make samples comparable on gender, age, and education had almost no effect on outcomes. The implications for a transition from face-to-face survey to online panel method are discussed. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

Stakeholders' perspectives on quality indicators for diabetes care: a qualitative study.

PubMed

Markhorst, Joekie; Martirosyan, Liana; Calsbeek, Hiske; Braspenning, Jozé

2012-01-01

Transparency in diabetes care requires quality indicators that are of interest to stakeholders in order to optimise their usage. Indicator development is often focused on consensus, and little is known about stakeholders' preferences for information on quality. To explore the preferences of consumers, providers, purchasers and policy makers for different quality domains and indicators in relation to the intended use of quality indicators. Between June and December 2009, 14 semi-structured interviews were held with stakeholders who have a decisive vote in the selection of the national indicator set for diabetes care in the Netherlands. The following subjects were explored: (1) the aims of using information on quality; (2) the interpretation of and preferences for the quality domains of safety, timeliness, effectiveness and patient-centredness in relation to the user aims; and (3) the preferences for structure, process or outcome indicators. Content analysis was used to analyse qualitative data. Stakeholders had similar and different aims according to their roles. The interpretations of quality domains varied greatly between the stakeholders. Besides differences in interpretation, their preferences were similar. Most stakeholders prioritised patient-centredness above the other domains of quality, ranked in order of priority as safety, effectiveness and timeliness, whereas purchasers also prioritised efficiency. All stakeholders preferred to use process indicators or a mix of process and outcome indicators. The preferences of the stakeholders for quality indicators seem to be neither well-refined nor congruent. The implementation of an indicator set can probably be improved if the stakeholders' definitions and preferences for quality domains become more explicit during the selection process for indicators.

Nursing home safety: does financial performance matter?

PubMed

Oetjen, Reid M; Zhao, Mei; Liu, Darren; Carretta, Henry J

2011-01-01

This study examines the relationship between financial performance and selected safety measures of nursing homes in the State of Florida. We used descriptive analysis on a total sample of 1,197. Safety information was from the Online Survey, Certification and Reporting (OSCAR) data of 2003 to 2005, while the financial performance measures were from the Medicare cost reports of 2002 to 2004. Finally, we examined the most frequently cited deficiencies as well as the relationship between financial performance and quality indicators. Nursing homes in the bottom quartile of financial performance perform poorly on most resident-safety measures of care; however, nursing homes in the top two financial categories also experienced a higher number of deficiencies. Nursing homes in the next to lowest quartile of financial performance category best perform on most of these safety measures. The results reinforce the need to monitor nursing home quality and resident safety in US nursing homes, especially among facilities with poor overall financial performance.

Integrated indicator to evaluate vehicle performance across: Safety, fuel efficiency and green domains.

PubMed

Torrao, G; Fontes, T; Coelho, M; Rouphail, N

2016-07-01

In general, car manufacturers face trade-offs between safety, efficiency and environmental performance when choosing between mass, length, engine power, and fuel efficiency. Moreover, the information available to the consumers makes difficult to assess all these components at once, especially when aiming to compare vehicles across different categories and/or to compare vehicles in the same category but across different model years. The main objective of this research was to develop an integrated tool able to assess vehicle's performance simultaneously for safety and environmental domains, leading to the research output of a Safety, Fuel Efficiency and Green Emissions (SEG) indicator able to evaluate and rank vehicle's performance across those three domains. For this purpose, crash data was gathered in Porto (Portugal) for the period 2006-2010 (N=1374). The crash database was analyzed and crash severity prediction models were developed using advanced logistic regression models. Following, the methodology for the SEG indicator was established combining the vehicle's safety and the environmental evaluation into an integrated analysis. The obtained results for the SEG indicator do not show any trade-off between vehicle's safety, fuel consumption and emissions. The best performance was achieved for newer gasoline passenger vehicles (<5year) with a smaller engine size (<1400cm(3)). According to the SEG indicator, a vehicle with these characteristics can be recommended for a safety-conscious profile user, as well as for a user more interested in fuel economy and/or in green performance. On the other hand, for larger engine size vehicles (>2000cm(3)) the combined score for safety user profile was in average more satisfactory than for vehicles in the smaller engine size group (<1400cm(3)), which suggests that in general, larger vehicles may offer extra protection. The achieved results demonstrate that the developed SEG integrated methodology can be a helpful tool for consumers to evaluate their vehicle selection through different domains (safety, fuel efficiency and green emissions). Furthermore, SEG indicator allows the comparison of vehicles across different categories and vehicle model years. Hence, this research is intended to support the decision-making process for transportation policy, safety and sustainable mobility, providing insights not only to policy makers, but also for general public guidance. Copyright © 2016 Elsevier Ltd. All rights reserved.

Using machine learning for sequence-level automated MRI protocol selection in neuroradiology.

PubMed

Brown, Andrew D; Marotta, Thomas R

2018-05-01

Incorrect imaging protocol selection can lead to important clinical findings being missed, contributing to both wasted health care resources and patient harm. We present a machine learning method for analyzing the unstructured text of clinical indications and patient demographics from magnetic resonance imaging (MRI) orders to automatically protocol MRI procedures at the sequence level. We compared 3 machine learning models - support vector machine, gradient boosting machine, and random forest - to a baseline model that predicted the most common protocol for all observations in our test set. The gradient boosting machine model significantly outperformed the baseline and demonstrated the best performance of the 3 models in terms of accuracy (95%), precision (86%), recall (80%), and Hamming loss (0.0487). This demonstrates the feasibility of automating sequence selection by applying machine learning to MRI orders. Automated sequence selection has important safety, quality, and financial implications and may facilitate improvements in the quality and safety of medical imaging service delivery.

A job safety program for construction workers designed to reduce the potential for occupational injury using tool box training sessions and computer-assisted biofeedback stress management techniques.

PubMed

Johnson, Kenneth A; Ruppe, Joan

2002-01-01

This project was conducted with a multicultural construction company in Hawaii, USA. The job duties performed included drywall and carpentry work. The following objectives were selected for this project: (a) fire prevention training and inspection of first aid equipment; (b) blood-borne pathogen training and risk evaluation; (c) ergonomic and risk evaluation intervention program; (d) electrical safety training and inspection program; (e) slips, trips, and falls safety training; (f) stress assessment and Personal Profile System; (g) safety and health program survey; (h) improving employee relations and morale by emphasizing spirituality; and (i) computer-assisted biofeedback stress management training. Results of the project indicated that observed safety hazards, reported injuries, and levels of perceived stress. were reduced for the majority of the population.

SAFETY/TOXICITY ASSESSMENT OF CERIA (A MODEL ENGINEERED NP) TO THE BRAIN

EPA Science Inventory

The results will indicate the influence of the size, shape and various surface chemistry properties of ENMs on their entrance into BBB cells and the brain, compared to selected peripheral organs, the effects they produce in the brain, their biopersistence and biotransformation...

Quality Indicators for Safe Medication Preparation and Administration: A Systematic Review

PubMed Central

Maaskant, Jolanda M.; de Boer, Monica; Krediet, C. T. Paul; Nieveen van Dijkum, Els J. M.

2015-01-01

Background One-third of all medication errors causing harm to hospitalized patients occur in the medication preparation and administration phase, which is predominantly a nursing activity. To monitor, evaluate and improve the quality and safety of this process, evidence-based quality indicators can be used. Objectives The aim of study was to identify evidence-based quality indicators (structure, process and outcome) for safe in-hospital medication preparation and administration. Methods MEDLINE, EMBASE and CINAHL were searched for relevant studies published up to January 2015. Additionally, nine databases were searched to identify relevant grey literature. Two reviewers independently selected studies if (1) the method for quality indicator development combined a literature search with expert panel opinion, (2) the study contained quality indicators on medication safety, and (3) any of the quality indicators were applicable to hospital medication preparation and administration. A multidisciplinary team appraised the studies independently using the AIRE instrument, which contains four domains and 20 items. Quality indicators applicable to in-hospital medication preparation and administration were extracted using a structured form. Results The search identified 1683 studies, of which 64 were reviewed in detail and five met the inclusion criteria. Overall, according to the AIRE domains, all studies were clear on purpose; most of them applied stakeholder involvement and used evidence reasonably; usage of the indicator in practice was scarcely described. A total of 21 quality indicators were identified: 5 structure indicators (e.g. safety management and high alert medication), 11 process indicators (e.g. verification and protocols) and 5 outcome indicators (e.g. harm and death). These quality indicators partially cover the 7 rights. Conclusion Despite the relatively small number of included studies, the identified quality indicators can serve as an excellent starting point for further development of nursing specific quality indicators for medication safety. Especially on the right patient, right route, right time and right documentation there is room future development of quality indicators. PMID:25884623

Indicators of food and water security in an Arctic Health context--results from an international workshop discussion.

PubMed

Nilsson, Lena Maria; Berner, James; Dudarev, Alexey A; Mulvad, Gert; Odland, Jon Øyvind; Parkinson, Alan; Rautio, Arja; Tikhonov, Constantine; Evengård, Birgitta

2013-01-01

In August 2012, a literature search with the aim of describing indicators on food and water security in an Arctic health context was initialized in collaboration between the Arctic Human Health Expert Group, SDWG/AHHEG and the AMAP (Arctic Monitoring and Assessment Programme within the Arctic Council) Human Health Assessment Group, AMAP/HHAG. In December 2012, workshop discussions were performed with representatives from both of these organizations, including 7 Arctic countries. The aim of this article is to describe the workshop discussions and the rational for the 12 indicators selected and the 9 rejected and to discuss the potential feasibility of these. Advantages and disadvantages of candidate indicators were listed. Informative value and costs for collecting were estimated separately on a 3-level scale: low, medium and high. Based on these reviews, the final selection of promoted and rejected indicators was performed and summarized in tables. Among 10 suggested indicators of food security, 6 were promoted: healthy weight, traditional food proportion in diet, monetary food costs, non-monetary food accessibility, food-borne diseases and food-related contaminants. Four were rejected: per-person dietary energy supply, food security modules, self-estimated food safety and healthy eating. Among 10 suggested indicators of water security, 6 were promoted: per-capita renewable water, accessibility of running water, waterborne diseases, drinking-water-related contaminants, authorized water quality assurance and water safety plans. Four were rejected: water consumption, types of water sources, periodic water shortages and household water costs.

Indicators of food and water security in an Arctic Health context – results from an international workshop discussion

PubMed Central

Nilsson, Lena Maria; Berner, James; Dudarev, Alexey A.; Mulvad, Gert; Odland, Jon Øyvind; Parkinson, Alan; Rautio, Arja; Tikhonov, Constantine; Evengård, Birgitta

2013-01-01

In August 2012, a literature search with the aim of describing indicators on food and water security in an Arctic health context was initialized in collaboration between the Arctic Human Health Expert Group, SDWG/AHHEG and the AMAP (Arctic Monitoring and Assessment Programme within the Arctic Council) Human Health Assessment Group, AMAP/HHAG. In December 2012, workshop discussions were performed with representatives from both of these organizations, including 7 Arctic countries. The aim of this article is to describe the workshop discussions and the rational for the 12 indicators selected and the 9 rejected and to discuss the potential feasibility of these. Advantages and disadvantages of candidate indicators were listed. Informative value and costs for collecting were estimated separately on a 3-level scale: low, medium and high. Based on these reviews, the final selection of promoted and rejected indicators was performed and summarized in tables. Among 10 suggested indicators of food security, 6 were promoted: healthy weight, traditional food proportion in diet, monetary food costs, non-monetary food accessibility, food-borne diseases and food-related contaminants. Four were rejected: per-person dietary energy supply, food security modules, self-estimated food safety and healthy eating. Among 10 suggested indicators of water security, 6 were promoted: per-capita renewable water, accessibility of running water, waterborne diseases, drinking-water-related contaminants, authorized water quality assurance and water safety plans. Four were rejected: water consumption, types of water sources, periodic water shortages and household water costs. PMID:23940840

Production and evaluation of children's dietary life safety index data on metropolitan cities and provinces in Korea

PubMed Central

Choi, Young-Sun; Lee, Jung-Sug; Kim, Hye-Young; Kwak, Tong-Kyung; Chung, Hae Rang; Kwon, Sehyug; Choi, Youn-Ju; Lee, Soon-Kyu

2012-01-01

This pilot study was performed to produce data of the Children's Dietary Life Safety (CDLS) Index which is required by the Special Act on Safety Management of Children's Dietary Life and to evaluate the CDLS Index for 7 metropolitan cities and 9 provinces in Korea. To calculate the CDLS Index score, data regarding the evaluation indicators in the children's food safety domain and children's nutrition safety domain were collected from the local governments in 2009. For data regarding the indicators in the children's perception & practice domain, a survey was conducted on 2,400 5th grade children selected by stratified sampling in 16 local areas. Relative scores of indicators in each domain were calculated using the data provided by local governments and the survey, the weights are applied on relative scores, and then the CDLS Index scores of local governments were produced by adding scores of the 3 domains. The national average scores of the food safety domain, the nutrition safety domain and the perception and practice domain were 23.74 (14.67-26.50 on a 40-point scale), 16.65 (12.25-19.60 on a 40-point scale), and 14.88 (14.16-15.30 on a 20-point scale), respectively. The national average score of the CDLS Index which was produced by adding the scores of the three domains was 55.27 ranging 46.44-58.94 among local governments. The CDLS Index scores produced in this study may provide the motivation for comparing relative accomplishment and for actively achieving the goals through establishment of the target value by local governments. Also, it can be used as useful data for the establishment and improvement of children's dietary life safety policy at the national level. PMID:23346305

Operating manual-based usability evaluation of medical devices: an effective patient safety screening method.

PubMed

Turley, James P; Johnson, Todd R; Smith, Danielle Paige; Zhang, Jaijie; Brixey, Juliana J

2006-04-01

Use of medical devices often directly contributes to medical errors. Because it is difficult or impossible to change the design of existing devices, the best opportunity for improving medical device safety is during the purchasing process. However, most hospital personnel are not familiar with the usability evaluation methods designed to identify aspects of a user interface that do not support intuitive and safe use. A review of medical device operating manuals is proposed as a more practical method of usability evaluation. Operating manuals for five volumetric infusion pumps from three manufacturers were selected for this study (January-April 2003). Each manual's safety message content was evaluated to determine whether the message indicated a device design characteristic that violated known usability principles (heuristics) or indicated a violation of an affordance of the device. "Minimize memory load," with 65 violations, was the heuristic violated most frequently across pumps. Variations between pumps, including the frequency and severity of violations for each, were noted. Results suggest that manual review can provide a proxy for heuristic evaluation of the actual medical device. This method, intended to be a component of prepurchasing evaluation, can complement more formal usability evaluation methods and be used to select a subset of devices for more extensive and formal testing.

Development and applicability of Hospital Survey on Patient Safety Culture (HSOPS) in Japan.

PubMed

Ito, Shinya; Seto, Kanako; Kigawa, Mika; Fujita, Shigeru; Hasegawa, Toshihiko; Hasegawa, Tomonori

2011-02-07

Patient safety culture at healthcare organizations plays an important role in guaranteeing, improving and promoting overall patient safety. Although several conceptual frameworks have been proposed in the past, no standard measurement tool has yet been developed for Japan. In order to examine possibilities to introduce the Hospital Survey on Patient Safety Culture (HSOPS) in Japan, the authors of this study translated the HSOPS into Japanese, and evaluated its factor structure, internal consistency, and construct validity. Healthcare workers (n = 6,395) from 13 acute care general hospitals in Japan participated in this survey. Confirmatory factor analysis indicated that the Japanese HSOPS' 12-factor model was selected as the most pertinent, and showed a sufficiently high standard partial regression coefficient. The internal reliability of the subscale scores was 0.46-0.88. The construct validity of each safety culture sub-dimension was confirmed by polychoric correlation, and by an ordered probit analysis. The results of the present study indicate that the factor structures of the Japanese and the American HSOPS are almost identical, and that the Japanese HSOPS has acceptable levels of internal reliability and construct validity. This shows that the HSOPS can be introduced in Japan.

Additional Risk Minimisation Measures for Medicinal Products in the European Union: A Review of the Implementation and Effectiveness of Measures in the United Kingdom by One Marketing Authorisation Holder.

PubMed

Agyemang, Elaine; Bailey, Lorna; Talbot, John

2017-01-01

Additional risk minimisation measures (aRMMs) for medicinal products are necessary to address specific important safety issues which may not be practically achieved through routine risk management measures alone. The implementation and determination of effectiveness for aRMMs can be a challenge as it involves multiple stakeholders. It is therefore important to have concise objectives to avoid undue burden on patients, healthcare professionals and the healthcare system. The aim of this study was to examine how aRMMs are implemented and how effectiveness is assessed in the European Union (EU) using practical examples from Roche Products Limited in the United Kingdom (UK) (referred to as the 'Company'). Three centrally authorised products were selected from the Company's portfolio, each of which had aRMMs to address important safety concerns; specifically, teratogenicity, medication error and infections. The implementation of EU aRMMs, effectiveness checks and specific UK activities were analysed. Hard copy folders and electronic sites for Company aRMMs were used to assess process indicators. Periodic benefit-risk evaluation reports for specified time intervals and the Company safety database was used in checking safety outcomes for the selected products. For each product, the effectiveness of aRMMs was analysed based on specific process indicators and the subsequent safety outcomes. Literature searches were performed on scientific databases for the purposes of the broader study. The main process indicators in measuring effectiveness of Company aRMMs were distribution metrics for educational materials, assessment of awareness and clinical actions among healthcare professionals (HCPs). Case reports of pregnancy, medication errors and progressive multifocal leukoencephalopathy (PML) were the outcome indicators for Erivedge ® ▼, Kadcyla ® ▼ and MabThera ® (the latter specifically in autoimmune indications: rheumatoid arthritis, granulomatosis with polyangiitis and microscopic polyangiitis) respectively. No pregnancy, one medication error and 10 confirmed PML cases were reported for Erivedge ® ▼, Kadcyla ® ▼ and MabThera ® respectively. For the chosen products, a reasonable awareness of aRMMs amongst HCPs is a positive indicator of success in the use of educational materials. However, low response rates from surveys indicate that voluntary feedback may not always achieve the desired level of response in measuring effectiveness. There is a challenge in determining overall effectiveness of aRMMs due to a lack of defined success thresholds. Further regulatory guidance to outline the elements and desired outcomes of aRMMs will be useful for consistency in achieving successful outcomes.

Laser and high-frequency cauthery gingivectomy in nonperiodontal indications: assessment and comparison of techniques

NASA Astrophysics Data System (ADS)

Bartak, Petr; Smucler, Roman

2003-06-01

The authors have verified the efficiency and safety of laser and high-frequency gingivectomy in non-periodontal indications. Within a prospective, non-selective study, they treated and monitored 357 dental areas in 139 teeth.Out of the total number, 248 areas were treated wtih a diode laser, 980nm; 109 areas with high-frequency electrocautery. The following parameters were monitored: a) regeneration of the marginal gingiva; b) generation of iatrogenic recessions or periodontal pockets; c) bleeding from gingival sulcus during probing; d) changes in tooth vitality; e) patient's subjective evaluation. The authors identified a high degree of safety in both laser and high-frequency gingivectomy, with no significant difference between these two methods. Laser gingivectomy appears to have a wider indication range, while high-frequency gingivectomy requires lower financial expenses.

Systemic safety project selection tool.

DOT National Transportation Integrated Search

2013-07-01

"The Systemic Safety Project Selection Tool presents a process for incorporating systemic safety planning into traditional safety management processes. The Systemic Tool provides a step-by-step process for conducting systemic safety analysis; conside...

Optical spectroscopy for food and beverages control

NASA Astrophysics Data System (ADS)

Mignani, Anna Grazia; Ciaccheri, Leonardo; Mencaglia, Andrea Azelio

2011-08-01

A selection of spectroscopy-based, fiber optic and micro-optic devices is presented. They have been designed and tested for monitoring the quality and safety of typical foodstuffs. The VIS-NIR spectra, considered as product fingerprints, allowed to discriminating the geographic region of production and to detecting nutritional and nutraceutic indicators.

Lactic acid bacteria and natural antimicrobials to improve the safety and shelf-life of minimally processed sliced apples and lamb's lettuce.

PubMed

Siroli, Lorenzo; Patrignani, Francesca; Serrazanetti, Diana I; Tabanelli, Giulia; Montanari, Chiara; Gardini, Fausto; Lanciotti, Rosalba

2015-05-01

Outbreaks of food-borne disease associated with the consumption of fresh and minimally processed fruits and vegetables have increased dramatically over the last few years. Traditional chemical sanitizers are unable to completely eradicate or kill the microorganisms on fresh produce. These conditions have stimulated research to alternative methods for increasing food safety. The use of protective cultures, particularly lactic acid bacteria (LAB), has been proposed for minimally processed products. However, the application of bioprotective cultures has been limited at the industrial level. From this perspective, the main aims of this study were to select LAB from minimally processed fruits and vegetables to be used as biocontrol agents and then to evaluate the effects of the selected strains, alone or in combination with natural antimicrobials (2-(E)-hexenal/hexanal, 2-(E)-hexenal/citral for apples and thyme for lamb's lettuce), on the shelf-life and safety characteristics of minimally processed apples and lamb's lettuce. The results indicated that applying the Lactobacillus plantarum strains CIT3 and V7B3 to apples and lettuce, respectively, increased both the safety and shelf-life. Moreover, combining the selected strains with natural antimicrobials produced a further increase in the shelf-life of these products without detrimental effects on the organoleptic qualities. Copyright © 2014 Elsevier Ltd. All rights reserved.

Impact of Venetoclax Exposure on Clinical Efficacy and Safety in Patients with Relapsed or Refractory Chronic Lymphocytic Leukemia.

PubMed

Freise, Kevin J; Jones, Aksana K; Eckert, Doerthe; Mensing, Sven; Wong, Shekman L; Humerickhouse, Rod A; Awni, Walid M; Salem, Ahmed Hamed

2017-05-01

Venetoclax is a selective, potent, first-in-class B-cell lymphoma-2 inhibitor that restores apoptosis in cancer cells and has demonstrated efficacy in a variety of hematological malignancies. The objective of this research was to characterize the relationship between venetoclax exposures and efficacy and safety in patients with relapsed or refractory (R/R) chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL). A total of 272 and 338 patients from four clinical studies were pooled for the exposure-efficacy and exposure-safety analyses, respectively. Demographics, baseline disease characteristics, and select co-medications were evaluated for their impact on efficacy (lymphocytes, tumor size, objective response [OR]) and safety (neutropenia and infection). Higher venetoclax concentrations led to a more rapid decrease in lymphocyte counts and tumor size, which translated into patients more rapidly achieving OR. The 17p deletion somatic mutation was not identified, in any of the analyses, to affect the responsiveness of patients to venetoclax. Model-based simulations of lymphocyte counts and tumor size estimated an OR rate (ORR) of 84.8 % (95 % confidence interval 81.5-88.0 %) at a venetoclax dosage of 400 mg daily, with minimal increase in ORR at higher doses. The safety analyses of the adverse events (grade 3 or higher) of neutropenia and infection indicated that higher average venetoclax concentrations were not associated with an increase in adverse events. The exposure-response analyses indicated that a venetoclax dosage regimen of 400 mg daily results in a high (>80 %) probability of achieving OR in R/R CLL/SLL patients, with minimal probability of increasing neutropenia or infection with higher exposures.

A Brighter Choice for Safety

NASA Technical Reports Server (NTRS)

2003-01-01

Emergency exit signs can be lifesavers, but only if they remain visible when people need them. All too often, power losses or poor visibility can render the signs ineffective. Luna Technologies International, Inc., of Kent, Washington, is shining new light on this safety issue. The company s LUNAplast(trademark) product line illuminates without the need for electricity, maintenance, or a power connection. LUNAplast, which benefited from tests conducted at Johnson Space Center, is so successful that NASA engineers selected it for the emergency exit pathway indicators on the International Space Station (ISS).

Impact of Modified System of Objectified Judgement Analysis (SOJA) methodology on prescribing costs of ACE inhibitors.

PubMed

Alabbadi, Ibrahim; Crealey, Grainne; Scott, Michael; Baird, Simon; Trouton, Tom; Mairs, Jill; McElnay, James

2006-01-01

System of Objectified Judgement Analysis (SOJA) is a structured approach to the selection of drugs for formulary inclusion. How- ever, while SOJA is a very important advance in drug selection for formulary purposes, it is hospital based and can only be applied to one indication at a time. In SOJA, cost has been given a primary role in the selection process as it has been included as a selection criterion from the start. Cost may therefore drive the selection of a particular drug product at the expense of other basic criteria such as safety or efficacy. The aims of this study were to use a modified SOJA approach in the selection of ACE inhibitors (ACEIs) for use in a joint formulary that bridges primary and secondary care within a health board in Northern Ireland, and to investigate the potential impact of the joint formulary on prescribing costs of ACEIs in that health board. The modified SOJA approach involved four phases in sequence: an evidence-based pharmacotherapeutic evaluation of all available ACEI drug entities, a separate safety/risk assessment analysis of products containing agents that exceeded the pharmacotherapeutic threshold, a budget-impact analysis and, finally, the selection of product lines. A comprehensive literature review and expert panel judgement informed the selection of criteria (and their relative weighting) for the pharmacotherapeutic evaluation. The resultant criteria/scoring system was circulated (in questionnaire format) to prescribers and stakeholders for comment. Based on statistical analysis of the latter survey results, the final scoring system was developed. Drug entities that exceeded the evidence threshold were sequentially entered into the second and third phases of the process. Five drug entities (11 currently available in the UK) exceeded the evidence threshold and 22 of 26 submitted product lines containing these drug entities satisfied the safety/risk assessment criteria. Three product lines, each containing a different drug entity, were selected for formulary inclusion after budget impact analysis was performed. The estimated potential annual cost savings for ACEIs (based on estimated annual usage in defined daily doses) for this particular health board was 42%. The modified SOJA approach has a significant contribution to make in containing the costs of ACEIs. Applying modified SOJA as a practical method for all indications will allow the development of a unified formulary that bridges secondary and primary care.

Health information security: a case study of three selected medical centers in iran.

PubMed

Hajrahimi, Nafiseh; Dehaghani, Sayed Mehdi Hejazi; Sheikhtaheri, Abbas

2013-03-01

Health Information System (HIS) is considered a unique factor in improving the quality of health care activities and cost reduction, but today with the development of information technology and use of internet and computer networks, patients' electronic records and health information systems have become a source for hackers. This study aims at checking health information security of three selected medical centers in Iran using AHP fuzzy and TOPSIS compound model. To achieve that security measures were identified, based on the research literature and decision making matrix using experts' points of view. Among the 27 indicators, seven indicators were selected as effective indicators and Fuzzy AHP technique was used to determine the importance of security indicators. Based on the comparisons made between the three selected medical centers to assess the security of health information, it is concluded that Chamran hospital has the most acceptable level of security and attention in three indicators of "verification and system design, user access management, access control system", Al Zahra Hospital in two indicators of "access management and network access control" and Amin Hospital in "equipment safety and system design". In terms of information security, Chamran Hospital ranked first, Al-Zahra Hospital ranked second and Al- Zahra hospital has the third place.

Health Information Security: A Case Study of Three Selected Medical Centers in Iran

PubMed Central

Hajrahimi, Nafiseh; Dehaghani, Sayed Mehdi Hejazi; Sheikhtaheri, Abbas

2013-01-01

Health Information System (HIS) is considered a unique factor in improving the quality of health care activities and cost reduction, but today with the development of information technology and use of internet and computer networks, patients’ electronic records and health information systems have become a source for hackers. Methods This study aims at checking health information security of three selected medical centers in Iran using AHP fuzzy and TOPSIS compound model. To achieve that security measures were identified, based on the research literature and decision making matrix using experts’ points of view. Results and discussion Among the 27 indicators, seven indicators were selected as effective indicators and Fuzzy AHP technique was used to determine the importance of security indicators. Based on the comparisons made between the three selected medical centers to assess the security of health information, it is concluded that Chamran hospital has the most acceptable level of security and attention in three indicators of “verification and system design, user access management, access control system”, Al Zahra Hospital in two indicators of “access management and network access control” and Amin Hospital in “equipment safety and system design”. In terms of information security, Chamran Hospital ranked first, Al-Zahra Hospital ranked second and Al- Zahra hospital has the third place. PMID:23572861

An overview of patient safety climate in the VA.

PubMed

Hartmann, Christine W; Rosen, Amy K; Meterko, Mark; Shokeen, Priti; Zhao, Shibei; Singer, Sara; Falwell, Alyson; Gaba, David M

2008-08-01

To assess variation in safety climate across VA hospitals nationally. Data were collected from employees at 30 VA hospitals over a 6-month period using the Patient Safety Climate in Healthcare Organizations survey. We sampled 100 percent of senior managers and physicians and a random 10 percent of other employees. At 10 randomly selected hospitals, we sampled an additional 100 percent of employees working in units with intrinsically higher hazards (high-hazard units [HHUs]). Data were collected using an anonymous survey design. We received 4,547 responses (49 percent response rate). The percent problematic response--lower percent reflecting higher levels of patient safety climate--ranged from 12.0-23.7 percent across hospitals (mean=17.5 percent). Differences in safety climate emerged by management level, clinician status, and workgroup. Supervisors and front-line staff reported lower levels of safety climate than senior managers; clinician responses reflected lower levels of safety climate than those of nonclinicians; and responses of employees in HHUs reflected lower levels of safety climate than those of workers in other areas. This is the first systematic study of patient safety climate in VA hospitals. Findings indicate an overall positive safety climate across the VA, but there is room for improvement.

Robotic selective neck dissection using a gasless postauricular facelift approach for early head and neck cancer: technical feasibility and safety.

PubMed

Tae, Kyung; Ji, Yong Bae; Song, Chang Myeon; Min, Hyun Jung; Kim, Kyung Rae; Park, Chul Won

2013-03-01

Abstract Background: Scarless and minimally invasive surgery is becoming popular in the head and neck area. We have developed a new robotic selective neck dissection procedure for head and neck squamous cell carcinoma (HNSCC) to avoid a long visible lateral neck scar. Here we report on the technical feasibility and safety of our procedure. We prospectively analyzed 4 patients with early HNSCC who underwent transoral robotic surgery (TORS) and concomitant robotic selective neck dissection via a gasless postauricular facelift approach using the da Vinci(®) Surgical System (Intuitive Surgical Inc., Sunnyvale, CA). Of these patients, 3 were male, and 1 was female. The mean age was 59.0±8.8 years. All patients had tongue cancer, with a clinically negative neck. Three patients were T1, and 1 patient was T2. All patients underwent partial glossectomy by TORS and elective robotic selective neck dissection including levels I, II, and III. The robotic selective neck dissection procedure was completed successfully in all patients. The mean operative time was 276±48 minutes. The mean number of lymph nodes removed was 19.3±7.3. Postoperative hematoma and transient marginal nerve palsy occurred in 1 patient each. Cosmetic satisfaction was excellent in all patients. Preliminary results indicate that robotic selective neck dissection via a gasless postauricular facelift approach is feasible and safe and allows for excellent postoperative cosmesis. Further studies are necessary to determine the oncologic safety and surgical completeness of this procedure compared with conventional neck dissection.

Benchmarking Global Food Safety Performances: The Era of Risk Intelligence.

PubMed

Valleé, Jean-Charles Le; Charlebois, Sylvain

2015-10-01

Food safety data segmentation and limitations hamper the world's ability to select, build up, monitor, and evaluate food safety performance. Currently, there is no metric that captures the entire food safety system, and performance data are not collected strategically on a global scale. Therefore, food safety benchmarking is essential not only to help monitor ongoing performance but also to inform continued food safety system design, adoption, and implementation toward more efficient and effective food safety preparedness, responsiveness, and accountability. This comparative study identifies and evaluates common elements among global food safety systems. It provides an overall world ranking of food safety performance for 17 Organisation for Economic Co-Operation and Development (OECD) countries, illustrated by 10 indicators organized across three food safety risk governance domains: risk assessment (chemical risks, microbial risks, and national reporting on food consumption), risk management (national food safety capacities, food recalls, food traceability, and radionuclides standards), and risk communication (allergenic risks, labeling, and public trust). Results show all countries have very high food safety standards, but Canada and Ireland, followed by France, earned excellent grades relative to their peers. However, any subsequent global ranking study should consider the development of survey instruments to gather adequate and comparable national evidence on food safety.

Serotonin reuptake inhibitors and breastfeeding: a systematic review.

PubMed

Orsolini, Laura; Bellantuono, Cesario

2015-01-01

The postnatal period represents a critical phase for mothers because of physiological hormonal changes, the increase of emotional reactions and a greater susceptibility for the onset/recrudescence of psychiatric disorders. Despite the evidence of an increasing utilization of antidepressant drugs during breastfeeding, there is still few reliable information on the neonatal safety of the selective serotonin reuptake inhibitors (SSRIs) and selective noradrenergic reuptake inhibitors (SNRIs) [serotonin reuptake inhibitors (SRIs)] in nursing mothers. The aim of this study is to provide a systematic review on the neonatal safety profile of these drugs during breastfeeding, also assessing the limits of available tools. MEDLINE and PubMed databases were searched without any language restrictions by using the following set of keywords: ((SSRIs OR selective serotonin inhibitor reuptake OR SNRIs OR selective serotonin noradrenaline inhibitor reuptake) AND (breastfeeding OR lactation OR breast milk)). A separate search was also performed for each SSRIs (paroxetine, fluvoxamine, fluoxetine, sertraline, citalopram and escitalopram) and SNRIs (venlafaxine and duloxetine). Sertraline and paroxetine show a better neonatal safety profile during breastfeeding as compared with other SRIs. Less data are available for fluvoxamine, escitalopram and duloxetine. Few studies followed up infants breastfeed for assessing the neurodevelopmental outcomes. Literature review clearly indicates paroxetine and sertraline as the drugs that should be preferred as first line choice in nursing women who need an antidepressant treatment. Copyright © 2014 John Wiley & Sons, Ltd.

Emerging analgesic drugs for Parkinson's disease.

PubMed

Perez-Lloret, Santiago; Rey, María Verónica; Dellapina, Estelle; Pellaprat, Jean; Brefel-Courbon, Christine; Rascol, Olivier

2012-06-01

Pain affects between 40 and 85% of Parkinson's disease (PD) patients. It is a frequently disabling and overlooked feature, which can significantly reduce health-related quality of life. Unfortunately, there are no universally recommended treatments for this condition. Evidence about the efficacy and safety of available analgesic treatments is summarized in this review. Potential targets for upcoming therapies are then discussed in light of what is currently known about the physiopathology of pain in PD. Protocols for efficacy and safety assessment of novel analgesic therapies are discussed. Finally, critical aspects of study protocol design such as patient selection or outcomes to be evaluated are discussed. Preliminary results indicate that duloxetine, cranial electrotherapy stimulation, rotigotine, subthalamic or pallidum nuclei stimulation or lesion or levodopa could be effective for treating pain in PD. Similarly, some case reports indicate that repetitive transcranial magnetic stimulation (rTMS) or apomorphine could be effective for relieving painful off-period dystonia. Clinical trials with rTMS or oxycodone/naloxone prolonged-release tablets for neuropathic pain or botulinum toxin for off-period dystonia are underway. Success of clinical trials about analgesic strategies in PD will depend on the selection of the right PD population to be treated, according to the type of pain, and the proper selection of study outcomes and follow-up of international recommendations.

Perhaps I am one of the lucky ones.

PubMed

Heenan, Michael

2010-01-01

I recently participated in the Ontario Hospital Association (OHA) webinar on quality and safety, in which I was asked to address the topic of engaging physicians in performance measurement, quality and safety. I am not a physician, but much of my work in healthcare has involved working with clinical leaders in these areas. At St. Joseph's Healthcare Hamilton, we started our quality and safety journey by creating a medical quality scorecard specifically designed for physicians. The card, written in physician-friendly versus business language, enabled physicians to drop the traditional business quadrants of finance and human resources and select four quadrants focused on clinical process and outcome indicators that matched their daily practice. Quality improvement initiatives resulting from the scorecard included the launch of a sepsis-management campaign in the emergency room and a new approach to neonatal safety.

[Strategy for implementing and assessing a health care risk management unit in a primary care area].

PubMed

Mena Mateo, José María; de la Fuente, Angel Sanz-Vírseda; Cañada Dorado, Asunción; Villamor Borrego, Manuela

2009-06-01

To describe the setting up of a clinical risk management unit (CRMU) within primary care management, as well as the aims of the project, its implementation phases and the assessment of the results after one year of experience. A safety plan was prepared, based on the European Excellence Model (EFQM), to establish a strategic working framework. The plan included 38 proposed actions, associated with criteria elements and 26 indicators to evaluate the selected criteria. A total of 82% of the anticipated actions were implemented in 2007, which included, actions related to teaching and training (15 activities with 237 trainees), spreading of information associated with patient safety, incident analysis (14) and the introduction of specific safe practices (12). Four of those were considered as "generalisable" safe practices and were spread to the rest of the CRMUs in the Autonomous Region of Madrid. The CRMUs have introduced and monitored three processes related to patient safety, participated in a formal programme on the polymedicated elderly, with good results in cover and quality of the indicators. A primary care team (PCT) from the area took part in the first study carried out in Spain on adverse effects in primary care (APEAS Study). The CRMU can give impetus to strategic lines of safety. The preparation of a strategy defining specific aims has helped in the introduction of patient safety activities and along with the proposed indicators enables the impact of the intervention to be assessed.

Food Safety Perceptions and Practices among Smallholder Pork Value Chain Actors in Hung Yen Province, Vietnam.

PubMed

Dang-Xuan, Sinh; Nguyen-Viet, Hung; Meeyam, Tongkorn; Fries, Reinhard; Nguyen-Thanh, Huong; Pham-Duc, Phuc; Lam, Steven; Grace, Delia; Unger, Fred

2016-09-01

Pork safety is an important public health concern in Vietnam and is a shared responsibility among many actors along the pork value chain. We examined the knowledge, perceptions, and practices regarding food safety, disease, and health risk among selected pork value chain actors (slaughterhouse owners and workers, people living around slaughterhouses, pork sellers, consumers, and veterinary and public health staff) in three districts in Hung Yen Province, Vietnam. We randomly selected 52 pork value chain actors to be surveyed through questionnaires, observation checklists, key informant interviews, and focus group discussions. Most slaughterhouse workers acquired knowledge and experience of food safety through "learning by doing" rather than from training by a veterinary or public health professional. Both slaughterhouse worker and pork seller groups had some accurate perceptions about pig diseases and foodborne diseases; however, misperceptions of risk and, especially, of zoonoses were present. Furthermore, while workers and sellers often use cloths to dry the meat and clean equipment, they did not think this was a risk for meat contamination. Moreover, when sellers wear protective equipment, such as gloves, masks, or hats, consumers perceive that the sellers may have health issues they are trying to conceal and so consumers avoid buying from them. The perceived freshness of pork, along with trust in the seller and in the pork production process, were strong indicators of consumer preference. And yet, pork value chain actors tend to trust their own individual food safety practices more, rather than the practices of other actors along the chain. Veterinary and public health staff emphasized the gap between regulations and food safety practices. Education and training on food safety risks and proper handling are priorities, along with integrated and intensive efforts to improve food safety among pork value chain actors.

Is Patient Safety Improving? National Trends in Patient Safety Indicators: 1998–2007

PubMed Central

Downey, John R; Hernandez-Boussard, Tina; Banka, Gaurav; Morton, John M

2012-01-01

Context Emphasis has been placed on quality and patient safety in medicine; however, little is known about whether quality over time has actually improved in areas such as patient safety indicators (PSIs). Objective To determine whether national trends for hospital PSIs have improved from 1998 to 2007. Design, Setting, and Participants Using PSI criteria from the Agency for Healthcare Research and Quality, PSIs were identified in the Nationwide Inpatient Sample (NIS) for all eligible inpatient admissions between 1998 and 2007. Joinpoint regression was used to estimate annual percentage changes (APCs) for PSIs. Main Outcome Measure Annual percent change for PSIs. Results From 1998 to 2007, 7.6 million PSI events occurred for over 69 million hospitalizations. A total of 14 PSIs showed statistically significant trends. Seven PSIs had increasing APC: postoperative pulmonary embolism or deep vein thrombosis (8.94), postoperative physiological or metabolic derangement (7.67), postoperative sepsis (7.17), selected infections due to medical care (4.05), decubitus ulcer (3.05), accidental puncture or laceration (2.64), and postoperative respiratory failure (1.46). Seven PSIs showed decreasing APCs: birth trauma injury to neonate (−17.79), failure to rescue (−6.05), postoperative hip fracture (−5.86), obstetric trauma–vaginal without instrument (−5.69), obstetric trauma–vaginal with instrument (−4.11), iatrogenic pneumothorax (−2.5), and postoperative wound dehiscence (−1.8). Conclusion This is the first study to establish national trends of PSIs during the past decade indicating areas for potential quality improvement prioritization. While many factors influence these trends, the results indicate opportunities for either emulation or elimination of current patient safety trends. PMID:22150789

Surface flow visualization using indicators

NASA Technical Reports Server (NTRS)

Crowder, J. P.

1982-01-01

Surface flow visualization using indicators in the cryogenic wind tunnel which requires a fresh look at materials and procedures to accommodate the new test conditions is described. Potential liquid and gaseous indicators are identified. The particular materials illustrate the various requirements an indicator must fulfill. The indicator must respond properly to the flow phenomenon of interest and must be observable. Boundary layer transition is the most important phenomenon for which flow visualization indicators may be employed. The visibility of a particular indicator depends on utilizing various optical or chemical reactions. Gaseous indicators are more difficult to utilize, but because of their diversity may present unusual and useful opportunities. Factors to be considered in selecting an indicator include handling safety, toxicity, potential for contamination of the tunnel, and cost.

A Double-Blind, Randomized, Placebo-Controlled Trial of Escitalopram in the Treatment of Pediatric Depression

ERIC Educational Resources Information Center

Wagner, Karen Dineen; Jonas, Jeffrey; Findling, Robert L.; Ventura, Daniel; Saikali, Khalil

2006-01-01

Objective: Escitalopram is a selective serotonin reuptake inhibitor antidepressant indicated for use in adults. This trial examined the efficacy and safety of escitalopram in pediatric depression. Method: Patients (6-17 years old) with major depressive disorder were randomized to receive 8 weeks of double-blind flexibly dosed treatment with…

78 FR 43967 - Mercedes-Benz USA, LLC, on Behalf of Daimler AG, Grant of Petition for Decision of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-22

... Federal Motor Vehicle Safety Standard (FMVSS) No. 110, Tire selection and rims and motor home/recreation... affixed to the driver's side B-pillar.* * * (b) Tire size designation, indicated by the headings ``size'' or ``original tire size'' or ``original size,'' and ``spare tire'' or ``spare,'' for the tires...

An Overview of Patient Safety Climate in the VA

PubMed Central

Hartmann, Christine W; Rosen, Amy K; Meterko, Mark; Shokeen, Priti; Zhao, Shibei; Singer, Sara; Falwell, Alyson; Gaba, David M

2008-01-01

Objective To assess variation in safety climate across VA hospitals nationally. Study Setting Data were collected from employees at 30 VA hospitals over a 6-month period using the Patient Safety Climate in Healthcare Organizations survey. Study Design We sampled 100 percent of senior managers and physicians and a random 10 percent of other employees. At 10 randomly selected hospitals, we sampled an additional 100 percent of employees working in units with intrinsically higher hazards (high-hazard units [HHUs]). Data Collection Data were collected using an anonymous survey design. Principal Findings We received 4,547 responses (49 percent response rate). The percent problematic response—lower percent reflecting higher levels of patient safety climate—ranged from 12.0–23.7 percent across hospitals (mean=17.5 percent). Differences in safety climate emerged by management level, clinician status, and workgroup. Supervisors and front-line staff reported lower levels of safety climate than senior managers; clinician responses reflected lower levels of safety climate than those of nonclinicians; and responses of employees in HHUs reflected lower levels of safety climate than those of workers in other areas. Conclusions This is the first systematic study of patient safety climate in VA hospitals. Findings indicate an overall positive safety climate across the VA, but there is room for improvement. PMID:18355257

An environmental scan of quality indicators in critical care.

PubMed

Valiani, Sabira; Rigal, Romain; Stelfox, Henry T; Muscedere, John; Martin, Claudio M; Dodek, Peter; Lamontagne, François; Fowler, Robert; Gheshmy, Afshan; Cook, Deborah J; Forster, Alan J; Hébert, Paul C

2017-06-21

We performed a directed environmental scan to identify and categorize quality indicators unique to critical care that are reported by key stakeholder organizations. We convened a panel of experts ( n = 9) to identify key organizations that are focused on quality improvement or critical care, and reviewed their online publications and website content for quality indicators. We identified quality indicators specific to the care of critically ill adult patients and then categorized them according to the Donabedian and the Institute of Medicine frameworks. We also noted the organizations' rationale for selecting these indicators and their reported evidence base. From 28 targeted organizations, we identified 222 quality indicators, 127 of which were unique. Of the 127 indicators, 63 (32.5%) were safety indicators and 61 (31.4%) were effectiveness indicators. The rationale for selecting quality indicators was supported by consensus for 58 (26.1%) of the 222 indicators and by published research evidence for 45 (20.3%); for 119 indicators (53.6%), the rationale was not reported or the reader was referred to other organizations' reports. Of the 127 unique quality indicators, 27 (21.2%) were accompanied by a formal grading of evidence, whereas for 52 (40.9%), no reference to evidence was provided. There are many quality indicators related to critical care that are available in the public domain. However, owing to a paucity of rationale for selection, supporting evidence and results of implementation, it is not clear which indicators should be adopted for use. Copyright 2017, Joule Inc. or its licensors.

An environmental scan of quality indicators in critical care

PubMed Central

Valiani, Sabira; Rigal, Romain; Stelfox, Henry T.; Muscedere, John; Martin, Claudio M.; Dodek, Peter; Lamontagne, François; Fowler, Robert; Gheshmy, Afshan; Cook, Deborah J.; Forster, Alan J.; Hébert, Paul C.

2017-01-01

Background: We performed a directed environmental scan to identify and categorize quality indicators unique to critical care that are reported by key stakeholder organizations. Methods: We convened a panel of experts (n = 9) to identify key organizations that are focused on quality improvement or critical care, and reviewed their online publications and website content for quality indicators. We identified quality indicators specific to the care of critically ill adult patients and then categorized them according to the Donabedian and the Institute of Medicine frameworks. We also noted the organizations' rationale for selecting these indicators and their reported evidence base. Results: From 28 targeted organizations, we identified 222 quality indicators, 127 of which were unique. Of the 127 indicators, 63 (32.5%) were safety indicators and 61 (31.4%) were effectiveness indicators. The rationale for selecting quality indicators was supported by consensus for 58 (26.1%) of the 222 indicators and by published research evidence for 45 (20.3%); for 119 indicators (53.6%), the rationale was not reported or the reader was referred to other organizations' reports. Of the 127 unique quality indicators, 27 (21.2%) were accompanied by a formal grading of evidence, whereas for 52 (40.9%), no reference to evidence was provided. Interpretation: There are many quality indicators related to critical care that are available in the public domain. However, owing to a paucity of rationale for selection, supporting evidence and results of implementation, it is not clear which indicators should be adopted for use. PMID:28637683

Eplerenone: a selective aldosterone receptor antagonist for patients with heart failure.

PubMed

Barnes, Brian J; Howard, Patricia A

2005-01-01

To evaluate the pharmacology, pharmacokinetics, safety, and clinical use of eplerenone in heart failure (HF). English-language MEDLINE searches were performed from 1966 to May 2004. Key words included eplerenone, aldosterone receptor antagonist, heart failure, myocardial infarction, left-ventricular dysfunction, and cost-effectiveness. Additional references were identified from bibliographies of selected articles. Human trials evaluating the efficacy, safety, and cost-effectiveness of aldosterone receptor antagonists in HF were evaluated. Eplerenone is the first selective aldosterone receptor antagonist. The drug is indicated to improve the survival of stable patients with left-ventricular systolic dysfunction (ejection fraction <40%) and clinical evidence of HF following acute myocardial infarction. Efficacy and safety in this population have been demonstrated in a large, randomized clinical trial. Eplerenone is associated with severe and sometimes life-threatening hyperkalemia. Patients with reduced renal function and diabetes, as well as those on other drugs that increase potassium levels, are at highest risk. Eplerenone is metabolized by the cytochrome P450 system and may interact with drugs that interfere with this system. A major advantage of eplerenone over the nonselective aldosterone receptor antagonist spironolactone is lack of binding to progesterone and androgen receptors, which is associated with drug-induced gynecomastia, breast pain, and impotence. The addition of eplerenone to traditional HF therapy has been shown to reduce morbidity and mortality in patients who develop left-ventricular dysfunction after acute myocardial infarction. Eplerenone's selectivity reduces sex hormone-related adverse effects. Despite these benefits, the overall cost-effectiveness has yet to be determined.

Comparison of safety effect estimates obtained from empirical Bayes before-after study, propensity scores-potential outcomes framework, and regression model with cross-sectional data.

PubMed

Wood, Jonathan S; Donnell, Eric T; Porter, Richard J

2015-02-01

A variety of different study designs and analysis methods have been used to evaluate the performance of traffic safety countermeasures. The most common study designs and methods include observational before-after studies using the empirical Bayes method and cross-sectional studies using regression models. The propensity scores-potential outcomes framework has recently been proposed as an alternative traffic safety countermeasure evaluation method to address the challenges associated with selection biases that can be part of cross-sectional studies. Crash modification factors derived from the application of all three methods have not yet been compared. This paper compares the results of retrospective, observational evaluations of a traffic safety countermeasure using both before-after and cross-sectional study designs. The paper describes the strengths and limitations of each method, focusing primarily on how each addresses site selection bias, which is a common issue in observational safety studies. The Safety Edge paving technique, which seeks to mitigate crashes related to roadway departure events, is the countermeasure used in the present study to compare the alternative evaluation methods. The results indicated that all three methods yielded results that were consistent with each other and with previous research. The empirical Bayes results had the smallest standard errors. It is concluded that the propensity scores with potential outcomes framework is a viable alternative analysis method to the empirical Bayes before-after study. It should be considered whenever a before-after study is not possible or practical. Copyright © 2014 Elsevier Ltd. All rights reserved.

Bertolette Selected as EHS Champion of Safety | Poster

Cancer.gov

Dan Bertolette has been selected as the most recent NCI at Frederick Champion of Safety, as part of the Champions of Safety Program sponsored by the Environment, Health, and Safety Program (EHS). The goal of the program, which began last year, is to raise awareness and promote a culture of safety by showing NCI at Frederick staff at work in their respective workplaces,

Do drug advertisements in Russian medical journals provide essential information for safe prescribing?

PubMed Central

Vlassov, Vasiliy; Mansfield, Peter; Lexchin, Joel; Vlassova, Anna

2001-01-01

Objective To examine pharmaceutical advertisements in medical journals for their adequacy of information. Methods We selected a convenience sample of 5 major Russian medical journals covering different fields of medicine and different types of publications. We evaluated all the ads in all the issues of the selected journals published during 1998. We counted the number of appearances of trade, chemical, and generic names; indication and contraindication; pharmacologic group; safety warnings; and references. Counts in all categories were aggregated for each advertiser. Results There were 397 placements of 207 distinct advertisements. Only 154 placements (40%) mentioned the generic name, 177 (45%) mentioned any indication, 42 (11%) mentioned safety warnings and contraindications, 21 (5%) warned about drug interactions, and 8 (2%) provided references. The 6 companies responsible for the most ads on average provided less information than the other companies. Conclusions Almost none of the drug ads published in Russian medical journals provide the basic information required for appropriate prescribing. This is despite the fact that in Russia, ads that omit essential information and that could lead consumers to misunderstandings about an advertised product are illegal. The arrival of drug advertising in Russia has brought little information and has been potentially damaging. PMID:11381003

Safety of probiotics and synbiotics in children under 18 years of age.

PubMed

van den Nieuwboer, M; Brummer, R J; Guarner, F; Morelli, L; Cabana, M; Claassen, E

2015-01-01

This study aimed to systematically evaluate safety of probiotics and synbiotics in children ageing 0-18 years. This study is the third and final part in a safety trilogy and an update is provided using the most recent available clinical data (2008-2013) by means of the Common Terminology Clinical Adverse Events (CTCAE version 4.0) classification. Safety aspects are represented and related to number of participants per probiotic strain/culture, study duration, dosage, clinical condition and selected afflictions. Analysis of 74 clinical studies indicated that probiotic and/or synbiotic administration in children is safe with regard to the specific evaluated strains, dosages and duration. The population of children include healthy, immune compromised and obese subjects, as well as subjects with intestinal disorders, infections and inflammatory disorders. This study revealed no major safety concerns, as the adverse events (AEs) were unrelated, or not suspected to be related, to the probiotic or synbiotic product. In general the study products were well tolerated. Overall, AEs occurred more frequent in the control arm compared to children receiving probiotics and/or synbiotics. Furthermore, the results indicate inadequate reporting and classification of AEs in the majority of the studies. In addition, generalizability of conclusions are greatly limited by the inconsistent, imprecise and potentially incomplete reporting as well as the variation in probiotic strains, dosages, administration regimes, study populations and reported outcomes.

A method for simplifying the analysis of traffic accidents injury severity on two-lane highways using Bayesian networks.

PubMed

Mujalli, Randa Oqab; de Oña, Juan

2011-10-01

This study describes a method for reducing the number of variables frequently considered in modeling the severity of traffic accidents. The method's efficiency is assessed by constructing Bayesian networks (BN). It is based on a two stage selection process. Several variable selection algorithms, commonly used in data mining, are applied in order to select subsets of variables. BNs are built using the selected subsets and their performance is compared with the original BN (with all the variables) using five indicators. The BNs that improve the indicators' values are further analyzed for identifying the most significant variables (accident type, age, atmospheric factors, gender, lighting, number of injured, and occupant involved). A new BN is built using these variables, where the results of the indicators indicate, in most of the cases, a statistically significant improvement with respect to the original BN. It is possible to reduce the number of variables used to model traffic accidents injury severity through BNs without reducing the performance of the model. The study provides the safety analysts a methodology that could be used to minimize the number of variables used in order to determine efficiently the injury severity of traffic accidents without reducing the performance of the model. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Employees in high-reliability organizations: systematic selection of personnel as a final criterion].

PubMed

Oubaid, V; Anheuser, P

2014-05-01

Employees represent an important safety factor in high-reliability organizations. The combination of clear organizational structures, a nonpunitive safety culture, and psychological personnel selection guarantee a high level of safety. The cockpit personnel selection process of a major German airline is presented in order to demonstrate a possible transferability into medicine and urology.

Living Liver Donor Selection and Resection at the University of Tokyo Hospital.

PubMed

Akamatsu, N; Kokudo, N

2016-05-01

Donor selection and operative procedures for adult-to-adult living donor liver transplantation at the University of Tokyo are presented. Donor selection criteria are as follows: age between 20 and 65 years, within 3 degrees of consanguinity, without coercion, free from any major comorbidities, body mass index (BMI) < 30, and ABO blood type identical or compatible. Liver biopsy is indicated for BMI > 25 kg/m(2) or any liver function abnormality, and those with macroscopic steatosis >10% are rejected. Thereafter, an indocyanine green retention test and dynamic computed tomography are evaluated. Graft type is determined based on computed tomography volumetry. An estimated graft volume of 40% to recipient standard liver volume ratio is the lower limit. For donor safety, the left liver is the first choice, provided that it satisfies the lower limit. Otherwise, right liver harvesting is indicated, providing that the estimated remnant liver volume is >30% of the donor's total liver volume. A posterior sector graft is a possible option. Between 1996 and 2014, 462 donor hepatectomies were performed, with 257 right livers, 179 left livers, and 26 posterior sectors. There was no mortality, and the incidence of morbidity grades I, II, IIIa, and IIIb was 16%, 5%, 5%, and 3%, respectively, without a difference between right and left liver grafts. The left liver was used without impairing recipient outcome. Two aborted hepatectomies (0.4%) and 3 near-miss events (0.6%) were encountered. Maximal effort should be applied to donor selection and operation for donor safety. Copyright © 2016 Elsevier Inc. All rights reserved.

The efficacy and safety of selective leukocytapheresis in the treatment of ulcerative colitis: a meta-analysis.

PubMed

Zhu, Mingming; Xu, Xitao; Nie, Fang; Tong, Jinlu; Xiao, Shudong; Ran, Zhihua

2011-08-01

The use of selective leukocytapheresis for the treatment of ulcerative colitis (UC) has been evaluated in several open and controlled trials, with varying outcomes. A meta-analysis was performed to better assess the efficacy and safety of selective leukocytapheresis as supplemental therapy compared with conventional pharmacotherapy in patients with UC. All randomized trials comparing selective leukocytapheresis supplementation with conventional pharmacotherapy were included from electronic databases and reference lists. A meta-analysis that pooled the outcome effects of leukocytapheresis and pharmacotherapy was performed. A fixed effect model or random effect model was selected depending on the heterogeneity test of the trials. Nine randomized controlled trials met the inclusion criteria contributing a total of 686 participants. Compared with conventional pharmacotherapy, leukocytapheresis supplementation presented a significant benefit in promoting a response rate (OR, 2.88, 95% CI: 1.60-5.18) and remission rate (OR, 2.04; 95% CI, 1.36-3.07) together with significant higher steroid-sparing effects (OR, 10.49; 95% CI, 3.44-31.93) in patients with active moderate-to-severe UC by intention-to-treat analysis. Leukocytapheresis was more effective in maintaining clinical remission for asymptomatic UC patients than conventional therapy (OR, 8.14; 95% CI, 2.22-29.90). The incidence of mild-moderate adverse effects was much less frequent in the leukocytapheresis groups than conventional pharmacotherapy groups (OR, 0.16; 95% CI, 0.04-0.60). Few severe adverse events were observed. Current data indicate that leukocytapheresis supplementation may be more efficacious on improving response and remission rates and tapering corticosteroid dosage with excellent tolerability and safety than conventional pharmacotherapy in patients with UC. In addition, more high-quality randomized controlled trials are required to confirm the higher efficacy of leukocytapheresis in patients with UC.

Development of an evaluation framework for African-European hospital patient safety partnerships.

PubMed

Rutter, Paul; Syed, Shamsuzzoha B; Storr, Julie; Hightower, Joyce D; Bagheri-Nejad, Sepideh; Kelley, Edward; Pittet, Didier

2014-04-01

Patient safety is recognised as a significant healthcare problem worldwide, and healthcare-associated infections are an important aspect. African Partnerships for Patient Safety is a WHO programme that pairs hospitals in Africa with hospitals in Europe with the objective to work together to improve patient safety. To describe the development of an evaluation framework for hospital-to-hospital partnerships participating in the programme. The framework was structured around the programme's three core objectives: facilitate strong interhospital partnerships, improve in-hospital patient safety and spread best practices nationally. Africa-based clinicians, their European partners and experts in patient safety were closely involved in developing the evaluation framework in an iterative process. The process defined six domains of partnership strength, each with measurable subdomains. We developed a questionnaire to measure these subdomains. Participants selected six indicators of hospital patient safety improvement from a short-list of 22 based on their relevance, sensitivity to intervention and measurement feasibility. Participants proposed 20 measures of spread, which were refined into a two-part conceptual framework, and a data capture tool created. Taking a highly participatory approach that closely involved its end users, we developed an evaluation framework and tools to measure partnership strength, patient safety improvements and the spread of best practice.

Extended time-to-collision measures for road traffic safety assessment.

PubMed

Minderhoud, M M; Bovy, P H

2001-01-01

This article describes two new safety indicators based on the time-to-collision notion suitable for comparative road traffic safety analyses. Such safety indicators can be applied in the comparison of a do-nothing case with an adapted situation, e.g. the introduction of intelligent driver support systems. In contrast to the classical time-to-collision value, measured at a cross section, the improved safety indicators use vehicle trajectories collected over a specific time horizon for a certain roadway segment to calculate the overall safety indicator value. Vehicle-specific indicator values as well as safety-critical probabilities can easily be determined from the developed safety measures. Application of the derived safety indicators is demonstrated for the assessment of the potential safety impacts of driver support systems from which it appears that some Autonomous Intelligent Cruise Control (AICC) designs are more safety-critical than the reference case without these systems. It is suggested that the indicator threshold value to be applied in the safety assessment has to be adapted when advanced AICC-systems with safe characteristics are introduced.

The relationship between attentional bias toward safety and driving behavior.

PubMed

Zheng, Tingting; Qu, Weina; Zhang, Kan; Ge, Yan

2016-11-01

As implicit cognitive processes garner more and more importance, studies in the fields of healthy psychology and organizational safety research have focused on attentional bias, a kind of selective allocation of attentional resources in the early stage of cognitive processing. However, few studies have explored the role of attentional bias on driving behavior. This study assessed drivers' attentional bias towards safety-related words (ABS) using the dot-probe paradigm and self-reported daily driving behaviors. The results revealed significant negative correlations between attentional bias scores and several indicators of dangerous driving. Drivers with fewer dangerous driving behaviors showed greater ABS. We also built a significant linear regression model between ABS and the total DDDI score, as well as ABS and the number of accidents. Finally, we discussed the possible mechanism underlying these associations and several limitations of our study. This study opens up a new topic for the exploration of implicit processes in driving safety research. Copyright © 2016 Elsevier Ltd. All rights reserved.

Performance Evaluation and Analysis of Rural Drinking Water Safety Project——A Case Study in Jiangsu, China

NASA Astrophysics Data System (ADS)

Du, Xiaorong

2017-04-01

Water is the basic condition for human survival and development. As China is the most populous country, rural drinking water safety problems are most conspicuous. Therefore, the Chinese government keeps increasing investment and has built a large number of rural drinking water safety projects. Scientific evaluation of project performance is of great significance to promote the sustainable operation of the project and the sustainable development of rural economy. Previous studies mainly focus on the economic benefits of the project, while ignoring the fact that the rural drinking water safety project is quasi-public goods, which has economic, social and ecological benefits. This paper establishes a comprehensive evaluation model for rural drinking water safety performance, which adapts the rules of "5E" (economy, efficiency, effectiveness, equity and environment) as the value orientation, and selects a rural drinking water safety project as object in case study at K District, which is in the north of Jiangsu Province, China. The results shows: 1) the comprehensive performance of K project is in good condition; 2) The performance of every part shows that the scores of criteria "efficiency", "environment" and "effect" are higher than the mean performance, while the "economy" is slightly lower than the mean and the "equity" is the lowest. 3) The performance of indicator layer shows that: the planned completion rate of project, the reduction rate of project cost and the penetration rate of water-use population are significantly lower than other indicators. Based on the achievements of previous studies and the characteristics of rural drinking water safety project, this study integrates the evaluation dimensions of equity and environment, which can contribute to a more comprehensive and systematic assessment of project performance and provide empirical data for performance evaluation and management of rural drinking water safety project. Key Words: Rural drinking water safety project; Performance evaluation; 5E rules; Comprehensive evaluation model

Safety approach to the selection of design criteria for the CRBRP reactor refueling system

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

Meisl, C J; Berg, G E; Sharkey, N F

1979-01-01

The selection of safety design criteria for Liquid Metal Fast Breeder Reactor (LMFBR) refueling systems required the extrapolation of regulations and guidelines intended for Light Water Reactor refueling systems and was encumbered by the lack of benefit from a commercially licensed predecessor other than Fermi. The overall approach and underlying logic are described for developing safety design criteria for the reactor refueling system (RRS) of the Clinch River Breeder Reactor Plant (CRBRP). The complete selection process used to establish the criteria is presented, from the definition of safety functions to the finalization of safety design criteria in the appropriate documents.more » The process steps are illustrated by examples.« less

Rational use of anticancer drugs and patient lawsuits in the state of São Paulo, Southeastern Brazil.

PubMed

Lopes, Luciane Cruz; Barberato-Filho, Silvio; Costa, Augusto Chad; Osorio-de-Castro, Claudia Garcia Serpa

2010-08-01

To assess the rationality of legal suits and administrative requests requiring anticancer drugs filed against and submitted to the São Paulo State Department of Health, in view of scientific evidence on efficacy and safety. A descriptive cross-sectional study was carried out based on information on lawsuits filed by cancer patients requiring anticancer drugs were furnished by the Department of Health. These drugs are among those having the greatest financial impact on the Brazilian Health System in 2006 and 2007. The drugs were assessed according to clinical evidence on efficacy and safety, based on Micromedex categorization, on systematic reviews and meta-analyses. Indications present in the legal documentation were compared to the indications approved by regulatory agencies. Bevacizumab, capecitabine, cetuximab, erlotinib, rituximab, imatinib, and temozolomide accounted for expenses over R$ 40 million to meet 1220 requests and lawsuits, at an average cost of R$ 33,500 per patient. Selected studies do not recommend all the indications for the prescribed drugs. Approximately 17% of requests and lawsuits did not provide evidence for the required indication, and these amounted to inappropriate expenses of, at least, R$ 6.8 million. The results reinforce the need for technical expertise in dealing with legal suits and for capacity-building of health professionals in approaching the scientific literature, in order to appropriately select drugs and to ensure the best therapeutic decision for each clinical condition, and thus guarantee access to safe and effective health technologies and, therefore, to enhance the quality of the Brazilian pharmaceutical services model in oncology.

Safety assessment in plant layout design using indexing approach: implementing inherent safety perspective. Part 2-Domino Hazard Index and case study.

PubMed

Tugnoli, Alessandro; Khan, Faisal; Amyotte, Paul; Cozzani, Valerio

2008-12-15

The design of layout plans requires adequate assessment tools for the quantification of safety performance. The general focus of the present work is to introduce an inherent safety perspective at different points of the layout design process. In particular, index approaches for safety assessment and decision-making in the early stages of layout design are developed and discussed in this two-part contribution. Part 1 (accompanying paper) of the current work presents an integrated index approach for safety assessment of early plant layout. In the present paper (Part 2), an index for evaluation of the hazard related to the potential of domino effects is developed. The index considers the actual consequences of possible escalation scenarios and scores or ranks the subsequent accident propagation potential. The effects of inherent and passive protection measures are also assessed. The result is a rapid quantification of domino hazard potential that can provide substantial support for choices in the early stages of layout design. Additionally, a case study concerning selection among various layout options is presented and analyzed. The case study demonstrates the use and applicability of the indices developed in both parts of the current work and highlights the value of introducing inherent safety features early in layout design.

Perspectives on Home Care Quality

PubMed Central

Kane, Rosalie A.; Kane, Robert L.; Illston, Laurel H.; Eustis, Nancy N.

1994-01-01

Home care quality assurance (QA) must consider features inherent in home care, including: multiple goals, limited provider control, and unique family roles. Successive panels of stakeholders were asked to rate the importance of selected home care outcomes. Most highly rated outcomes were freedom from exploitation, satisfaction with care, physical safety, affordability, and physical functioning. Panelists preferred outcome indicators to process and structure, and all groups emphasized “enabling” criteria. Themes highlighted included: interpersonal components of care; normalizing life for clientele; balancing quality of life with safety; developing flexible, negotiated care plans; mechanisms for accountability and case management. These themes were formulated differently according to the stakeholders' role. Providers preferred intermediate outcomes, akin to process. PMID:10140158

Inclusion of social indicators in decision support tools for the selection of sustainable site remediation options.

PubMed

Cappuyns, Valérie

2016-12-15

Sustainable remediation requires a balanced decision-making process in which environmental, economic and social aspects of different remediation options are all considered together and the optimum remediation solution is selected. More attention has been paid to the evaluation of environmental and economic aspects, in particular to reduce the human and environmental risks and the remediation costs, to the exclusion of social aspects of remediation. This paper investigates how social aspects are currently considered in sustainability assessments of remediation projects. A selection of decision support tools (DSTs), used for the sustainability assessment of a remediation project, is analyzed to define how social aspects are considered in those tools. The social indicator categories of the Sustainable Remediation Forum - United Kingdom (SuRF-UK), are used as a basis for this evaluation. The consideration of social aspects in the investigated decision support tools is limited, but a clear increase is noticed in more recently developed tools. Among the five social indicator categories defined by SuRF-UK to facilitate a holistic consideration of social aspects of a remediation project only "Human health and safety" is systematically taken into account. "Neighbourhood and locality" is also often addressed, mostly emphasizing the potential disturbance caused by the remediation activities. However, the evaluation of 'Ethics and Equality', Communities and community involvement', and 'Uncertainty and evidence' is often neglected. Nevertheless, concrete examples can be found in some of the investigated tools. Specific legislation, standard procedures, and guidelines that have to be followed in a region or country are mainly been set up in the context of protecting human and ecosystem health, safety and prevention of nuisance. However, they sometimes already include some of the aspects addressed by the social indicators. In this perspective the use of DST to evaluate the sustainability of a site remediation project, should be tuned to the legislation, guidelines and procedures that are in force in a specific country or region. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparative analysis of zonal systems for macro-level crash modeling.

PubMed

Cai, Qing; Abdel-Aty, Mohamed; Lee, Jaeyoung; Eluru, Naveen

2017-06-01

Macro-level traffic safety analysis has been undertaken at different spatial configurations. However, clear guidelines for the appropriate zonal system selection for safety analysis are unavailable. In this study, a comparative analysis was conducted to determine the optimal zonal system for macroscopic crash modeling considering census tracts (CTs), state-wide traffic analysis zones (STAZs), and a newly developed traffic-related zone system labeled traffic analysis districts (TADs). Poisson lognormal models for three crash types (i.e., total, severe, and non-motorized mode crashes) are developed based on the three zonal systems without and with consideration of spatial autocorrelation. The study proposes a method to compare the modeling performance of the three types of geographic units at different spatial configurations through a grid based framework. Specifically, the study region is partitioned to grids of various sizes and the model prediction accuracy of the various macro models is considered within these grids of various sizes. These model comparison results for all crash types indicated that the models based on TADs consistently offer a better performance compared to the others. Besides, the models considering spatial autocorrelation outperform the ones that do not consider it. Based on the modeling results and motivation for developing the different zonal systems, it is recommended using CTs for socio-demographic data collection, employing TAZs for transportation demand forecasting, and adopting TADs for transportation safety planning. The findings from this study can help practitioners select appropriate zonal systems for traffic crash modeling, which leads to develop more efficient policies to enhance transportation safety. Copyright © 2017 Elsevier Ltd and National Safety Council. All rights reserved.

Medical students' perceptions of a novel institutional incident reporting system : A thematic analysis.

PubMed

Gordon, Morris; Parakh, Dillan

2017-10-01

Errors in healthcare are a major patient safety issue, with incident reporting a key solution. The incident reporting system has been integrated within a new medical curriculum, encouraging medical students to take part in this key safety process. The aim of this study was to describe the system and assess how students perceived the reporting system with regards to its role in enhancing safety. Employing a thematic analysis, this study used interviews with medical students at the end of the first year. Thematic indices were developed according to the information emerging from the data. Through open, axial and then selective stages of coding, an understanding of how the system was perceived was established. Analysis of the interview specified five core themes: (1) Aims of the incident reporting system; (2) internalized cognition of the system; (3) the impact of the reporting system; (4) threshold for reporting; (5) feedback on the systems operation. Selective analysis revealed three overriding findings: lack of error awareness and error wisdom as underpinned by key theoretical constructs, student support of the principle of safety, and perceptions of a blame culture. Students did not interpret reporting as a manner to support institutional learning and safety, rather many perceived it as a tool for a blame culture. The impact reporting had on students was unexpected and may give insight into how other undergraduates and early graduates interpret such a system. Future studies should aim to produce interventions that can support a reporting culture.

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

Administrative goals and safety standards for hazard control on forested recreation sites

Treesearch

Lee A. Paine

1973-01-01

For efficient control of tree hazard on recreation sites, a specific administrative goal must be selected. A safety standard designed to achieve the selected goal and a uniform hazard-rating procedure will then promote a consistent level of safety at an acceptable cost. Safety standards can be established with the aid of data for past years, and dollar evaluations are...

Chemodosimetric analysis in food-safety monitoring: design, synthesis, and application of a bimetallic Re(I)-Pt(II) complex for detection of dimethyl sulfide in foods.

PubMed

Chow, Cheuk-Fai; Gong, Fu-Wen; Gong, Cheng-Bin

2014-09-21

Detection of neutral biogenic sulfides plays a crucial role in food safety. A new heterobimetallic Re(I)-Pt(II) donor-acceptor complex--[Re(biq)(CO)3(CN)]-[Pt(DMSO)(Cl)2] (1, biq = 2,2'-biquinoline)--was synthesized and characterized. The X-ray crystallographic and photophysical data for 1 are reported in this study. Complex 1 indicated the luminescent chemodosimetric selectivity for dimethyl sulfide, which persisted even in the presence of a variety of interfering vapors, with a detection limit as low as 0.96 ppm. The binding constant (log K) of 1 toward dimethyl sulfide was 3.63 ± 0.03. The analyte selectivity of the complexes was found to be dependent on the ligand coordinated to the Re(I) center. Real samples (beef, chicken, and pork) were monitored real-time for gaseous dimethyl sulfide. Complex 1 shows a linear spectrofluorimetric response with increasing storage time of the meats at 30 °C.

Nutritional value and potential chemical food safety hazards of selected Polish sausages as influenced by their traditionality.

PubMed

Halagarda, Michał; Kędzior, Władysław; Pyrzyńska, Ewa

2018-05-01

Traditional food products have been regaining consumer interest worldwide. The aim of the study was to investigate the differences in nutritional value of traditional and conventional Polish sausages and to determine potential chemical hazards connected with these products. The research material consisted of 5 varieties of registered traditional sausages and 4 varieties of conventional sausages. The nutritional value was identified based on selected indicators: protein, fat, NaCl, total ash, water, Feder's number, Ca, Fe, Mg, K, Zn, Cr, Cu; whereas the chemical food safety - based on: nitrates and nitrites, total and added phosphorus, Cd, Pb. The results of this study show that traditional sausages have higher content of protein, zinc, magnesium and potassium as well as lower concentrations of calcium, water and total ash, plus lower water to protein ratio in comparison to conventional counterparts. Polyphosphates are not used in the production of traditional sausages and the amounts of added nitrites are at low levels. Copyright © 2018 Elsevier Ltd. All rights reserved.

New Criteria of Indication and Selection of Patients to Cochlear Implant

PubMed Central

Sampaio, André L. L.; Araújo, Mercêdes F. S.; Oliveira, Carlos A. C. P.

2011-01-01

Numerous changes continue to occur in cochlear implant candidacy. In general, these have been accompanied by concomitant and satisfactory changes in surgical techniques. Together, this has advanced the utility and safety of cochlear implantation. Most devices are now approved for use in patients with severe to profound unilateral hearing loss rather then the prior requirement of a bilateral profound loss. Furthermore, studies have begun utilizing short electrode arrays for shallow insertion in patients with considerable low-frequency residual hearing. This technique will allow the recipient to continue to use acoustically amplified hearing for the low frequencies simultaneously with a cochlear implant for the high frequencies. The advances in design of, and indications for, cochlear implants have been matched by improvements in surgical techniques and decrease in complications. The resulting improvements in safety and efficacy have further encouraged the use of these devices. This paper will review the new concepts in the candidacy of cochlear implant. Medline data base was used to search articles dealing with the following topics: cochlear implant in younger children, cochlear implant and hearing preservation, cochlear implant for unilateral deafness and tinnitus, genetic hearing loss and cochlear implant, bilateral cochlear implant, neuropathy and cochlear implant and neural plasticity, and the selection of patients for cochlear implant. PMID:22013448

The Dual Estrogen Receptor α Inhibitory Effects of the Tissue-Selective Estrogen Complex for Endometrial and Breast Safety

PubMed Central

Han, Sang Jun; Begum, Khurshida; Foulds, Charles E.; Hamilton, Ross A.; Bailey, Suzanna; Malovannaya, Anna; Chan, Doug; Qin, Jun

2016-01-01

The conjugated estrogen/bazedoxifene tissue-selective estrogen complex (TSEC) is designed to minimize the undesirable effects of estrogen in the uterus and breast tissues and to allow the beneficial effects of estrogen in other estrogen-target tissues, such as the bone and brain. However, the molecular mechanism underlying endometrial and breast safety during TSEC use is not fully understood. Estrogen receptor α (ERα)–estrogen response element (ERE)–DNA pull-down assays using HeLa nuclear extracts followed by mass spectrometry–immunoblotting analyses revealed that, upon TSEC treatment, ERα interacted with transcriptional repressors rather than coactivators. Therefore, the TSEC-mediated recruitment of transcriptional repressors suppresses ERα-mediated transcription in the breast and uterus. In addition, TSEC treatment also degraded ERα protein in uterine tissue and breast cancer cells, but not in bone cells. Interestingly, ERα-ERE-DNA pull-down assays also revealed that, upon TSEC treatment, ERα interacted with the F-box protein 45 (FBXO45) E3 ubiquitin ligase. The loss-of- and gain-of-FBXO45 function analyses indicated that FBXO45 is involved in TSEC-mediated degradation of the ERα protein in endometrial and breast cells. In preclinical studies, these synergistic effects of TSEC on ERα inhibition also suppressed the estrogen-dependent progression of endometriosis. Therefore, the endometrial and breast safety effects of TSEC are associated with synergy between the selective recruitment of transcriptional repressors to ERα and FBXO45-mediated degradation of the ERα protein. PMID:26487511

Bertolette Selected as EHS Champion of Safety | Poster

Cancer.gov

Dan Bertolette has been selected as the most recent NCI at Frederick Champion of Safety, as part of the Champions of Safety Program sponsored by the Environment, Health, and Safety Program (EHS). The goal of the program, which began last year, is to raise awareness and promote a culture of safety by showing NCI at Frederick staff at work in their respective workplaces, according to Terri Bray, director, EHS. “Since we have so many varied work environments here, safety often takes on a different look, according to workplace. We want to take the opportunity to show real people in real situations, to encourage safety everywhere,” Bray said.

Use of strategic environmental assessment in the site selection process for a radioactive waste disposal facility in Slovenia.

PubMed

Dermol, Urška; Kontić, Branko

2011-01-01

The benefits of strategic environmental considerations in the process of siting a repository for low- and intermediate-level radioactive waste (LILW) are presented. The benefits have been explored by analyzing differences between the two site selection processes. One is a so-called official site selection process, which is implemented by the Agency for radwaste management (ARAO); the other is an optimization process suggested by experts working in the area of environmental impact assessment (EIA) and land-use (spatial) planning. The criteria on which the comparison of the results of the two site selection processes has been based are spatial organization, environmental impact, safety in terms of potential exposure of the population to radioactivity released from the repository, and feasibility of the repository from the technical, financial/economic and social point of view (the latter relates to consent by the local community for siting the repository). The site selection processes have been compared with the support of the decision expert system named DEX. The results of the comparison indicate that the sites selected by ARAO meet fewer suitability criteria than those identified by applying strategic environmental considerations in the framework of the optimization process. This result stands when taking into account spatial, environmental, safety and technical feasibility points of view. Acceptability of a site by a local community could not have been tested, since the formal site selection process has not yet been concluded; this remains as an uncertain and open point of the comparison. Copyright © 2010 Elsevier Ltd. All rights reserved.

Risk-adapted approach for fever and neutropenia in paediatric cancer patients--a national multicentre study.

PubMed

Miedema, Karin G E; Tissing, Wim J E; Abbink, Floor C H; Ball, Lynne M; Michiels, Erna M C; van Vliet, Michel J; de Vries, Wilma Y; Kamps, Willem A; Norbruis, Obbe F; Fiocco, Marta; de Groot-Kruseman, Hester A; van de Wetering, Marianne D; de Bont, Eveline S J M

2016-01-01

In this national multicentre study, we examined the safety of reducing antibiotics in selected paediatric cancer patients with febrile neutropenia. Patients with signs of a bacterial infection and/or abnormal vital signs indicating sepsis were considered high risk and received antibiotic therapy. Remaining patients were allocated to low- or medium risk, depending on their interleukin-8 level. Low-risk patients did not receive any antibiotics and were discharged from the hospital after having been afebrile for 12 h. Medium-risk patients were re-evaluated after 72 h of antibiotic treatment and, in selected patients, antibiotics were stopped. Two hundred thirty-three febrile neutropenic episodes in 141 paediatric cancer patients were included in the study. Sixty-four episodes were classified high risk (28%), 122 medium risk (52%), and 47 (20%) low risk. In the medium-risk group, antibiotics were stopped after 72 h in 50 in 122 episodes (41%). Median duration of antibiotic treatment and hospital admission was significantly lower in low- and medium-risk episodes with early discharge. No failures were observed in the medium-risk group with early discharge. In the low-risk group, six failures were observed (12.8%), due to coagulase-negative staphylococci-positive blood cultures and recurrent fever. We showed that it is safe to shorten antibiotic treatment to 72 h in selected medium-risk patients with febrile neutropenia, regardless of the neutrophil count. The safety of withholding antibiotics in selected low-risk paediatric cancer patients with febrile neutropenia requires further investigation, using more suitable definitions for safety. Reduction in hospital admissions allows children with cancer more time at home and consequently improves their quality of life. Copyright © 2015 Elsevier Ltd. All rights reserved.

Performance and Safety Characteristics in Ice-Climbing Equipment Selection.

ERIC Educational Resources Information Center

Wells, W. Tom

This study sought to determine whether Alaskan ice climbers place more emphasis on performance characteristics or on safety characteristics when selecting their various ice-climbing equipment. A survey distributed to members of the Alaska Alpine Club and the Alaska Alpine Rescue Group was developed to contain responses related to both safety and…

Prospective safety performance evaluation on construction sites.

PubMed

Wu, Xianguo; Liu, Qian; Zhang, Limao; Skibniewski, Miroslaw J; Wang, Yanhong

2015-05-01

This paper presents a systematic Structural Equation Modeling (SEM) based approach for Prospective Safety Performance Evaluation (PSPE) on construction sites, with causal relationships and interactions between enablers and the goals of PSPE taken into account. According to a sample of 450 valid questionnaire surveys from 30 Chinese construction enterprises, a SEM model with 26 items included for PSPE in the context of Chinese construction industry is established and then verified through the goodness-of-fit test. Three typical types of construction enterprises, namely the state-owned enterprise, private enterprise and Sino-foreign joint venture, are selected as samples to measure the level of safety performance given the enterprise scale, ownership and business strategy are different. Results provide a full understanding of safety performance practice in the construction industry, and indicate that the level of overall safety performance situation on working sites is rated at least a level of III (Fair) or above. This phenomenon can be explained that the construction industry has gradually matured with the norms, and construction enterprises should improve the level of safety performance as not to be eliminated from the government-led construction industry. The differences existing in the safety performance practice regarding different construction enterprise categories are compared and analyzed according to evaluation results. This research provides insights into cause-effect relationships among safety performance factors and goals, which, in turn, can facilitate the improvement of high safety performance in the construction industry. Copyright © 2015 Elsevier Ltd. All rights reserved.

An investigation into online videos as a source of safety hazard reports.

PubMed

Nasri, Leila; Baghersad, Milad; Gruss, Richard; Marucchi, Nico Sung Won; Abrahams, Alan S; Ehsani, Johnathon P

2018-06-01

Despite the advantages of video-based product reviews relative to text-based reviews in detecting possible safety hazard issues, video-based product reviews have received no attention in prior literature. This study focuses on online video-based product reviews as possible sources to detect safety hazards. We use two common text mining methods - sentiment and smoke words - to detect safety issues mentioned in videos on the world's most popular video sharing platform, YouTube. 15,402 product review videos from YouTube were identified as containing either negative sentiment or smoke words, and were carefully manually viewed to verify whether hazards were indeed mentioned. 496 true safety issues (3.2%) were found. Out of 9,453 videos that contained smoke words, 322 (3.4%) mentioned safety issues, vs. only 174 (2.9%) of the 5,949 videos with negative sentiment words. Only 1% of randomly-selected videos mentioned safety hazards. Comparing the number of videos with true safety issues that contain sentiment words vs. smoke words in their title or description, we show that smoke words are a more accurate predictor of safety hazards in video-based product reviews than sentiment words. This research also discovers words that are indicative of true hazards versus false positives in online video-based product reviews. Practical applications: The smoke words lists and word sub-groups generated in this paper can be used by manufacturers and consumer product safety organizations to more efficiently identify product safety issues from online videos. This project also provides realistic baselines for resource estimates for future projects that aim to discover safety issues from online videos or reviews. Copyright © 2018 National Safety Council and Elsevier Ltd. All rights reserved.

Overview of the U.S. DOE Hydrogen Safety, Codes and Standards Program. Part 4: Hydrogen Sensors; Preprint

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

Buttner, William J.; Rivkin, Carl; Burgess, Robert

Hydrogen sensors are recognized as a critical element in the safety design for any hydrogen system. In this role, sensors can perform several important functions including indication of unintended hydrogen releases, activation of mitigation strategies to preclude the development of dangerous situations, activation of alarm systems and communication to first responders, and to initiate system shutdown. The functionality of hydrogen sensors in this capacity is decoupled from the system being monitored, thereby providing an independent safety component that is not affected by the system itself. The importance of hydrogen sensors has been recognized by DOE and by the Fuel Cellmore » Technologies Office's Safety and Codes Standards (SCS) program in particular, which has for several years supported hydrogen safety sensor research and development. The SCS hydrogen sensor programs are currently led by the National Renewable Energy Laboratory, Los Alamos National Laboratory, and Lawrence Livermore National Laboratory. The current SCS sensor program encompasses the full range of issues related to safety sensors, including development of advance sensor platforms with exemplary performance, development of sensor-related code and standards, outreach to stakeholders on the role sensors play in facilitating deployment, technology evaluation, and support on the proper selection and use of sensors.« less

Factors associated with self-reported inattentive driving at highway-rail grade crossings.

PubMed

Zhao, Shanshan; Khattak, Aemal J

2017-12-01

This research identified factors associated with inattentive driving at Highway-Rail Grade Crossings (HRGCs) by investigating drivers' self-reported inattentive driving experiences and factors pertaining to their socioeconomic, personality, attitudinal, and other characteristics. A random selection of 2500 households in Nebraska received a survey questionnaire designed for licensed motor vehicle drivers; respondents returned 980 questionnaires. Factor analysis identified latent variables evaluating drivers' patience and inclination to wait for trains, attitudes toward new technology, law enforcement or education regarding HRGC safety, and the propensity to commit serious traffic violations at HRGCs. The investigation utilized a structural equation model for analysis. This model indicated that drivers with a higher risk of inattentive driving at HRGCs were: female, younger in age, from households with higher incomes, with shorter tenure (in years) in their current city of residence, more frequently used HRGCs, received less information on safety at HRGCs, had less patience to wait for trains to pass and had less interest in safety improvement technology, law enforcement or safety education at HRGCs. These research findings provide useful information for future research and to policy makers for improving public safety. Additionally, the results are useful for safety educational program providers for targeted program delivery to drivers that are more vulnerable to distracted driving at HRGCs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Good practices on cost - effective road infrastructure safety investments.

PubMed

Yannis, George; Papadimitriou, Eleonora; Evgenikos, Petros; Dragomanovits, Anastasios

2016-12-01

The paper presents the findings of a research project aiming to quantify and subsequently classify several infrastructure-related road safety measures, based on the international experience attained through extensive and selected literature review and additionally on a full consultation process including questionnaire surveys addressed to experts and relevant workshops. Initially, a review of selected research reports was carried out and an exhaustive list of road safety infrastructure investments covering all types of infrastructure was compiled. Individual investments were classified according to the infrastructure investment area and the type of investment and were thereafter analysed on the basis of key safety components. These investments were subsequently ranked in relation to their safety effects and implementation costs and on the basis of this ranking, a set of five most promising investments was selected for an in-depth analysis. The results suggest that the overall cost effectiveness of a road safety infrastructure investment is not always in direct correlation with the safety effect and is recommended that cost-benefit ratios and safety effects are always examined in conjunction with each other in order to identify the optimum solution for a specific road safety problem in specific conditions and with specific objectives.

Indicators of School Crime and Safety: 2012. NCES 2013-036/NCJ 241446

ERIC Educational Resources Information Center

Robers, Simone; Kemp, Jana; Truman, Jennifer

2013-01-01

Establishing reliable indicators of the current state of school crime and safety across the nation and regularly updating and monitoring these indicators is important in ensuring the safety of our nation's students. This is the aim of "Indicators of School Crime and Safety." This report is the fifteenth in a series of annual publications…

[Development and validation of the Korean patient safety culture scale for nursing homes].

PubMed

Yoon, Sook Hee; Kim, Byungsoo; Kim, Se Young

2013-06-01

The purpose of this study was to develop a tool to evaluate patient safety culture in nursing homes and to test its validity and reliability. A preliminary tool was developed through interviews with focus group, content validity tests, and a pilot study. A nationwide survey was conducted from February to April, 2011, using self-report questionnaires. Participants were 982 employees in nursing homes. Data were analyzed using Cronbach's alpha, item analysis, factor analysis, and multitrait/multi-Item analysis. From the results of the analysis, 27 final items were selected from 49 items on the preliminary tool. Items with low correlation with total scale were excluded. The 4 factors sorted by factor analysis contributed 63.4% of the variance in the total scale. The factors were labeled as leadership, organizational system, working attitude, management practice. Cronbach's alpha for internal consistency was .95 and the range for the 4 factors was from .86 to .93. The results of this study indicate that the Korean Patient Safety Culture Scale has reliability and validity and is suitable for evaluation of patient safety culture in Korean nursing homes.

Statistical classification of drug incidents due to look-alike sound-alike mix-ups.

PubMed

Wong, Zoie Shui Yee

2016-06-01

It has been recognised that medication names that look or sound similar are a cause of medication errors. This study builds statistical classifiers for identifying medication incidents due to look-alike sound-alike mix-ups. A total of 227 patient safety incident advisories related to medication were obtained from the Canadian Patient Safety Institute's Global Patient Safety Alerts system. Eight feature selection strategies based on frequent terms, frequent drug terms and constituent terms were performed. Statistical text classifiers based on logistic regression, support vector machines with linear, polynomial, radial-basis and sigmoid kernels and decision tree were trained and tested. The models developed achieved an average accuracy of above 0.8 across all the model settings. The receiver operating characteristic curves indicated the classifiers performed reasonably well. The results obtained in this study suggest that statistical text classification can be a feasible method for identifying medication incidents due to look-alike sound-alike mix-ups based on a database of advisories from Global Patient Safety Alerts. © The Author(s) 2014.

Food-packaging interactions influencing quality and safety.

PubMed

Hotchkiss, J H

1997-01-01

Interactions between foods and packaging can be detrimental to quality and/or safety. Changes in product flavour due to aroma sorption and the transfer of undesirable flavours from packaging to foods are important mechanisms of deterioration when foods are packaged in polymer-based materials. Careful consideration must be given to those factors affecting such interactions when selecting packaging materials in order to maximize product quality, safety, and shelf-life while minimizing undesirable changes. Product considerations include sensitivity to flavour and related deteriorations, colour changes, vitamin loss, microbial activity, and amount of flavour available. Storage considerations include temperature, time, and processing method. Polymer considerations include type of polymer and processing method, volume or mass of polymer to product ratio, and whether the interaction is Fickian or non-Fickian. Methodology to determine the extent of such interactions must be developed. Direct interactions between food and packaging are not necessarily detrimental. The same principles governing undesirable interactions can be used to affect desirable outcomes. Examples include films which directly intercept or absorb oxygen, inhibit microorganisms, remove undesirable flavours by sorption, or indicate safety and product shelf-life.

Safety in surgery: is selection the missing link?

PubMed

Paice, Alistair G; Aggarwal, Rajesh; Darzi, Ara

2010-09-01

Health care providers comprise an example of a "high risk organization." Safety failings within these organizations have the potential to cause significant public harm. Significant safety improvements in other high risk organizations such as the aviation industry have led to the concept of a high reliability organization (HRO)--a high risk organization that has enjoyed a prolonged safety record. A strong organizational culture is common to all successful HROs, encompassing powerful systems of selection and training. Aircrew selection processes provide a good example of this and are examined in detail in this article using the Royal Air Force process as an example. If the lessons of successful HROs are to be applied to health care organizations, candidate selection to specialties such as surgery must become more objective and robust. Other HROs can provide valuable lessons in how this may be approached.

Regulator Loss Functions and Hierarchical Modeling for Safety Decision Making.

PubMed

Hatfield, Laura A; Baugh, Christine M; Azzone, Vanessa; Normand, Sharon-Lise T

2017-07-01

Regulators must act to protect the public when evidence indicates safety problems with medical devices. This requires complex tradeoffs among risks and benefits, which conventional safety surveillance methods do not incorporate. To combine explicit regulator loss functions with statistical evidence on medical device safety signals to improve decision making. In the Hospital Cost and Utilization Project National Inpatient Sample, we select pediatric inpatient admissions and identify adverse medical device events (AMDEs). We fit hierarchical Bayesian models to the annual hospital-level AMDE rates, accounting for patient and hospital characteristics. These models produce expected AMDE rates (a safety target), against which we compare the observed rates in a test year to compute a safety signal. We specify a set of loss functions that quantify the costs and benefits of each action as a function of the safety signal. We integrate the loss functions over the posterior distribution of the safety signal to obtain the posterior (Bayes) risk; the preferred action has the smallest Bayes risk. Using simulation and an analysis of AMDE data, we compare our minimum-risk decisions to a conventional Z score approach for classifying safety signals. The 2 rules produced different actions for nearly half of hospitals (45%). In the simulation, decisions that minimize Bayes risk outperform Z score-based decisions, even when the loss functions or hierarchical models are misspecified. Our method is sensitive to the choice of loss functions; eliciting quantitative inputs to the loss functions from regulators is challenging. A decision-theoretic approach to acting on safety signals is potentially promising but requires careful specification of loss functions in consultation with subject matter experts.

How Agricultural Media Cover Safety Compared with Periodicals in Two Other Hazardous Industries.

PubMed

Marolf, Amanda; Heiberger, Scott; Evans, James; Joseph, Lura

2017-01-26

This analysis featured a uniquely broad look at challenges and potentials for engaging agricultural and other industrial media more effectively in covering safety. It involved a content analysis of selected industry periodicals serving agriculture, mining, and transportation, which are three of the nation's most hazardous industries, in terms of human safety. Use of the social amplification of risk framework (SARF) provided insight on safety coverage. In particular, it tested previous research indicating that media coverage tends to amplify (increase) more than attenuate (decrease) a sense of risk. Analysis involved 18 periodicals (9 agriculture, 7 transportation, and 2 mining) spanning a five-year period from 2008 to 2012. Full-text digital analysis identified terms found in safety articles across all three industries. A manual review of articles revealed the quantity and nature of safety coverage within and among these industries. Results identified 528 safety-related articles published during the period. Transportation and mining periodicals averaged more than twice as many safety articles as the agricultural periodicals. The amount of coverage within the three industries also varied greatly. Findings on the nature of coverage supported previous media research within the SARF. Coverage across all three industries was clearly oriented more to amplifying than to attenuating risk. This study adds to the understanding of variations, commonalities, challenges, and potentials for enhancing safety coverage by media serving these three industries. It also provides direction for engaging industry media more effectively in the public safety mission. The authors recommend seven areas of opportunity for further research. Copyright© by the American Society of Agricultural Engineers.

[Development of key indicators for nurses performance evaluation and estimation of their weights for management by objectives].

PubMed

Lee, Eun Hwa; Ahn, Sung Hee

2010-02-01

This methodological research was designed to develop performance evaluation key indicators (PEKIs) for management by objectives (MBO) and to estimate their weights for hospital nurses. The PEKIs were developed by selecting preliminary indicators from a literature review, examining content validity and identifying their level of importance. Data were collected from November 14, 2007 to February 18, 2008. Data set for importance of indicators was obtained from 464 nurses and weights of PEKIs domain was from 453 nurses, who worked for at least 2 yr in one of three hospitals. Data were analyzed using X(2)-test, factor analysis, and the Analytical Hierarchy Process. Based upon Content Validity Index of .8 or above, 61 indicators were selected from the 100 preliminary indicators. Finally, 40 PEKIs were developed from the 61 indicators, and categorized into 10 domains. The highest weight of the 10 domains was customer satisfaction, which was followed by patient education, direct nursing care, profit increase, safety management, improvement of nursing quality, completeness of nursing records, enhancing competence of nurses, indirect nursing care, and cost reduction, in that order. PEKIs and their weights can be utilized for impartial evaluation and MBO for hospital nurses. Further research to verify PEKIs would lead to successful implementation of MBO.

Safety belt promotion: theory and practice.

PubMed

Nelson, G D; Moffit, P B

1988-02-01

The purpose of this paper is to provide practitioners a rationale and description of selected theoretically based approaches to safety belt promotion. Theory failure is a threat to the integrity and effectiveness of safety belt promotion. The absence of theory driven programs designed to promote safety belt use is a concern of this paper. Six theoretical models from the social and behavioral sciences are reviewed with suggestions for application to promoting safety belt use and include Theory of Reasoned Action, the Health Belief Model, Fear Arousal, Operant Learning, Social Learning Theory, and Diffusion of Innovations. Guidelines for the selection and utilization of theory are discussed.

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 could use this overview to study gaps, and validate or falsify relationships. Safety practitioners could use the insights to evaluate organizational safety policies, and to further development of safety interventions. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

[Ambulatory anesthesia in pediatric surgery].

PubMed

Ben Khalifa, S; Hila, S; Hamzaoui, M; el Cadhi, A; Jlidi, S; Nouira, F; Hellal, Y; Houissa, T; Chaouachi, B

2000-04-01

Child is an ideal patient for day care surgery. So more than 60% of paediatric surgery could benefit by ambulatory surgery. Preoperative visit may select patients for ambulatory surgery. Medical exam may lead to choose pre operative screening. The ideal ambulatory anesthesia is locoregional technic or inhalatory one. Tracheal intubation don't contre indicate ambulatory surgery. Recovery of mental abilities following general anesthesia has not the same significance as in adult. Many studies confirm the safety of paediatric outpatients anesthesia.

Surgical Tourniquets in Orthopaedics

DTIC Science & Technology

2009-12-01

occlusion pressure and the ratio of the cuff width to the limb circumference23. This relationship is shown in Figure 4, indicating that, for a given limb...measured limb occlusion pressure to account for physiologic Fig. 3 a: A normal node of Ranvier of a nerve in a limb, showing a nodal gap 1 to 2 mm in ...limb occlusion pressure an additional pressure safety margin that is selected to be greater than the magnitude of any increase in limb occlusion

Countermeasures that work : a highway safety countermeasure guide for state highway safety offices

DOT National Transportation Integrated Search

2007-01-01

This guide is a basic reference to assist State Highway Safety Offices (SHSOs) in selecting : effective, science-based traffic safety countermeasures for major highway safety problem areas. : The guide describes major strategies and countermeasures t...

Countermeasures that work : a highway safety countermeasure guide for state highway safety offices

DOT National Transportation Integrated Search

2005-01-01

This guide is a basic reference to assist State Highway Safety Offices (SHSOs) in selecting effective, science-based traffic safety countermeasures for major highway safety problem areas. The guide: describes major strategies and countermeasures that...

Countermeasures that work : a highway safety countermeasure guide for state highway safety offices

DOT National Transportation Integrated Search

2009-01-01

This guide is a basic reference to assist State Highway Safety Offices (SHSOs) in selecting effective, science-based traffic safety countermeasures for major highway safety problem areas. The guide: describes major strategies and countermeasures that...

Countermeasures that work : a highway safety countermeasure guide for state highway safety offices

DOT National Transportation Integrated Search

2008-01-01

This guide is a basic reference to assist State Highway Safety Offices (SHSOs) in selecting effective, science-based traffic safety countermeasures for major highway safety problem areas. The guide: describes major strategies and countermeasures that...

Assessment of the safety of injection practices and injection-related procedures in family health units and centers in Alexandria.

PubMed

Elhoseeny, Taghareed A; Mourad, Juidan K

2014-08-01

The Safe Injection Global Network (SIGN) developed an intervention strategy for reducing overuse of injections and promoting the administration of safe injections. Tool C--Revised is designed to assess the safety of the most common procedures that puncture the skin within health services. The aim of the study was to assess injection safety within the primary healthcare facilities in Alexandria using Tool C--Revised. A total of 45 family health units and centers in Alexandria were selected by proportional allocation from the eight regions of Alexandria. The Tool C--Revised of the WHO was used for observation of the entire facility, injection practices and injection-related procedures, and sterilization practices. Interview of different health providers and immediate supervisor of injections was carried out. Indicators that reflect risk included: deficiency of alcohol-based hand rub for cleansing hands (13.3%), compliance with hand wash before preparing a procedure (56.9% before injection practices, 61.3% before phlebotomy, and 67.6% before lancet puncture), and wearing a new pair of gloves before new procedures (48.6% before injection practices, 9.7% for phlebotomy, 11.8% for lancet puncture, and 80% for both intravenous injections and infusions). Enough disposable equipment in all facilities for at least 2 weeks dependent on the statement of the average numbers of procedures per week was shown. Only 38% of the providers had received training regarding injection safety in the last 2 years and 62.5% had completed their three doses of hepatitis B vaccine. Only 42.2% of staffs who handled healthcare waste had access to heavy gloves. Indicators related to injection and injection-related practices that reflect risk to patients include deficiency of alcohol-based hand rub tools, nonadherence to hand hygiene before preparing an injection, and inadequate adherence to using a clean barrier when opening a glass ampule and use of gloves. Indicators that may reflect risk to patients and providers include inadequate injection safety training and incomplete hepatitis B vaccination of healthcare providers. Indicators that may reflect risk to providers include nonadherence to safety precautions related to injection practices, such as inadequate access to heavy gloves by staff handling healthcare waste.

INPRO Assessment of an INS in the Area of Safety of Fuel Cycle Installations

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

Raj, B.; Busurin, Y.; Depisch, F.

2006-07-01

INPRO has defined requirements organized in a hierarchy of Basic Principles, User Requirements and Criteria (consisting of an indicator and an acceptance limit) to be met by innovative nuclear reactor systems (INS) in six areas, namely: economics, safety, waste management, environment, proliferation resistance, and infrastructure. If an INS meets all requirements in all areas it represents a sustainable system for the supply of energy, capable of making a significant contribution to meeting the energy needs of the 21. century. Draft manuals have been developed, for each INPRO area, to provide guidance for performing an assessment of whether an INS meetsmore » the INPRO requirements in a given area. The manuals set out the information that needs to be assembled to perform an assessment and provide guidance on selecting the acceptance limits and, for a given INS, for determining the value of the indicators for comparison with the associated acceptance limits. Each manual also includes an example of a specific assessment to illustrate the guidance. This paper discusses the manual for performing an INPRO assessment in the area of safety of fuel cycle installations. The example, chosen solely for the purpose of illustrating the INPRO methodology, describes an assessment of an MOX fuel fabrication plant based on sol-gel technology and illustrates an assessment performed for an INS at an early stage of development. The safety issues and the assessment steps are presented in detail in the paper. (authors)« less

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.

Countermeasures that work : a highway safety countermeasure guide for state highway safety offices, fifth edition, 2010.

DOT National Transportation Integrated Search

2010-01-01

This guide is a basic reference to assist State Highway Safety Offices (SHSOs) in selecting : effective, science-based traffic safety countermeasures for major highway safety problem areas. : The guide: : o describes major strategies and countermeasu...

Valuing Equal Protection in Aviation Security Screening.

PubMed

Nguyen, Kenneth D; Rosoff, Heather; John, Richard S

2017-12-01

The growing number of anti-terrorism policies has elevated public concerns about discrimination. Within the context of airport security screening, the current study examines how American travelers value the principle of equal protection by quantifying the "equity premium" that they are willing to sacrifice to avoid screening procedures that result in differential treatments. In addition, we applied the notion of procedural justice to explore the effect of alternative selective screening procedures on the value of equal protection. Two-hundred and twenty-two respondents were randomly assigned to one of three selective screening procedures: (1) randomly, (2) using behavioral indicators, or (3) based on demographic characteristics. They were asked to choose between airlines using either an equal or a discriminatory screening procedure. While the former requires all passengers to be screened in the same manner, the latter mandates all passengers undergo a quick primary screening and, in addition, some passengers are selected for a secondary screening based on a predetermined selection criterion. Equity premiums were quantified in terms of monetary cost, wait time, convenience, and safety compromise. Results show that equity premiums varied greatly across respondents, with many indicating little willingness to sacrifice to avoid inequitable screening, and a smaller minority willing to sacrifice anything to avoid the discriminatory screening. The selective screening manipulation was effective in that equity premiums were greater under selection by demographic characteristics compared to the other two procedures. © 2017 Society for Risk Analysis.

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 offer suggestions for future research and practice including (i) deriving a common definition of safety climate, (ii) developing and testing construction-specific indicators of safety climate, and (iii) focusing on construction-specific issues such as the transient workforce, subcontracting, work organization, and induction/acculturation processes. © The Author 2016. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Post-earthquake building safety assessments for the Canterbury Earthquakes

USGS Publications Warehouse

Marshall, J.; Barnes, J.; Gould, N.; Jaiswal, K.; Lizundia, B.; Swanson, David A.; Turner, F.

2012-01-01

This paper explores the post-earthquake building assessment program that was utilized in Christchurch, New Zealand following the Canterbury Sequence of earthquakes beginning with the Magnitude (Mw.) 7.1 Darfield event in September 2010. The aftershocks or triggered events, two of which exceeded Mw 6.0, continued with events in February and June 2011 causing the greatest amount of damage. More than 70,000 building safety assessments were completed following the February event. The timeline and assessment procedures will be discussed including the use of rapid response teams, selection of indicator buildings to monitor damage following aftershocks, risk assessments for demolition of red-tagged buildings, the use of task forces to address management of the heavily damaged downtown area and the process of demolition. Through the post-event safety assessment program that occurred throughout the Canterbury Sequence of earthquakes, many important lessons can be learned that will benefit future response to natural hazards that have potential to damage structures.

Ambulatory anesthesia for cosmetic surgery in Brazil.

PubMed

May, Diego Marcelo

2016-08-01

Outpatient plastic surgery is growing around the world. This industry faces unique challenges in terms of patient selection and standards of practice to ensure safety and cost-effectiveness. This review will highlight information about anesthesia practice for outpatient cosmetic surgery in Brazil, especially regarding regulation, legislation, and medical tourism. Medical tourism is growing worldwide, with a flow of patients traveling from developed to developing countries where procedures can be done at a fraction of the cost as in the patient's home country. Though generally well tolerated, there are concerns about incomplete data on outcomes of office-based surgeries and lack of safety standards. Brazil is one of the world's leaders in cosmetic surgery. Strong legislation governing outpatient facilities and continued development of accrediting standards for healthcare facilities are indications of a commitment to patient safety and high quality of care. Although the market for medical tourism in this country is high, there are still barriers to overcome before Brazil reaches its full potential in this industry.

Geriatric Patient Safety Indicators Based on Linked Administrative Health Data to Assess Anticoagulant-Related Thromboembolic and Hemorrhagic Adverse Events in Older Inpatients: A Study Proposal

PubMed Central

Quantin, Catherine; Reich, Oliver; Tuppin, Philippe; Fagot-Campagna, Anne; Paccaud, Fred; Peytremann-Bridevaux, Isabelle; Burnand, Bernard

2017-01-01

Background Frail older people with multiple interacting conditions, polypharmacy, and complex care needs are particularly exposed to health care-related adverse events. Among these, anticoagulant-related thromboembolic and hemorrhagic events are particularly frequent and serious in older inpatients. The growing use of anticoagulants in this population and their substantial risk of toxicity and inefficacy have therefore become an important patient safety and public health concern worldwide. Anticoagulant-related adverse events and the quality of anticoagulation management should thus be routinely assessed to improve patient safety in vulnerable older inpatients. Objective This project aims to develop and validate a set of outcome and process indicators based on linked administrative health data (ie, insurance claims data linked to hospital discharge data) assessing older inpatient safety related to anticoagulation in both Switzerland and France, and enabling comparisons across time and among hospitals, health territories, and countries. Geriatric patient safety indicators (GPSIs) will assess anticoagulant-related adverse events. Geriatric quality indicators (GQIs) will evaluate the management of anticoagulants for the prevention and treatment of arterial or venous thromboembolism in older inpatients. Methods GPSIs will measure cumulative incidences of thromboembolic and bleeding adverse events based on hospital discharge data linked to insurance claims data. Using linked administrative health data will improve GPSI risk adjustment on patients’ conditions that are present at admission and will capture in-hospital and postdischarge adverse events. GQIs will estimate the proportion of index hospital stays resulting in recommended anticoagulation at discharge and up to various time frames based on the same electronic health data. The GPSI and GQI development and validation process will comprise 6 stages: (1) selection and specification of candidate indicators, (2) definition of administrative data-based algorithms, (3) empirical measurement of indicators using linked administrative health data, (4) validation of indicators, (5) analyses of geographic and temporal variations for reliable and valid indicators, and (6) data visualization. Results Study populations will consist of 166,670 Swiss and 5,902,037 French residents aged 65 years and older admitted to an acute care hospital at least once during the 2012-2014 period and insured for at least 1 year before admission and 1 year after discharge. We will extract Swiss data from the Helsana Group data warehouse and French data from the national health insurance information system (SNIIR-AM). The study has been approved by Swiss and French ethics committees and regulatory organizations for data protection. Conclusions Validated GPSIs and GQIs should help support and drive quality and safety improvement in older inpatients, inform health care stakeholders, and enable international comparisons. We discuss several limitations relating to the representativeness of study populations, accuracy of administrative health data, methods used for GPSI criterion validity assessment, and potential confounding bias in comparisons based on GQIs, and we address these limitations to strengthen study feasibility and validity. PMID:28495660

Urban transport safety assessment in akure based on corresponding performance indicators

NASA Astrophysics Data System (ADS)

Oye, Adedamola; Aderinlewo, Olufikayo; Croope, Silvana

2013-03-01

The level of safety of the transportation system in Akure, Nigeria was assessed by identifying the associated road safety problems and developing the corresponding safety performance indicators. These indicators were analysed with respect to accidents that occurred within the city from the year 2005 to 2009 based on the corresponding attributable risk measures. The results of the analysis showed the state of existing safety programs in Akure town. Six safety performance indicators were identified namely alcohol and drug use, excessive speeds, protection system (use of seat belts and helmets), use of day time running lights, state of vehicles (passive safety) and road condition. These indicators were used to determine the percentage of injury accidents as follows: 83.33% and 86.36% for years 2005 and 2006 respectively, 81.46% for year 2007 while years 2008 and 2009 had 82.86% and 78.12% injury accidents respectively.

Indicators of safety compromise in gastrointestinal endoscopy.

PubMed

Borgaonkar, Mark Ram; Hookey, Lawrence; Hollingworth, Roger; Kuipers, Ernst J; Forster, Alan; Armstrong, David; Barkun, Alan; Bridges, Ron; Carter, Rose; de Gara, Chris; Dube, Catherine; Enns, Robert; Macintosh, Donald; Forget, Sylviane; Leontiadis, Grigorios; Meddings, Jonathan; Cotton, Peter; Valori, Roland

2012-02-01

The importance of quality indicators has become increasingly recognized in gastrointestinal endoscopy. Patient safety requires the identification and monitoring of occurrences associated with harm or the potential for harm. The identification of relevant indicators of safety compromise is, therefore, a critical element that is key to the effective implementation of endoscopy quality improvement programs. To identify key indicators of safety compromise in gastrointestinal endoscopy. The Canadian Association of Gastroenterology Safety and Quality Indicators in Endoscopy Consensus Group was formed to address issues of quality in endoscopy. A subcommittee was formed to identify key safety indicators. A systematic literature review was undertaken, and articles pertinent to safety in endoscopy were identified and reviewed. All complications and measures used to document safety were recorded. From this, a preliminary list of 16 indicators was compiled and presented to the 35-person consensus group during a three-day meeting. A revised list of 20 items was subsequently put to the consensus group for vote for inclusion on the final list of safety indicators. Items were retained only if the consensus group highly agreed on their importance. A total of 19 indicators of safety compromise were retained and grouped into the three following categories: medication-related - the need for CPR, use of reversal agents, hypoxia, hypotension, hypertension, sedation doses in patients older than 70 years of age, allergic reactions and laryngospasm⁄bronchospasm; procedure-related early - perforation, immediate postpolypectomy bleeding, need for hospital admission or transfer to emergency department from the gastroenterology unit, instrument impaction, severe persistent abdominal pain requiring evaluation proven to not be perforation; and procedure-related delayed - death within 30 days of procedure, 14-day unplanned hospitalization, 14-day unplanned contact with a health provider, gastrointestinal bleeding within 14 days of procedure, infection or symptomatic metabolic complications. The 19 indicators of safety compromise in endoscopy, identified by a rigorous, evidence-based consensus process, provide clear outcomes to be recorded by all facilities as part of their continuing quality improvement programs.

Kansas City Plant Celebrates Safety Milestone

ScienceCinema

None

2017-12-09

A gang of motorcycle riders arrived at the NNSA's Kansas City Plant on July 1 to help celebrate a significant safety achievement - working nearly five million hours, covering a one-year period without a lost-time injury. The bikers -- some of whom are plant employees -- represent Bikers Against Child Abuse, the local nonprofit selected to receive a $5,000 donation as part of the plant's safety achievement celebration. The organization was selected because it aligns with the plant's community outreach focus on Family Safety & Security and partnership with the plant's union members.

Identification of an updated set of prescribing-safety indicators for GPs

PubMed Central

Spencer, Rachel; Bell, Brian; Avery, Anthony J; Gookey, Gill; Campbell, Stephen M

2014-01-01

Background Medication error is an important contributor to patient morbidity and mortality and is associated with inadequate patient safety measures. However, prescribing-safety tools specifically designed for use in general practice are lacking. Aim To identify and update a set of prescribing-safety indicators for assessing the safety of prescribing in general practice, and to estimate the risk of harm to patients associated with each indicator. Design and setting RAND/UCLA consensus development of indicators in UK general practice. Method Prescribing indicators were identified from a systematic review and previous consensus exercise. The RAND Appropriateness Method was used to further identify and develop the indicators with an electronic-Delphi method used to rate the risk associated with them. Twelve GPs from all the countries of the UK participated in the RAND exercise, with 11 GPs rating risk using the electronic-Delphi approach. Results Fifty-six prescribing-safety indicators were considered appropriate for inclusion (overall panel median rating of 7–9, with agreement). These indicators cover hazardous prescribing across a range of therapeutic indications, hazardous drug–drug combinations and inadequate laboratory test monitoring. Twenty-three (41%) of these indicators were considered high risk or extreme risk by 80% or more of the participants. Conclusion This study identified a set of 56 indicators that were considered, by a panel of GPs, to be appropriate for assessing the safety of GP prescribing. Twenty-three of these indicators were considered to be associated with high or extreme risk to patients and should be the focus of efforts to improve patient safety. PMID:24686882

Occupational safety training and practices in selected vocational training institutions and workplaces in Kampala, Uganda.

PubMed

Kintu, Denis; Kyakula, Michael; Kikomeko, Joseph

2015-01-01

Several industrial accidents, some of them fatal, have been reported in Uganda. Causes could include training gaps in vocational training institutions (VTIs) and workplaces. This study investigated how occupational safety training in VTIs and workplaces is implemented. The study was carried out in five selected VTIs and workplaces in Kampala. Data were collected from instructors, workshop technicians, students, workshop managers, production supervisors, machine operators and new technicians in the workplaces. A total of 35 respondents participated in the study. The results revealed that all curricula in VTIs include a component of safety but little is practiced in VTI workshops; in workplaces no specific training content was followed and there were no regular consultations between VTIs and industry on safety skills requirements, resulting in a mismatch in safety skills training. The major constraints to safety training include inadequate funds to purchase safety equipment and inadequate literature on safety.

Developing and establishing the validity and reliability of the perceptions toward Aviation Safety Action Program (ASAP) and Line Operations Safety Audit (LOSA) questionnaires

NASA Astrophysics Data System (ADS)

Steckel, Richard J.

Aviation Safety Action Program (ASAP) and Line Operations Safety Audits (LOSA) are voluntary safety reporting programs developed by the Federal Aviation Administration (FAA) to assist air carriers in discovering and fixing threats, errors and undesired aircraft states during normal flights that could result in a serious or fatal accident. These programs depend on voluntary participation of and reporting by air carrier pilots to be successful. The purpose of the study was to develop and validate a measurement scale to measure U.S. air carrier pilots' perceived benefits and/or barriers to participating in ASAP and LOSA programs. Data from these surveys could be used to make changes to or correct pilot misperceptions of these programs to improve participation and the flow of data. ASAP and LOSA a priori models were developed based on previous research in aviation and healthcare. Sixty thousand ASAP and LOSA paper surveys were sent to 60,000 current U.S. air carrier pilots selected at random from an FAA database of pilot certificates. Two thousand usable ASAP and 1,970 usable LOSA surveys were returned and analyzed using Confirmatory Factor Analysis. Analysis of the data using confirmatory actor analysis and model generation resulted in a five factor ASAP model (Ease of use, Value, Improve, Trust and Risk) and a five factor LOSA model (Value, Improve, Program Trust, Risk and Management Trust). ASAP and LOSA data were not normally distributed, so bootstrapping was used. While both final models exhibited acceptable fit with approximate fit indices, the exact fit hypothesis and the Bollen-Stine p value indicated possible model mis-specification for both ASAP and LOSA models.

Impact of Pilot Delay and Non-Responsiveness on the Safety Performance of Airborne Separation

NASA Technical Reports Server (NTRS)

Consiglio, Maria; Hoadley, Sherwood; Wing, David; Baxley, Brian; Allen, Bonnie Danette

2008-01-01

Assessing the safety effects of prediction errors and uncertainty on automationsupported functions in the Next Generation Air Transportation System concept of operations is of foremost importance, particularly safety critical functions such as separation that involve human decision-making. Both ground-based and airborne, the automation of separation functions must be designed to account for, and mitigate the impact of, information uncertainty and varying human response. This paper describes an experiment that addresses the potential impact of operator delay when interacting with separation support systems. In this study, we evaluated an airborne separation capability operated by a simulated pilot. The experimental runs are part of the Safety Performance of Airborne Separation (SPAS) experiment suite that examines the safety implications of prediction errors and system uncertainties on airborne separation assistance systems. Pilot actions required by the airborne separation automation to resolve traffic conflicts were delayed within a wide range, varying from five to 240 seconds while a percentage of randomly selected pilots were programmed to completely miss the conflict alerts and therefore take no action. Results indicate that the strategicAirborne Separation Assistance System (ASAS) functions exercised in the experiment can sustain pilot response delays of up to 90 seconds and more, depending on the traffic density. However, when pilots or operators fail to respond to conflict alerts the safety effects are substantial, particularly at higher traffic densities.

Initial development of a practical safety audit tool to assess fleet safety management practices.

PubMed

Mitchell, Rebecca; Friswell, Rena; Mooren, Lori

2012-07-01

Work-related vehicle crashes are a common cause of occupational injury. Yet, there are few studies that investigate management practices used for light vehicle fleets (i.e. vehicles less than 4.5 tonnes). One of the impediments to obtaining and sharing information on effective fleet safety management is the lack of an evidence-based, standardised measurement tool. This article describes the initial development of an audit tool to assess fleet safety management practices in light vehicle fleets. The audit tool was developed by triangulating information from a review of the literature on fleet safety management practices and from semi-structured interviews with 15 fleet managers and 21 fleet drivers. A preliminary useability assessment was conducted with 5 organisations. The audit tool assesses the management of fleet safety against five core categories: (1) management, systems and processes; (2) monitoring and assessment; (3) employee recruitment, training and education; (4) vehicle technology, selection and maintenance; and (5) vehicle journeys. Each of these core categories has between 1 and 3 sub-categories. Organisations are rated at one of 4 levels on each sub-category. The fleet safety management audit tool is designed to identify the extent to which fleet safety is managed in an organisation against best practice. It is intended that the audit tool be used to conduct audits within an organisation to provide an indicator of progress in managing fleet safety and to consistently benchmark performance against other organisations. Application of the tool by fleet safety researchers is now needed to inform its further development and refinement and to permit psychometric evaluation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Conceptual framework for holistic dialysis management based on key performance indicators.

PubMed

Liu, Hu-Chen; Itoh, Kenji

2013-10-01

This paper develops a theoretical framework of holistic hospital management based on performance indicators that can be applied to dialysis hospitals, clinics or departments in Japan. Selection of a key indicator set and its validity tests were performed primarily by a questionnaire survey to dialysis experts as well as their statements obtained through interviews. The expert questionnaire asked respondents to rate the degree of "usefulness" for each of 66 indicators on a three-point scale (19 responses collected). Applying the theoretical framework, we selected a minimum set of key performance indicators for dialysis management that can be used in the Japanese context. The indicator set comprised 27 indicators and items that will be collected through three surveys: patient satisfaction, employee satisfaction, and safety culture. The indicators were confirmed by expert judgment from viewpoints of face, content and construct validity as well as their usefulness. This paper established a theoretical framework of performance measurement for holistic dialysis management from primary healthcare stakeholders' perspectives. In this framework, performance indicators were largely divided into healthcare outcomes and performance shaping factors. Indicators of the former type may be applied for the detection of operational problems or weaknesses in a dialysis hospital, clinic or department, while latent causes of each problem can be more effectively addressed by the latter type of indicators in terms of process, structure and culture/climate within the organization. © 2013 The Authors. Therapeutic Apheresis and Dialysis © 2013 International Society for Apheresis.

Introduction of structural health and safety monitoring warning systems for Shenzhen-Hong Kong Western Corridor Shenzhen Bay Bridge

NASA Astrophysics Data System (ADS)

Li, N.; Zhang, X. Y.; Zhou, X. T.; Leng, J.; Liang, Z.; Zheng, C.; Sun, X. F.

2008-03-01

Though the brief introduction of the completed structural health and safety monitoring warning systems for Shenzhen-Hongkong western corridor Shenzhen bay highway bridge (SZBHMS), the self-developed system frame, hardware and software scheme of this practical research project are systematically discussed in this paper. The data acquisition and transmission hardware and the basic software based on the NI (National Instruments) Company virtual instruments technology were selected in this system, which adopted GPS time service receiver technology and so on. The objectives are to establish the structural safety monitoring and status evaluation system to monitor the structural responses and working conditions in real time and to analyze the structural working statue using information obtained from the measured data. It will be also provided the scientific decision-making bases for the bridge management and maintenance. Potential technical approaches to the structural safety warning systems, status identification and evaluation method are presented. The result indicated that the performance of the system has achieved the desired objectives, ensure the longterm high reliability, real time concurrence and advanced technology of SZBHMS. The innovate achievement which is the first time to implement in domestic, provide the reference for long-span bridge structural health and safety monitoring warning systems design.

2003 highway-rail grade crossing safety research needs workshop. Volume 2 : appendices

DOT National Transportation Integrated Search

2009-01-01

The purposes of the workshop were to provide up-to-date information and research reports from selected organizations, analyze a number of safety research topics by a selected group of delegates from all areas of technology and government organization...

44 CFR 150.4 - Nomination and selection criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Nomination and selection criteria. 150.4 Section 150.4 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY FIRE PREVENTION AND CONTROL PUBLIC SAFETY AWARDS TO PUBLIC SAFETY OFFICERS...

The importance of environmental quality and catch potential to fishing site selection by freshwater anglers in Mississippi

USGS Publications Warehouse

Schramm, H.L.; Gerard, P.D.; Gill, D.A.

2003-01-01

We measured the importance of 24 fishing site attributes to Mississippi freshwater anglers. Factor analysis identified four multiattribute factors as important in the selection of fishing location: CLEAN ENVIRONMENT CATCH, COST AND HARVEST and AMENITIES AND SAFETY. In general, the importance of site selection factors differed little among anglers grouped by preferred type of fish, preferred fishing location (lakes and reservoirs, rivers and streams, ponds, or reservoir tailwaters), usual manner of fishing (engine-powered boat, nonpowered boat, or shore), or change in fishing frequency. COST AND HARVEST was more important to anglers with high harvest orientations. We found low correlations between site selection factor importance scores and angler age, fishing frequency, fishing expenditures, or fishing motivation factors. We suggest that the general lack of differences in site selection factors among angler groups indicates that management strategies to improve fishing site attributes should benefit all angler groups. Clean fishing environments and awareness of the availability of desired sport fishes were "very" or "extremely" important to fishing site selection by more than 70% of Mississippi freshwater anglers and should be priority management objectives.

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.

Research on regularized mean-variance portfolio selection strategy with modified Roy safety-first principle.

PubMed

Atta Mills, Ebenezer Fiifi Emire; Yan, Dawen; Yu, Bo; Wei, Xinyuan

2016-01-01

We propose a consolidated risk measure based on variance and the safety-first principle in a mean-risk portfolio optimization framework. The safety-first principle to financial portfolio selection strategy is modified and improved. Our proposed models are subjected to norm regularization to seek near-optimal stable and sparse portfolios. We compare the cumulative wealth of our preferred proposed model to a benchmark, S&P 500 index for the same period. Our proposed portfolio strategies have better out-of-sample performance than the selected alternative portfolio rules in literature and control the downside risk of the portfolio returns.

Investigation of structural factors of safety for the space shuttle

NASA Technical Reports Server (NTRS)

1972-01-01

A study was made of the factors governing the structural design of the fully reusable space shuttle booster to establish a rational approach to select optimum structural factors of safety. The study included trade studies of structural factors of safety versus booster service life, weight, cost, and reliability. Similar trade studies can be made on other vehicles using the procedures developed. The major structural components of a selected baseline booster were studied in depth, each being examined to determine the fatigue life, safe-life, and fail-safe capabilities of the baseline design. Each component was further examined to determine its reliability and safety requirements, and the change of structural weight with factors of safety. The apparent factors of safety resulting from fatigue, safe-life, proof test, and fail-safe requirements were identified. The feasibility of reduced factors of safety for design loads such as engine thrust, which are well defined, was examined.

Safety and Waste Management for SAM Pathogen Methods

EPA Pesticide Factsheets

The General Safety and Waste Management page offers section-specific safety and waste management details for the pathogens included in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

Safety and Waste Management for SAM Biotoxin Methods

EPA Pesticide Factsheets

The General Safety and Waste Management page offers section-specific safety and waste management details for the biotoxins included in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

Detecting adverse events in surgery: comparing events detected by the Veterans Health Administration Surgical Quality Improvement Program and the Patient Safety Indicators.

PubMed

Mull, Hillary J; Borzecki, Ann M; Loveland, Susan; Hickson, Kathleen; Chen, Qi; MacDonald, Sally; Shin, Marlena H; Cevasco, Marisa; Itani, Kamal M F; Rosen, Amy K

2014-04-01

The Patient Safety Indicators (PSIs) use administrative data to screen for select adverse events (AEs). In this study, VA Surgical Quality Improvement Program (VASQIP) chart review data were used as the gold standard to measure the criterion validity of 5 surgical PSIs. Independent chart review was also used to determine reasons for PSI errors. The sensitivity, specificity, and positive predictive value of PSI software version 4.1a were calculated among Veterans Health Administration hospitalizations (2003-2007) reviewed by VASQIP (n = 268,771). Nurses re-reviewed a sample of hospitalizations for which PSI and VASQIP AE detection disagreed. Sensitivities ranged from 31% to 68%, specificities from 99.1% to 99.8%, and positive predictive values from 31% to 72%. Reviewers found that coding errors accounted for some PSI-VASQIP disagreement; some disagreement was also the result of differences in AE definitions. These results suggest that the PSIs have moderate criterion validity; however, some surgical PSIs detect different AEs than VASQIP. Future research should explore using both methods to evaluate surgical quality. Published by Elsevier Inc.

Transgenic Farm Animals

NASA Astrophysics Data System (ADS)

Solomon, Morse B.; Eastridge, Janet S.; Paroczay, Ernest W.

Conventional science to improve muscle and meat parameters has involved breeding strategies, such as selection of dominant traits or selection of preferred traits by cross breeding, and the use of endogenous and exogenous hormones. Improvements in the quality of food products that enter the market have largely been the result of postharvest intervention strategies. Biotechnology is a more extreme scientific method that offers the potential to improve the quality, yield, and safety of food products by direct genetic manipulation. In the December 13, 2007 issue of the Southeast Farm Press, an article by Roy Roberson pointed out that biotechnology is driving most segments of U.S. farm growth. He indicated that nationwide, the agriculture industry is booming and much of that growth is the result of biotechnology advancements.

[High-quality nursing health care environment: the patient safety perspective].

PubMed

Tu, Yu-Ching; Wang, Ruey-Hsia

2011-06-01

Patient safety is regarded as an important indicator of nursing care quality, and nurses hold frontline responsibility to maintain patient safety. Many countries now face healthcare provider shortfalls, and recognize a close correlation between adequate manpower and patient safety. Many healthcare organizations work to foster positive work environments in order to improve health service quality. The active participation and "buy in" of nurses, patients and policymakers are critical to maximize healthcare environment quality and improve patient safety. This article adopts Donabedian's theoretical "Structure-Process-Outcome" model of quality (Donabedian, 1988) and presumes all high-quality healthcare environment indicators to be linked to patient safety. In addition to raising public awareness regarding the influence of healthcare environment quality on patient safety, this research suggests certain indicators for tracking and assessing healthcare environment quality. Future research may design an empirical study based on these indicators to help further enhance healthcare environment quality and the professional development of nurses.

Safety and Waste Management for SAM Chemistry Methods

EPA Pesticide Factsheets

The General Safety and Waste Management page offers section-specific safety and waste management details for the chemical analytes included in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

Safety and Waste Management for SAM Radiochemical Methods

EPA Pesticide Factsheets

The General Safety and Waste Management page offers section-specific safety and waste management details for the radiochemical analytes included in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

Countermeasures that work : a highway safety countermeasure guide for state highway safety offices : eighth edition : 2015

DOT National Transportation Integrated Search

2015-11-01

The guide is a basic reference to assist State Highway Safety Offices in selecting effective, evidence- based : countermeasures for traffic safety problem areas. These areas include: : - Alcohol-and Drug-Impaired Driving; : - Seat Belts and Child Res...

Countermeasures that work : a highway safety countermeasure guide for state highway safety offices : seventh edition : 2013

DOT National Transportation Integrated Search

2013-04-01

The guide is a basic reference to assist State Highway Safety Offices (SHSOs) in selecting effective, evidence-based countermeasures for traffic safety problem areas. These areas include: : - Alcohol-Impaired and Drugged Driving; : - Seat Belts and C...

Structural Deterministic Safety Factors Selection Criteria and Verification

NASA Technical Reports Server (NTRS)

Verderaime, V.

1992-01-01

Though current deterministic safety factors are arbitrarily and unaccountably specified, its ratio is rooted in resistive and applied stress probability distributions. This study approached the deterministic method from a probabilistic concept leading to a more systematic and coherent philosophy and criterion for designing more uniform and reliable high-performance structures. The deterministic method was noted to consist of three safety factors: a standard deviation multiplier of the applied stress distribution; a K-factor for the A- or B-basis material ultimate stress; and the conventional safety factor to ensure that the applied stress does not operate in the inelastic zone of metallic materials. The conventional safety factor is specifically defined as the ratio of ultimate-to-yield stresses. A deterministic safety index of the combined safety factors was derived from which the corresponding reliability proved the deterministic method is not reliability sensitive. The bases for selecting safety factors are presented and verification requirements are discussed. The suggested deterministic approach is applicable to all NASA, DOD, and commercial high-performance structures under static stresses.

41 CFR 301-11.11 - How do I select lodging and make lodging reservations?

Code of Federal Regulations, 2012 CFR

2012-07-01

... always stay in a “fire safe” facility. This is a facility that meets the fire safety requirements of the Hotel and Motel Fire Safety Act of 1990 (the Act), as amended (see 5 U.S.C. 5707a). (c) When selecting a...

41 CFR 301-11.11 - How do I select lodging and make lodging reservations?

Code of Federal Regulations, 2013 CFR

2013-07-01

... always stay in a “fire safe” facility. This is a facility that meets the fire safety requirements of the Hotel and Motel Fire Safety Act of 1990 (the Act), as amended (see 5 U.S.C. 5707a). (c) When selecting a...

41 CFR 301-11.11 - How do I select lodging and make lodging reservations?

Code of Federal Regulations, 2014 CFR

2014-07-01

... always stay in a “fire safe” facility. This is a facility that meets the fire safety requirements of the Hotel and Motel Fire Safety Act of 1990 (the Act), as amended (see 5 U.S.C. 5707a). (c) When selecting a...

Risk-Taking, Safety and Older People. Selected Bibliographies on Ageing 3.

ERIC Educational Resources Information Center

Jackson, Wendy, Comp.

This annotated bibliography, which was developed as part of a series of selected bibliographies on aging for Great Britain's Centre for Policy on Ageing, contains a total of 368 entries organized under the following subject headings: risk (identification, nature, responsibilities, risk taking, security); environmental safety (hazards, design,…

Transportation Safety Information Report : 1982 Annual Summary

DOT National Transportation Integrated Search

1983-01-01

The "Transportation Safety Information Report" is a compendium of selected national-level transportation safety statistics for all modes of transportation. The report presents and compares data for transportation fatalities, accidents, and injuries f...

General Safety and Waste Management Related to SAM

EPA Pesticide Factsheets

The General Safety and Waste Management page offers section-specific safety and waste management details for chemicals, radiochemicals, pathogens, and biotoxins included in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

Transportation Safety Information Report : 1987 Annual Summary

DOT National Transportation Integrated Search

1988-01-01

The "Transportation Safety Information Report" is a compendium of selected national-level transportation safety statistics for all modes of transportation. The report presents and compares data for transportation fatalities, accidents, and injuries f...

Integration of Occupational Safety to Contractors` or Subcontractors` Performance Evaluation in Construction Projects

NASA Astrophysics Data System (ADS)

Kozlovská, Mária; Struková, Zuzana

2013-06-01

Several factors should be considered by the owner and general contractor in the process of contractors` and subcontractors` selection and evaluation. The paper reviews the recent models addressed to guide general contractors in subcontractors' selection process and in evaluation of different contractors during the execution of the project. Moreover the paper suggests the impact of different contractors' performance to the overall level of occupational health and safety culture at the sites. It deals with the factors influencing the safety performance of contractors during construction and analyses the methods for assessing the safety performance of construction contractors. The results of contractors' safety performance evaluation could be a useful tool in motivating contractors to achieve better safety outcomes or could have effect on owners` or general contractors' decision making about contractors suitability for future contracting works.

Drug formulary review process for sargramostim and filgrastim: focus on analysis of adverse drug reactions.

PubMed

Kellihan, M J

1993-01-01

Selection of a drug for formulary inclusion involves evaluation of safety, efficacy, and cost. The colony-stimulating factors (CSFs) sargramostim and filgrastim have a broad range of potential indications and represent a costly formulary addition when acquisition price alone is considered; their comparative safety is unclear. These factors suggest that the CSFs should be closely scrutinized prior to formulary addition. In the absence of direct comparative studies, an assessment of the safety of CSFs involves evaluation of information provided in the product circular, official drug compendia, adverse biologic reports submitted to the United States Food and Drug Administration, and data from key clinical trials. Data in the product circulars report on adverse events in small numbers of patients treated for chemotherapy-induced neutropenia (filgrastim) or neutropenia subsequent to bone marrow transplantation (sargramostim). The official compendia and clinical trials include experience with CSFs produced in a variety of expression systems; these data are not limited to sargramostim and filgrastim. Importantly, there was a similar incidence of adverse events in patients who received sargramostim or filgrastim and in those who took placebo reported in the product circulars and the pivotal trials, suggesting that the underlying disease may have an important role in determining the side-effect profile of these agents. Adverse biologic reports represent experience with sargramostim and filgrastim obtained under actual clinical conditions and suggest that the same types of adverse events are seen with sargramostim as with filgrastim. This analysis suggests that a decision to select filgrastim over sargramostim for formulary inclusion based on the safety profile is not appropriate because currently available data are equivocal and that such decisions would more appropriately be based on efficacy and cost.

The Role of Geographical Indication in Supporting Food Safety: A not Taken for Granted Nexus

PubMed Central

2014-01-01

The paper focuses on the role of geographical indication in supporting strategies of food safety. Starting from the distinction between generic and specific quality, the article analyses the main factors influencing food safety in cases of geographical indication products, by stressing the importance of traceability systems and biodiversity in securing generic and specific quality. In the second part, the paper investigates the coordination problems behind a designation of origin and conditions to foster an effective collective action, a prerequisite to grant food safety through geographical indications. PMID:27800417

Indicators and Methods for Evaluating Economic, Ecosystem ...

EPA Pesticide Factsheets

The U.S. Human Well-being Index (HWBI) is a composite measure that incorporates economic, environmental, and societal well-being elements through the eight domains of connection to nature, cultural fulfillment, education, health, leisure time, living standards, safety and security, and social cohesion (USEPA 2012a; Smith et al. 2013). Twenty-eight services, represented by a collection of indicators and metrics, have been identified as influencing these domains of human well-being. By taking an inventory of stocks or measuring the results of a service, a relationship function can be derived to understand how changes in the provisioning of that service can influence the HWBI. An extensive review of existing services was performed to identify current services, indicators and metrics in use. This report describes the indicators and methods we have selected to evaluate the provisioning of economic, ecosystem, and social services related to human well-being. Provide metadata and methods for calculating services provisioning scores for HWBI modeling framework

System safety education focused on industrial engineering

NASA Technical Reports Server (NTRS)

Johnston, W. L.; Morris, R. S.

1971-01-01

An educational program, designed to train students with the specific skills needed to become safety specialists, is described. The discussion concentrates on application, selection, and utilization of various system safety analytical approaches. Emphasis is also placed on the management of a system safety program, its relationship with other disciplines, and new developments and applications of system safety techniques.

Geriatric Patient Safety Indicators Based on Linked Administrative Health Data to Assess Anticoagulant-Related Thromboembolic and Hemorrhagic Adverse Events in Older Inpatients: A Study Proposal.

PubMed

Le Pogam, Marie-Annick; Quantin, Catherine; Reich, Oliver; Tuppin, Philippe; Fagot-Campagna, Anne; Paccaud, Fred; Peytremann-Bridevaux, Isabelle; Burnand, Bernard

2017-05-11

Frail older people with multiple interacting conditions, polypharmacy, and complex care needs are particularly exposed to health care-related adverse events. Among these, anticoagulant-related thromboembolic and hemorrhagic events are particularly frequent and serious in older inpatients. The growing use of anticoagulants in this population and their substantial risk of toxicity and inefficacy have therefore become an important patient safety and public health concern worldwide. Anticoagulant-related adverse events and the quality of anticoagulation management should thus be routinely assessed to improve patient safety in vulnerable older inpatients. This project aims to develop and validate a set of outcome and process indicators based on linked administrative health data (ie, insurance claims data linked to hospital discharge data) assessing older inpatient safety related to anticoagulation in both Switzerland and France, and enabling comparisons across time and among hospitals, health territories, and countries. Geriatric patient safety indicators (GPSIs) will assess anticoagulant-related adverse events. Geriatric quality indicators (GQIs) will evaluate the management of anticoagulants for the prevention and treatment of arterial or venous thromboembolism in older inpatients. GPSIs will measure cumulative incidences of thromboembolic and bleeding adverse events based on hospital discharge data linked to insurance claims data. Using linked administrative health data will improve GPSI risk adjustment on patients' conditions that are present at admission and will capture in-hospital and postdischarge adverse events. GQIs will estimate the proportion of index hospital stays resulting in recommended anticoagulation at discharge and up to various time frames based on the same electronic health data. The GPSI and GQI development and validation process will comprise 6 stages: (1) selection and specification of candidate indicators, (2) definition of administrative data-based algorithms, (3) empirical measurement of indicators using linked administrative health data, (4) validation of indicators, (5) analyses of geographic and temporal variations for reliable and valid indicators, and (6) data visualization. Study populations will consist of 166,670 Swiss and 5,902,037 French residents aged 65 years and older admitted to an acute care hospital at least once during the 2012-2014 period and insured for at least 1 year before admission and 1 year after discharge. We will extract Swiss data from the Helsana Group data warehouse and French data from the national health insurance information system (SNIIR-AM). The study has been approved by Swiss and French ethics committees and regulatory organizations for data protection. Validated GPSIs and GQIs should help support and drive quality and safety improvement in older inpatients, inform health care stakeholders, and enable international comparisons. We discuss several limitations relating to the representativeness of study populations, accuracy of administrative health data, methods used for GPSI criterion validity assessment, and potential confounding bias in comparisons based on GQIs, and we address these limitations to strengthen study feasibility and validity. ©Marie-Annick Le Pogam, Catherine Quantin, Oliver Reich, Philippe Tuppin, Anne Fagot-Campagna, Fred Paccaud, Isabelle Peytremann-Bridevaux, Bernard Burnand. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 11.05.2017.

Broad Perspectives on Mars Landing Site Selection: Geological Factors from Centimeter to Kilometer Scales

NASA Technical Reports Server (NTRS)

Jakosky, B. M.; Golombek, M. P.

2001-01-01

Selection of a landing site for the '03 and later Mars surface missions represents a balance between potential science results and landing site safety. Although safety has to be the prime consideration, it is the melding together of spacecraft hazard analysis with science analysis that provides the key to understanding the nature of the surface for determining both its safety for landing and its scientific potential. Our goal here is to discuss the geological factors that go into a determination of site safety, at scales from centimeters up to kilometers, and to understand the implications for the resulting scientific return that can be expected.

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...

Transportation Safety Information Report : Second Quarter 1984

DOT National Transportation Integrated Search

1984-01-01

The "Transportation Safety Information Report" is a compendium of selected national-level transportation safety statistics for all modes of transportation. The report presents and compares data on a monthly and quarterly basis for transportation fata...

Transportation Safety Information Report : Second Quarter 1985

DOT National Transportation Integrated Search

1985-10-01

The "Transportation Safety Information Report" is a compendium of selected national-level transportation safety statistics for all modes of transportation. The report presents and compares data on a monthly and quarterly basis for transportation fata...

Quantifying Vermont transportation safety factors.

DOT National Transportation Integrated Search

2010-01-01

VTrans and its partners have selected traffic safety : priority areas in their Strategic Highway Safety Plan. : In this project, researchers focus on three of these : prioritized critical emphasis areas: 1) Keeping vehicles : on the roadway, 2) Young...

Genetic selection for temperament traits in dairy and beef cattle.

PubMed

Haskell, Marie J; Simm, Geoff; Turner, Simon P

2014-01-01

Animal temperament can be defined as a response to environmental or social stimuli. There are a number of temperament traits in cattle that contribute to their welfare, including their response to handling or milking, response to challenge such as human approach or intervention at calving, and response to conspecifics. In a number of these areas, the genetic basis of the trait has been studied. Heritabilities have been estimated and in some cases quantitative trait loci (QTL) have been identified. The variation is sometimes considerable and moderate heritabilities have been found for the major handling temperament traits, making them amenable to selection. Studies have also investigated the correlations between temperament and other traits, such as productivity and meat quality. Despite this, there are relatively few examples of temperament traits being used in selection programmes. Most often, animals are screened for aggression or excessive fear during handling or milking, with extreme animals being culled, or EBVs for temperament are estimated, but these traits are not commonly included routinely in selection indices, despite there being economic, welfare and human safety drivers for their. There may be a number of constraints and barriers. For some traits and breeds, there may be difficulties in collecting behavioral data on sufficiently large populations of animals to estimate genetic parameters. Most selection indices require estimates of economic values, and it is often difficult to assign an economic value to a temperament trait. The effects of selection primarily for productivity traits on temperament and welfare are discussed. Future opportunities include automated data collection methods and the wider use of genomic information in selection.

Genetic selection for temperament traits in dairy and beef cattle

PubMed Central

Haskell, Marie J.; Simm, Geoff; Turner, Simon P.

2014-01-01

Animal temperament can be defined as a response to environmental or social stimuli. There are a number of temperament traits in cattle that contribute to their welfare, including their response to handling or milking, response to challenge such as human approach or intervention at calving, and response to conspecifics. In a number of these areas, the genetic basis of the trait has been studied. Heritabilities have been estimated and in some cases quantitative trait loci (QTL) have been identified. The variation is sometimes considerable and moderate heritabilities have been found for the major handling temperament traits, making them amenable to selection. Studies have also investigated the correlations between temperament and other traits, such as productivity and meat quality. Despite this, there are relatively few examples of temperament traits being used in selection programmes. Most often, animals are screened for aggression or excessive fear during handling or milking, with extreme animals being culled, or EBVs for temperament are estimated, but these traits are not commonly included routinely in selection indices, despite there being economic, welfare and human safety drivers for their. There may be a number of constraints and barriers. For some traits and breeds, there may be difficulties in collecting behavioral data on sufficiently large populations of animals to estimate genetic parameters. Most selection indices require estimates of economic values, and it is often difficult to assign an economic value to a temperament trait. The effects of selection primarily for productivity traits on temperament and welfare are discussed. Future opportunities include automated data collection methods and the wider use of genomic information in selection. PMID:25374582

Safety of inhaled glycopyrronium in patients with COPD: a comprehensive analysis of clinical studies and post-marketing data.

PubMed

D'Urzo, Anthony D; Kerwin, Edward M; Chapman, Kenneth R; Decramer, Marc; DiGiovanni, Robert; D'Andrea, Peter; Hu, Huilin; Goyal, Pankaj; Altman, Pablo

2015-01-01

Chronic use of inhaled anticholinergics by patients with chronic obstructive pulmonary disease (COPD) has raised long-term safety concerns, particularly cardiovascular. Glycopyrronium is a once-daily anticholinergic with greater receptor selectivity than previously available agents. We assessed the safety of inhaled glycopyrronium using data pooled from two analysis sets, involving six clinical studies and over 4,000 patients with COPD who received one of the following treatments: glycopyrronium 50 μg, placebo (both delivered via the Breezhaler device), or tiotropium 18 μg (delivered via the HandiHaler device). Data were pooled from studies that varied in their duration and severity of COPD of the patients (ie, ≤12 weeks duration with patients having moderate or severe COPD; and >1 year duration with patients having severe and very severe COPD). Safety comparisons were made for glycopyrronium vs tiotropium or placebo. Poisson regression was used to assess the relative risk for either active drug or placebo (and between drugs where placebo was not available) for assessing the incidence of safety events. During post-marketing surveillance (PMS), safety was assessed by obtaining reports from various sources, and disproportionality scores were computed using EMPIRICA. In particular, the cardiac safety of glycopyrronium during the post-marketing phase was evaluated. The overall incidence of adverse events and deaths was similar across groups, while the incidence of serious adverse events was numerically higher in placebo. Furthermore, glycopyrronium did not result in an increased risk of cerebro-cardiovascular events vs placebo. There were no new safety reports during the PMS phase that suggested an increased risk compared to results from the clinical studies. Moreover, the cardiac safety of glycopyrronium during the PMS phase was also consistent with the clinical data. The overall safety profile of glycopyrronium was similar to its comparators indicating no increase in the overall risk for any of the investigated safety end points.

[Design, implementation and evaluation of a management model of patient safety in hospitals in Catalonia, Spain].

PubMed

Saura, Rosa Maria; Moreno, Pilar; Vallejo, Paula; Oliva, Glòria; Alava, Fernando; Esquerra, Miquel; Davins, Josep; Vallès, Roser; Bañeres, Joaquim

2014-07-01

Since its inception in 2006, the Alliance for Patient Safety in Catalonia has played a major role in promoting and shaping a series of projects related to the strategy of the Ministry of Health, Social Services and Equality, for improving patient safety. One such project was the creation of functional units or committees of safety in hospitals in order to facilitate the management of patient safety. The strategy has been implemented in hospitals in Catalonia which were selected based on criteria of representativeness. The intervention was based on two lines of action, one to develop the model framework and the other for its development. Firstly the strategy for safety management based on EFQM (European Foundation for Quality Management) was defined with the development of standards, targets and indicators to implement security while the second part involved the introduction of tools, methodologies and knowledge to the management support of patient safety and risk prevention. The project was developed in four hospital areas considered higher risk, each assuming six goals for safety management. Some of these targets such as the security control panel or system of adverse event reporting were shared. 23 hospitals joined the project in Catalonia. Despite the different situations in each centre, high compliance was achieved in the development of the objectives. In each of the participating areas the security control panel was developed. Stable structures for safety management were established or strengthened. Training in patient safety played and important role, 1415 professionals participated. Through these kind of projects not only have been introduced programs of proven effectiveness in reducing risks, but they also provide to the facilities a work system that allows autonomy in diagnosis and analysis of the different risk situations or centre specific safety issues. Copyright © 2014. Published by Elsevier Espana.

Improving safety culture through the health and safety organization: a case study.

PubMed

Nielsen, Kent J

2014-02-01

International research indicates that internal health and safety organizations (HSO) and health and safety committees (HSC) do not have the intended impact on companies' safety performance. The aim of this case study at an industrial plant was to test whether the HSO can improve company safety culture by creating more and better safety-related interactions both within the HSO and between HSO members and the shop-floor. A quasi-experimental single case study design based on action research with both quantitative and qualitative measures was used. Based on baseline mapping of safety culture and the efficiency of the HSO three developmental processes were started aimed at the HSC, the whole HSO, and the safety representatives, respectively. Results at follow-up indicated a marked improvement in HSO performance, interaction patterns concerning safety, safety culture indicators, and a changed trend in injury rates. These improvements are interpreted as cultural change because an organizational double-loop learning process leading to modification of the basic assumptions could be identified. The study provides evidence that the HSO can improve company safety culture by focusing on safety-related interactions. © 2013. Published by Elsevier Ltd and National Safety Council.

School Bus Safety.

ERIC Educational Resources Information Center

Stroup, Karen Bruner; And Others

1991-01-01

Equipment to allow safe transportation of disabled children is reviewed. Such equipment includes infant car seats, child safety seats, safety vests, and accommodations for children in casts and/or braces. Five principles for evaluation and selection of safe seating options are given as are safety rules and information on standards and resources.…

A risk-based decision support framework for selection of appropriate safety measure system for underground coal mines.

PubMed

Samantra, Chitrasen; Datta, Saurav; Mahapatra, Siba Sankar

2017-03-01

In the context of underground coal mining industry, the increased economic issues regarding implementation of additional safety measure systems, along with growing public awareness to ensure high level of workers safety, have put great pressure on the managers towards finding the best solution to ensure safe as well as economically viable alternative selection. Risk-based decision support system plays an important role in finding such solutions amongst candidate alternatives with respect to multiple decision criteria. Therefore, in this paper, a unified risk-based decision-making methodology has been proposed for selecting an appropriate safety measure system in relation to an underground coal mining industry with respect to multiple risk criteria such as financial risk, operating risk, and maintenance risk. The proposed methodology uses interval-valued fuzzy set theory for modelling vagueness and subjectivity in the estimates of fuzzy risk ratings for making appropriate decision. The methodology is based on the aggregative fuzzy risk analysis and multi-criteria decision making. The selection decisions are made within the context of understanding the total integrated risk that is likely to incur while adapting the particular safety system alternative. Effectiveness of the proposed methodology has been validated through a real-time case study. The result in the context of final priority ranking is seemed fairly consistent.

Safety, Pharmacokinetics, and Pharmacodynamics in Healthy Volunteers Treated With GDC-0853, a Selective Reversible Bruton's Tyrosine Kinase Inhibitor.

PubMed

Herman, Ann E; Chinn, Leslie W; Kotwal, Shweta G; Murray, Elaine R; Zhao, Rui; Florero, Marilyn; Lin, Alyse; Moein, Anita; Wang, Rena; Bremer, Meire; Kokubu, Serika; Serone, Adrian P; Hanze, Eva L; Viberg, Anders; Morimoto, Alyssa M; Winter, Helen R; Katsumoto, Tamiko R

2018-06-01

GDC-0853 is a small molecule inhibitor of Bruton's tyrosine kinase (BTK) that is highly selective and noncovalent, leading to reversible binding. In double-blind, randomized, and placebo-controlled phase I healthy volunteer studies, GDC-0853 was well tolerated, with no dose-limiting adverse events (AEs) or serious AEs. The maximum tolerated dose was not reached during dose escalation (≤600 mg, single ascending dose (SAD) study; ≤250 mg twice daily (b.i.d.) and ≤500 mg once daily, 14-day multiple ascending dose (MAD) study). Plasma concentrations peaked 1-3 hours after oral administration and declined thereafter, with a steady-state half-life ranging from 4.2-9.9 hours. Independent assays demonstrated dose-dependent BTK target engagement. Based on pharmacokinetic/pharmacodynamic (PK/PD) simulations, a once-daily dosing regimen (e.g., 100 mg, q.d.) is expected to maintain a high level of BTK inhibition over the dosing interval. Taken together, the safety and PK/PD data support GDC-0853 evaluation in rheumatoid arthritis, lupus, and other autoimmune or inflammatory indications. © 2018 American Society for Clinical Pharmacology and Therapeutics.

Targeting the cyclin D-cyclin-dependent kinase (CDK) 4/6-retinoblastoma pathway with selective CDK 4/6 inhibitors in hormone receptor-positive breast cancer: rationale, current status, and future directions.

PubMed

Spring, Laura; Bardia, Aditya; Modi, Shanu

2016-01-01

Dysregulation of the cyclin D-cyclin-dependent kinase (CDK) 4/6-INK4-retinoblastoma (Rb) pathway is an important contributor to endocrine therapy resistance. Recent clinical development of selective inhibitors of CDK4 and CDK6 kinases has led to renewed interest in cell cycle regulators, following experience with relatively non-selective pan-CDK inhibitors that often resulted in limited activity and poor safety profiles in the clinic. The highly selective oral CDK 4/6 inhibitors palbociclib (PD0332991), ribociclib (LEE011), and abemaciclib (LY2835219) are able to inhibit the proliferation of Rb-positive tumor cells and have demonstrated dose-dependent growth inhibition in ER+ breast cancer models. In metastatic breast cancer, all three agents are being explored in combination with endocrine therapy in Phase III studies. Results so far indicated promising efficacy and manageable safety profiles, and led to the FDA approval of palbociclib. Phase II-III studies of these agents, in combination with endocrine therapy, are also underway in early breast cancer in the neoadjuvant and adjuvant settings. Selective CDK 4/6 inhibitors are also being investigated with other targeted agents or chemotherapy in the advanced setting. This article reviews the rationale for targeting cyclin D-CDK 4/6 in hormone receptor-positive (HR+) breast cancer, provides an overview of the available preclinical and clinical data with CDK 4/6 inhibitors in breast cancer to date, and summarizes the main features of ongoing clinical trials of these new agents in breast cancer. Future trials evaluating further combination strategies with CDK 4/6 backbone and translational studies refining predictive biomarkers are needed to help personalize the optimal treatment regimen for individual patients with ER+ breast cancer.

Role of Quantitative Clinical Pharmacology in Pediatric Approval and Labeling.

PubMed

Mehrotra, Nitin; Bhattaram, Atul; Earp, Justin C; Florian, Jeffry; Krudys, Kevin; Lee, Jee Eun; Lee, Joo Yeon; Liu, Jiang; Mulugeta, Yeruk; Yu, Jingyu; Zhao, Ping; Sinha, Vikram

2016-07-01

Dose selection is one of the key decisions made during drug development in pediatrics. There are regulatory initiatives that promote the use of model-based drug development in pediatrics. Pharmacometrics or quantitative clinical pharmacology enables development of models that can describe factors affecting pharmacokinetics and/or pharmacodynamics in pediatric patients. This manuscript describes some examples in which pharmacometric analysis was used to support approval and labeling in pediatrics. In particular, the role of pharmacokinetic (PK) comparison of pediatric PK to adults and utilization of dose/exposure-response analysis for dose selection are highlighted. Dose selection for esomeprazole in pediatrics was based on PK matching to adults, whereas for adalimumab, exposure-response, PK, efficacy, and safety data together were useful to recommend doses for pediatric Crohn's disease. For vigabatrin, demonstration of similar dose-response between pediatrics and adults allowed for selection of a pediatric dose. Based on model-based pharmacokinetic simulations and safety data from darunavir pediatric clinical studies with a twice-daily regimen, different once-daily dosing regimens for treatment-naïve human immunodeficiency virus 1-infected pediatric subjects 3 to <12 years of age were evaluated. The role of physiologically based pharmacokinetic modeling (PBPK) in predicting pediatric PK is rapidly evolving. However, regulatory review experiences and an understanding of the state of science indicate that there is a lack of established predictive performance of PBPK in pediatric PK prediction. Moving forward, pharmacometrics will continue to play a key role in pediatric drug development contributing toward decisions pertaining to dose selection, trial designs, and assessing disease similarity to adults to support extrapolation of efficacy. Copyright © 2016 U.S. Government work not protected by U.S. copyright.

78 FR 70078 - Advisory Committee on Reactor Safeguards; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-22

... Pike, Rockville, Maryland. Wednesday, December 4, 2013, Conference Room T2-B1, 11545 Rockville Pike....: Selected Chapters of the Safety Evaluation Report (SER) With Open Items Associated With the Calvert Cliffs...)(4).] 10:45 a.m.-12:45 p.m.: Topical Report and Selected Chapters of the Safety Evaluation Reports...

Assessment of the benefits and costs associated with the adoption of the recommended fire safety practices for rail transit materials selection

DOT National Transportation Integrated Search

1982-12-01

This report presents the results of an assessment of the benefits and costs associated with the adoption of Recommended Fire Safety Practices for Rail Transit Materials Selection for rapid rail transit and light rail transit vehicles. The potential b...

Risks and injuries in laser and high-frequency applications

NASA Astrophysics Data System (ADS)

Giering, K.; Philipp, Carsten M.; Berlien, Hans-Peter

1995-01-01

An analysis of injuries and risks using high frequency (HF) and lasers in medicine based on a literature search with MEDLINE was performed. The cases reported in the literature were classified according to the following criteria: (1) Avoidable in an optimal operational procedure. These kind of injuries are caused by a chain of unfortunate incidents. They are in principle avoidable by the 'right action at the right time' which presupposes an appropriate training of the operating team, selection of the optimal parameters for procedure and consideration of all safety instructions. (2) Avoidable, caused by malfunction of the equipment and/or accessories. The injuries classified into this group are avoidable if all safety regulations were fulfilled. This includes a pre-operational check-up and the use of medical lasers and high frequency devices only which meet the international safety standards. (3) Avoidable, caused by misuse/mistake. Injuries of this group were caused by an inappropriate selection of the procedure, wrong medical indication or mistakes during application. (4) Unavoidable, fateful. These injuries can be caused by risks inherent to the type of energy used, malfunction of the equipment and/or accessories though a pre-operational check-up was done. Some risks and complications are common to high frequency and laser application. But whereas these risks can be excluded easily in laser surgery there is often a great expenditure necessary or they are not avoidable if high frequency if used. No unavoidable risks due to laser energy occur.

Safety profile and protocol prevention of adverse reactions to uroangiographic contrast media in diagnostic imaging.

PubMed

Rossi, C; Reginelli, A; D'Amora, M; Di Grezia, G; Mandato, Y; D'Andrea, A; Brunese, L; Grassi, R; Rotondi, A

2014-01-01

The purpose of the study is to examine the incidence of adverse reactions caused by non-ionic contrast media in selected patients after desensitization treatment and to evaluate the safety profile of organ iodine contrast media (i.c.m.) in a multistep prevention protocol. In a population of 2000 patients that had received a CT scan, 100 patients with moderate/high risk for adverse reactions against iodinated contrast agents followed a premedication protocol and all adverse reactions are reported and classified as mild, moderate or severe. 1.7 percent of the pre-treated patients reported a mild, immediate type reaction to iodine contrast; of these five patients with allergy 0.71 percent had received iomeprol, 0.35 percent received ioversol and 0.71 percent received iopromide. The incidence of adverse reactions was reported to be higher (4 out of 5 patients) among those that referred a history of hypersensitivity against iodinated i.c.m. Although intravenous contrast materials have greatly improved, especially in terms of their safety profile, they should not be administered if there isn't a clear or justified indication. In conclusion, even if we know that the majority of these reactions are idiosyncratic and unpredictable we propose, with the aim of improving our knowledge on this subject, a multicenter study, based on skin allergy tests (prick test, patch test, intradermal reaction) in selected patients that have had previous experiences of hypersensitivity against parenteral organ iodine contrast media.

Molecular size is important for the safety and selective inhibition of intrinsic factor Xase for fucosylated chondroitin sulfate.

PubMed

Yan, Lufeng; Li, Junhui; Wang, Danli; Ding, Tian; Hu, Yaqin; Ye, Xingqian; Linhardt, Robert J; Chen, Shiguo

2017-12-15

Fucosylated chondroitin sulfate from sea cucumber Isostichopus badionotus (FCS-Ib) showed potent anticoagulant activities without selectivity. The present study focused on developing safe FCS-Ib oligomers showing selective inhibition of intrinsic factor Xase (anti-FXase) prepared through partial N-deacetylation-deaminative cleavage. The N-deacetylation degree was regulated by reaction time, controlling the resulting oligomer distribution. Structure analysis confirmed the selectivity of degradation, and 12 high purity fractions with trisaccharide-repeating units were separated. In vitro anticoagulant assays indicated a decrease in molecular weight (Mw) dramatically reduced activated partial thromboplastin time (APTT), thrombin time (TT), AT-dependent anti-FIIa and anti-FXa activities, while the oligomers retained potent anti-FXase activity until they fell below 3kDa. Meanwhile, human FXII activation and platelet aggregation were markedly reduced with decreasing Mw and were moderate when under 12.0kDa. Thus, fragments of 3-12.0kDa should be safe and effective as selective inhibitors of intrinsic tenase complex for application as clinical anticoagulants. Copyright © 2017 Elsevier Ltd. All rights reserved.

Probiotic and synbiotic safety in infants under two years of age.

PubMed

van den Nieuwboer, M; Claassen, E; Morelli, L; Guarner, F; Brummer, R J

2014-03-01

In this study, we systematically evaluated safety aspects in clinical trials with probiotics and synbiotics in young infants (0-2 years of age). This study is an update of earlier reports and covers the recent literature from 2008-2013. The safety evaluation is performed along the Common Terminology Clinical Adverse Events (CTCAE) version 4.0 scale, hereby also providing guidance for future studies. Safety aspects are represented and related to number of participants per probiotic strain/culture, study duration, dosage, clinical condition and selected afflictions. The results show a deficiency in the precise reporting and classification of adverse events in most studies. Analysis of 57 clinical trials with probiotics and synbiotics in combination with eight follow-up studies indicate that probiotic administration to infants between 0 and 24 months is safe with regard to the evaluated strains in infants with a particular health status or susceptibility. Most adverse events and serious adverse events were considered unrelated to the study product, and there were no major safety concerns. Almost all studies concluded that none of the adverse effects were related to the study product; the study products are generally well tolerated. Finally, inconsistent, imprecise and potentially incomplete reporting as well as the variation in probiotic strains, dosages, administration regimes, study populations and reported outcomes, greatly limit the generalizability of conclusions and argue convincingly for obligatory and standardised behaviour on adverse events (CTCAE) reporting in 'food' studies.

Systemic study on the safety of immuno-deficient nude mice treated by atmospheric plasma-activated water

NASA Astrophysics Data System (ADS)

Dehui, XU; Qingjie, CUI; Yujing, XU; Bingchuan, WANG; Miao, TIAN; Qiaosong, LI; Zhijie, LIU; Dingxin, LIU; Hailan, CHEN; Michael, G. KONG

2018-04-01

Cold atmospheric-pressure plasma is a new technology, widely used in many fields of biomedicine, especially in cancer treatment. Cold plasma can selectively kill a variety of tumor cells, and its biological safety in clinical trials is also very important. In many cases, the patient’s immune level is relatively low, so we first studied the safety assessment of plasma treatment in an immuno-compromised animal model. In this study, we examined the safety of immuno-deficient nude mice by oral lavage treatment of plasma-activated water, and studied the growth status, main organs and blood biochemical indexes. Acute toxicity test results showed that the maximum dose of plasma treatment for 15 min had no lethal effect and other acute toxicity. There were no significant changes in body weight and survival status of mice after 2 min and 4 min of plasma-activated water (PAW) treatment for 2 weeks. After treatment, the major organs, including heart, liver, spleen, lung and kidney, were not significantly changed in organ coefficient and tissue structure. Blood biochemical markers showed that blood neutrophils and mononuclear cells were slightly increased, and the others remained unchanged. Liver function, renal function, electrolytes, glucose metabolism and lipid metabolism were not affected by different doses of PAW treatment. The above results indicate that PAW treatment can be used to treat immuno-deficient nude mice without significant safety problems.

Inland Waterway Environmental Safety

NASA Astrophysics Data System (ADS)

Reshnyak, Valery; Sokolov, Sergey; Nyrkov, Anatoliy; Budnik, Vlad

2018-05-01

The article presents the results of development of the main components of the environmental safety when operating vessels on inland waterways, which include strategy selection ensuring the environmental safety of vessels, the selection and justification of a complex of environmental technical means, activities to ensure operation of vessels taking into account the environmental technical means. Measures to ensure environmental safety are developed on the basis of the principles aimed at ensuring environmental safety of vessels. They include the development of strategies for the use of environmental protection equipment, which are determined by the conditions for wastewater treatment of purified sewage and oily bilge water as well as technical characteristics of the vessels, the introduction of the process of the out-of-the-vessel processing of ship pollution as a technology for their movement. This must take into account the operating conditions of vessels on different sections of waterways. An algorithm of actions aimed at ensuring ecological safety of operated vessels is proposed.

A double-regulated oncolytic adenovirus with improved safety for adenocarcinoma therapy

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

Wei, Na; Fan, Jun Kai; Gu, Jin Fa

2009-10-16

Safety and efficiency are equally important to be considered in developing oncolytic adenovirus. Previously, we have reported that ZD55, an oncolytic adenovirus with the deletion of E1B-55K gene, exhibited potent antitumor activity. In this study, to improve the safety of ZD55, we utilized MUC1 promoter to replace the native promoter of E1A on the basis of ZD55, and generated a double-regulated adenovirus, named MUD55. Our data demonstrated that the expression of early and late genes of MUD55 was both reduced in MUC1-negative cells, resulting in its stricter glandular-tumor selective progeny production. The cytopathic effect of MUD55 was about 10-fold lowermore » than mono-regulated adenovirus ZD55 or Ad.MUC1 in normal cells and not obviously attenuated in glandular tumor cells. Moreover, MUD55 showed the least liver toxicity when administrated by intravenous injection in nude mice. These results indicate that MUD55 could be a promising candidate for the treatment of adenocarcinoma.« less

The Influence of Neighborhood Aesthetics, Safety, and Social Cohesion on Perceived Stress in Disadvantaged Communities.

PubMed

Henderson, Heather; Child, Stephanie; Moore, Spencer; Moore, Justin B; Kaczynski, Andrew T

2016-09-01

Limited research has explored how specific elements of physical and social environments influence mental health indicators such as perceived stress, or whether such associations are moderated by gender. This study examined the relationship between selected neighborhood characteristics and perceived stress levels within a primarily low-income, older, African-American population in a mid-sized city in the Southeastern U.S. Residents (n = 394; mean age=55.3 years, 70.9% female, 89.3% African American) from eight historically disadvantaged neighborhoods completed surveys measuring perceptions of neighborhood safety, social cohesion, aesthetics, and stress. Multivariate linear regression models examined the association between each of the three neighborhood characteristics and perceived stress. Greater perceived safety, improved neighborhood aesthetics, and social cohesion were significantly associated with lower perceived stress. These associations were not moderated by gender. These findings suggest that improving social attributes of neighborhoods may have positive impacts on stress and related benefits for population health. Future research should examine how neighborhood characteristics influence stress over time. © Society for Community Research and Action 2016.

In Vitro Susceptibility of Leishmania infantum to Artemisinin Derivatives and Selected Trioxolanes

PubMed Central

Albuquerque, Andreia; Cabral, Lília I. L.; Lopes, Liliana; Campino, Lenea

2015-01-01

Leishmaniasis is among the world's most neglected diseases. Currently available drugs for treatment present drawbacks, urging the need for more effective, safer, and cheaper drugs. A small library of artemisinin-derived trioxanes and synthetic trioxolanes was tested against promastigote and intramacrophage amastigote forms of Leishmania infantum. The trioxolanes LC50 and LC95 presented the best activity and safety profiles, showing potential for further studies in the context of leishmanial therapy. Our results indicate that the compounds tested exhibit peroxide-dependent activity. PMID:26014947

Spacecraft fire-safety experiments for space station: Technology development mission

NASA Technical Reports Server (NTRS)

Youngblood, Wallace W.

1988-01-01

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

Development of future indications for BOTOX.

PubMed

Brin, Mitchell F

2009-10-01

Since the late 1970s, local injections of BoNT have provided clinical benefit for patients with inappropriately contracting muscles with or without pain or sensory disturbance. Marketing authorization for some BoNTs, depending on country, include core indications of dystonia (blepharospasm and cervical dystonia), large muscle spastic disorders (not yet approved in the United States, e.g., adult post-stroke spasticity and equinus foot deformity), hyperhidrosis and aesthetic. Subsequent development has extended to selected conditions characterized by recurrent or chronic pain (migraine headache), and urologic indications (neurogenic/idiopathic overactive bladder; prostate hyperplasia), with multiple additional opportunities available. Portfolio management requires a careful individual opportunity assessment of scientific and technical aspects (basic science foundation, potential to treat unmet medical need, product-specific risk in specific populations, therapeutic margin/safety profile, and probability of successful registration pathway). This article describes ongoing development targets for BOTOX.

Leading and lagging indicators of occupational health and safety: The moderating role of safety leadership.

PubMed

Sheehan, Cathy; Donohue, Ross; Shea, Tracey; Cooper, Brian; Cieri, Helen De

2016-07-01

In response to the call for empirical evidence of a connection between leading and lagging indicators of occupational health and safety (OHS), the first aim of the current research is to consider the association between leading and lagging indicators of OHS. Our second aim is to investigate the moderating effect of safety leadership on the association between leading and lagging indicators. Data were collected from 3578 employees nested within 66 workplaces. Multi-level modelling was used to test the two hypotheses. The results confirm an association between leading and lagging indicators of OHS as well as the moderating impact of middle management safety leadership on the direct association. The association between leading and lagging indicators provides OHS practitioners with useful information to substantiate efforts within organisations to move away from a traditional focus on lagging indicators towards a preventative focus on leading indicators. The research also highlights the important role played by middle managers and the value of OHS leadership development and investment at the middle management level. Copyright © 2016 Elsevier Ltd. All rights reserved.

Indicators of School Crime and Safety: 2013. NCES 2014-042/NCJ 243299

ERIC Educational Resources Information Center

Robers, Simone; Kemp, Jana; Rathbun, Amy; Morgan, Rachel E.

2014-01-01

"Indicators of School Crime and Safety: 2013" provides the most recent national indicators on school crime and safety. The information presented in this report is intended to serve as a reference for policymakers and practitioners so that they can develop effective programs and policies aimed at violence and school crime prevention.…

Indicators of School Crime and Safety: 2006. NCES 2007-003

ERIC Educational Resources Information Center

Dinkes, Rachel; Cataldi, Emily Forrest; Kena, Grace; Baum, Katrina

2006-01-01

This report provides the most recent national indicators on school crime and safety. Some of these indicators document that student safety has improved. For example, the victimization rate of students ages 12-18 at school declined from 73 victimizations per 1,000 students in 2003 to 55 per 1,000 students victimizations in 2004. However, other…

Indicators of School Crime and Safety: 2008. NCES 2009-022/NCJ 226343

ERIC Educational Resources Information Center

Dinkes, Rachel; Kemp, Jana; Baum, Katrina

2009-01-01

"Indicators of School Crime and Safety: 2008" provides the most recent national indicators on school crime and safety. The information presented in this report is intended to serve as a reference for policymakers and practitioners so that they can develop effective programs and policies aimed at violence and school crime prevention. The…

Child safety seat and safety belt use among urban travelers.

DOT National Transportation Integrated Search

1984-01-01

During nine days in June 1977 and nine in June 1983, four major metropolitan areas of Virginia were surveyed to determine whether safety restraints were being used by urban travelers. Observers stationed at selected signalized intersections displayed...

Safety evaluation of centerline plus shoulder rumble strips.

DOT National Transportation Integrated Search

2015-06-01

The Federal Highway Administration organized a pooled fund study of 38 States to evaluate low-cost safety strategies as part of its strategic highway safety effort. One of the strategies selected for evaluation was the combined application of centerl...

Framework for selection and evaluation of bicycle and pedestrian safety projects in Virginia.

DOT National Transportation Integrated Search

2008-01-01

The Virginia Department of Transportation's (VDOT) Bicycle and Pedestrian Safety (BPS) Program provides funds for implementing short-term, low-cost bicycle and pedestrian safety projects in Virginia. This initiative is administered by evaluating each...

Safety evaluation of wet reflective pavement markers.

DOT National Transportation Integrated Search

2015-09-01

The Federal Highway Administration organized a pooled fund study of 38 States to evaluate low-cost safety : strategies as part of its strategic highway safety effort. One of the strategies selected for evaluation was the : application of wet-reflecti...

Safety evaluation of wet-reflective pavement markings.

DOT National Transportation Integrated Search

2015-09-01

The Federal Highway Administration organized a pooled fund study of 38 States to evaluate low-cost safety strategies as part of its strategic highway safety effort. One of the strategies selected for evaluation was the application of wet-reflective p...

Safety evaluation of intersection conflict warning system.

DOT National Transportation Integrated Search

2016-06-01

FHWA organized a pooled fund study of 40 States to evaluate low-cost safety strategies as part of its strategic highway safety effort. One of the strategies selected for evaluation was intersection conflict warning systems (ICWSs). This strategy is i...

Customising turnaround time indicators to requesting clinician: a 10-year study through balanced scorecard indicators.

PubMed

Salinas, Maria; López-Garrigós, Maite; Santo-Quiles, Ana; Gutierrez, Mercedes; Lugo, Javier; Lillo, Rosa; Leiva-Salinas, Carlos

2014-09-01

The purpose of this study is, first to present a 10-year monitoring of postanalytical turnaround time (TAT) adapted to different clinicians and patient situations, second to evaluate and analyse the indicators results during that period of time, and finally to show a synthetic appropriate indicator to be included in the balanced scorecard management system. TAT indicator for routine samples was devised as the percentage of certain key tests that were verified before a specific time on the phlebotomy day. A weighted mean synthetic indicator was also designed. They were calculated for inpatients at 15:00 and 12:00 and for primary care patients only at 15:00. The troponin TAT of emergency department patients, calculated as the difference between the troponin verification and registration time, was selected as the stat laboratory TAT indicator. The routine and stat TAT improved along the 10-year study period. The synthetic indicator showed the same trend. The implementation of systematic and continuous monitoring over years, promoted a continuous improvement in TAT which will probably benefit patient outcome and safety.

78 FR 15920 - Federal Motor Vehicle Safety Standards; Tire Selection and Rims

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-13

... [Docket No. NHTSA-2013-0030] RIN 2127-AL24 Federal Motor Vehicle Safety Standards; Tire Selection and Rims...: Notice of proposed rulemaking (NPRM). SUMMARY: This document proposes to amend Federal Motor Vehicle... installed on new trailers with a gross vehicle weight rating (GVWR) of 4,536 kg (10,000 lbs.) or less. It...

The natural selection of organizational and safety culture within a small to medium sized enterprise (SME).

PubMed

Brooks, Benjamin

2008-01-01

Small to Medium Sized Enterprises (SMEs) form the majority of Australian businesses. This study uses ethnographic research methods to describe the organizational culture of a small furniture-manufacturing business in southern Australia. Results show a range of cultural assumptions variously 'embedded' within the enterprise. In line with memetics - Richard Dawkin's cultural application of Charles Darwin's theory of Evolution by Natural Selection, the author suggests that these assumptions compete to be replicated and retained within the organization. The author suggests that dominant assumptions are naturally selected, and that the selection can be better understood by considering the cultural assumptions in reference to Darwin's original principles and Frederik Barth's anthropological framework of knowledge. The results are discussed with reference to safety systems, negative cultural elements called Cultural Safety Viruses, and how our understanding of this particular organizational culture might be used to build resistance to these viruses.

Occupational Safety & Health. Inspectors' Opinions on Improving OSHA Effectiveness. Fact Sheet for Subcommittee on Health and Safety, Committee on Education and Labor, House of Representatives.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Div. of Human Resources.

Questionnaires gathered opinions of all Occupational Safety and Health Administration (OSHA) field supervisors and a randomly selected sample of one-third of the compliance officers about OSHA's approach to improving workplace safety and health. Major topics addressed were enforcement, safety and health standards, education and training, employer…

Major depressive disorder: new clinical, neurobiological, and treatment perspectives

PubMed Central

Kupfer, David J; Frank, Ellen; Phillips, Mary L

2012-01-01

In this Seminar we discuss developments from the past 5 years in the diagnosis, neurobiology, and treatment of major depressive disorder. For diagnosis, psychiatric and medical comorbidity have been emphasised as important factors in improving the appropriate assessment and management of depression. Advances in neurobiology have also increased, and we aim to indicate genetic, molecular, and neuroimaging studies that are relevant for assessment and treatment selection of this disorder. Further studies of depression-specific psychotherapies, the continued application of antidepressants, the development of new treatment compounds, and the status of new somatic treatments are also discussed. We address two treatment-related issues: suicide risk with selective serotonin reuptake inhibitors, and the safety of antidepressants in pregnancy. Although clear advances have been made, no fully satisfactory treatments for major depression are available. PMID:22189047

The system of technical diagnostics of the industrial safety information network

NASA Astrophysics Data System (ADS)

Repp, P. V.

2017-01-01

This research is devoted to problems of safety of the industrial information network. Basic sub-networks, ensuring reliable operation of the elements of the industrial Automatic Process Control System, were identified. The core tasks of technical diagnostics of industrial information safety were presented. The structure of the technical diagnostics system of the information safety was proposed. It includes two parts: a generator of cyber-attacks and the virtual model of the enterprise information network. The virtual model was obtained by scanning a real enterprise network. A new classification of cyber-attacks was proposed. This classification enables one to design an efficient generator of cyber-attacks sets for testing the virtual modes of the industrial information network. The numerical method of the Monte Carlo (with LPτ - sequences of Sobol), and Markov chain was considered as the design method for the cyber-attacks generation algorithm. The proposed system also includes a diagnostic analyzer, performing expert functions. As an integrative quantitative indicator of the network reliability the stability factor (Kstab) was selected. This factor is determined by the weight of sets of cyber-attacks, identifying the vulnerability of the network. The weight depends on the frequency and complexity of cyber-attacks, the degree of damage, complexity of remediation. The proposed Kstab is an effective integral quantitative measure of the information network reliability.

A probabilistic bridge safety evaluation against floods.

PubMed

Liao, Kuo-Wei; Muto, Yasunori; Chen, Wei-Lun; Wu, Bang-Ho

2016-01-01

To further capture the influences of uncertain factors on river bridge safety evaluation, a probabilistic approach is adopted. Because this is a systematic and nonlinear problem, MPP-based reliability analyses are not suitable. A sampling approach such as a Monte Carlo simulation (MCS) or importance sampling is often adopted. To enhance the efficiency of the sampling approach, this study utilizes Bayesian least squares support vector machines to construct a response surface followed by an MCS, providing a more precise safety index. Although there are several factors impacting the flood-resistant reliability of a bridge, previous experiences and studies show that the reliability of the bridge itself plays a key role. Thus, the goal of this study is to analyze the system reliability of a selected bridge that includes five limit states. The random variables considered here include the water surface elevation, water velocity, local scour depth, soil property and wind load. Because the first three variables are deeply affected by river hydraulics, a probabilistic HEC-RAS-based simulation is performed to capture the uncertainties in those random variables. The accuracy and variation of our solutions are confirmed by a direct MCS to ensure the applicability of the proposed approach. The results of a numerical example indicate that the proposed approach can efficiently provide an accurate bridge safety evaluation and maintain satisfactory variation.

Comparison of Mono-, Bi-, and Tripolar Configurations for Stimulation and Recording With an Interfascicular Interface.

PubMed

Nielsen, Thomas N; Sevcencu, Cristian; Struijk, Johannes J

2014-01-01

Previous studies have indicated that electrodes placed between fascicles can provide nerve recruitment with high topological selectivity if the areas of interest in the nerve are separated with passive elements. In this study, we investigated if this separation of fascicles also can provide topologically selective nerve recordings and compared the performance of mono-, bi-, and tripolar configurations for stimulation and recording with an intra-neural interface. The interface was implanted in the sciatic nerve of 10 rabbits and achieved a median selectivity of Ŝ=0.98-0.99 for all stimulation configurations, while recording selectivity configurations was in the range of Ŝ=0.70-0.80 with the monopolar configuration providing the lowest and the average reference configuration the highest recording selectivity. Interfascicular electrodes could provide an interesting addition to the bulk of peripheral nerve interfaces available for neural prosthetic devices. The separation of the nerve into chambers by the passive elements of the electrode could ensure a higher selectivity than comparable cuff electrodes and the intra-neural location could provide an option of targeting mainly central fascicles. Further studies are, however, still required to develop biocompatible electrodes and test their stability and safety in chronic experiments.

Railway safety climate: a study on organizational development.

PubMed

Cheng, Yung-Hsiang

2017-09-07

The safety climate of an organization is considered a leading indicator of potential risk for railway organizations. This study adopts the perceptual measurement-individual attribute approach to investigate the safety climate of a railway organization. The railway safety climate attributes are evaluated from the perspective of railway system staff. We identify four safety climate dimensions from exploratory factor analysis, namely safety communication, safety training, safety management and subjectively evaluated safety performance. Analytical results indicate that the safety climate differs at vertical and horizontal organizational levels. This study contributes to the literature by providing empirical evidence of the multilevel safety climate in a railway organization, presents possible causes of the differences under various cultural contexts and differentiates between safety climate scales for diverse workgroups within the railway organization. This information can be used to improve the safety sustainability of railway organizations and to conduct safety supervisions for the government.

Effects of hydration on cognitive function of pilots.

PubMed

Lindseth, Paul D; Lindseth, Glenda N; Petros, Thomas V; Jensen, Warren C; Caspers, Julie

2013-07-01

The objective of this study was to examine the effect of fluid intake and possible dehydration on cognitive flight performance of pilots. A repeated-measures, counterbalanced, mixed study design was used to examine differences in working memory, spatial orientation, and cognitive flight performance of 40 randomly selected healthy pilots after having high and low fluid intakes. Serial weights were also analyzed to determine differences in cognitive flight performance of the dehydrated (1-3% weight loss) and hydrated study participants. Results showed flight performance and spatial cognition test scores were significantly (p < 0.05) poorer for pilots who had low fluid intakes and experienced dehydration in comparison to the hydrated pilots. These findings indicate fluid intake differences resulting in dehydration may have safety implications because peak cognitive performance among pilots is critical for flight safety. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

Global ship accidents and ocean swell-related sea states

NASA Astrophysics Data System (ADS)

Zhang, Zhiwei; Li, Xiao-Ming

2017-11-01

With the increased frequency of shipping activities, navigation safety has become a major concern, especially when economic losses, human casualties and environmental issues are considered. As a contributing factor, the sea state plays a significant role in shipping safety. However, the types of dangerous sea states that trigger serious shipping accidents are not well understood. To address this issue, we analyzed the sea state characteristics during ship accidents that occurred in poor weather or heavy seas based on a 10-year ship accident dataset. Sea state parameters of a numerical wave model, i.e., significant wave height, mean wave period and mean wave direction, were analyzed for the selected ship accident cases. The results indicated that complex sea states with the co-occurrence of wind sea and swell conditions represent threats to sailing vessels, especially when these conditions include similar wave periods and oblique wave directions.

Processing and filtrating of driver fatigue characteristic parameters based on rough set

NASA Astrophysics Data System (ADS)

Ye, Wenwu; Zhao, Xuyang

2018-05-01

With the rapid development of economy, people become increasingly rich, and cars have become a common means of transportation in daily life. However, the problem of traffic safety is becoming more and more serious. And fatigue driving is one of the main causes of traffic accidents. Therefore, it is of great importance for us to study the detection of fatigue driving to improve traffic safety. In the cause of determining whether the driver is tired, the characteristic quantity related to the steering angle of the steering wheel and the characteristic quantity of the driver's pulse are all important indicators. The fuzzy c-means clustering is used to discretize the above indexes. Because the characteristic parameters are too miscellaneous, rough set is used to filtrate these characteristics. Finally, this paper finds out the highest correlation with fatigue driving. It is proved that these selected characteristics are of great significance to the evaluation of fatigue driving.

Benefits of public roadside safety rest areas in Texas : technical report.

DOT National Transportation Integrated Search

2011-05-01

The objective of this investigation was to develop a benefit-cost analysis methodology for safety rest areas in : Texas and to demonstrate its application in select corridors throughout the state. In addition, this project : considered novel safety r...

Quantifying Vermont transportation safety factors : young drivers and departure from lane.

DOT National Transportation Integrated Search

2010-06-01

The Vermont Agency of Transportation (VTrans) and its partners have selected traffic safety : priority areas in their Strategic Highway Safety Plan adopted in 2006. In this project, we : focus on the following prioritized areas 1) keeping vehicles on...

16 CFR 1209.34 - Qualification testing.

Code of Federal Regulations, 2010 CFR

2010-01-01

....34 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS INTERIM SAFETY STANDARD FOR CELLULOSE INSULATION Certification § 1209.34 Qualification testing. (a... labelers, or importers may select samples for qualification testing of a product in any manner they desire. ...

Association between Selective Beta-adrenergic Drugs and Blood Pressure Elevation: Data Mining of the Japanese Adverse Drug Event Report (JADER) Database.

PubMed

Ohyama, Katsuhiro; Inoue, Michiko

2016-01-01

Selective beta-adrenergic drugs are used clinically to treat various diseases. Because of imperfect receptor selectivity, beta-adrenergic drugs cause some adverse drug events by stimulating other adrenergic receptors. To examine the association between selective beta-adrenergic drugs and blood pressure elevation, we reviewed the Japanese Adverse Drug Event Reports (JADERs) submitted to the Japan Pharmaceuticals and Medical Devices Agency. We used the Medical Dictionary for Regulatory Activities (MedDRA) Preferred Terms extracted from Standardized MedDRA queries for hypertension to identify events related to blood pressure elevation. Spontaneous adverse event reports from April 2004 through May 2015 in JADERs, a data mining algorithm, and the reporting odds ratio (ROR) were used for quantitative signal detection, and assessed by the case/non-case method. Safety signals are considered significant if the ROR estimates and lower bound of the 95% confidence interval (CI) exceed 1. A total of 2021 reports were included in this study. Among the nine drugs examined, significant signals were found, based on the 95%CI for salbutamol (ROR: 9.94, 95%CI: 3.09-31.93) and mirabegron (ROR: 7.52, 95%CI: 4.89-11.55). The results of this study indicate that some selective beta-adrenergic drugs are associated with blood pressure elevation. Considering the frequency of their indications, attention should be paid to their use in elderly patients to avoid adverse events.

Landscaping of highway medians and roadway safety at unsignalized intersections.

PubMed

Chen, Hongyun; Fabregas, Aldo; Lin, Pei-Sung

2016-05-01

Well-planted and maintained landscaping can help reduce driving stress, provide better visual quality, and decrease over speeding, thus improving roadway safety. Florida Department of Transportation (FDOT) Standard Index (SI-546) is one of the more demanding standards in the U.S. for landscaping design criteria at highway medians near intersections. The purposes of this study were to (1) empirically evaluate the safety results of SI-546 at unsignalized intersections and (2) quantify the impacts of geometrics, traffic, and landscaping design features on total crashes and injury plus fatal crashes. The studied unsignalized intersections were divided into (1) those without median trees near intersections, (2) those with median trees near intersections that were compliant with SI-546, and (3) those with median trees near intersections that were non-compliant with SI-546. A total of 72 intersections were selected, for which five-year crash data from 2006-2010 were collected. The sites that were compliant with SI-546 showed the best safety performance in terms of the lowest crash counts and crash rates. Four crash predictive models-two for total crashes and two for injury crashes-were developed. The results indicated that improperly planted and maintained median trees near highway intersections can increase the total number of crashes and injury plus fatal crashes at a 90% confidence level; no significant difference could be found in crash rates between sites that were compliant with SI-546 and sites without trees. All other conditions remaining the same, an intersection with trees that was not compliant with SI-546 had 63% more crashes and almost doubled injury plus fatal crashes than those at intersections without trees. The study indicates that appropriate landscaping in highway medians near intersections can be an engineering technology that not only improves roadway environmental quality but also maintains intersection safety. Copyright © 2016. Published by Elsevier Ltd.

Assessment of Orthographic Similarity of Drugs Names between Iran and Overseas Using the Solar Model

PubMed Central

ABOLHASSANI, Nazanin; AKBARI SARI, Ali; RASHIDIAN, Arash; RASTEGARPANAH, Mansoor

2017-01-01

Background: The recognition of patient safety is now occupying a prominent place on the health policy agenda since medical errors can result in adverse events. The existence of confusing drug names is one of the most common causes of medication errors. In Iran, the General Office of Trademarks Registry (GOTR), for four years (2010–2014) was responsible for approving drug proprietary names. This study aimed to investigate the performance of the GOTR in terms of drug names orthographic similarity using the SOLAR model. Methods: First, 100 names were randomly selected from the GOTR’s database. Then, each name was searched through pharmaceutical websites including Martindale (the Complete Drug Reference published by Pharmaceutical Press), Drugs.com and Medicines Complete. Pair of drugs whose names look orthographically similar with different indications were identified. Then, the SOLAR model was utilized to determine orthographic similarity between all pair of drug names. Results: The mean of match values of these 100 pairs of drug was 77% indicating the high risk of similarity. The match value for most of the reviewed pairs (92%) was high (≥66%). This value was medium (≥ 33% and <66%) just for 8% of the pairs of drug. These results indicate high risk of confusion due to similarity of drug names. Conclusion: The stewardship of the GOTR in patient safety considerations is fundamentally problematic. Thus, as a best practice, we recommend that proprietary names of drugs be evaluated by an entity within the health system. While an entity within the health system should address patient safety considerations, the GOTR is responsible for intellectual property rights. PMID:29259940

49 CFR 176.704 - Requirements relating to transport indices and criticality safety indices.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 2 2011-10-01 2011-10-01 false Requirements relating to transport indices and... Requirements relating to transport indices and criticality safety indices. (a) The sum of the transport indices..., transport and unloading are to be supervised by persons qualified in the transport of radioactive material...

49 CFR 176.704 - Requirements relating to transport indices and criticality safety indices.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Requirements relating to transport indices and... Requirements relating to transport indices and criticality safety indices. (a) The sum of the transport indices..., transport and unloading are to be supervised by persons qualified in the transport of radioactive material...

75 FR 9018 - Pipeline Safety: Random Drug Testing Rate

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-26

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket ID PHMSA-2010-0034] Pipeline Safety: Random Drug Testing Rate AGENCY: Pipeline and Hazardous Materials... pipelines and operators of liquefied natural gas facilities must select and test a percentage of covered...

77 FR 2606 - Pipeline Safety: Random Drug Testing Rate

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-18

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket ID PHMSA-2012-0004] Pipeline Safety: Random Drug Testing Rate AGENCY: Pipeline and Hazardous Materials... pipelines and operators of liquefied natural gas facilities must select and test a percentage of covered...

Investigation of a supplementary tool to assist in the prioritization of emphasis areas in North American strategic highway safety plans.

PubMed

Park, Peter Y; Young, Jason

2012-03-01

An important potential benefit of a jurisdiction developing an upper-level traffic safety policy statement, such as a strategic highway safety plan (SHSP) or a traffic safety action plan, is the creation of a manageable number of focus areas, known as emphasis areas. The responsible agencies in the jurisdiction can then direct their finite resources in a systematic and strategic way designed to maximize the effort to reduce the number and severity of roadway collisions. In the United States, the federal government through AASHTO has suggested 22 potential emphasis areas. In Canada, CCMTA's 10 potential emphasis areas have been listed for consideration. This study reviewed the SHSP and traffic safety action plan of 53 jurisdictions in North America, and conducted descriptive data analyses to clarify the issues that currently affect the selection and prioritization process of jurisdiction-specific emphasis areas. We found that the current process relies heavily on high-level collision data analysis and communication among the SHSP stakeholders, but may not be the most efficient and effective way of selecting and prioritizing the emphasis areas and allocating safety improvement resources. This study then formulated a formal collision diagnosis test, known as the beta-binomial test, to clarify and illuminate the selection and the prioritization of jurisdiction-specific emphasis areas. We developed numerical examples to demonstrate how engineers can apply the proposed diagnosis test to improve the selection and prioritization of individual jurisdictions' emphasis areas. Copyright © 2011 Elsevier Ltd. All rights reserved.

Continuous-time safety-first portfolio selection with jump-diffusion processes

NASA Astrophysics Data System (ADS)

Yan, Wei

2012-04-01

This article is concerned with continuous-time portfolio selection based on a safety-first criterion under discontinuous price processes (jump-diffusion processes). The solution of the corresponding Hamilton-Jacobi-Bellman equation of the problem is demonstrated. The analytical solutions are presented when there does not exist any riskless asset. Moreover, the problem is also discussed while there exists one riskless asset.

Medicaid Markets and Pediatric Patient Safety in Hospitals

PubMed Central

Smith, Richard B; Cheung, Robyn; Owens, Pamela; Wilson, R Mark; Simpson, Lisa

2007-01-01

Objective To examine the association of Medicaid market characteristics to potentially preventable adverse medical events for hospitalized children, controlling for patient- and hospital-level factors. Data Sources/Study Setting Two carefully selected Agency for Healthcare Research and Quality (AHRQ) pediatric patient safety indicators (decubitus ulcers and laceration) are analyzed using the new pediatric-specific, risk-adjusting, patient safety algorithm from the AHRQ. All pediatric hospital discharges for patients age 0–17 in Florida, New York, and Wisconsin, and at risk of any of these two patient safety events, are examined for the years 1999–2001 (N=859,922). Study Design Logistic regression on the relevant pool of discharges estimates the probability an individual patient experiences one of the two PSI events. Data Extraction Methods Pediatric discharges from the 1999 to 2001 State Inpatient Databases (SIDs) from the AHRQ Healthcare Cost and Utilization Project, merged with hospital-level data from the American Hospital Association's Annual Survey, Medicaid data obtained from the Centers for Medicare and Medicaid Services and state Medicaid offices, and private and Medicaid managed care enrollment data obtained from InterStudy, are used in the estimations. Principal Findings At the market level, patients in markets in which Medicaid payers face relatively little competition are more likely to experience a patient safety event (odds ratio [OR]=1.602), while patients in markets in which hospitals face relatively little competition are less likely to experience an adverse event (OR=0.686). At the patient-discharge and hospital levels, Medicaid characteristics are not significantly associated with the incidence of a pediatric patient safety event. Conclusions Our analysis offers additional insights to previous work and suggests a new factor—the Medicaid-payer market—as relevant to the issue of pediatric patient safety. PMID:17850529

[Explore method about post-marketing safety re-evaluation of Chinese patent medicines based on HIS database in real world].

PubMed

Yang, Wei; Xie, Yanming; Zhuang, Yan

2011-10-01

There are many kinds of Chinese traditional patent medicine used in clinical practice and many adverse events have been reported by clinical professionals. Chinese patent medicine's safety problems are the most concerned by patients and physicians. At present, many researchers have studied re-evaluation methods about post marketing Chinese medicine safety inside and outside China. However, it is rare that using data from hospital information system (HIS) to re-evaluating post marketing Chinese traditional patent medicine safety problems. HIS database in real world is a good resource with rich information to research medicine safety. This study planed to analyze HIS data selected from ten top general hospitals in Beijing, formed a large HIS database in real world with a capacity of 1 000 000 cases in total after a series of data cleaning and integrating procedures. This study could be a new project that using information to evaluate traditional Chinese medicine safety based on HIS database. A clear protocol has been completed as for the first step for the whole study. The protocol is as follows. First of all, separate each of the Chinese traditional patent medicines existing in the total HIS database as a single database. Secondly, select some related laboratory tests indexes as the safety evaluating outcomes, such as routine blood, routine urine, feces routine, conventional coagulation, liver function, kidney function and other tests. Thirdly, use the data mining method to analyze those selected safety outcomes which had abnormal change before and after using Chinese patent medicines. Finally, judge the relationship between those abnormal changing and Chinese patent medicine. We hope this method could imply useful information to Chinese medicine researchers interested in safety evaluation of traditional Chinese medicine.

Development and validation of hospital information system-generated indicators of the appropriateness of oral anticoagulant prescriptions in hospitalised adults: the PACHA study protocol.

PubMed

Petit-Monéger, Aurélie; Thiessard, Frantz; Jouhet, Vianney; Noize, Pernelle; Berdaï, Driss; Kret, Marion; Sitta, Rémi; Salmi, Louis-Rachid; Saillour-Glénisson, Florence

2017-08-31

The appropriateness of oral anticoagulant prescriptions is a major challenge to improve quality and safety of care. As indicators of the appropriateness of oral anticoagulant prescriptions are lacking, the aim of the study is to develop and validate a panel of such indicators, in hospitalised adults, from the hospital information system of two university hospitals in France. The study will be carried out in four steps: (1) a literature review to identify indicators of the appropriateness of oral anticoagulant prescriptions and their conditions of appropriateness; (2) a Delphi consensus method to assess the potential utility and operational implementation of the selected indicators; (3) techniques of medical data search to implement indicators from the hospital information system and; (4) a cross-sectional study to assess the ability of indicators to detect inappropriate oral anticoagulant prescriptions, performance of medical data search techniques for tracking or retrieving information and the ability of tools to be transferred into other institutions. The fourth step will include up to 80 patient hospital stays for each indicator, depending on the prevalence of inappropriate prescriptions estimated in interim analyses. This work addresses the current lack of quality indicators of the appropriateness of oral anticoagulant prescriptions. We aim to develop and validate such indicators for integrating them into hospital clinical practice, as part of a structured approach to improve quality and safety of care. As each hospital information system is different, we will propose tools transferable to other healthcare institutions to allow an automated construction of these indicators. The PACHA study protocol was approved by institutional review boards and ethics committees (CPP Sud-Ouest et Outre Mer III-DC 2016/119; CPP Ile-de-France II-CDW_2016_0014). Clinical Trial.gov registration: NCT02898090. © 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.

Development and validation of hospital information system-generated indicators of the appropriateness of oral anticoagulant prescriptions in hospitalised adults: the PACHA study protocol

PubMed Central

Petit-Monéger, Aurélie; Thiessard, Frantz; Jouhet, Vianney; Noize, Pernelle; Berdaï, Driss; Kret, Marion; Sitta, Rémi; Salmi, Louis-Rachid; Saillour-Glénisson, Florence

2017-01-01

Introduction The appropriateness of oral anticoagulant prescriptions is a major challenge to improve quality and safety of care. As indicators of the appropriateness of oral anticoagulant prescriptions are lacking, the aim of the study is to develop and validate a panel of such indicators, in hospitalised adults, from the hospital information system of two university hospitals in France. Methods and analysis The study will be carried out in four steps: (1) a literature review to identify indicators of the appropriateness of oral anticoagulant prescriptions and their conditions of appropriateness; (2) a Delphi consensus method to assess the potential utility and operational implementation of the selected indicators; (3) techniques of medical data search to implement indicators from the hospital information system and; (4) a cross-sectional study to assess the ability of indicators to detect inappropriate oral anticoagulant prescriptions, performance of medical data search techniques for tracking or retrieving information and the ability of tools to be transferred into other institutions. The fourth step will include up to 80 patient hospital stays for each indicator, depending on the prevalence of inappropriate prescriptions estimated in interim analyses. Ethics and dissemination This work addresses the current lack of quality indicators of the appropriateness of oral anticoagulant prescriptions. We aim to develop and validate such indicators for integrating them into hospital clinical practice, as part of a structured approach to improve quality and safety of care. As each hospital information system is different, we will propose tools transferable to other healthcare institutions to allow an automated construction of these indicators. The PACHA study protocol was approved by institutional review boards and ethics committees (CPP Sud-Ouest et Outre Mer III—DC 2016/119; CPP Ile-de-France II—CDW_2016_0014). Registration details Clinical Trial.gov registration: NCT02898090. PMID:28860229

Drug safety data mining with a tree-based scan statistic.

PubMed

Kulldorff, Martin; Dashevsky, Inna; Avery, Taliser R; Chan, Arnold K; Davis, Robert L; Graham, David; Platt, Richard; Andrade, Susan E; Boudreau, Denise; Gunter, Margaret J; Herrinton, Lisa J; Pawloski, Pamala A; Raebel, Marsha A; Roblin, Douglas; Brown, Jeffrey S

2013-05-01

In post-marketing drug safety surveillance, data mining can potentially detect rare but serious adverse events. Assessing an entire collection of drug-event pairs is traditionally performed on a predefined level of granularity. It is unknown a priori whether a drug causes a very specific or a set of related adverse events, such as mitral valve disorders, all valve disorders, or different types of heart disease. This methodological paper evaluates the tree-based scan statistic data mining method to enhance drug safety surveillance. We use a three-million-member electronic health records database from the HMO Research Network. Using the tree-based scan statistic, we assess the safety of selected antifungal and diabetes drugs, simultaneously evaluating overlapping diagnosis groups at different granularity levels, adjusting for multiple testing. Expected and observed adverse event counts were adjusted for age, sex, and health plan, producing a log likelihood ratio test statistic. Out of 732 evaluated disease groupings, 24 were statistically significant, divided among 10 non-overlapping disease categories. Five of the 10 signals are known adverse effects, four are likely due to confounding by indication, while one may warrant further investigation. The tree-based scan statistic can be successfully applied as a data mining tool in drug safety surveillance using observational data. The total number of statistical signals was modest and does not imply a causal relationship. Rather, data mining results should be used to generate candidate drug-event pairs for rigorous epidemiological studies to evaluate the individual and comparative safety profiles of drugs. Copyright © 2013 John Wiley & Sons, Ltd.

A low-cost wireless system for autonomous generation of road safety alerts

NASA Astrophysics Data System (ADS)

Banks, B.; Harms, T.; Sedigh Sarvestani, S.; Bastianini, F.

2009-03-01

This paper describes an autonomous wireless system that generates road safety alerts, in the form of SMS and email messages, and sends them to motorists subscribed to the service. Drivers who regularly traverse a particular route are the main beneficiaries of the proposed system, which is intended for sparsely populated rural areas, where information available to drivers about road safety, especially bridge conditions, is very limited. At the heart of this system is the SmartBrick, a wireless system for remote structural health monitoring that has been presented in our previous work. Sensors on the SmartBrick network regularly collect data on water level, temperature, strain, and other parameters important to safety of a bridge. This information is stored on the device, and reported to a remote server over the GSM cellular infrastructure. The system generates alerts indicating hazardous road conditions when the data exceeds thresholds that can be remotely changed. The remote server and any number of designated authorities can be notified by email, FTP, and SMS. Drivers can view road conditions and subscribe to SMS and/or email alerts through a web page. The subscription-only form of alert generation has been deliberately selected to mitigate privacy concerns. The proposed system can significantly increase the safety of travel through rural areas. Real-time availability of information to transportation authorities and law enforcement officials facilitates early or proactive reaction to road hazards. Direct notification of drivers further increases the utility of the system in increasing the safety of the traveling public.

Effect of temperature and sunlight on the stability of human adenoviruses and MS2 as fecal contaminants on fresh produce surfaces.

PubMed

Carratalà, Anna; Rodriguez-Manzano, Jesús; Hundesa, Ayalkibet; Rusiñol, Marta; Fresno, Sandra; Cook, Nigel; Girones, Rosina

2013-06-17

Determining the stability, or persistence in an infectious state, of foodborne viral pathogens attached to surfaces of soft fruits and salad vegetables is essential to underpin risk assessment studies in food safety. Here, we evaluate the effect of temperature and sunlight on the stability of infectious human adenoviruses type 2 and MS2 bacteriophages on lettuce and strawberry surfaces as representative fresh products. Human adenoviruses have been selected because of their double role as viral pathogens and viral indicators of human fecal contamination. Stability assays were performed with artificially contaminated fresh samples kept in the dark or under sunlight exposure at 4 and 30°C over 24h. The results indicate that temperature is the major factor affecting HAdV stability in fresh produce surfaces, effecting decay between 3 and 4 log after 24h at 30°C. The inactivation times to achieve a reduction between 1 and 4-log are calculated for each experimental condition. This work provides useful information to be considered for improving food safety regarding the transmission of foodborne viruses through supply chains. Copyright © 2013 Elsevier B.V. All rights reserved.

Biosimilar medicines - Review.

PubMed

Dos Reis, Camila; Teixo, Ricardo; Mendes, Fernando; Cruz, Rui Santos

2016-03-16

By definition, biosimilars are similar to a biological reference that has already received marketing authorization for biologic drugs.The purpose of biosimilars is reducing costs, thus increasing access to this treatment, however, the concerns of health professionals and users refer to the fact that to reduce costs will not neglecting the quality, effectiveness and especially security. The aim of this study is then to assess the degree of similarity between the biosimilar and its reference biopharmaceuticals, trying to understand the production process, requirements necessary for approval, and its impact on the quality, safety, efficacy and costs. For the systematic review without meta-analysis, we researched articles to the b-on, Pubmed and Medscape to 2005-2014, and selected 23 articles that contributed to the verification of the objectives of this study. Several studies indicate that overall the biosimilar and biological reference showed no significant differences except those inherent to the production process, being the first susceptible to comparability tests demonstrating the similarity in terms of clinical efficacy and safety. Biosimilars will be increasingly present in the future as promising therapeutic arsenal and targeted therapy, however, issues related to immunogenicity, interchangeability, automatic substitution and extrapolation of indications should continue to be studied and debated.

48 CFR 1223.7000 - Contract clauses.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SOCIOECONOMIC PROGRAMS ENVIRONMENT, ENERGY AND WATER EFFICIENCY, RENEWABLE ENERGY TECHNOLOGIES, OCCUPATIONAL SAFETY, AND DRUG-FREE WORKPLACE Safety Requirements for Selected DOT Contracts 1223.7000 Contract clauses...

Measurement tools and process indicators of patient safety culture in primary care. A mixed methods study by the LINNEAUS collaboration on patient safety in primary care.

PubMed

Parker, Dianne; Wensing, Michel; Esmail, Aneez; Valderas, Jose M

2015-09-01

There is little guidance available to healthcare practitioners about what tools they might use to assess the patient safety culture. To identify useful tools for assessing patient safety culture in primary care organizations in Europe; to identify those aspects of performance that should be assessed when investigating the relationship between safety culture and performance in primary care. Two consensus-based studies were carried out, in which subject matter experts and primary healthcare professionals from several EU states rated (a) the applicability to their healthcare system of several existing safety culture assessment tools and (b) the appropriateness and usefulness of a range of potential indicators of a positive patient safety culture to primary care settings. The safety culture tools were field-tested in four countries to ascertain any challenges and issues arising when used in primary care. The two existing tools that received the most favourable ratings were the Manchester patient safety framework (MaPsAF primary care version) and the Agency for healthcare research and quality survey (medical office version). Several potential safety culture process indicators were identified. The one that emerged as offering the best combination of appropriateness and usefulness related to the collection of data on adverse patient events. Two tools, one quantitative and one qualitative, were identified as applicable and useful in assessing patient safety culture in primary care settings in Europe. Safety culture indicators in primary care should focus on the processes rather than the outcomes of care.

Measurement tools and process indicators of patient safety culture in primary care. A mixed methods study by the LINNEAUS collaboration on patient safety in primary care

PubMed Central

Parker, Dianne; Wensing, Michel; Esmail, Aneez; Valderas, Jose M

2015-01-01

ABSTRACT Background: There is little guidance available to healthcare practitioners about what tools they might use to assess the patient safety culture. Objective: To identify useful tools for assessing patient safety culture in primary care organizations in Europe; to identify those aspects of performance that should be assessed when investigating the relationship between safety culture and performance in primary care. Methods: Two consensus-based studies were carried out, in which subject matter experts and primary healthcare professionals from several EU states rated (a) the applicability to their healthcare system of several existing safety culture assessment tools and (b) the appropriateness and usefulness of a range of potential indicators of a positive patient safety culture to primary care settings. The safety culture tools were field-tested in four countries to ascertain any challenges and issues arising when used in primary care. Results: The two existing tools that received the most favourable ratings were the Manchester patient safety framework (MaPsAF primary care version) and the Agency for healthcare research and quality survey (medical office version). Several potential safety culture process indicators were identified. The one that emerged as offering the best combination of appropriateness and usefulness related to the collection of data on adverse patient events. Conclusion: Two tools, one quantitative and one qualitative, were identified as applicable and useful in assessing patient safety culture in primary care settings in Europe. Safety culture indicators in primary care should focus on the processes rather than the outcomes of care. PMID:26339832

THE REGRESSION MODEL OF IRAN LIBRARIES ORGANIZATIONAL CLIMATE

PubMed Central

Jahani, Mohammad Ali; Yaminfirooz, Mousa; Siamian, Hasan

2015-01-01

Background: The purpose of this study was to drawing a regression model of organizational climate of central libraries of Iran’s universities. Methods: This study is an applied research. The statistical population of this study consisted of 96 employees of the central libraries of Iran’s public universities selected among the 117 universities affiliated to the Ministry of Health by Stratified Sampling method (510 people). Climate Qual localized questionnaire was used as research tools. For predicting the organizational climate pattern of the libraries is used from the multivariate linear regression and track diagram. Results: of the 9 variables affecting organizational climate, 5 variables of innovation, teamwork, customer service, psychological safety and deep diversity play a major role in prediction of the organizational climate of Iran’s libraries. The results also indicate that each of these variables with different coefficient have the power to predict organizational climate but the climate score of psychological safety (0.94) plays a very crucial role in predicting the organizational climate. Track diagram showed that five variables of teamwork, customer service, psychological safety, deep diversity and innovation directly effects on the organizational climate variable that contribution of the team work from this influence is more than any other variables. Conclusions: Of the indicator of the organizational climate of climateQual, the contribution of the team work from this influence is more than any other variables that reinforcement of teamwork in academic libraries can be more effective in improving the organizational climate of this type libraries. PMID:26622203

THE REGRESSION MODEL OF IRAN LIBRARIES ORGANIZATIONAL CLIMATE.

PubMed

Jahani, Mohammad Ali; Yaminfirooz, Mousa; Siamian, Hasan

2015-10-01

The purpose of this study was to drawing a regression model of organizational climate of central libraries of Iran's universities. This study is an applied research. The statistical population of this study consisted of 96 employees of the central libraries of Iran's public universities selected among the 117 universities affiliated to the Ministry of Health by Stratified Sampling method (510 people). Climate Qual localized questionnaire was used as research tools. For predicting the organizational climate pattern of the libraries is used from the multivariate linear regression and track diagram. of the 9 variables affecting organizational climate, 5 variables of innovation, teamwork, customer service, psychological safety and deep diversity play a major role in prediction of the organizational climate of Iran's libraries. The results also indicate that each of these variables with different coefficient have the power to predict organizational climate but the climate score of psychological safety (0.94) plays a very crucial role in predicting the organizational climate. Track diagram showed that five variables of teamwork, customer service, psychological safety, deep diversity and innovation directly effects on the organizational climate variable that contribution of the team work from this influence is more than any other variables. Of the indicator of the organizational climate of climateQual, the contribution of the team work from this influence is more than any other variables that reinforcement of teamwork in academic libraries can be more effective in improving the organizational climate of this type libraries.

Child safety seat and safety belt use among urban travelers : results of the 1985 survey.

DOT National Transportation Integrated Search

1986-01-01

During nine days in June 1983, 1984, and 1985, four major metropolitan areas of Virginia were surveyed to determine the extent to which safety restraints were being used by urban travelers. Observers stationed at selected signalized intersections dis...

Road safety measures : a catalogue of estimates of effect : summary

DOT National Transportation Integrated Search

2002-04-01

This report contains a catalogue of estimates of the effects on road safety of selected road safety measures. The report is intended to be used as a reference manual in drafting the national transport plan for Norway for the term 2006-2015.

Child safety seat and safety belt use among urban travelers : results of the 1983-1986 surveys.

DOT National Transportation Integrated Search

1986-01-01

The four major metropolitan areas of Virginia were surveyed to determine the extent to which safety restraints were being used by urban travelers. Observers were stationed at selected signalized intersections and displayed to stopped motorists a clip...

Child safety seat and safety belt use among urban travelers : results of the 1984 survey.

DOT National Transportation Integrated Search

1985-01-01

During nine days in June 1983 and nine in June 1984, four major metropolitan areas of Virginia were surveyed to determine whether safety restraints were being used by urban travelers. Observers stationed at selected signalized intersections displayed...

Assessment of sidewalk/bicycle-lane gaps with safety and developing statewide pedestrian crash rates.

DOT National Transportation Integrated Search

2016-05-31

Pedestrian and bicycle safety have emerged to be of major concern to federal and selected states in the U.S. With the : increased emphasis on the multimodal transportation, pedestrian and bicycle safety has become more common for : governmental agenc...

9 CFR 317.5 - Generically approved labeling.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Section 317.5 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE..., without such labeling being submitted for approval to the Food Safety and Inspection Service in Washington... particular. (2) The Food Safety and Inspection Service shall select samples of generically approved labeling...

The Immunogenicity and Safety of CYD-Tetravalent Dengue Vaccine (CYD-TDV) in Children and Adolescents: A Systematic Review.

PubMed

Agarwal, Raksheeth; Wahid, Mardiastuti H; Yausep, Oliver E; Angel, Sharon H; Lokeswara, Angga W

2017-01-01

to assess the immunogenicity and safety of CYD-tetravalent dengue vaccine (CYD-TDV) in children. comprehensive literature searches were conducted on various databases. Randomized-controlled trials on children with CYD-TDV as intervention were selected based on inclusion and exclusion criteria. Data extracted from selected trials included safety of vaccine and immunogenicity in terms of Geometric Mean Titres (GMT) of antibodies.   six clinical trials were selected based on preset criteria. GMT values were obtained using 50% Plaque Reduction Neutralization Test (PRNT) and safety was semi-quantitatively assessed based on adverse effects. Additional data processing was done to obtain a better understanding on the trends among the studies. The results showed that the groups vaccinated with CYD-TDV showed higher immunogenicity against dengue virus antigens than the control groups. Safety results were satisfactory in all trials, and most severe side effects were unrelated to the vaccine. CYD-TDV is both effective and safe for patients in endemic regions. This gives promise for further development and large-scale research on this vaccine to assess its efficacy in decreasing dengue prevalence, and its pervasive implementation in endemic countries, such as Indonesia.

Prevention of 3 "never events" in the operating room: fires, gossypiboma, and wrong-site surgery.

PubMed

Zahiri, Hamid R; Stromberg, Jeffrey; Skupsky, Hadas; Knepp, Erin K; Folstein, Matthew; Silverman, Ronald; Singh, Devinder

2011-03-01

This study sought to identify and provide preventative recommendations for potentially devastating safety violations in the operating room. A Medline database search from 1950 to current using the terms patient safety and operating room was conducted. All topics identified were reviewed. Three patient safety violations with potential for immediate and devastating outcomes were selected for discussion using evidence-based literature. The search identified 2851 articles, 807 of which were directly related to patient safety in the operating room. Topics addressed by these 807 included infectious complications (26%), fires (11%), communication/teamwork (6%), retained foreign objects (3%), safety checklists (1%), and wrong-site surgery (1%). Fires, gossypiboma, and wrong-site surgery were selected for discussion. Although fire, gossypiboma, and wrong-site surgery should be "never events" in the operating room, they continue to persist as 3 common patient safety violations. This study provides the epidemiology, common etiologies, and evidence-based preventative recommendations for each.

Assessing flight safety differences between the United States regional and major airlines

NASA Astrophysics Data System (ADS)

Sharp, Broderick H.

During 2008, the U.S. domestic airline departures exceeded 28,000 flights per day. Thirty-nine or less than 0.2 of 1% of these flights resulted in operational incidents or accidents. However, even a low percentage of airline accidents and incidents continue to cause human suffering and property loss. The charge of this study was the comparison of U.S. major and regional airline safety histories. The study spans safety events from January 1982 through December 2008. In this quantitative analysis, domestic major and regional airlines were statistically tested for their flight safety differences. Four major airlines and thirty-seven regional airlines qualified for the safety study which compared the airline groups' fatal accidents, incidents, non-fatal accidents, pilot errors, and the remaining six safety event probable cause types. The six other probable cause types are mechanical failure, weather, air traffic control, maintenance, other, and unknown causes. The National Transportation Safety Board investigated each airline safety event, and assigned a probable cause to each event. A sample of 500 events was randomly selected from the 1,391 airlines' accident and incident population. The airline groups' safety event probabilities were estimated using the least squares linear regression. A probability significance level of 5% was chosen to conclude the appropriate research question hypothesis. The airline fatal accidents and incidents probability levels were 1.2% and 0.05% respectively. These two research questions did not reach the 5% significance level threshold. Therefore, the airline groups' fatal accidents and non-destructive incidents probabilities favored the airline groups' safety differences hypothesis. The linear progression estimates for the remaining three research questions were 71.5% for non-fatal accidents, 21.8% for the pilot errors, and 7.4% significance level for the six probable causes. These research questions' linear regressions are greater than the 5% level. Consequently, these three research questions favored airline groups' safety similarities hypothesis. The study indicates the U.S. domestic major airlines were safer than the regional airlines. Ideas for potential airline safety progress can examine pilot fatigue, the airline groups' hiring policies, the government's airline oversight personnel, or the comparison of individual airline's operational policies.

Safety Sufficiency for NextGen: Assessment of Selected Existing Safety Methods, Tools, Processes, and Regulations

NASA Technical Reports Server (NTRS)

Xu, Xidong; Ulrey, Mike L.; Brown, John A.; Mast, James; Lapis, Mary B.

2013-01-01

NextGen is a complex socio-technical system and, in many ways, it is expected to be more complex than the current system. It is vital to assess the safety impact of the NextGen elements (technologies, systems, and procedures) in a rigorous and systematic way and to ensure that they do not compromise safety. In this study, the NextGen elements in the form of Operational Improvements (OIs), Enablers, Research Activities, Development Activities, and Policy Issues were identified. The overall hazard situation in NextGen was outlined; a high-level hazard analysis was conducted with respect to multiple elements in a representative NextGen OI known as OI-0349 (Automation Support for Separation Management); and the hazards resulting from the highly dynamic complexity involved in an OI-0349 scenario were illustrated. A selected but representative set of the existing safety methods, tools, processes, and regulations was then reviewed and analyzed regarding whether they are sufficient to assess safety in the elements of that OI and ensure that safety will not be compromised and whether they might incur intolerably high costs.

Innovative safety valve selection techniques and data.

PubMed

Miller, Curt; Bredemyer, Lindsey

2007-04-11

The new valve data resources and modeling tools that are available today are instrumental in verifying that that safety levels are being met in both current installations and project designs. If the new ISA 84 functional safety practices are followed closely, good industry validated data used, and a user's maintenance integrity program strictly enforced, plants should feel confident that their design has been quantitatively reinforced. After 2 years of exhaustive reliability studies, there are now techniques and data available to support this safety system component deficiency. Everyone who has gone through the process of safety integrity level (SIL) verification (i.e. reliability math) will appreciate the progress made in this area. The benefits of these advancements are improved safety with lower lifecycle costs such as lower capital investment and/or longer testing intervals. This discussion will start with a review of the different valve, actuator, and solenoid/positioner combinations that can be used and their associated application restraints. Failure rate reliability studies (i.e. FMEDA) and data associated with the final combinations will then discussed. Finally, the impact of the selections on each safety system's SIL verification will be reviewed.

Microbiological sampling plan based on risk classification to verify supplier selection and production of served meals in food service operation.

PubMed

Lahou, Evy; Jacxsens, Liesbeth; Van Landeghem, Filip; Uyttendaele, Mieke

2014-08-01

Food service operations are confronted with a diverse range of raw materials and served meals. The implementation of a microbial sampling plan in the framework of verification of suppliers and their own production process (functionality of their prerequisite and HACCP program), demands selection of food products and sampling frequencies. However, these are often selected without a well described scientifically underpinned sampling plan. Therefore, an approach on how to set-up a focused sampling plan, enabled by a microbial risk categorization of food products, for both incoming raw materials and meals served to the consumers is presented. The sampling plan was implemented as a case study during a one-year period in an institutional food service operation to test the feasibility of the chosen approach. This resulted in 123 samples of raw materials and 87 samples of meal servings (focused on high risk categorized food products) which were analyzed for spoilage bacteria, hygiene indicators and food borne pathogens. Although sampling plans are intrinsically limited in assessing the quality and safety of sampled foods, it was shown to be useful to reveal major non-compliances and opportunities to improve the food safety management system in place. Points of attention deduced in the case study were control of Listeria monocytogenes in raw meat spread and raw fish as well as overall microbial quality of served sandwiches and salads. Copyright © 2014 Elsevier Ltd. All rights reserved.

Active-comparator design and new-user design in observational studies

PubMed Central

Yoshida, Kazuki; Solomon, Daniel H.; Kim, Seoyoung C.

2015-01-01

SUMMARY Over the past decade, an increasing number of observational studies have examined the effectiveness or safety of rheumatoid arthritis treatments. However, unlike randomized controlled trials (RCTs), observational studies of drug effects face methodological challenges including confounding by indication. Two design principles - active comparator design and new user design can help mitigate such challenges in observational studies. To improve validity of study findings, observational studies should be designed in such a way that makes them more closely approximate RCTs. The active comparator design compares the drug of interest to another commonly used agent for the same indication, rather than a ‘non-user’ group. This principle helps select treatment groups similar in treatment indications (both measured and unmeasured characteristics). The new user design includes a cohort of patients from the time of treatment initiation, so that it can assess patients’ pretreatment characteristics and capture all events occurring anytime during follow-up. PMID:25800216

Research on the method of information system risk state estimation based on clustering particle filter

NASA Astrophysics Data System (ADS)

Cui, Jia; Hong, Bei; Jiang, Xuepeng; Chen, Qinghua

2017-05-01

With the purpose of reinforcing correlation analysis of risk assessment threat factors, a dynamic assessment method of safety risks based on particle filtering is proposed, which takes threat analysis as the core. Based on the risk assessment standards, the method selects threat indicates, applies a particle filtering algorithm to calculate influencing weight of threat indications, and confirms information system risk levels by combining with state estimation theory. In order to improve the calculating efficiency of the particle filtering algorithm, the k-means cluster algorithm is introduced to the particle filtering algorithm. By clustering all particles, the author regards centroid as the representative to operate, so as to reduce calculated amount. The empirical experience indicates that the method can embody the relation of mutual dependence and influence in risk elements reasonably. Under the circumstance of limited information, it provides the scientific basis on fabricating a risk management control strategy.

Pesticides residues and metals in plant products from agricultural area of Belgrade, Serbia.

PubMed

Ethorđević, Tijana; Ethurović, Rada

2012-03-01

The objective of study was to assess the levels of selected metals and pesticides in plant products from agricultural area of Belgrade, Serbia in order to indicate their possible sources and risks of contamination and to evaluate their sanitary probity and safety. The concentrations of cadmium, copper, iron, manganese, nickel, lead and zinc were below limits established by national and international regulations (maximum found concentrations were 0.028, 1.91, 11.16, 1.77, 0.605, 0.073 and 1.76 mg kg(-1) respectively). Only residue of one of examined pesticides was found in amount below MRL (bifenthrin 2.46 μg kg(-1)) in only one of analysed samples, while others were below detection limits. Obtained results indicate that crops from examined agricultural areas are unpolluted by contaminants used for plant protection and nutrition, indicating good agricultural practice regarding pesticides and fertilizer usage as well as moderate industrial production within examined areas.

Cytotoxicity and antiviral activities of Asplenium nidus, Phaleria macrocarpa and Eleusine indica

NASA Astrophysics Data System (ADS)

Tahir, Mariya Mohd; Ibrahim, Nazlina; Yaacob, Wan Ahmad

2014-09-01

Three local medicinal plants namely Asplenium nidus (langsuyar), Eleusine indica (sambau) and Phaleria macrocarpa (mahkota dewa) were screened for the cytotoxicity and antiviral activities. Six plant extracts were prepared including the aqueous and methanol extracts from A. nidus leaf and root, aqueous extract from dried whole plant of E. indica and methanol extract from P. macrocarpa fruits. Cytotoxicity screening in Vero cell line by MTT assay showed that the CC50 values ranged from 15 to 60 mg/mL thus indicating the safety of the extracts even at high concentrations. Antiviral properties of the plant extracts were determined by plaque reduction assay. The EC50 concentrations were between 3.2 to 47 mg/mL. The selectivity indices (SI = CC50/EC50) of each tested extracts ranged from 4.3 to 63.25 indicating the usefulness of the extracts as potential antiviral agents.

Mobile phone radiation health risk controversy: the reliability and sufficiency of science behind the safety standards.

PubMed

Leszczynski, Dariusz; Xu, Zhengping

2010-01-27

There is ongoing discussion whether the mobile phone radiation causes any health effects. The International Commission on Non-Ionizing Radiation Protection, the International Committee on Electromagnetic Safety and the World Health Organization are assuring that there is no proven health risk and that the present safety limits protect all mobile phone users. However, based on the available scientific evidence, the situation is not as clear. The majority of the evidence comes from in vitro laboratory studies and is of very limited use for determining health risk. Animal toxicology studies are inadequate because it is not possible to "overdose" microwave radiation, as it is done with chemical agents, due to simultaneous induction of heating side-effects. There is a lack of human volunteer studies that would, in unbiased way, demonstrate whether human body responds at all to mobile phone radiation. Finally, the epidemiological evidence is insufficient due to, among others, selection and misclassification bias and the low sensitivity of this approach in detection of health risk within the population. This indicates that the presently available scientific evidence is insufficient to prove reliability of the current safety standards. Therefore, we recommend to use precaution when dealing with mobile phones and, whenever possible and feasible, to limit body exposure to this radiation. Continuation of the research on mobile phone radiation effects is needed in order to improve the basis and the reliability of the safety standards.

Mobile phone radiation health risk controversy: the reliability and sufficiency of science behind the safety standards

PubMed Central

2010-01-01

There is ongoing discussion whether the mobile phone radiation causes any health effects. The International Commission on Non-Ionizing Radiation Protection, the International Committee on Electromagnetic Safety and the World Health Organization are assuring that there is no proven health risk and that the present safety limits protect all mobile phone users. However, based on the available scientific evidence, the situation is not as clear. The majority of the evidence comes from in vitro laboratory studies and is of very limited use for determining health risk. Animal toxicology studies are inadequate because it is not possible to "overdose" microwave radiation, as it is done with chemical agents, due to simultaneous induction of heating side-effects. There is a lack of human volunteer studies that would, in unbiased way, demonstrate whether human body responds at all to mobile phone radiation. Finally, the epidemiological evidence is insufficient due to, among others, selection and misclassification bias and the low sensitivity of this approach in detection of health risk within the population. This indicates that the presently available scientific evidence is insufficient to prove reliability of the current safety standards. Therefore, we recommend to use precaution when dealing with mobile phones and, whenever possible and feasible, to limit body exposure to this radiation. Continuation of the research on mobile phone radiation effects is needed in order to improve the basis and the reliability of the safety standards. PMID:20205835

Human resource factors associated with workplace safety and health education of small manufacturing businesses in Korea.

PubMed

Park, Kyoung-Ok

2018-01-25

Human resources (HR) are essential indicators of safety and health (SH) status, and HR can be key sources of workplace safety management such as safety and health education at work (SHEW). This study analyzed significant HR factors associated with SHEW of small manufacturing businesses in Korea. The secondary data of the 2012 Korea Occupational Safety and Health Trend Survey were used to achieve this research purpose. A total of 2,089 supervisors or managers employed in the small manufacturing businesses completed the interview survey. Survey businesses were selected by multiple stratified sampling method based on industry code, business size, and region in Korea. The survey included workplace characteristics of HR and SHEW. SHEW was significantly related to business size, occupational injury incidence in the previous year, foreign and elderly worker employment, presence of site supervisors, and presence of SH committees (p <.05). SHEW for office workers, non-office workers, and newcomers was associated with business size, presence of site supervisors, and presence of SH committees in logistic regression analysis (p <.001). Businesses with 30-49 workers conducted SHEW 3.64 times more than did businesses with 5 to fewer than 10 workers. The companies that had occupational injuries in the previous year conducted SHEW 1.68 times more than the others. The businesses that had site supervisors and committees conducted SHEW 2.30 and 2.18 times more, respectively, than others. Site supervisors and SH committees were significant HR factors that improved SHEW in small manufacturing businesses.

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.

Do perceptions of effective distractive driving public service announcements differ between adults and teens?

PubMed

Solomon, Barbara J; Hendry, Phyllis; Kalynych, Colleen; Taylor, Pam; Tepas, Joseph J

2010-10-01

Motor vehicle crashes remain the leading cause of death and disability in teenagers. Graduated licensing laws, enforcement of a legal drinking age of 21 years, zero tolerance, and mandatory restraints have been successful in reducing crashes and fatalities. Media safety campaigns have been less successful. This study was designed to analyze whether perceived effectiveness of public service announcements (PSAs) differed between teens and adults. We hypothesized that adult-derived intent differs from teen perception. High-school students attending an annual municipal student safety exposition were asked to rank order six PSAs that were previously judged by an almost all adult committee. Additionally, students were asked to rate the PSAs on an agreement Likert scale assessing interest, understandability, and believability and to indicate potential effect on driving behavior. Students further graded their agreement with 10 top-published driving distracters and were asked to list additional perceived driving distracters. Of the 330 surveys collected, 201 students aged 14 years to 19 years selected at least one choice and 181 ranked-ordered >1 PSA. The PSA #3 selected by the original adult judges was ranked second (33%) by teens with PSA #1 in first place (34%). PSA 1 was not considered as effective by the adult judges. Student age, race, grade, or gender did not produce statistically significant differences. A cohort of 186 teens responded to nationally noted driving distracters with >86% in agreement. Eating and applying cosmetics were additional distracters noted by students completing the survey. Preventative media messages should include teen stakeholder review. The components of effective adolescent safety messages continue to require further study.

30 CFR 77.1000 - Highwalls, pits and spoil banks; plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... safe working conditions. The mining methods employed by the operator shall be selected to insure... Section 77.1000 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS, SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND...

The CIS Database: Occupational Health and Safety Information Online.

ERIC Educational Resources Information Center

Siegel, Herbert; Scurr, Erica

1985-01-01

Describes document acquisition, selection, indexing, and abstracting and discusses online searching of the CIS database, an online system produced by the International Occupational Safety and Health Information Centre. This database comprehensively covers information in the field of occupational health and safety. Sample searches and search…

Recent patents on biosafety strategies of selectable marker genes in genetically modified crops.

PubMed

Jiang, Yiming; Hu, Xiaoning; Huang, Haiying

2014-01-01

Genetically modified crops (GMCs) have been planted world wide since 1990s, but the potential insecurity of selectable marker genes raises the questions about GMC safety. Therefore, several researches have been conducted on marker gene safety issues and recently several patents have been issued on this subject. There are two main approaches to achieve this goal: seeking the biosafety selectable marker and eliminating these insecure marker genes after transformation. Results show that these two systems are quite effective. Recent patents on the two ways are discussed in this review.

[Cyclooxygenase inhibitors and antiplatelet effect of acetylsalicylic acid. selective approach to nonsteroidal anti-inflammatory drugs in cardiological practice].

PubMed

Lomakin, N V; Gruzdev, A K

2011-01-01

Nonsteroidal anti-inflammatory drugs (NSAIDs) represent class of medicines which is wide concerning chemical structure and mechanism of action. In the light of contradictory data on efficacy and safety of NSAID in cardiovascular patients selection of most appropriate NSAID (basing on profile of efficacy and safety) in patients receiving continuous therapy with low dose aspirin appears to be a problem. In this paper we discuss peculiarities of drug interaction between cyclooxygenase inhibitors and acetylsalicylic acid, and principles of selection of adequate NSAI.

Application of patient safety indicators internationally: a pilot study among seven countries.

PubMed

Drösler, Saskia E; Klazinga, Niek S; Romano, Patrick S; Tancredi, Daniel J; Gogorcena Aoiz, Maria A; Hewitt, Moira C; Scobie, Sarah; Soop, Michael; Wen, Eugene; Quan, Hude; Ghali, William A; Mattke, Soeren; Kelley, Edward

2009-08-01

To explore the potential for international comparison of patient safety as part of the Health Care Quality Indicators project of the Organization for Economic Co-operation and Development (OECD) by evaluating patient safety indicators originally published by the US Agency for Healthcare Research and Quality (AHRQ). A retrospective cross-sectional study. Acute care hospitals in the USA, UK, Sweden, Spain, Germany, Canada and Australia in 2004 and 2005/2006. Routine hospitalization-related administrative data from seven countries were analyzed. Using algorithms adapted to the diagnosis and procedure coding systems in place in each country, authorities in each of the participating countries reported summaries of the distribution of hospital-level and overall (national) rates for each AHRQ Patient Safety Indicator to the OECD project secretariat. Each country's vector of national indicator rates and the vector of American patient safety indicators rates published by AHRQ (and re-estimated as part of this study) were highly correlated (0.821-0.966). However, there was substantial systematic variation in rates across countries. This pilot study reveals that AHRQ Patient Safety Indicators can be applied to international hospital data. However, the analyses suggest that certain indicators (e.g. 'birth trauma', 'complications of anesthesia') may be too unreliable for international comparisons. Data quality varies across countries; undercoding may be a systematic problem in some countries. Efforts at international harmonization of hospital discharge data sets as well as improved accuracy of documentation should facilitate future comparative analyses of routine databases.

Workability of Safety Education and Training for Workers' Strategy in Accident Reduction in Selected Manufacturing Industries in Lagos State

ERIC Educational Resources Information Center

Ayodele, Rachael B.; Olubayo-Fatiregun, Martina A.

2013-01-01

This study determined the workability of Safety Education and Training for Workers' strategy in reducing accidents. A descriptive survey research design was used. A total of 20 Managerial staff with mean work experience of 13.5 years was selected from 10 manufacturing industries in Lagos State, using intact group method. They were 100% males. Data…

33 CFR 164.42 - Rate of turn indicator.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Rate of turn indicator. 164.42...) PORTS AND WATERWAYS SAFETY NAVIGATION SAFETY REGULATIONS § 164.42 Rate of turn indicator. Each vessel of... turn indicator. [CGD 83-004, 49 FR 43468, Oct. 29, 1984] ...

33 CFR 164.42 - Rate of turn indicator.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Rate of turn indicator. 164.42...) PORTS AND WATERWAYS SAFETY NAVIGATION SAFETY REGULATIONS § 164.42 Rate of turn indicator. Each vessel of... turn indicator. [CGD 83-004, 49 FR 43468, Oct. 29, 1984] ...

Patients’ perceived value of pharmacy quality measures: a mixed-methods study

PubMed Central

Shiyanbola, Olayinka O; Mort, Jane R

2015-01-01

Objective To describe patients’ perceived value and use of quality measures in evaluating and choosing community pharmacies. Design Focus group methodology was combined with a survey tool. During the focus groups, participants assessed the value of the Pharmacy Quality Alliance's quality measures in evaluating and choosing a pharmacy. Also, participants completed questionnaires rating their perceived value of quality measures in evaluating a pharmacy (1 being low value and 5 being high) or choosing a pharmacy (yes/no). Thematic analysis and descriptive statistics were used to analyse the focus groups and surveys, respectively. Setting Semistructured focus groups were conducted in a private meeting space of an urban and a rural area of a Mid-western State in the USA. Participants Thirty-four adults who filled prescription medications in community pharmacies for a chronic illness were recruited in community pharmacies, senior centres and public libraries. Results While comments indicated that all measures were important, medication safety measures (eg, drug-drug interactions) were valued more highly than others. Rating of quality measure utility in evaluating a pharmacy ranged from a mean of 4.88 (‘drug-drug interactions’) to a mean of 4.0 (‘absence of controller therapy for patients with asthma’). Patients were hesitant to use quality information in choosing a pharmacy (depending on the participant's location) but might consider if moving to a new area or having had a negative pharmacy experience. Use of select quality measures to choose a pharmacy ranged from 97.1% of participants using ‘drug-drug interactions’ (medication safety measure) to 55.9% using ‘absence of controller therapy for patients with asthma’. Conclusions The study participants valued quality measures in evaluating and selecting a community pharmacy, with medication safety measures valued highest. The participants reported that the quality measures would not typically cause a switch in pharmacy but might influence their selection in certain situations. PMID:25600253

30 CFR 77.313 - Wet-coal feedbins; low-level indicators.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Wet-coal feedbins; low-level indicators. 77.313 Section 77.313 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS, SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND...

30 CFR 77.313 - Wet-coal feedbins; low-level indicators.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Wet-coal feedbins; low-level indicators. 77.313 Section 77.313 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS, SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND...

30 CFR 77.313 - Wet-coal feedbins; low-level indicators.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Wet-coal feedbins; low-level indicators. 77.313 Section 77.313 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS, SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND...

30 CFR 77.313 - Wet-coal feedbins; low-level indicators.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Wet-coal feedbins; low-level indicators. 77.313 Section 77.313 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS, SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND...

30 CFR 77.313 - Wet-coal feedbins; low-level indicators.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Wet-coal feedbins; low-level indicators. 77.313 Section 77.313 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS, SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND...

A road safety performance indicator for vehicle fleet compatibility.

PubMed

Christoph, Michiel; Vis, Martijn Alexander; Rackliff, Lucy; Stipdonk, Henk

2013-11-01

This paper discusses the development and the application of a safety performance indicator which measures the intrinsic safety of a country's vehicle fleet related to fleet composition. The indicator takes into account both the 'relative severity' of individual collisions between different vehicle types, and the share of those vehicle types within a country's fleet. The relative severity is a measure for the personal damage that can be expected from a collision between two vehicles of any type, relative to that of a collision between passenger cars. It is shown how this number can be calculated using vehicle mass only. A sensitivity analysis is performed to study the dependence of the indicator on parameter values and basic assumptions made. The indicator is easy to apply and satisfies the requirements for appropriate safety performance indicators. It was developed in such a way that it specifically scores the intrinsic safety of a fleet due to its composition, without being influenced by other factors, like helmet wearing. For the sake of simplicity, and since the required data is available throughout Europe, the indicator was applied to the relative share of three of the main vehicle types: passenger cars, heavy goods vehicles and motorcycles. Using the vehicle fleet data from 13EU Member States and Norway, the indicator was used to rank the countries' safety performance. The UK was found to perform best in terms of its fleet composition (value is 1.07), while Greece has the worst performance with the highest indicator value (1.41). Copyright © 2013 Elsevier Ltd. All rights reserved.

Remaining challenges in childhood cancer and newer targeted therapeutics.

PubMed

Smith, Malcolm A; Reaman, Gregory H

2015-02-01

Despite the enormously important and gratifying advances in cancer treatment outcomes for children with cancer, cancer remains the biggest cause of death from disease in children. Because the etiology and biology of cancers that occur in children differ dramatically from those that occur in adults, the immediate extrapolation of efficacy and safety of new cancer drugs to childhood cancer indications is not possible. We discuss factors that will play key roles in guiding pediatric oncologists as they select lines of research to pursue in their quest for more effective treatments for children with cancer. Published by Elsevier Inc.

Driver speed selection on high-speed two-lane highways: Comparing speed profiles between uniform and differential speed limits.

PubMed

Russo, Brendan J; Savolainen, Peter T; Gates, Timothy J; Kay, Jonathan J; Frazier, Sterling

2017-07-04

Although a considerable amount of prior research has investigated the impacts of speed limits on traffic safety and operations, much of this research, and nearly all of the research related to differential speed limits, has been specific to limited access freeways. The unique safety and operational issues on highways without access control create difficulty relating the conclusions from prior freeway-related speed limit research to 2-lane highways, particularly research on differential limits due to passing limitations and subsequent queuing. Therefore, the objective of this study was to assess differences in driver speed selection with respect to the posted speed limit on rural 2-lane highways, with a particular emphasis on the differences between uniform and differential speed limits. Data were collected from nearly 59,000 vehicles across 320 sites in Montana and 4 neighboring states. Differences in mean speeds, 85th percentile speeds, and the standard deviation in speeds for free-flowing vehicles were examined across these sites using ordinary least squares regression models. Ultimately, the results of the analysis show that the mean speed, 85th percentile speed, and variability in travel speeds for free-flowing vehicles on 2-lane highways are generally lower at locations with uniform 65 mph speed limits, compared to locations with differential limits of 70 mph for cars and 60 mph for trucks. In addition to posted speed limits, several site characteristics were shown to influence speed selection including shoulder widths, frequency of horizontal curves, percentage of the segment that included no passing zones, and hourly volumes. Differences in vehicle speed characteristics were also observed between states, indicating that speed selection may also be influenced by local factors, such as driver population or enforcement.

Battery-free radio frequency identification (RFID) sensors for food quality and safety

PubMed Central

Potyrailo, Radislav A.; Nagraj, Nandini; Tang, Zhexiong; Mondello, Frank J.; Surman, Cheryl; Morris, William

2012-01-01

The market demands for new sensors for food quality and safety stimulate the development of new sensing technologies that can provide an unobtrusive sensor form factor, battery-free operation, and minimal sensor cost. Intelligent labeling of food products to indicate and report their freshness and other conditions is one of important possible applications of such new sensors. We have applied passive (battery-free) radio frequency identification (RFID) sensors for highly sensitive and selective detection of food freshness and bacterial growth. In these sensors, the electric field generated in the RFID sensor antenna extends out from the plane of the RFID sensor and is affected by the ambient environment providing the opportunity for sensing. This environment may be in the form of a food sample within the electric field of the sensing region or a sensing film deposited onto the sensor antenna. Examples of applications include monitoring of freshness of milk, freshness of fish, and bacterial growth in a solution. Unlike other food freshness monitoring approaches that require a thin film battery for operation of an RFID sensor and fabrication of custom-made sensors, our developed passive RFID sensing approach combines advantages of both battery-free and cost-effective sensor design and offers response selectivity that is impossible to achieve with other individual sensors. PMID:22881825

Battery-free radio frequency identification (RFID) sensors for food quality and safety.

PubMed

Potyrailo, Radislav A; Nagraj, Nandini; Tang, Zhexiong; Mondello, Frank J; Surman, Cheryl; Morris, William

2012-09-05

Market demands for new sensors for food quality and safety stimulate the development of new sensing technologies that can provide an unobtrusive sensor form, battery-free operation, and minimal sensor cost. Intelligent labeling of food products to indicate and report their freshness and other conditions is one important possible application of such new sensors. This study applied passive (battery-free) radio frequency identification (RFID) sensors for the highly sensitive and selective detection of food freshness and bacterial growth. In these sensors, the electric field generated in the RFID sensor antenna extends from the plane of the RFID sensor and is affected by the ambient environment, providing the opportunity for sensing. This environment may be in the form of a food sample within the electric field of the sensing region or a sensing film deposited onto the sensor antenna. Examples of applications include monitoring of milk freshness, fish freshness, and bacterial growth in a solution. Unlike other food freshness monitoring approaches that require a thin film battery for operation of an RFID sensor and fabrication of custom-made sensors, the passive RFID sensing approach developed here combines the advantages of both battery-free and cost-effective sensor design and offers response selectivity that is impossible to achieve with other individual sensors.

Nonrenal toxicities of acetaminophen, aspirin, and nonsteroidal anti-inflammatory agents.

PubMed

Matzke, G R

1996-07-01

Approximately 2% of the United States population consumes an analgesic, antipyretic, or nonsteroidal antiinflammatory drug (NSAID) each day. Aspirin and acetaminophen have been available to the public without a prescription (over-the-counter) for decades, while most NSAIDs are still only available with a prescription from a physician. The recent trend of switching NSAIDs from prescription to over-the-counter status may be perceived by some as an indication of their inherent safety. However, all these agents have been associated with a unique but overlapping safety profile. In fact, significant adverse events (AEs) on multiple organ systems, including the kidney and gastrointestinal tract, have been reported with most of these agents. In this review, the incidence of the nonrenal AEs of aspirin, acetaminophen, and selected NSAIDs are tabulated. The strengths of the causative associations are highlighted, the relative risks for the gastrointestinal and cardiovascular AEs are discussed, and the relationship to patient risk factors and drug characteristics, such as dose and half-life, are reviewed. The selection of the optimal agent for an individual patient depends on the balance between the desired pharmacodynamic response, the patient's pharmacotherapy history, and the degree of AE risk one is willing to accept. Therapy should be initiated in all settings with the lowest possible dosage since the incidence of the major AEs is dose related.

Development and biological properties of a new live attenuated mumps vaccine.

PubMed

Saika, Shizuko; Kidokoro, Minoru; Kubonoya, Hiroko; Ito, Kozo; Ohkawa, Tokitada; Aoki, Athuko; Nagata, Noriyo; Suzuki, Kazuyoshi

2006-01-01

To develop a new live attenuated mumps vaccine, a wild mumps Y7 strain isolated from a patient who developed mild parotitis was treated with nitrosoguanidine and ultraviolet, followed by selection of a temperature-sensitive clone. The selected clone, Y125, showed stable temperature-sensitivity in Vero cells. Intraspinal inoculation of marmosets with the Y125 produced only minimal histopathological changes, while intracerebral inoculation of neonatal rats revealed that the Y125 did not cause hydrocephalus. Both these effects of the Y125 were similar to those of the non-neurovirulent Jeryl Lynn strain. Furthermore, subcutaneous inoculation of the Y125 induced high levels of neutralizing antibodies in all Cercopithecus monkeys examined. Although the safety and immunogenicity should be confirmed in further field trials in humans, the present results indicate that the Y125 could be a promising vaccine candidate.

Profile of selected bacterial counts and Salmonella prevalence on raw poultry in a poultry slaughter establishment.

PubMed

James, W O; Williams, W O; Prucha, J C; Johnston, R; Christensen, W

1992-01-01

The USDA Food Safety and Inspection Service determined populations of bacteria on poultry during processing at a slaughter plant in Puerto Rico in November and December 1987. The plant was selected because of its management's willingness to support important changes in equipment and processing procedures. The plant was representative of modern slaughter facilities. Eight-hundred samples were collected over 20 consecutive 8-hour days of operation from 5 sites in the processing plant. Results indicated that slaughter, dressing, and chilling practices significantly decreased the bacterial contamination on poultry carcasses, as determined by counts of aerobic bacteria, Enterobacteriaceae, and Escherichia coli. Salmonella was not enumerated; rather, it was determined to be present or absent by culturing almost the entire rinse. The prevalence of Salmonella in the study decreased during evisceration, then increased during immersion chilling.

Can machine learning complement traditional medical device surveillance? A case study of dual-chamber implantable cardioverter-defibrillators.

PubMed

Ross, Joseph S; Bates, Jonathan; Parzynski, Craig S; Akar, Joseph G; Curtis, Jeptha P; Desai, Nihar R; Freeman, James V; Gamble, Ginger M; Kuntz, Richard; Li, Shu-Xia; Marinac-Dabic, Danica; Masoudi, Frederick A; Normand, Sharon-Lise T; Ranasinghe, Isuru; Shaw, Richard E; Krumholz, Harlan M

2017-01-01

Machine learning methods may complement traditional analytic methods for medical device surveillance. Using data from the National Cardiovascular Data Registry for implantable cardioverter-defibrillators (ICDs) linked to Medicare administrative claims for longitudinal follow-up, we applied three statistical approaches to safety-signal detection for commonly used dual-chamber ICDs that used two propensity score (PS) models: one specified by subject-matter experts (PS-SME), and the other one by machine learning-based selection (PS-ML). The first approach used PS-SME and cumulative incidence (time-to-event), the second approach used PS-SME and cumulative risk (Data Extraction and Longitudinal Trend Analysis [DELTA]), and the third approach used PS-ML and cumulative risk (embedded feature selection). Safety-signal surveillance was conducted for eleven dual-chamber ICD models implanted at least 2,000 times over 3 years. Between 2006 and 2010, there were 71,948 Medicare fee-for-service beneficiaries who received dual-chamber ICDs. Cumulative device-specific unadjusted 3-year event rates varied for three surveyed safety signals: death from any cause, 12.8%-20.9%; nonfatal ICD-related adverse events, 19.3%-26.3%; and death from any cause or nonfatal ICD-related adverse event, 27.1%-37.6%. Agreement among safety signals detected/not detected between the time-to-event and DELTA approaches was 90.9% (360 of 396, k =0.068), between the time-to-event and embedded feature-selection approaches was 91.7% (363 of 396, k =-0.028), and between the DELTA and embedded feature selection approaches was 88.1% (349 of 396, k =-0.042). Three statistical approaches, including one machine learning method, identified important safety signals, but without exact agreement. Ensemble methods may be needed to detect all safety signals for further evaluation during medical device surveillance.

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.

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

Adult Learning in Health and Safety: Some Issues and Approaches.

ERIC Educational Resources Information Center

O Fathaigh, Mairtin

This document, which was developed for presentation at a seminar on adult learning and safety, examines approaches to occupational safety and health (OSH) learning/training in the workplace. Section 1 examines selected factors affecting adults' learning in workplace OSH programs. The principal dimensions along which individual adult learners will…

Safety of High Speed Magnetic Levitation Transportation Systems - Comparison of U.S. and Foreign Safety Requirements for Application to U.S. Maglev Systems

DOT National Transportation Integrated Search

1993-09-01

This report presents the results of a systematic review of the safety requirements selected for the German Transrapid : electromagnetic (EMS) type maglev system to determine their applicability and completeness with respect to the : construction and ...

77 FR 18298 - Improvements to the Compliance, Safety, Accountability (CSA) Motor Carrier Safety Measurement...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-27

... effectively identify and prioritize high-risk and other unsafe motor carriers for enforcement interventions... interventions by more accurately identifying safety sensitive carriers (i.e., carriers transporting people and carriers hauling hazardous materials (HM)), so that such firms can be selected for CSA interventions at...

Evaluation of Human Reliability in Selected Activities in the Railway Industry

NASA Astrophysics Data System (ADS)

Sujová, Erika; Čierna, Helena; Molenda, Michał

2016-09-01

The article focuses on evaluation of human reliability in the human - machine system in the railway industry. Based on a survey of a train dispatcher and of selected activities, we have identified risk factors affecting the dispatcher`s work and the evaluated risk level of their influence on the reliability and safety of preformed activities. The research took place at the authors` work place between 2012-2013. A survey method was used. With its help, authors were able to identify selected work activities of train dispatcher's risk factors that affect his/her work and the evaluated seriousness of its influence on the reliability and safety of performed activities. Amongst the most important finding fall expressions of unclear and complicated internal regulations and work processes, a feeling of being overworked, fear for one's safety at small, insufficiently protected stations.

Strategies for improving safety performance in construction firms.

PubMed

Alarcón, Luis Fernando; Acuña, Diego; Diethelm, Sven; Pellicer, Eugenio

2016-09-01

Over the years many prevention management practices have been implemented to prevent and mitigate accidents at the construction site. However, there is little evidence of the effectiveness of individual or combined practices used by companies to manage occupational health and safety issues. The authors selected a sample of 1180 construction firms and 221 individual practices applied in these companies to analyze their effectiveness reducing injury rates over a period of four years in Chile. Different methods were used to study this massive database including: visual analyses of graphical information, statistical analyses and classification techniques. Results showed that practices related to safety incentives and rewards are the most effective from the accident rate viewpoint, even though they are seldom used by companies; on the other hand, practices related to accidents and incidents investigation had a slight negative impact on the accident rate because they are frequently used as a reactive measure. In general, the higher the percentage of prevention practices implemented in a strategy, the lower the accident rate. However, the analysis of the combined effect of prevention practices indicated that the choice of the right combination of practices was more important than just the number of practices implemented. Copyright © 2016 Elsevier Ltd. All rights reserved.

The development of an inherent safety approach to the prevention of domino accidents.

PubMed

Cozzani, Valerio; Tugnoli, Alessandro; Salzano, Ernesto

2009-11-01

The severity of industrial accidents in which a domino effect takes place is well known in the chemical and process industry. The application of an inherent safety approach for the prevention of escalation events leading to domino accidents was explored in the present study. Reference primary scenarios were analyzed and escalation vectors were defined. Inherent safety distances were defined and proposed as a metric to express the intensity of the escalation vectors. Simple rules of thumb were presented for a preliminary screening of these distances. Swift reference indices for layout screening with respect to escalation hazard were also defined. Two case studies derived from existing layouts of oil refineries were selected to understand the potentialities coming from the application in the methodology. The results evidenced that the approach allows a first comparative assessment of the actual domino hazard in a layout, and the identification of critical primary units with respect to escalation events. The methodology developed also represents a useful screening tool to identify were to dedicate major efforts in the design of add-on measures, optimizing conventional passive and active measures for the prevention of severe domino accidents.

Linking Nurses' Clinical Leadership to Patient Care Quality: The Role of Transformational Leadership and Workplace Empowerment.

PubMed

Boamah, Sheila

2018-03-01

Background While improving patient safety requires strong nursing leadership, there has been little empirical research that has examined the mechanisms by which leadership influences patient safety outcomes. Aim To test a model examining relationships among transformational leadership, structural empowerment, staff nurse clinical leadership, and nurse-assessed adverse patient outcomes. Methods A cross-sectional survey was conducted with a randomly selected sample of 378 registered nurses working in direct patient care in acute care hospitals across Ontario, Canada. Structural equation modeling was used to test the hypothesized model. Results The model had an acceptable fit, and all paths were significant. Transformational leadership was significantly associated with decreased adverse patient outcomes through structural empowerment and staff nurse clinical leadership. Discussion This study highlights the importance of transformational leadership in creating empowering practice environments that foster high-quality care. The findings indicate that a more complete understanding of what drives desired patient outcomes warrants the need to focus on how to empower nurses and foster clinical leadership practices at the point of care. Conclusion In planning safety strategies, managers must demonstrate transformational leadership behaviors in order to modify the work environment to create better defenses for averting adverse events.

Small business owners' opinions about written health and safety information.

PubMed

Brosseau, Lisa M; Fredrickson, Ann L; Casey, Mary Anne

2007-04-01

Owners of small manufacturing businesses from twelve industrial sectors (n=40) participated in focus groups. They most frequently read trade and local business publications; few regularly read or receive health and safety materials. They select business-related materials that are specific to their business, give them new ideas, or have information that is easy to use. Insurance companies and business associations are the most frequently mentioned sources of health and safety information. The most important aspects of a prototype newsletter are sponsorship, color and graphics, length and relevance. Most are positive about a university logo, because it indicates a trusted source. The front page should have a table of contents with short descriptions of articles and catchy headlines. A newsletter should take no more than ten minutes to read. Owners did not like articles that were written in first person, used quotes, were too personal or gave no solutions. Owners think a newsletter will be successful if it is targeted to their industry, shows costs, includes case studies about local businesses, isn't too academic, focuses on a different topic with each issue, and gives readers an opportunity to provide feedback.

The relationships between OHS prevention costs, safety performance, employee satisfaction and accident costs.

PubMed

Bayram, Metin; Ünğan, Mustafa C; Ardıç, Kadir

2017-06-01

Little is known about the costs of safety. A literature review conducted for this study indicates there is a lack of survey-based research dealing with the effects of occupational health and safety (OHS) prevention costs. To close this gap in the literature, this study investigates the interwoven relationships between OHS prevention costs, employee satisfaction, OHS performance and accident costs. Data were collected from 159 OHS management system 18001-certified firms operating in Turkey and analyzed through structural equation modeling. The findings indicate that OHS prevention costs have a significant positive effect on safety performance, employee satisfaction and accident costs savings; employee satisfaction has a significant positive effect on accident costs savings; and occupational safety performance has a significant positive effect on employee satisfaction and accident costs savings. Also, the results indicate that safety performance and employee satisfaction leverage the relationship between prevention costs and accident costs.

Indicators of School Crime and Safety: 2001.

ERIC Educational Resources Information Center

Kaufman, Phillip; Chen, Xianglei; Choy, Susan P.; Peter, Katharin; Ruddy, Sally A.; Miller, Amanda K.; Fleury, Jill K.; Chandler, Kathryn A.; Planty, Michael G.; Rand, Michael R.

2001-01-01

Presents the latest indicator data on school crime and student safety, including updates on student and teacher victimization, weapons and fights at school, students' alcohol and marijuana use, and students' reports of drug availability at school. Data present a mixed picture of school safety, with a decline in overall crime rates but continued…

Applicability of universal Bacteroidales genetic marker for microbial monitoring of drinking water sources in comparison to conventional indicators.

PubMed

Shahryari, A; Nikaeen, M; Khiadani Hajian, M; Nabavi, F; Hatamzadeh, M; Hassanzadeh, A

2014-11-01

Water quality monitoring is essential for the provision of safe drinking water. In this study, we compared a selection of fecal indicators with universal Bacteroidales genetic marker to identify fecal pollution of a variety of drinking water sources. A total of 60 samples were collected from water sources. The microbiological parameters included total coliforms, fecal coliforms, Escherichia coli and fecal streptococci as the fecal indicator bacteria (FIB), Clostridium perfringens and H2S bacteria as alternative indicators, universal Bacteroidales genetic marker as a promising alternative fecal indicator, and Salmonella spp., Shigella spp., and E. coli O157 as pathogenic bacteria. From 60 samples analyzed, Bacteroidales was the most frequently detected indicator followed by total coliforms. However, the Bacteroidales assay failed to detect the marker in nine samples positive for FIB and other alternative indicators. The results of our study showed that the absence of Bacteroidales is not necessarily an evidence of fecal and pathogenic bacteria absence and may be unable to ensure the safety of the water. Further research, however, is required for a better understanding of the use of a Bacteroidales genetic marker as an indicator in water quality monitoring programs.

Weighting Criteria and Prioritizing of Heat stress indices in surface mining using a Delphi Technique and Fuzzy AHP-TOPSIS Method.

PubMed

Asghari, Mehdi; Nassiri, Parvin; Monazzam, Mohammad Reza; Golbabaei, Farideh; Arabalibeik, Hossein; Shamsipour, Aliakbar; Allahverdy, Armin

2017-01-01

Heat stress as a physical harmful agent can increase the risk of health and safety problems in different workplaces such as mining. Although there are different indices to assess the heat stress imposed on workers, choosing the best index for a specific workplace is so important. Since various criteria affect an index applicability, extracting the most effective ones and determining their weights help to prioritize the existing indices and select the optimal index. In order to achieve this aim, present study compared some heat stress indices using effective methods. The viewpoints of occupational health experts and the qualitative Delphi methods were used to extract the most important criteria. Then, the weights of 11 selected criteria were determined by Fuzzy Analytic Hierarchy Process. Finally, fuzzy TOPSIS technique was applied for choosing the most suitable heat stress index. According to result, simplicity, reliability, being low cost, and comprehensiveness were the most determinative criteria for a heat stress index. Based on these criteria and their weights, the existing indices were prioritized. Eventually, wet bulb glob temperature appropriated the first priority and it was proposed as an applicable index for evaluating the heat stress at outdoor hot environments such as surface mines. The use of these strong methods allows introducing the most simple, precise, and applicable tool for evaluation the heat stress in hot environments. It seems that WBGT acts as an appropriate index for assessing the heat stress in mining activities at outdoors.

Evaluation of pedestrian safety at intersections: A theoretical framework based on pedestrian-vehicle interaction patterns.

PubMed

Ni, Ying; Wang, Menglong; Sun, Jian; Li, Keping

2016-11-01

Pedestrians are the most vulnerable road users, and pedestrian safety has become a major research focus in recent years. Regarding the quality and quantity issues with collision data, conflict analysis using surrogate safety measures has become a useful method to study pedestrian safety. However, given the inequality between pedestrians and vehicles in encounters and the multiple interactions between pedestrians and vehicles, it is insufficient to simply use the same indicator(s) or the same way to aggregate indicators for all conditions. In addition, behavioral factors cannot be neglected. To better use information extracted from trajectories for safety evaluation and pay more attention on effects of behavioral factors, this paper develops a more sophisticated framework for pedestrian conflict analysis that takes pedestrian-vehicle interactions into consideration. A concept of three interaction patterns has been proposed for the first time, namely "hard interaction," "no interaction," and "soft-interaction." Interactions have been categorized under one of these patterns by analyzing profiles of speed and conflict indicators during the whole interactive processes. In this paper, a support vector machine (SVM) approach has been adopted to classify severity levels for a dataset including 1144 events extracted from three intersections in Shanghai, China, followed by an analysis of variable importance. The results revealed that different conflict indicators have different contributions to indicating the severity level under various interaction patterns. Therefore, it is recommended either to use specific conflict indicators or to use weighted indicator aggregation for each interaction pattern when evaluating pedestrian safety. The implementation has been carried out at the fourth crosswalk, and the results indicate that the proposed method can achieve a higher accuracy and better robustness than conventional methods. Furthermore, the method is helpful for better understanding underlying levels of safety from the behavioral perspective, which can also provide evidence for targeted traffic education on proper behaviors. Copyright © 2016 Elsevier Ltd. All rights reserved.

Primary outcome indices in illicit drug dependence treatment research: systematic approach to selection and measurement of drug use end-points in clinical trials

PubMed Central

Donovan, Dennis M.; Bigelow, George E.; Brigham, Gregory S.; Carroll, Kathleen M.; Cohen, Allan J.; Gardin, John G.; Hamilton, John A.; Huestis, Marilyn A.; Hughes, John R.; Lindblad, Robert; Marlatt, G. Alan; Preston, Kenzie L.; Selzer, Jeffrey A.; Somoza, Eugene C.; Wakim, Paul G.; Wells, Elizabeth A.

2012-01-01

Aims Clinical trials test the safety and efficacy of behavioral and pharmacological interventions in drug-dependent individuals. However, there is no consensus about the most appropriate outcome(s) to consider in determining treatment efficacy or on the most appropriate methods for assessing selected outcome(s). We summarize the discussion and recommendations of treatment and research experts, convened by the US National Institute on Drug Abuse, to select appropriate primary outcomes for drug dependence treatment clinical trials, and in particular the feasibility of selecting a common outcome to be included in all or most trials. Methods A brief history of outcomes employed in prior drug dependence treatment research, incorporating perspectives from tobacco and alcohol research, is included. The relative merits and limitations of focusing on drug-taking behavior, as measured by self-report and qualitative or quantitative biological markers, are evaluated. Results Drug-taking behavior, measured ideally by a combination of self-report and biological indicators, is seen as the most appropriate proximal primary outcome in drug dependence treatment clinical trials. Conclusions We conclude that the most appropriate outcome will vary as a function of salient variables inherent in the clinical trial, such as the type of intervention, its target, treatment goals (e.g. abstinence or reduction of use) and the perspective being taken (e.g. researcher, clinical program, patient, society). It is recommended that a decision process, based on such trial variables, be developed to guide the selection of primary and secondary outcomes as well as the methods to assess them. PMID:21781202

Advancements of molecularly imprinted polymers in the food safety field.

PubMed

Wang, Peilong; Sun, Xiaohua; Su, Xiaoou; Wang, Tie

2016-06-07

Molecularly imprinted technology (MIT) has been widely employed to produce stable, robust and cheap molecularly imprinted polymer (MIP) materials that possess selective binding sites for recognition of target analytes in food, such as pesticides, veterinary drugs, mycotoxins, illegal drugs and so on. Because of high selectivity and specificity, MIPs have drawn great attention in the food safety field. In this review, the recent developments of MIPs in various applications for food safety, including sample preparation, chromatographic separation, sensing, immunoassay etc., have been summarized. We particularly discuss the advancements and limitations in these applications, as well as attempts carried out for their improvement.

The effect of road network patterns on pedestrian safety: A zone-based Bayesian spatial modeling approach.

PubMed

Guo, Qiang; Xu, Pengpeng; Pei, Xin; Wong, S C; Yao, Danya

2017-02-01

Pedestrian safety is increasingly recognized as a major public health concern. Extensive safety studies have been conducted to examine the influence of multiple variables on the occurrence of pedestrian-vehicle crashes. However, the explicit relationship between pedestrian safety and road network characteristics remains unknown. This study particularly focused on the role of different road network patterns on the occurrence of crashes involving pedestrians. A global integration index via space syntax was introduced to quantify the topological structures of road networks. The Bayesian Poisson-lognormal (PLN) models with conditional autoregressive (CAR) prior were then developed via three different proximity structures: contiguity, geometry-centroid distance, and road network connectivity. The models were also compared with the PLN counterpart without spatial correlation effects. The analysis was based on a comprehensive crash dataset from 131 selected traffic analysis zones in Hong Kong. The results indicated that higher global integration was associated with more pedestrian-vehicle crashes; the irregular pattern network was proved to be safest in terms of pedestrian crash occurrences, whereas the grid pattern was the least safe; the CAR model with a neighborhood structure based on road network connectivity was found to outperform in model goodness-of-fit, implying the importance of accurately accounting for spatial correlation when modeling spatially aggregated crash data. Copyright © 2016 Elsevier Ltd. All rights reserved.

A 3D printed smartphone optosensing platform for point-of-need food safety inspection.

PubMed

Liu, Zhonggang; Zhang, Yali; Xu, Shujia; Zhang, Heng; Tan, Yixun; Ma, Chenming; Song, Rong; Jiang, Lelun; Yi, Changqing

2017-05-08

The deficiency in rapid and in-field detection methods and portable devices that are reliable, easy-to-use, and low cost, results in the difficulties to uphold the high safety standards in China. In this study, we introduce a rapid and cost-effective smartphone-based method for point-of-need food safety inspection, which employs aptamer-conjugated AuNPs as the colorimetric indicator, and a battery-powered optosensing accessory attached to the camera of a smartphone for transmission images capture. A user-friendly and easy-to-use Android application is developed for automatic digital image processing and result reporting. Streptomycin (STR) is selected as the proof-of-concept target, and its specific quantitation can be realized with a LOD of 12.3 nM (8.97 μg kg -1 ) using the reported smartphone-based method. The quantitation of STR in honey, milk and tap water confirm the reliability and applicability of the reported method. The extremely high acceptance of smartphone in remote and metropolitan areas of China and ease-of-use of the reported method facilitate active food contaminant and toxicant screening, thus making the implementation of the whole food supply chain monitoring and surveillance possible and hence significantly improving the current Chinese food safety control system. Copyright © 2017 Elsevier B.V. All rights reserved.

Mode of action and safety of lactosporin, a novel antimicrobial protein produced by Bacillus coagulans ATCC 7050

PubMed Central

Riazi, Shadi; Dover, Sara E.; Chikindas, Michael L.

2012-01-01

Aims To determine the mechanism of action of antimicrobial protein, lactosporin, against Gardnerella vaginalis and to evaluate its safety in-vitro. Methods and Results Bacillus coagulans ATCC 7050 was grown at 37 °C for 18 hours. The cell free supernatant was concentrated 10-fold and screened for antimicrobial activity against indicator strain Micrococcus luteus. The mode of action of lactosporin was determined by measuring the potassium release and monitoring the changes in transmembrane potential (Δψ) and transmembrane pH (ΔpH) of the sensitive cells. Lactosporin caused efflux of potassium ions from M. luteus cells and dissipation of ΔpH in G. vaginalis while it had no effect on the Δψ. The safety of lactosporin was evaluated by using EpiVaginal™ ectocervical (VEC-100) tissue model. Over 80% of the cells in the vaginal tissue remained viable after exposure to lactosporin for 24 hours. Conclusions Lactosporin potentially exerts its antimicrobial activity by selective dissipation of ΔpH and/or by causing leakage of ions from the sensitive cells. Safety studies suggest that lactosporin is a non-cytotoxix antimicrobial for vaginal application. Significance and Impact of the Study This study revealed that lactosporin is an effective and safe antimicrobial preparation with potential application for control of bacterial vaginosis. PMID:22737982

[Evaluation on the effects of education regarding road safety among middle school students].

PubMed

Jin, Hui-Qing; Li, Ying-Chun; Zhang, Shu-Lin; Yu, Wan-Sheng

2009-08-01

To evaluate the intervention effects for road traffic accident prevention among middle school students through understanding their knowledge, attitude and practice (KAP) on road safety. Students in Grade 1 and Grade 2 from 7 junior and senior middle schools in Ji'nan city were selected as intervention group and students from a middle school in Hefei city served as control group. Education was provided to the intervention group and all the middle school students in Ji'nan city. Changes of KAP on road safety were measured for both groups during the follow-up period, and comparison on KAP for the two groups was carried statistically. The mean scores of road safety knowledge for intervention group improved significantly during the follow-up period (from 0.9 - 3.8), while these indices did not change much in the control group (from 0 - 0.2). Negative attitude on road safety was found in both groups, but less in the intervention group. More students started to admit that middle school students themselves should be responsible for most of the RTAs. Per week frequency of violating traffic rules did not improve, however during the follow-up period on both groups as still 75% to 80% of the students violating the traffic rules less than 2 times per week. Although three kinds and one kind of traffic rules violation seemed to have improved in the intervention group and in the control group, there were still two and three other kinds turned worse in the intervention and in the control group, respectively. Program on road safety education significantly improved the relative knowledge for middle school student and it exerted positive effects in road safety attitude to some extent. However, no significant effect was found in the improvement on their behavior. Education on road safety should be carried out in the early stage of childhood with newer and more effective intervention approaches.

Emotional exhaustion and workload predict clinician-rated and objective patient safety

PubMed Central

Welp, Annalena; Meier, Laurenz L.; Manser, Tanja

2015-01-01

Aims: To investigate the role of clinician burnout, demographic, and organizational characteristics in predicting subjective and objective indicators of patient safety. Background: Maintaining clinician health and ensuring safe patient care are important goals for hospitals. While these goals are not independent from each other, the interplay between clinician psychological health, demographic and organizational variables, and objective patient safety indicators is poorly understood. The present study addresses this gap. Method: Participants were 1425 physicians and nurses working in intensive care. Regression analysis (multilevel) was used to investigate the effect of burnout as an indicator of psychological health, demographic (e.g., professional role and experience) and organizational (e.g., workload, predictability) characteristics on standardized mortality ratios, length of stay and clinician-rated patient safety. Results: Clinician-rated patient safety was associated with burnout, trainee status, and professional role. Mortality was predicted by emotional exhaustion. Length of stay was predicted by workload. Contrary to our expectations, burnout did not predict length of stay, and workload and predictability did not predict standardized mortality ratios. Conclusion: At least in the short-term, clinicians seem to be able to maintain safety despite high workload and low predictability. Nevertheless, burnout poses a safety risk. Subjectively, burnt-out clinicians rated safety lower, and objectively, units with high emotional exhaustion had higher standardized mortality ratios. In summary, our results indicate that clinician psychological health and patient safety could be managed simultaneously. Further research needs to establish causal relationships between these variables and support to the development of managerial guidelines to ensure clinicians’ psychological health and patients’ safety. PMID:25657627

Relationship among Food-Safety Knowledge, Beliefs, and Risk-Reduction Behavior in University Students in Japan

ERIC Educational Resources Information Center

Takeda, Sayaka; Akamatsu, Rie; Horiguchi, Itsuko; Marui, Eiji

2011-01-01

Objective: To identify whether university students who have both food-safety knowledge and beliefs perform risk-reduction behaviors. Design: Cross-sectional research using a questionnaire that included food-safety knowledge, perceptions, risk-reduction behavior, stages for the selection of safer food based on the Transtheoretical Model, and…

77 FR 22706 - Special Local Regulation and Safety Zone; America's Cup Sailing Events, San Francisco, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-17

...] Special Local Regulation and Safety Zone; America's Cup Sailing Events, San Francisco, CA AGENCY: Coast... regulation and temporary safety zone proposed for those portions of the ``America's Cup World Series,'' the ``Louis Vuitton Cup'' challenger selection series, and the ``America's Cup Finals Match'' sailing regattas...

49 CFR 209.501 - Review of rail transportation safety and security route analysis.

Code of Federal Regulations, 2010 CFR

2010-10-01

... establish that the route chosen by the carrier poses the least overall safety and security risk, the... analysis, including a clear description of the risks on the selected route that have not been... commercially practicable alternative route poses fewer overall safety and security risks than the route...

Product Safety, It's No Accident. A Consumer Product Safety Monthly Planning Guide for Community Organizations.

ERIC Educational Resources Information Center

Consumer Product Safety Commission, Washington, DC.

A consumer product safety monthly planning guide for community organizations is provided. The material is organized into suggested monthly topics with seasonal emphasis. Each section highlights selected information about how to identify potential hazards associated with categories of products. Each section also includes recommendaitons of ways to…

Relationship among food-safety knowledge, beliefs, and risk-reduction behavior in university students in Japan.

PubMed

Takeda, Sayaka; Akamatsu, Rie; Horiguchi, Itsuko; Marui, Eiji

2011-01-01

To identify whether university students who have both food-safety knowledge and beliefs perform risk-reduction behaviors. Cross-sectional research using a questionnaire that included food-safety knowledge, perceptions, risk-reduction behavior, stages for the selection of safer food based on the Transtheoretical Model, and demographic characteristics. Four universities in eastern Japan and 2 universities in western Japan. University students (n = 799). Food-safety knowledge, beliefs, and risk-reduction behaviors. Answers on measures assessing risk perception and food-safety knowledge were combined to form 4 groups of participants. Relationships among demographic characteristics, the 4 groups, risk-reduction behaviors, stage of change, and severity and susceptibility were assessed. The proportion of students who had more knowledge of food safety and a belief that "there are no 100% safe food items" was high in the group that frequently performed risk-reduction behaviors, as it was in the group who had taken a basic class about food or health care and who had, or were working toward, a food or nutrition qualification. University students who thought that there were no 100% safe food items and who had more knowledge about food safety were more likely to confirm food-safety information when selecting food. Copyright © 2011 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Consumer Product Safety Commission

MedlinePlus

... mail Inside CPSC Accessibility Privacy Policy Budget, Performances & Finance Open Government Freedom of Information (FOIA) Inspector General ... leave the U.S. Consumer Product Safety Commission (CPSC) public website. The link you selected is for a ...

47 CFR 80.329 - Safety signals and messages.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 5 2013-10-01 2013-10-01 false Safety signals and messages. 80.329 Section 80... Safety Procedures § 80.329 Safety signals and messages. (a) The safety signal indicates that the station... warnings. (b) In radiotelegraphy, the safety signal consists of three repetitions of the group TTT, sent...

47 CFR 80.329 - Safety signals and messages.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 5 2014-10-01 2014-10-01 false Safety signals and messages. 80.329 Section 80... Safety Procedures § 80.329 Safety signals and messages. (a) The safety signal indicates that the station... warnings. (b) In radiotelegraphy, the safety signal consists of three repetitions of the group TTT, sent...

47 CFR 80.329 - Safety signals and messages.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 5 2012-10-01 2012-10-01 false Safety signals and messages. 80.329 Section 80... Safety Procedures § 80.329 Safety signals and messages. (a) The safety signal indicates that the station... warnings. (b) In radiotelegraphy, the safety signal consists of three repetitions of the group TTT, sent...

Constructing a Bayesian network model for improving safety behavior of employees at workplaces.

PubMed

Mohammadfam, Iraj; Ghasemi, Fakhradin; Kalatpour, Omid; Moghimbeigi, Abbas

2017-01-01

Unsafe behavior increases the risk of accident at workplaces and needs to be managed properly. The aim of the present study was to provide a model for managing and improving safety behavior of employees using the Bayesian networks approach. The study was conducted in several power plant construction projects in Iran. The data were collected using a questionnaire composed of nine factors, including management commitment, supporting environment, safety management system, employees' participation, safety knowledge, safety attitude, motivation, resource allocation, and work pressure. In order for measuring the score of each factor assigned by a responder, a measurement model was constructed for each of them. The Bayesian network was constructed using experts' opinions and Dempster-Shafer theory. Using belief updating, the best intervention strategies for improving safety behavior also were selected. The result of the present study demonstrated that the majority of employees do not tend to consider safety rules, regulation, procedures and norms in their behavior at the workplace. Safety attitude, safety knowledge, and supporting environment were the best predictor of safety behavior. Moreover, it was determined that instantaneous improvement of supporting environment and employee participation is the best strategy to reach a high proportion of safety behavior at the workplace. The lack of a comprehensive model that can be used for explaining safety behavior was one of the most problematic issues of the study. Furthermore, it can be concluded that belief updating is a unique feature of Bayesian networks that is very useful in comparing various intervention strategies and selecting the best one form them. Copyright © 2016 Elsevier Ltd. All rights reserved.

Workplace safety and health programs, practices, and conditions in auto collision repair businesses.

PubMed

Brosseau, L M; Bejan, A; Parker, D L; Skan, M; Xi, M

2014-01-01

This article describes the results of a pre-intervention safety assessment conducted in 49 auto collision repair businesses and owners' commitments to specific improvements. A 92-item standardized audit tool employed interviews, record reviews, and observations to assess safety and health programs, training, and workplace conditions. Owners were asked to improve at least one-third of incorrect, deficient, or missing (not in compliance with regulations or not meeting best practice) items, of which a majority were critical or highly important for ensuring workplace safety. Two-thirds of all items were present, with the highest fraction related to electrical safety, machine safety, and lockout/tagout. One-half of shops did not have written safety programs and had not conducted recent training. Many had deficiencies in respiratory protection programs and practices. Thirteen businesses with a current or past relationship with a safety consultant had a significantly higher fraction of correct items, in particular related to safety programs, up-to-date training, paint booth and mixing room conditions, electrical safety, and respiratory protection. Owners selected an average of 58% of recommended improvements; they were most likely to select items related to employee Right-to-Know training, emergency exits, fire extinguishers, and respiratory protection. They were least likely to say they would improve written safety programs, stop routine spraying outside the booth, or provide adequate fire protection for spray areas outside the booth. These baseline results suggest that it may be possible to bring about workplace improvements using targeted assistance from occupational health and safety professionals.

A review of national policies and strategies to improve quality of health care and patient safety: a case study from Lebanon and Jordan.

PubMed

El-Jardali, Fadi; Fadlallah, Racha

2017-08-16

Improving quality of care and patient safety practices can strengthen health care delivery systems, improve health sector performance, and accelerate attainment of health-related Sustainability Development Goals. Although quality improvement is now prominent on the health policy agendas of governments in low- and middle-income countries (LMICs), including countries of the Eastern Mediterranean Region (EMR), progress to date has not been optimal. The objective of this study is to comprehensively review existing quality improvement and patient safety policies and strategies in two selected countries of the EMR (Lebanon and Jordan) to determine the extent to which these have been institutionalized within existing health systems. We used a mixed methods approach that combined documentation review, stakeholder surveys and key informant interviews. Existing quality improvement and patient safety initiatives were assessed across five components of an analytical framework for assessing health care quality and patient safety: health systems context; national policies and legislation; organizations and institutions; methods, techniques and tools; and health care infrastructure and resources. Both Lebanon and Jordan have made important progress in terms of increased attention to quality and accreditation in national health plans and strategies, licensing requirements for health care professionals and organizations (albeit to varying extents), and investments in health information systems. A key deficiency in both countries is the absence of an explicit national policy for quality improvement and patient safety across the health system. Instead, there is a spread of several (disjointed) pieces of legal measures and national plans leading to fragmentation and lack of clear articulation of responsibilities across the entire continuum of care. Moreover, both countries lack national sets of standardized and applicable quality indicators for performance measurement and benchmarking. Importantly, incentive systems that link contractual agreement, regulations, accreditation, and performance indicators are underutilized in Lebanon and absent in Jordan. At the healthcare organizational level, there is a need to instill a culture of continuous quality improvement and promote professional training in quality improvement and patient safety. Study findings highlight the importance of aligning policies, organizations, methods, capacities and resources in order to institutionalize quality improvement and patient safety practices in health systems. Gaps and dysfunctions identified can help inform national deliberations and dialogues among key stakeholders in each study country. Findings can also inform future quality improvement efforts in the EMR and beyond, with a particular emphasis on LMICs.

Evaluation of the Quality of Occupational Health and Safety Management Systems Based on Key Performance Indicators in Certified Organizations.

PubMed

Mohammadfam, Iraj; Kamalinia, Mojtaba; Momeni, Mansour; Golmohammadi, Rostam; Hamidi, Yadollah; Soltanian, Alireza

2017-06-01

Occupational Health and Safety Management Systems are becoming more widespread in organizations. Consequently, their effectiveness has become a core topic for researchers. This paper evaluates the performance of the Occupational Health and Safety Assessment Series 18001 specification in certified companies in Iran. The evaluation is based on a comparison of specific criteria and indictors related to occupational health and safety management practices in three certified and three noncertified companies. Findings indicate that the performance of certified companies with respect to occupational health and safety management practices is significantly better than that of noncertified companies. Occupational Health and Safety Assessment Series 18001-certified companies have a better level of occupational health and safety; this supports the argument that Occupational Health and Safety Management Systems play an important strategic role in health and safety in the workplace.

Safety First: The Role of Trust and School Safety in Non-Suicidal Self-Injury

ERIC Educational Resources Information Center

Noble, Rick Nelson; Sornberger, Michael J.; Toste, Jessica R.; Heath, Nancy L.; McLouth, Rusty

2011-01-01

Non-suicidal self-injury (NSSI) has become very prominent among adolescents in middle and high school settings. However, little research has evaluated the role of the school environment in the behaviour. This study examined whether indices of school trust and perceived safety were predictive of NSSI behaviour. Results indicate that these variables…

An Evaluation of Proposed School Safety Indicators for Georgia.

ERIC Educational Resources Information Center

Todd, Knox H.; Kellermann, Arthur L.; Wald, Marlena; Lipscomb, Leslie; Fajman, Nancy

One of the tasks of the Council for School Performance is to implement measures of school safety to determine the impact of Georgia Lottery for Education expenditures. During the 1994-95 school year, the council pilot-tested several indicators of school safety. This document presents the results of an evaluation that examined the relevance,…

A multi-objective optimization approach for the selection of working fluids of geothermal facilities: Economic, environmental and social aspects.

PubMed

Martínez-Gomez, Juan; Peña-Lamas, Javier; Martín, Mariano; Ponce-Ortega, José María

2017-12-01

The selection of the working fluid for Organic Rankine Cycles has traditionally been addressed from systematic heuristic methods, which perform a characterization and prior selection considering mainly one objective, thus avoiding a selection considering simultaneously the objectives related to sustainability and safety. The objective of this work is to propose a methodology for the optimal selection of the working fluid for Organic Rankine Cycles. The model is presented as a multi-objective approach, which simultaneously considers the economic, environmental and safety aspects. The economic objective function considers the profit obtained by selling the energy produced. Safety was evaluated in terms of individual risk for each of the components of the Organic Rankine Cycles and it was formulated as a function of the operating conditions and hazardous properties of each working fluid. The environmental function is based on carbon dioxide emissions, considering carbon dioxide mitigation, emission due to the use of cooling water as well emissions due material release. The methodology was applied to the case of geothermal facilities to select the optimal working fluid although it can be extended to waste heat recovery. The results show that the hydrocarbons represent better solutions, thus among a list of 24 working fluids, toluene is selected as the best fluid. Copyright © 2017 Elsevier Ltd. All rights reserved.

Propensity scores-potential outcomes framework to incorporate severity probabilities in the highway safety manual crash prediction algorithm.

PubMed

Sasidharan, Lekshmi; Donnell, Eric T

2014-10-01

Accurate estimation of the expected number of crashes at different severity levels for entities with and without countermeasures plays a vital role in selecting countermeasures in the framework of the safety management process. The current practice is to use the American Association of State Highway and Transportation Officials' Highway Safety Manual crash prediction algorithms, which combine safety performance functions and crash modification factors, to estimate the effects of safety countermeasures on different highway and street facility types. Many of these crash prediction algorithms are based solely on crash frequency, or assume that severity outcomes are unchanged when planning for, or implementing, safety countermeasures. Failing to account for the uncertainty associated with crash severity outcomes, and assuming crash severity distributions remain unchanged in safety performance evaluations, limits the utility of the Highway Safety Manual crash prediction algorithms in assessing the effect of safety countermeasures on crash severity. This study demonstrates the application of a propensity scores-potential outcomes framework to estimate the probability distribution for the occurrence of different crash severity levels by accounting for the uncertainties associated with them. The probability of fatal and severe injury crash occurrence at lighted and unlighted intersections is estimated in this paper using data from Minnesota. The results show that the expected probability of occurrence of fatal and severe injury crashes at a lighted intersection was 1 in 35 crashes and the estimated risk ratio indicates that the respective probabilities at an unlighted intersection was 1.14 times higher compared to lighted intersections. The results from the potential outcomes-propensity scores framework are compared to results obtained from traditional binary logit models, without application of propensity scores matching. Traditional binary logit analysis suggests that the probability of occurrence of severe injury crashes is higher at lighted intersections compared to unlighted intersections, which contradicts the findings obtained from the propensity scores-potential outcomes framework. This finding underscores the importance of having comparable treated and untreated entities in traffic safety countermeasure evaluations. Copyright © 2014 Elsevier Ltd. All rights reserved.

Public attitudes toward passive restraints

DOT National Transportation Integrated Search

1978-08-01

Author's abstract: The U. S. Department of Transportation, National Highway Traffic Safety Administration sponsored a major survey to examine public attitudes toward automobile safety. The survey used a scientifically selected sample of 2,016 adult A...

Food Safety for People with Cancer

MedlinePlus

... became ill from food you ate in a restaurant or other food establishment. The health department staff ... to 4 p.m. Eastern Time. An extensive selection of timely food safety messages is also available ...

Transportation Safety Information Report : 1988 annual summary

DOT National Transportation Integrated Search

1989-12-01

The Report is a compendium of selected national-level transportation safety statistics for all modes of transportation and for multimodal transportation of hazardous materials. The report presents and compares data for transportation fatalities, acci...

Update and enhancement of ODOT's crash reduction factors.

DOT National Transportation Integrated Search

2006-06-01

Appropriate selection of cost-effective countermeasures for highway safety improvement projects requires an : estimate of the safety effects of alternative designs. The Oregon Department of Transportation (ODOT), like many : agencies, makes these est...

Safety Education Resources: Childproofing Your Home

MedlinePlus

... mail Inside CPSC Accessibility Privacy Policy Budget, Performances & Finance Open Government Freedom of Information (FOIA) Inspector General ... leave the U.S. Consumer Product Safety Commission (CPSC) public website. The link you selected is for a ...

Choices, choices: the application of multi-criteria decision analysis to a food safety decision-making problem.

PubMed

Fazil, A; Rajic, A; Sanchez, J; McEwen, S

2008-11-01

In the food safety arena, the decision-making process can be especially difficult. Decision makers are often faced with social and fiscal pressures when attempting to identify an appropriate balance among several choices. Concurrently, policy and decision makers in microbial food safety are under increasing pressure to demonstrate that their policies and decisions are made using transparent and accountable processes. In this article, we present a multi-criteria decision analysis approach that can be used to address the problem of trying to select a food safety intervention while balancing various criteria. Criteria that are important when selecting an intervention were determined, as a result of an expert consultation, to include effectiveness, cost, weight of evidence, and practicality associated with the interventions. The multi-criteria decision analysis approach we present is able to consider these criteria and arrive at a ranking of interventions. It can also provide a clear justification for the ranking as well as demonstrate to stakeholders, through a scenario analysis approach, how to potentially converge toward common ground. While this article focuses on the problem of selecting food safety interventions, the range of applications in the food safety arena is truly diverse and can be a significant tool in assisting decisions that need to be coherent, transparent, and justifiable. Most importantly, it is a significant contributor when there is a need to strike a fine balance between various potentially competing alternatives and/or stakeholder groups.

Best practice strategies to safeguard drug prescribing and drug administration: an anthology of expert views and opinions.

PubMed

Seidling, Hanna M; Stützle, Marion; Hoppe-Tichy, Torsten; Allenet, Benoît; Bedouch, Pierrick; Bonnabry, Pascal; Coleman, Jamie J; Fernandez-Llimos, Fernando; Lovis, Christian; Rei, Maria Jose; Störzinger, Dominic; Taylor, Lenka A; Pontefract, Sarah K; van den Bemt, Patricia M L A; van der Sijs, Heleen; Haefeli, Walter E

2016-04-01

While evidence on implementation of medication safety strategies is increasing, reasons for selecting and relinquishing distinct strategies and details on implementation are typically not shared in published literature. We aimed to collect and structure expert information resulting from implementing medication safety strategies to provide advice for decision-makers. Medication safety experts with clinical expertise from thirteen hospitals throughout twelve European and North American countries shared their experience in workshop meetings, on-site-visits and remote structured interviews. We performed an expert-based, in-depth assessment of implementation of best-practice strategies to improve drug prescribing and drug administration. Workflow, variability and recommended medication safety strategies in drug prescribing and drug administration processes. According to the experts, institutions chose strategies that targeted process steps known to be particularly error-prone in the respective setting. Often, the selection was channeled by local constraints such as the e-health equipment and critically modulated by national context factors. In our study, the experts favored electronic prescribing with clinical decision support and medication reconciliation as most promising interventions. They agreed that self-assessment and introduction of medication safety boards were crucial to satisfy the setting-specific differences and foster successful implementation. While general evidence for implementation of strategies to improve medication safety exists, successful selection and adaptation of a distinct strategy requires a thorough knowledge of the institute-specific constraints and an ongoing monitoring and adjustment of the implemented measures.

X-33 Telemetry Best Source Selection, Processing, Display, and Simulation Model Comparison

NASA Technical Reports Server (NTRS)

Burkes, Darryl A.

1998-01-01

The X-33 program requires the use of multiple telemetry ground stations to cover the launch, ascent, transition, descent, and approach phases for the flights from Edwards AFB to landings at Dugway Proving Grounds, UT and Malmstrom AFB, MT. This paper will discuss the X-33 telemetry requirements and design, including information on fixed and mobile telemetry systems, best source selection, and support for Range Safety Officers. A best source selection system will be utilized to automatically determine the best source based on the frame synchronization status of the incoming telemetry streams. These systems will be used to select the best source at the landing sites and at NASA Dryden Flight Research Center to determine the overall best source between the launch site, intermediate sites, and landing site sources. The best source at the landing sites will be decommutated to display critical flight safety parameters for the Range Safety Officers. The overall best source will be sent to the Lockheed Martin's Operational Control Center at Edwards AFB for performance monitoring by X-33 program personnel and for monitoring of critical flight safety parameters by the primary Range Safety Officer. The real-time telemetry data (received signal strength, etc.) from each of the primary ground stations will also be compared during each nu'ssion with simulation data generated using the Dynamic Ground Station Analysis software program. An overall assessment of the accuracy of the model will occur after each mission. Acknowledgment: The work described in this paper was NASA supported through cooperative agreement NCC8-115 with Lockheed Martin Skunk Works.

A strategic management model for evaluation of health, safety and environmental performance.

PubMed

Abbaspour, Majid; Toutounchian, Solmaz; Roayaei, Emad; Nassiri, Parvin

2012-05-01

Strategic health, safety, and environmental management system (HSE-MS) involves systematic and cooperative planning in each phase of the lifecycle of a project to ensure that interaction among the industry group, client, contractor, stakeholder, and host community exists with the highest level of health, safety, and environmental standard performances. Therefore, it seems necessary to assess the HSE-MS performance of contractor(s) by a comparative strategic management model with the aim of continuous improvement. The present Strategic Management Model (SMM) has been illustrated by a case study and the results show that the model is a suitable management tool for decision making in a contract environment, especially in oil and gas fields and based on accepted international standards within the framework of management deming cycle. To develop this model, a data bank has been created, which includes the statistical data calculated by converting the HSE performance qualitative data into quantitative values. Based on this fact, the structure of the model has been formed by defining HSE performance indicators according to the HSE-MS model. Therefore, 178 indicators have been selected which have been grouped into four attributes. Model output provides quantitative measures of HSE-MS performance as a percentage of an ideal level with maximum possible score for each attribute. Defining the strengths and weaknesses of the contractor(s) is another capability of this model. On the other hand, this model provides a ranking that could be used as the basis for decision making at the contractors' pre-qualification phase or during the execution of the project.

Recent antiseizure medications in the Intensive Care Unit.

PubMed

Orinx, Cindy; Legros, Benjamin; Gaspard, Nicolas

2017-08-01

Seizures and status epilepticus (SE), both clinical and subclinical, are frequent in critically ill patients. The list of available antiseizure medications (ASMs) is expanding and now includes older and widely used drugs as well as more recent medications with a better safety and pharmacokinetics profile. We review a selection of recent publications about the indications and administration of ASMs in critical care for the prophylaxis and treatment of seizures and SE, focusing on recent ASMs available as intravenous formulation and emphasizing pharmacokinetics and safety issues in relation to several aspects of critical illness. Levetiracetam, lacosamide and more recently brivaracetam, represent interesting alternatives to older ASMs, mostly due to a more favorable safety and pharmacokinetic profile. Low-quality studies suggest that this profile results in better tolerability in treated patients. Ketamine might represent a useful addition in our anesthetic armamentarium for refractory SE, due to its different mechanism of action and cardiovascular properties. Little evidence is available however to support the prophylactic use of ASMs in critically ill patients, except in specific settings (traumatic brain injury and subarachnoid hemorrhage). Head-to-head studies comparing recent and older ASMs in the treatment of acute seizures and SE are ongoing or awaiting publication. Administration of ASMs to critically ill patients needs to be adapted to organ dysfunction, and especially to renal dysfunction for recent drugs. Recent ASMs and could represent better treatment choices in critically ill patients than older ones but this needs to be confirmed in randomized controlled studies. In general, further studies are required to clarify the indications and optimal use of ASMs in the critical care setting.

Associations between safety climate and safety management practices in the construction industry.

PubMed

Marín, Luz S; Lipscomb, Hester; Cifuentes, Manuel; Punnett, Laura

2017-06-01

Safety climate, a group-level measure of workers' perceptions regarding management's safety priorities, has been suggested as a key predictor of safety outcomes. However, its relationship with actual injury rates is inconsistent. We posit that safety climate may instead be a parallel outcome of workplace safety practices, rather than a determinant of workers' safety behaviors or outcomes. Using a sample of 25 commercial construction companies in Colombia, selected by injury rate stratum (high, medium, low), we examined the relationship between workers' safety climate perceptions and safety management practices (SMPs) reported by safety officers. Workers' perceptions of safety climate were independent of their own company's implementation of SMPs, as measured here, and its injury rates. However, injury rates were negatively related to the implementation of SMPs. Safety management practices may be more important than workers' perceptions of safety climate as direct predictors of injury rates. © 2017 Wiley Periodicals, Inc.

Evaluation of 1983 selective speed enforcement projects in Virginia.

DOT National Transportation Integrated Search

1985-01-01

This report describes and evaluates Virginia's 1983 selective speed enforcement projects. These projects are one of the various types of highway safety programs, classified as selective traffic enforcement projects (STEPs) partially funded by the fed...

Effectiveness and safety of nutritional supplements in the treatment of hereditary retinal dystrophies: a systematic review

PubMed Central

Brito-García, N; del Pino-Sedeño, T; Trujillo-Martín, M M; Coco, R M; Rodríguez de la Rúa, E; del Cura-González, I; Serrano-Aguilar, P

2017-01-01

The hereditary retinal dystrophies (HRDs) are a group of genetically determined disorders that result in loss of the visual function. There is a lack of standard pharmacological treatments or widely accepted nutritional recommendations. The objective of this review is to summarise the scientific evidence on the effectiveness and safety of nutritional supplements for the treatment of HRDs. We conducted a scientific literature search on Medline and PreMedline, EMBASE, SCI-EXPANDED, SSCI, and The Cochrane Library up to August 2014. Experimental, quasi-experimental and controlled observational studies were selected. Eight studies were ultimately included, seven on retinitis pigmentosa (RP) and one on Best disease. Vitamin A, vitamin E, docosahexaenoic acid (DHA), lutein and β-carotene were assessed. A 15 000 IU daily dose of vitamin A was reported to have shown a small protective effect on the progression of RP, as was the use of the carotenoids lutein and β-carotene. Different DHA doses has no effect on RP or Best disease. No supplement showed severe adverse effects in the selected studies although strong evidence of toxicity exists for high doses of vitamin A and β-carotene in certain populations. The selected studies concluded that there may be a small beneficial effect of vitamin A, lutein and β-carotene on the progression of RP. The limited evidence available indicates some well-designed additional studies on combined supplements strategies may achieve more robust conclusions. Moreover, the scarcity of evidence available on the treatment of HRD other than RP with nutritional supplements supports the need for further research efforts. PMID:27935602

Evaluation of features to support safety and quality in general practice clinical software

PubMed Central

2011-01-01

Background Electronic prescribing is now the norm in many countries. We wished to find out if clinical software systems used by general practitioners in Australia include features (functional capabilities and other characteristics) that facilitate improved patient safety and care, with a focus on quality use of medicines. Methods Seven clinical software systems used in general practice were evaluated. Fifty software features that were previously rated as likely to have a high impact on safety and/or quality of care in general practice were tested and are reported here. Results The range of results for the implementation of 50 features across the 7 clinical software systems was as follows: 17-31 features (34-62%) were fully implemented, 9-13 (18-26%) partially implemented, and 9-20 (18-40%) not implemented. Key findings included: Access to evidence based drug and therapeutic information was limited. Decision support for prescribing was available but varied markedly between systems. During prescribing there was potential for medicine mis-selection in some systems, and linking a medicine with its indication was optional. The definition of 'current medicines' versus 'past medicines' was not always clear. There were limited resources for patients, and some medicines lists for patients were suboptimal. Results were provided to the software vendors, who were keen to improve their systems. Conclusions The clinical systems tested lack some of the features expected to support patient safety and quality of care. Standards and certification for clinical software would ensure that safety features are present and that there is a minimum level of clinical functionality that clinicians could expect to find in any system.

The administration of probiotics and synbiotics in immune compromised adults: is it safe?

PubMed

Van den Nieuwboer, M; Brummer, R J; Guarner, F; Morelli, L; Cabana, M; Claasen, E

2015-03-01

This study aimed to systematically evaluate safety of probiotics and synbiotics in immune compromised adults (≥18 years). Safety was analysed using the Common Terminology Clinical Adverse Events (CTCAE version 4.0) classification, thereby providing an update on previous reports using the most recent available clinical data (2008-2013). Safety aspects are represented and related to number of participants per probiotic strain/culture, study duration, dosage, clinical condition and selected afflictions. Analysis of 57 clinical studies indicates that probiotic and/or synbiotic administration in immune compromised adults is safe with regard to the current evaluated probiotic strains, dosages and duration. Individuals were considered immune compromised if HIV-infected, critically ill, underwent surgery or had an organ- or an autoimmune disease. There were no major safety concerns in the study, as none of the serious adverse events (AE)s were related, or suspected to be related, to the probiotic or synbiotic product and the study products were well tolerated. Overall, AEs occurred less frequent in immune compromised subjects receiving probiotics and/or synbiotics compared to the control group. In addition, the results demonstrated a flaw in precise reporting and classification of AE in most studies. Furthermore, generalisability of conclusions are greatly limited by the inconsistent, imprecise and potentially incomplete reporting as well as the variation in probiotic strains, dosages, administration regimes, study populations and reported outcomes. We argue that standardised reporting on adverse events (CTCAE) in 'food' studies should be obligatory, thereby improving reliability of data and re-enforcing the safety profile of probiotics.

Nonclinical safety of the sodium-glucose cotransporter 2 inhibitor empagliflozin.

PubMed

Bogdanffy, Matthew S; Stachlewitz, Robert F; van Tongeren, Susan; Knight, Brian; Sharp, Dale E; Ku, Warren; Hart, Susan Emeigh; Blanchard, Kerry

2014-01-01

Empagliflozin, a selective inhibitor of the renal tubular sodium-glucose cotransporter 2, was developed for treatment of type 2 diabetes mellitus. Nonclinical safety of empagliflozin was studied in a battery of tests to support global market authorization. Safety pharmacology studies indicated no effect of empagliflozin on measures of respiratory or central nervous system function in rats or cardiovascular safety in telemeterized dogs. In CD-1 mouse, Wistar Han rat, or beagle dogs up to 13, 26, or 52 weeks of treatment, respectively, empagliflozin exhibited a toxicity profile consistent with secondary supratherapeutic pharmacology related to glucose loss and included decreased body weight and body fat, increased food consumption, diarrhea, dehydration, decreased serum glucose and increases in other serum parameters reflective of increased protein catabolism, gluconeogenesis, and electrolyte imbalances, and urinary changes such as polyuria and glucosuria. Microscopic changes were consistently observed in kidney and included tubular nephropathy and interstitial nephritis (dog), renal mineralization (rat) and tubular epithelial cell karyomegaly, single cell necrosis, cystic hyperplasia, and hypertrophy (mouse). Empagliflozin was not genotoxic. Empagliflozin was not carcinogenic in female mice or female rats. Renal adenoma and carcinoma were induced in male mice only at exposures 45 times the maximum clinical dose. These tumors were associated with a spectrum of nonneoplastic changes suggestive of a nongenotoxic, cytotoxic, and cellular proliferation-driven mechanism. In male rats, testicular interstitial cell tumors and hemangiomas of the mesenteric lymph node were observed; both tumors are common in rats and are unlikely to be relevant to humans. These studies demonstrate the nonclinical safety of empagliflozin. © The Author(s) 2014.

Vessel traffic safety in busy waterways: A case study of accidents in western shenzhen port.

PubMed

Mou, J M; Chen, P F; He, Y X; Yip, Tsz Leung; Li, W H; Tang, J; Zhang, H Z

2016-08-03

Throughout the world, busy waterways near large ports witness heavy vessel traffic in recent decades. The waterways are characterized by high risk in terms of loss of life, property, and pollution to environment. To facilitate maritime safety management with satisfactory efficiency and efficacy, the authors propose a framework of safety indexes to evaluate the risk level in busy waterways according to the accident severity, fatality rate and special indicators of maritime transportation. The safety indexes consist of Safety Evaluation Index (SEI) and Safety Warning Index (SWI), and are derived from the proposed risk criteria of Chinese vessel traffic. As a case study, data on vessel traffic accidents reported in the Western Shenzhen Port, South China from 1995 to 2015 are analyzed. The actual risk level of this area during the period is calculated under the framework. The implementation of the safety indexes indicate that the risk criteria and safety indexes are practicable and effective for the vessel traffic management. The methodology based on long-term accident data can significantly support the risk analysis in the macroscopic perspective for busy ports and waterways, such that SWI can act as threshold to trigger actions, while SEI can act as an indicator to measure safety status. Copyright © 2016 Elsevier Ltd. All rights reserved.

Practice Bulletin No. 152: Emergency Contraception.

PubMed

2015-09-01

Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Common indications for emergency contraception include contraceptive failure (eg, condom breakage or missed doses of oral contraceptives) and failure to use any form of contraception (). Although oral emergency contraception was first described in the medical literature in the 1960s, the U.S. Food and Drug Administration (FDA) approved the first dedicated product for emergency contraception in 1998. Since then, several new products have been introduced. Methods of emergency contraception include oral administration of combined estrogen-progestin, progestin only, or selective progesterone receptor modulators and insertion of a copper intrauterine device (IUD). Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when a need arises (). The purpose of this Practice Bulletin is to review the evidence for the efficacy and safety of available methods of emergency contraception and to increase awareness of these methods among obstetrician-gynecologists and other gynecologic providers.

Formulary Selection Criteria for Biosimilars: Considerations for US Health-System Pharmacists.

PubMed

Griffith, Niesha; McBride, Ali; Stevenson, James G; Green, Larry

2014-10-01

Pharmacists will play a key role in evaluating biosimilars for formulary inclusion in the United States. As defined by US law, a biosimilar is a biologic that is highly similar to its reference product, notwithstanding minor differences in clinically inactive components, and should not have clinically meaningful differences from its reference product in safety, purity, and potency. We review biosimilars and the current European Union and US regulatory pathways for biosimilars. Furthermore, we propose a checklist of considerations to ensure that US pharmacists thoroughly evaluate future biosimilars for formulary inclusion. Included in the checklist are considerations related to the availability of preapproval and postapproval safety and efficacy data; differences in product characteristics and immunogenicity between the biosimilar and reference product; manufacturer-related parameters that can affect a reliable supply of quality products; health-system and patient perspectives on product packaging, labeling, storage, and administration; costs and insurance coverage; patient education; interchangeability and differences in the range of indications; and evaluation of institutions' information technology systems.

Sunscreening Agents

PubMed Central

Martis, Jacintha; Shobha, V; Sham Shinde, Rutuja; Bangera, Sudhakar; Krishnankutty, Binny; Bellary, Shantala; Varughese, Sunoj; Rao, Prabhakar; Naveen Kumar, B.R.

2013-01-01

The increasing incidence of skin cancers and photodamaging effects caused by ultraviolet radiation has increased the use of sunscreening agents, which have shown beneficial effects in reducing the symptoms and reoccurrence of these problems. Many sunscreen compounds are in use, but their safety and efficacy are still in question. Efficacy is measured through indices, such as sun protection factor, persistent pigment darkening protection factor, and COLIPA guidelines. The United States Food and Drug Administration and European Union have incorporated changes in their guidelines to help consumers select products based on their sun protection factor and protection against ultraviolet radiation, whereas the Indian regulatory agency has not yet issued any special guidance on sunscreening agents, as they are classified under cosmetics. In this article, the authors discuss the pharmacological actions of sunscreening agents as well as the available formulations, their benefits, possible health hazards, safety, challenges, and proper application technique. New technologies and scope for the development of sunscreening agents are also discussed as well as the role of the physician in patient education about the use of these agents. PMID:23320122

An Efficient Taguchi Approach for the Performance Optimization of Health, Safety, Environment and Ergonomics in Generation Companies.

PubMed

Azadeh, Ali; Sheikhalishahi, Mohammad

2015-06-01

A unique framework for performance optimization of generation companies (GENCOs) based on health, safety, environment, and ergonomics (HSEE) indicators is presented. To rank this sector of industry, the combination of data envelopment analysis (DEA), principal component analysis (PCA), and Taguchi are used for all branches of GENCOs. These methods are applied in an integrated manner to measure the performance of GENCO. The preferred model between DEA, PCA, and Taguchi is selected based on sensitivity analysis and maximum correlation between rankings. To achieve the stated objectives, noise is introduced into input data. The results show that Taguchi outperforms other methods. Moreover, a comprehensive experiment is carried out to identify the most influential factor for ranking GENCOs. The approach developed in this study could be used for continuous assessment and improvement of GENCO's performance in supplying energy with respect to HSEE factors. The results of such studies would help managers to have better understanding of weak and strong points in terms of HSEE factors.

Formulary Selection Criteria for Biosimilars: Considerations for US Health-System Pharmacists

PubMed Central

McBride, Ali; Stevenson, James G.; Green, Larry

2014-01-01

Abstract Pharmacists will play a key role in evaluating biosimilars for formulary inclusion in the United States. As defined by US law, a biosimilar is a biologic that is highly similar to its reference product, notwithstanding minor differences in clinically inactive components, and should not have clinically meaningful differences from its reference product in safety, purity, and potency. We review biosimilars and the current European Union and US regulatory pathways for biosimilars. Furthermore, we propose a checklist of considerations to ensure that US pharmacists thoroughly evaluate future biosimilars for formulary inclusion. Included in the checklist are considerations related to the availability of preapproval and postapproval safety and efficacy data; differences in product characteristics and immunogenicity between the biosimilar and reference product; manufacturer-related parameters that can affect a reliable supply of quality products; health-system and patient perspectives on product packaging, labeling, storage, and administration; costs and insurance coverage; patient education; interchangeability and differences in the range of indications; and evaluation of institutions’ information technology systems. PMID:25477613

Attitudes of Greek Drivers with Focus on Mobile Phone Use While Driving.

PubMed

Yannis, George; Theofilatos, Athanasios; Marinou, Paraskevi

2015-01-01

This article investigates the attitudes and behavior of Greek drivers with specific focus on mobile phone use while driving. The research is based on the data of the pan-European SARTRE 4 survey, which was conducted on a representative sample of Greek drivers in 2011. Analysis of the drivers' behavior was carried out by the statistical methods of factor and cluster analysis. According to the results of factor analysis, Greek drivers' responses in the selected questions were summarized into 4 factors, describing road behavior and accident involvement probability as well as their views on issues concerning other drivers' road behaviors, fatigued driving, enforcement of road safety, and mobile phone use while driving. The results of cluster analysis indicated 5 different groups of Greek drivers--the moderate, the optimistic, the conservative, the risky, and the reasonably cautious--and the characteristics of each group where identified. These results may be useful for the appropriate design of targeted road safety campaigns and other countermeasures.

Occupational Safety. Hand Tools. Pre-Apprenticeship Phase 1 Training.

ERIC Educational Resources Information Center

Lane Community Coll., Eugene, OR.

This self-paced student training module on safety when using hand tools is one of a number of modules developed for Pre-apprenticeship Phase 1 Training. Purpose of the module is to teach students the correct safety techniques for operating common hand- and arm-powered tools, including selection, maintenance, technique, and uses. The module may…

77 FR 16805 - Notice of Request for Extension and Revision of a Currently Approved Information Collection...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-22

... availability is limited. To facilitate the scheduling of the Food Safety Mobile's visits when it is available... regarding its electronic Food Safety Mobile questionnaire. FSIS is planning to increase the total annual... selected food safety news and information. This service is available at http://www.fsis.usda.gov/news_and...

Focus Group Studies on Food Safety Knowledge, Perceptions, and Practices of School-Going Adolescent Girls in South India

ERIC Educational Resources Information Center

Gavaravarapu, Subba Rao M.; Vemula, Sudershan R.; Rao, Pratima; Mendu, Vishnu Vardhana Rao; Polasa, Kalpagam

2009-01-01

Objective: To understand food safety knowledge, perceptions, and practices of adolescent girls. Design: Focus group discussions (FGDs) with 32 groups selected using stratified random sampling. Setting: Four South Indian states. Participants: Adolescent girls (10-19 years). Phenomena of Interest: Food safety knowledge, perceptions, and practices.…

Zone guide for pedestrian safety

DOT National Transportation Integrated Search

2008-12-01

Just as communities can efficiently mount crime prevention programs by focusing them in high-crime areas, they can also efficiently concentrate pedestrian safety improvements by carefully selecting where they are applied. To do this, they need to be ...

49 CFR 192.51 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY TRANSPORTATION OF NATURAL AND OTHER GAS BY PIPELINE... for the selection and qualification of pipe and components for use in pipelines. ...

Infection as a Background to Safety: Source Material for Teaching.

ERIC Educational Resources Information Center

Wyatt, H. V.

1986-01-01

Offers selections from papers which illustrate accidents, epidemics, and bad practices which could be used as background material for lessons on laboratory safety. Advocates the need for instruction on pathogenicity and infectivity. (ML)

Countermeasures that work : seventh edition : traffic tech.

DOT National Transportation Integrated Search

2013-04-01

The National Highway Traffic Safety Administration has published the seventh edition of Countermeasures That Work. The guide is a basic reference to assist State Highway Safety Offices (SHSOs) in selecting effective, evidence-based countermeasures fo...

44 CFR 150.7 - Selection process.

Code of Federal Regulations, 2012 CFR

2012-10-01

... HOMELAND SECURITY FIRE PREVENTION AND CONTROL PUBLIC SAFETY AWARDS TO PUBLIC SAFETY OFFICERS § 150.7... § 150.3 and the criteria prescribed in § 150.4(a)(2). In reviewing nominations, the Attorney General or...

44 CFR 150.7 - Selection process.

Code of Federal Regulations, 2013 CFR

2013-10-01

... HOMELAND SECURITY FIRE PREVENTION AND CONTROL PUBLIC SAFETY AWARDS TO PUBLIC SAFETY OFFICERS § 150.7... § 150.3 and the criteria prescribed in § 150.4(a)(2). In reviewing nominations, the Attorney General or...

Indicators of School Crime and Safety: 2005. NCES 2006-001

ERIC Educational Resources Information Center

DeVoe, Jill F.; Peter, Katharin; Noonan, Margaret; Snyder, Thomas D.; Baum, Katrina; Snyder, Thomas D.

2005-01-01

Indicators of School Crime and Safety: 2005 is the eighth in a series of annual reports produced by the National Center for Education Statistics (NCES) in the U.S. Department of Education and the Bureau of Justice Statistics (BJS) in the U.S. Department of Justice that present the most recent data available on school crime and student safety. The…

[Active surveillance of adverse drug reaction in the era of big data: challenge and opportunity for control selection].

PubMed

Wang, S F; Zhan, S Y

2016-07-01

Electronic healthcare databases have become an important source for active surveillance of drug safety in the era of big data. The traditional epidemiology research designs are needed to confirm the association between drug use and adverse events based on these datasets, and the selection of the comparative control is essential to each design. This article aims to explain the principle and application of each type of control selection, introduce the methods and parameters for method comparison, and describe the latest achievements in the batch processing of control selection, which would provide important methodological reference for the use of electronic healthcare databases to conduct post-marketing drug safety surveillance in China.

Sensor Selection and Optimization for Health Assessment of Aerospace Systems

NASA Technical Reports Server (NTRS)

Maul, William A.; Kopasakis, George; Santi, Louis M.; Sowers, Thomas S.; Chicatelli, Amy

2007-01-01

Aerospace systems are developed similarly to other large-scale systems through a series of reviews, where designs are modified as system requirements are refined. For space-based systems few are built and placed into service. These research vehicles have limited historical experience to draw from and formidable reliability and safety requirements, due to the remote and severe environment of space. Aeronautical systems have similar reliability and safety requirements, and while these systems may have historical information to access, commercial and military systems require longevity under a range of operational conditions and applied loads. Historically, the design of aerospace systems, particularly the selection of sensors, is based on the requirements for control and performance rather than on health assessment needs. Furthermore, the safety and reliability requirements are met through sensor suite augmentation in an ad hoc, heuristic manner, rather than any systematic approach. A review of the current sensor selection practice within and outside of the aerospace community was conducted and a sensor selection architecture is proposed that will provide a justifiable, dependable sensor suite to address system health assessment requirements.

Sensor Selection and Optimization for Health Assessment of Aerospace Systems

NASA Technical Reports Server (NTRS)

Maul, William A.; Kopasakis, George; Santi, Louis M.; Sowers, Thomas S.; Chicatelli, Amy

2008-01-01

Aerospace systems are developed similarly to other large-scale systems through a series of reviews, where designs are modified as system requirements are refined. For space-based systems few are built and placed into service these research vehicles have limited historical experience to draw from and formidable reliability and safety requirements, due to the remote and severe environment of space. Aeronautical systems have similar reliability and safety requirements, and while these systems may have historical information to access, commercial and military systems require longevity under a range of operational conditions and applied loads. Historically, the design of aerospace systems, particularly the selection of sensors, is based on the requirements for control and performance rather than on health assessment needs. Furthermore, the safety and reliability requirements are met through sensor suite augmentation in an ad hoc, heuristic manner, rather than any systematic approach. A review of the current sensor selection practice within and outside of the aerospace community was conducted and a sensor selection architecture is proposed that will provide a justifiable, defendable sensor suite to address system health assessment requirements.

Isolation, characterization, and evaluation of wild isolates of Lactobacillus reuteri from pig feces.

PubMed

Lee, Deog Yong; Seo, Yeon-Soo; Rayamajhi, Nabin; Kang, Mi Lan; Lee, Su In; Yoo, Han Sang

2009-12-01

Lactic acid bacteria (LAB) are a well-used probiotics for health improvements in both humans and animals. Despite of several benefits, non-host-specific LAB showed poor probiotics effects due to difficulty in colonization and competition with normal flora. Therefore, the feasibility of porcine LAB isolates was evaluated as a probiotics. Ten of 49 Lactobacillus spp. isolates harbored 2 approximately 10 kb plasmid DNA. Seven strains were selected based on the safety test, such as hemolytic activity, ammonia, indole, and phenylalanine production. After safety test, five strains were selected again by several tests, such as epithelial adherence, antimicrobial activity, tolerance against acid, bile, heat, and cold-drying, and production of acid and hydrogen peroxide. Then, enzyme profiles (ZYM test) and antibiotics resistance were analyzed for further characterization. Five Lactobacillus reuteri isolates from pig feces were selected by safety and functional tests. The plasmid DNA which was able to develop vector system was detected in the isolates. Together with these approaches, pig-specific Lactobacillus spp. originated from pigs were selected. These strains may be useful tools to develop oral delivery system.

Assessment of tissue allograft safety monitoring with administrative healthcare databases: a pilot project using Medicare data.

PubMed

Dhakal, Sanjaya; Burwen, Dale R; Polakowski, Laura L; Zinderman, Craig E; Wise, Robert P

2014-03-01

Assess whether Medicare data are useful for monitoring tissue allograft safety and utilization. We used health care claims (billing) data from 2007 for 35 million fee-for-service Medicare beneficiaries, a predominantly elderly population. Using search terms for transplant-related procedures, we generated lists of ICD-9-CM and CPT(®) codes and assessed the frequency of selected allograft procedures. Step 1 used inpatient data and ICD-9-CM procedure codes. Step 2 added non-institutional provider (e.g., physician) claims, outpatient institutional claims, and CPT codes. We assembled preliminary lists of diagnosis codes for infections after selected allograft procedures. Many ICD-9-CM codes were ambiguous as to whether the procedure involved an allograft. Among 1.3 million persons with a procedure ascertained using the list of ICD-9-CM codes, only 1,886 claims clearly involved an allograft. CPT codes enabled better ascertainment of some allograft procedures (over 17,000 persons had corneal transplants and over 2,700 had allograft skin transplants). For spinal fusion procedures, CPT codes improved specificity for allografts; of nearly 100,000 patients with ICD-9-CM codes for spinal fusions, more than 34,000 had CPT codes indicating allograft use. Monitoring infrequent events (infections) after infrequent exposures (tissue allografts) requires large study populations. A strength of the large Medicare databases is the substantial number of certain allograft procedures. Limitations include lack of clinical detail and donor information. Medicare data can potentially augment passive reporting systems and may be useful for monitoring tissue allograft safety and utilization where codes clearly identify allograft use and coding algorithms can effectively screen for infections.

Pharmacokinetics and safety of the selective progesterone receptor modulator vilaprisan in healthy postmenopausal women
.

PubMed

Schultze-Mosgau, Marcus-Hillert; Schuett, Barbara; Hafner, Frank-Thorsten; Zollmann, Frank; Kaiser, Andreas; Hoechel, Joachim; Rohde, Beate

2017-01-01

Vilaprisan is a novel, potent, and highly selective progesterone receptor modulator, which might offer a promising option for the treatment of uterine fibroids. In this randomized, placebo-controlled, parallel-group phase 1 study, the pharmacokinetics and safety of vilaprisan were investigated in healthy postmenopausal women. Subjects received a single oral dose of vilaprisan (1, 5, 15, or 30 mg) or placebo and - after a wash-out period - daily doses of the same strength over 28 days. Safety assessments included vital signs, ECGs, clinical laboratory tests, and adverse events. Blood samples for pharmacokinetic (PK) profiles were collected over 14 days after single dose (sd) and multiple dose (md; day 28). Vilaprisan was well tolerated. Mild to moderate adverse events occurred with similar frequency at all dose levels. Following single dose, maximum vilaprisan concentrations were observed 1 - 2 hours post-dose. Terminal half-lives ranged from 31 to 38 hours. Maximum concentrations of vilaprisan (Cmax) and exposure to vilaprisan (AUC) increased roughly dose-proportionally from 3.74 µg/L (1 mg) to 68.6 µg/L (30 mg) and 58.5 µg×h/L to 1,590 µg×h/L, respectively. With daily dosing, accumulation consistent with the long terminal half-life was observed (AUC(0-24)md/AUC(0-24)sd ratios: 1.9 to 3.2). The ratio AUC(0-24)md/AUCsd increased with dose from ~ 1 (1 mg) to 1.5 (30 mg). Exposure to vilaprisan increased roughly dose-proportionally in the dose range studied and accumulated after multiple dosing as expected based on t1/2, indicating linear pharmacokinetics of vilaprisan in the expected therapeutic dose range.
.

International expert consensus statement: Percutaneous transluminal renal denervation for the treatment of resistant hypertension.

PubMed

Schlaich, Markus P; Schmieder, Roland E; Bakris, George; Blankestijn, Peter J; Böhm, Michael; Campese, Vito M; Francis, Darrel P; Grassi, Guido; Hering, Dagmara; Katholi, Richard; Kjeldsen, Sverre; Krum, Henry; Mahfoud, Felix; Mancia, Giuseppe; Messerli, Franz H; Narkiewicz, Krzysztof; Parati, Gianfranco; Rocha-Singh, Krishna J; Ruilope, Luis M; Rump, Lars C; Sica, Domenic A; Sobotka, Paul A; Tsioufis, Costas; Vonend, Oliver; Weber, Michael A; Williams, Bryan; Zeller, Thomas; Esler, Murray D

2013-12-03

Catheter-based radiofrequency ablation technology to disrupt both efferent and afferent renal nerves has recently been introduced to clinical medicine after the demonstration of significant systolic and diastolic blood pressure reductions. Clinical trial data available thus far have been obtained primarily in patients with resistant hypertension, defined as standardized systolic clinic blood pressure ≥ 160 mm Hg (or ≥ 150 mm Hg in patients with type 2 diabetes) despite appropriate pharmacologic treatment with at least 3 antihypertensive drugs, including a diuretic agent. Accordingly, these criteria and blood pressure thresholds should be borne in mind when selecting patients for renal nerve ablation. Secondary forms of hypertension and pseudoresistance, such as nonadherence to medication, intolerance of medication, and white coat hypertension, should have been ruled out, and 24-h ambulatory blood pressure monitoring is mandatory in this context. Because there are theoretical concerns with regard to renal safety, selected patients should have preserved renal function, with an estimated glomerular filtration rate ≥ 45 ml/min/1.73 m(2). Optimal periprocedural management of volume status and medication regimens at specialized and experienced centers equipped with adequate infrastructure to cope with potential procedural complications will minimize potential patient risks. Long-term safety and efficacy data are limited to 3 years of follow-up in small patient cohorts, so efforts to monitor treated patients are crucial to define the long-term performance of the procedure. Although renal nerve ablation could have beneficial effects in other conditions characterized by elevated renal sympathetic nerve activity, its potential use for such indications should currently be limited to formal research studies of its safety and efficacy. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

An Excel-Based System to Manage Radiation Safety for the Family of Patients Undergoing 131I Therapy.

PubMed

Steward, Palmer G

2017-06-01

The purpose of this study was to develop spreadsheet workbooks that assist in the radiation safety counseling of 131 I therapy patients and their families, providing individualized guidelines that avoid imposing overly conservative restrictions on family members and others. Methods: The mathematic model included biphasic patient radionuclide retention. The extrathyroidal component was a cylindric volume with a diameter corresponding to the patient's size and included patient self-absorption, whereas the thyroidal component was a point source whose transmission was reduced by self-absorption. A separate model in which the thyroid, extrathyroid, and bladder compartments fed serially from one to the next was developed to depict the radionuclide levels within the patient and to estimate the activity entering the environment at each urination. Results: The system was organized into a set of 4 workbooks: the first to be used with ablation patients prepared using thyrogen, the second with ablation patients prepared by deprivation, the third with hyperthyroid patients, and the fourth with the unusual hyperthyroid patient who finds the restrictions to be oppressive and returns 5-10 d after administration for a measurement and reassessment. The workbooks evaluated the radiation field strength external to the patient and indicated restrictions based on selected dose limits. To assist physicians in suggesting contamination precautions, the workbooks also evaluated the radioactivity present within the patient and the estimated discharge into the environment as a function of time. Conclusion: The workbooks that were developed assist the radiation safety counselor in individualizing radiation protection procedures for the family of patients undergoing 131 I therapy. The workbook system avoids overly conservative assumptions while permitting selection of appropriate dose limits for each individual. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

A Monte-Carlo simulation analysis for evaluating the severity distribution functions (SDFs) calibration methodology and determining the minimum sample-size requirements.

PubMed

Shirazi, Mohammadali; Reddy Geedipally, Srinivas; Lord, Dominique

2017-01-01

Severity distribution functions (SDFs) are used in highway safety to estimate the severity of crashes and conduct different types of safety evaluations and analyses. Developing a new SDF is a difficult task and demands significant time and resources. To simplify the process, the Highway Safety Manual (HSM) has started to document SDF models for different types of facilities. As such, SDF models have recently been introduced for freeway and ramps in HSM addendum. However, since these functions or models are fitted and validated using data from a few selected number of states, they are required to be calibrated to the local conditions when applied to a new jurisdiction. The HSM provides a methodology to calibrate the models through a scalar calibration factor. However, the proposed methodology to calibrate SDFs was never validated through research. Furthermore, there are no concrete guidelines to select a reliable sample size. Using extensive simulation, this paper documents an analysis that examined the bias between the 'true' and 'estimated' calibration factors. It was indicated that as the value of the true calibration factor deviates further away from '1', more bias is observed between the 'true' and 'estimated' calibration factors. In addition, simulation studies were performed to determine the calibration sample size for various conditions. It was found that, as the average of the coefficient of variation (CV) of the 'KAB' and 'C' crashes increases, the analyst needs to collect a larger sample size to calibrate SDF models. Taking this observation into account, sample-size guidelines are proposed based on the average CV of crash severities that are used for the calibration process. Copyright © 2016 Elsevier Ltd. All rights reserved.

Efficacy and safety of topical diquafosol ophthalmic solution for treatment of dry eye: a systematic review of randomized clinical trials.

PubMed

Wu, Di; Chen, Wang Qi; Li, Ryan; Wang, Yan

2015-06-01

To evaluate the efficacy and safety of topical diquafosol ophthalmic solution for treatment of dry eye. Randomized clinical trials (RCTs) from MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) were identified to evaluate the efficacy and safety of topical administration of diquafosol to patients with dry eyes. Data evaluation was based on endpoints including Schirmer test, tear film break-up time, ocular surface staining score, subjective symptom score, and adverse events. A total of 8 RCTs involving 1516 patients were selected based on the prespecified criteria. Significant improvement of Schirmer test values and tear film break-up time were reported in 40% (2 of 5) and 80% (4 of 5) studies, respectively. Ocular surface staining scores significantly decreased in 100% (fluorescein corneal staining, 6 of 6; Rose Bengal corneal and conjunctival staining, 4 of 4) RCTs. Symptoms significantly improved in 75% (6 of 8) RCTs in patients with dry eyes. No severe adverse events were reported with the concentration of diquafosol from 0.5% to 5%. Heterogeneity in study design prevented meta-analysis from statistical integration and summarization. Topical diquafosol seems to be a safe therapeutic option for the treatment of dry eye. The high variability of the selected RCTs compromised the strength of evidence and limits the determination of efficacy. However, the topical administration of diquafosol seems to be beneficial in improving the integrity of the epithelial cell layer of the ocular surface and mucin secretion in patients with dry eyes. This review indicates a need for standardized criteria and methods for evaluation to assess the efficacy of diquafosol in the future clinical trials.

Exploration of impact measures of safety belt use laws. Volume 2, Literature reviewed, expert team comments on indicators, and indicator catalog

DOT National Transportation Integrated Search

1990-02-01

This project identified, evaluated, and recommended indicators of safety belt use law (SBUL) impact (other than fatality reduction and observed belt usage) as well as institutional sources that collect them. The project involved an extensive literatu...

Clinical pharmacology review of safinamide for the treatment of Parkinson's disease.

PubMed

Fabbri, Margherita; Rosa, Mario M; Abreu, Daisy; Ferreira, Joaquim J

2015-12-01

Safinamide (Xadago™) is an oral α-aminoamide derivative marketed for the treatment of Parkinson's disease (PD). The drug has both dopaminergic properties, namely highly selective and reversible inhibition of monoamine oxidase B, and nondopamimetic properties, namely selective sodium channel blockade and calcium channel modulation, with consequent inhibition of excessive glutamate release. In 2014, safinamide was approved in the European Economic Area, as "an add-on therapy to stable dose levodopa, alone or in combination with other PD therapies in mid- to late-stage-fluctuating PD patients." In addition, evidence has been provided for safinamide in the treatment of motor symptoms in early PD patients. This article summarizes the pharmacological properties, development program, clinical indications for PD treatment, stratified according to several disease's stages and the safety profile of safinamide. A meta-analysis of the most frequent adverse events among Phase III trials has been also performed.

Underground coal miners' foot and boot problems.

PubMed

Wood, G; Marr, S; Berry, G; Nubé, V; Cole, J

1999-11-01

The New South Wales (NSW) Joint Coal Board Health and Safety Trust funded an investigation into foot problems reported by 400 randomly selected underground coal miners from 15 mines in NSW. Miners were interviewed and their responses were entered directly into laptop computers. Digital cameras were also used to take pictures of skin conditions and miners' posture. Observations of the skin results indicate that miners find gumboots to be hot, sweaty and uncomfortable. Skin breakdown and tinea, is frequent and disabling and responsible for absences from the workforce that are costly for both miner and employer. A more comfortable and better designed boot is needed, fabricated in waterproof leather together with socks that 'wick' the moisture away from the foot. Socks worn were of varying components and washed at irregular intervals, indicating a need for regular changes of socks and improved hygiene.

[Practical and theoretical aspects of cost-benefit relations in viscerosynthesis].

PubMed

Fuchs, K H; Heimbucher, J; Geiger, D; Thiede, A

1997-01-01

The necessity of limiting health care costs requires adequate service recording and quality control even in visceral surgery. In this field, the safety of the anastomoses is of greatest importance. Anastomoses at risk are esophageal connections to jejunum or colon and deep rectal anastomoses. At these locations expensive suture devices, such as stapling instruments, can be used in a cost saving aspect, if they help to increase anastomotic safety, time saving and expansion of surgical indication. Manual sutures thus represent the cheapest anastomotic technique as continuous sutures would cost between DM 10.- to 20.- and single stitch sutures between DM 60.- and 100.-. A surgical school should prevalently aim at training manual anastomoses, while special anastomotic techniques should only complete the skill for selected indications. The overall staff expenditure for extended operations amounts around DM 600.- per hour respectively DM 10.- per minute. Time for surgery might be shortened by auxiliary tools as much as to perform an additional operation. However, a circular stapler anastomosis that costs between DM 650.- to 850.- is twice as expensive as manual sutures notwithstanding the double time needed. In the past years, the necessity for a rational use of different anastomotic techniques has shown to be mandatory since, increasingly, financial aspects of health economy require cost benefit calculations in visceral surgery.

Patient safety culture and associated factors: A quantitative and qualitative study of healthcare workers' view in Jimma zone Hospitals, Southwest Ethiopia.

PubMed

Wami, Sintayehu Daba; Demssie, Amsalu Feleke; Wassie, Molla Mesele; Ahmed, Ansha Nega

2016-09-20

Patient safety culture is an important aspect for quality healthcare delivery and is an issue of high concern globally. In Ethiopia health system little is known and information is limited in scope about patient safety culture. Therefore, the aim of this study was to assess the level of patient safety culture and associated factors in Jimma zone Hospitals, southwest Ethiopia. Facility based cross sectional quantitative study triangulated with qualitative approaches was employed from March to April 30/2015. Stratified sampling technique was used to select 637 study participants among 4 hospitals. The standardized tool which measures 12 patient safety culture composites was used for data collection. Bivariate and multivariate linear regression analyses were performed using SPSS version 20. Significance level was obtained at 95 % CI and p-value < 0.05. Semi structured guide in depth interview was used to collect the qualitative data. Content analysis of the interview was performed. The overall level of patient safety culture was 46.7 % (95 % CI: 43.0, 51.2). Hours worked per week (β =-0.06, 95 % CI:-0.12,-0.001), reporting adverse event (β = 3.34, 95 % CI: 2.12, 4.57), good communication (β = 2.78, 95 % CI: 2.29, 3.28), teamwork within hospital (β = 1.91, 95 % CI: 1.37, 2.46), level of staffing (β = 1.32, 95 % CI: 0.89, 1.75), exchange of feedback about error (β = 1.37, 95 % CI: 0.91, 1.83) and participation in patient safety program (β = 1.3, 95 % CI: 0.57, 2.03) were factors significantly associated with the patient safety culture. The in depth interview indicated incident reporting, resources, healthcare worker attitude and patient involvement as important factors that influence patient safety culture. The overall level of patient safety culture was low. Working hours, level of staffing, teamwork, communications openness, reporting an event and exchange of feedback about error were associated with patient safety culture. Therefore, interventions of systemic approach through facilitating opportunities for communication openness, cooperation and exchange of ideas between healthcare workers are needed to improve the level of patient safety culture.

Cross-validation of an employee safety climate model in Malaysia.

PubMed

Bahari, Siti Fatimah; Clarke, Sharon

2013-06-01

Whilst substantial research has investigated the nature of safety climate, and its importance as a leading indicator of organisational safety, much of this research has been conducted with Western industrial samples. The current study focuses on the cross-validation of a safety climate model in the non-Western industrial context of Malaysian manufacturing. The first-order factorial validity of Cheyne et al.'s (1998) [Cheyne, A., Cox, S., Oliver, A., Tomas, J.M., 1998. Modelling safety climate in the prediction of levels of safety activity. Work and Stress, 12(3), 255-271] model was tested, using confirmatory factor analysis, in a Malaysian sample. Results showed that the model fit indices were below accepted levels, indicating that the original Cheyne et al. (1998) safety climate model was not supported. An alternative three-factor model was developed using exploratory factor analysis. Although these findings are not consistent with previously reported cross-validation studies, we argue that previous studies have focused on validation across Western samples, and that the current study demonstrates the need to take account of cultural factors in the development of safety climate models intended for use in non-Western contexts. The results have important implications for the transferability of existing safety climate models across cultures (for example, in global organisations) and highlight the need for future research to examine cross-cultural issues in relation to safety climate. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

Antifungal Therapy in Birds: Old Drugs in a New Jacket.

PubMed

Antonissen, Gunther; Martel, An

2018-05-01

The use of antifungals in birds is characterized by interspecies and interindividual variability in the pharmacokinetics, affecting drug safety and efficacy. Oral antifungal drug absorption is a complex process affected by drug formulation characteristics, gastrointestinal anatomy, and physiology. New antifungal drug delivery systems can enhance drug stability, reduce off-target side effects, prolong residence time in the blood, and improve efficacy. Topical administration of antifungals through nebulization shows promising results. However, therapeutic output is highly influenced by drug formulation and type of nebulizer, indicating these factors should be taken into account when selecting this medication route. Copyright © 2018 Elsevier Inc. All rights reserved.

Deriving and Validating a Road Safety Performance Indicator for Vehicle Fleet Passive Safety

PubMed Central

Page, Marianne; Rackliff, Lucy

2006-01-01

Road safety performance indicators (RSPI) are policy tools which describe the extent of insecure operational safety conditions within traffic systems. This study describes the production of an RSPI which represents the presence within a country’s vehicle fleet, of vehicles that may not effectively protect an occupant in a collision. This work is highly original, as it uses the entire vehicle database of European Union Member States in order to estimate the average level of passive safety offered by the entire fleet in each country. The EuroNCAP safety ratings and vehicle age of each vehicle in each fleet have been obtained to calculate the RSPI. The methodology used could be adopted as an international standard. PMID:16968645

The determinants of employee participation in occupational health and safety management.

PubMed

Masso, Märt

2015-01-01

This article focuses on employee direct participation in occupational health and safety (OHS) management. The article explains what determines employee opportunities to participate in OHS management. The explanatory framework focuses on safety culture and safety management at workplaces. The framework is empirically tested using Estonian cross-sectional, multilevel data of organizations and their employees. The analysis indicates that differences in employee participation in OHS management in the Estonian case could be explained by differences in OHS management practices rather than differences in safety culture. This indicates that throughout the institutional change and shift to the European model of employment relations system, change in management practices has preceded changes in safety culture which according to theoretical argument is supposed to follow culture change.

Modern traffic control devices to improve safety at rural intersections.

DOT National Transportation Integrated Search

2011-12-01

"Engineers with the Texas Department of Transportation (TxDOT) frequently make changes to traffic control devices : (TCDs) to improve intersection safety. To use available funds judiciously, engineers make incremental changes in : order to select the...

Terrain Safety Assessment in Support of the Mars Science Laboratory Mission

NASA Technical Reports Server (NTRS)

Kipp, Devin

2012-01-01

In August 2012, the Mars Science Laboratory (MSL) mission will pioneer the next generation of robotic Entry, Descent, and Landing (EDL) systems by delivering the largest and most capable rover to date to the surface of Mars. The process to select the MSL landing site took over five years and began with over 50 initial candidate sites from which four finalist sites were chosen. The four finalist sites were examined in detail to assess overall science merit, EDL safety, and rover traversability on the surface. Ultimately, the engineering assessments demonstrated a high level of safety and robustness at all four finalist sites and differences in the assessment across those sites were small enough that neither EDL safety nor rover traversability considerations could significantly discriminate among the final four sites. Thus the MSL landing site at Gale Crater was selected from among the four finalists primarily on the basis of science considerations.

Molecular diagnosis and immunotherapy.

PubMed

Sastre, Joaquín; Sastre-Ibañez, Marina

2016-12-01

To describe recent insights into how molecular diagnosis can improve indication and selection of suitable allergens for specific immunotherapy and increase the safety of this therapy. As specific allergen immunotherapy targets specific allergens, identification of the disease-eliciting allergen is a prerequisite for accurate prescription of treatment. In areas of complex sensitization to aeroallergens or in cases of hymenoptera venom allergy, the use of molecular diagnosis has demonstrated that it may lead to a change in indication and selection of allergens for immunotherapy in a large proportion of patients when compared with diagnosis based on skin prick testing and/or specific IgE determination with commercial extracts. These changes in immunotherapy prescription aided by molecular diagnosis have been demonstrated to be cost-effective in some scenarios. Certain patterns of sensitization to grass or olive pollen and bee allergens may identify patients with higher risk of adverse reaction during immunotherapy. Molecular diagnosis, when used with other tools and patients' clinical records, can help clinicians better to select the most appropriate patients and allergens for specific immunotherapy and, in some cases, predict the risk of adverse reactions. The pattern of sensitization to allergens could potentially predict the efficacy of allergen immunotherapy provided that these immunotherapy products contain a sufficient amount of these allergens. Nevertheless, multiplex assay remains a third-level approach, not to be used as screening method in current practice.

Health system frameworks and performance indicators in eight countries: A comparative international analysis

PubMed Central

Braithwaite, Jeffrey; Hibbert, Peter; Blakely, Brette; Plumb, Jennifer; Hannaford, Natalie; Long, Janet Cameron; Marks, Danielle

2017-01-01

Objectives: Performance indicators are a popular mechanism for measuring the quality of healthcare to facilitate both quality improvement and systems management. Few studies make comparative assessments of different countries’ performance indicator frameworks. This study identifies and compares frameworks and performance indicators used in selected Organisation for Economic Co-operation and Development health systems to measure and report on the performance of healthcare organisations and local health systems. Countries involved are Australia, Canada, Denmark, England, the Netherlands, New Zealand, Scotland and the United States. Methods: Identification of comparable international indicators and analyses of their characteristics and of their broader national frameworks and contexts were undertaken. Two dimensions of indicators – that they are nationally consistent (used across the country rather than just regionally) and locally relevant (measured and reported publicly at a local level, for example, a health service) – were deemed important. Results: The most commonly used domains in performance frameworks were safety, effectiveness and access. The search found 401 indicators that fulfilled the ‘nationally consistent and locally relevant’ criteria. Of these, 45 indicators are reported in more than one country. Cardiovascular, surgery and mental health were the most frequently reported disease groups. Conclusion: These comparative data inform researchers and policymakers internationally when designing health performance frameworks and indicator sets. PMID:28228948

30 CFR 56.4402 - Safety can use.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Safety can use. 56.4402 Section 56.4402 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... drawn from storage shall be kept in safety cans labeled to indicate the contents. ...

30 CFR 57.4402 - Safety can use.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Safety can use. 57.4402 Section 57.4402 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... drawn from storage shall be kept in safety cans labeled to indicate the contents. ...

Survey of Cancer Patient Safety Culture: A Comparison of Chemotherapy and Oncology Departments of Teaching Hospitals of Tehran

PubMed Central

Raeissi, Pouran; Sharifi, Marziye; Khosravizadeh, Omid; Heidari, Mohammad

2017-01-01

Background: Patient safety culture plays an important role in healthcare systems, especially in chemotherapy and oncology departments (CODs), and its assessment can help to improve quality of services and hospital care. Objective: This study aimed to evaluate and compare items and dimensions of patient safety culture in the CODs of selected teaching hospitals of Iran and Tehran University of Medical Sciences. Materials and Methods: This descriptive-analytical cross-sectional survey was conducted during a six-month period on 270 people from chemotherapy and oncology departments selected through a cluster sampling method. All participants answered the standard questionnaire for “Hospital Survey of Patient Safety Culture” (HSOPSC). Statistical analyses were performed using SPSS/18 software. Results: The average score for patient safety culture was three for the majority of the studied CODs. Statistically significant differences were observed for supervisor actions, teamwork within various units, feedback and communications about errors, and the level of hospital management support. (p<0.05). Relationships between studied hospitals and patient safety culture were not statistically significant (p>0.05). Conclusion: Our results showed that the overall status of patient safety culture is not good in the studied CODs. In particular, teamwork across different units and organizational learning with continuous improvement were the only two properly operating items among 12 dimensions of patient safety culture. Therefore, systematic interventions are strongly required to promote communication. PMID:29072411

A novel safety assessment strategy applied to non-selective extracts.

PubMed

Koster, Sander; Leeman, Winfried; Verheij, Elwin; Dutman, Ellen; van Stee, Leo; Nielsen, Lene Munch; Ronsmans, Stefan; Noteborn, Hub; Krul, Lisette

2015-06-01

A main challenge in food safety research is to demonstrate that processing of foodstuffs does not lead to the formation of substances for which the safety upon consumption might be questioned. This is especially so since food is a complex matrix in which the analytical detection of substances, and consequent risk assessment thereof, is difficult to determine. Here, a pragmatic novel safety assessment strategy is applied to the production of non-selective extracts (NSEs), used for different purposes in food such as for colouring purposes, which are complex food mixtures prepared from reference juices. The Complex Mixture Safety Assessment Strategy (CoMSAS) is an exposure driven approach enabling to efficiently assess the safety of the NSE by focussing on newly formed substances or substances that may increase in exposure during the processing of the NSE. CoMSAS enables to distinguish toxicologically relevant from toxicologically less relevant substances, when related to their respective levels of exposure. This will reduce the amount of work needed for identification, characterisation and safety assessment of unknown substances detected at low concentration, without the need for toxicity testing using animal studies. In this paper, the CoMSAS approach has been applied for elderberry and pumpkin NSEs used for food colouring purposes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Awareness and implementation of nine World Health Organization's patient safety solutions among three groups of healthcare workers in Oman.

PubMed

Al-Mandhari, Ahmed; Al-Zakwani, Ibrahim; Al-Adawi, Samir; Al-Barwani, Samra; Jeyaseelan, Lakshmanan

2016-09-30

The pressing need to reduce burgeoning poor safety measures affecting millions worldwide has alerted World Health Assembly to set-up mechanisms to increase patient safety. In response to such needs, World Health Organization (WHO) formulated nine life-saving patient safety solutions that would be essential to lower reduce healthcare-related harm. There is a paucity of research examining awareness of such nine patient safety solutions. This study has been designed and conducted to compare self-estimated awareness and practice of the World Health Organization's nine "Life-saving Patient Safety Solutions" aide memoirs among different groups of healthcare workers in Oman. All nationwide healthcare workers (nurses, physicians and allied health professionals) in hospitals and primary healthcare under the auspice of Ministry of Health were the target population of this survey. Participants were selected by a simple, systematic random sampling from the list of staff in each representative institution. The study was conducted from November 2012 to February 2013. A total of 800 participants (590 from health centers and 210 from hospitals) were invited to participate in this study. A total number of 763 healthcare professionals consented to participate. The overall response rate was 95 % with the majority being nurses, female staff and who had an average of more than 4 years of experience. Overall, 85 % of the participants self-estimated awareness of the nine life-saving patient safety solutions showed the nurses being the most aware, followed by physicians with the allied health professionals showing suboptimal awareness. The primary healthcare center staff demonstrated higher awareness compared to hospital staff. There was a complex relationship between health professional's age, place of work and awareness and practice. This study lays the foundation for international comparisons of self-estimated awareness and practice towards nine patient safety solutions. The data from Oman indicates the need for more attention to be directed towards heightening awareness and practice of the nine patient safety solutions.

Updating of Safety Criteria for Basic Diagnostic Indicators of Dam at the Sayano-Shushenskaya HPP

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

Gordon, L. A.; Skvortsova, A. E.

2013-09-15

Values of diagnostic indicators [K]-limitations placed on radial displacements and turn angles of horizontal sections of the dam - which are permitted for each upper-pool level within the range from 520 to 539 m are determined and proposed for inclusion in the Declaration of Safety. Empirical relationships used to develop safety criteria K1 and K2 are modified.

Granite disposal of U.S. high-level radioactive waste.

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

Freeze, Geoffrey A.; Mariner, Paul E.; Lee, Joon H.

This report evaluates the feasibility of disposing U.S. high-level radioactive waste in granite several hundred meters below the surface of the earth. The U.S. has many granite formations with positive attributes for permanent disposal. Similar crystalline formations have been extensively studied by international programs, two of which, in Sweden and Finland, are the host rocks of submitted or imminent repository license applications. This report is enabled by the advanced work of the international community to establish functional and operational requirements for disposal of a range of waste forms in granite media. In this report we develop scoping performance analyses, basedmore » on the applicable features, events, and processes (FEPs) identified by international investigators, to support generic conclusions regarding post-closure safety. Unlike the safety analyses for disposal in salt, shale/clay, or deep boreholes, the safety analysis for a mined granite repository depends largely on waste package preservation. In crystalline rock, waste packages are preserved by the high mechanical stability of the excavations, the diffusive barrier of the buffer, and favorable chemical conditions. The buffer is preserved by low groundwater fluxes, favorable chemical conditions, backfill, and the rigid confines of the host rock. An added advantage of a mined granite repository is that waste packages would be fairly easy to retrieve, should retrievability be an important objective. The results of the safety analyses performed in this study are consistent with the results of comprehensive safety assessments performed for sites in Sweden, Finland, and Canada. They indicate that a granite repository would satisfy established safety criteria and suggest that a small number of FEPs would largely control the release and transport of radionuclides. In the event the U.S. decides to pursue a potential repository in granite, a detailed evaluation of these FEPs would be needed to inform site selection and safety assessment.« less

Quantitative evolutionary design

PubMed Central

Diamond, Jared

2002-01-01

The field of quantitative evolutionary design uses evolutionary reasoning (in terms of natural selection and ultimate causation) to understand the magnitudes of biological reserve capacities, i.e. excesses of capacities over natural loads. Ratios of capacities to loads, defined as safety factors, fall in the range 1.2-10 for most engineered and biological components, even though engineered safety factors are specified intentionally by humans while biological safety factors arise through natural selection. Familiar examples of engineered safety factors include those of buildings, bridges and elevators (lifts), while biological examples include factors of bones and other structural elements, of enzymes and transporters, and of organ metabolic performances. Safety factors serve to minimize the overlap zone (resulting in performance failure) between the low tail of capacity distributions and the high tail of load distributions. Safety factors increase with coefficients of variation of load and capacity, with capacity deterioration with time, and with cost of failure, and decrease with costs of initial construction, maintenance, operation, and opportunity. Adaptive regulation of many biological systems involves capacity increases with increasing load; several quantitative examples suggest sublinear increases, such that safety factors decrease towards 1.0. Unsolved questions include safety factors of series systems, parallel or branched pathways, elements with multiple functions, enzyme reaction chains, and equilibrium enzymes. The modest sizes of safety factors imply the existence of costs that penalize excess capacities. Those costs are likely to involve wasted energy or space for large or expensive components, but opportunity costs of wasted space at the molecular level for minor components. PMID:12122135

Can machine learning complement traditional medical device surveillance? A case study of dual-chamber implantable cardioverter–defibrillators

PubMed Central

Ross, Joseph S; Bates, Jonathan; Parzynski, Craig S; Akar, Joseph G; Curtis, Jeptha P; Desai, Nihar R; Freeman, James V; Gamble, Ginger M; Kuntz, Richard; Li, Shu-Xia; Marinac-Dabic, Danica; Masoudi, Frederick A; Normand, Sharon-Lise T; Ranasinghe, Isuru; Shaw, Richard E; Krumholz, Harlan M

2017-01-01

Background Machine learning methods may complement traditional analytic methods for medical device surveillance. Methods and results Using data from the National Cardiovascular Data Registry for implantable cardioverter–defibrillators (ICDs) linked to Medicare administrative claims for longitudinal follow-up, we applied three statistical approaches to safety-signal detection for commonly used dual-chamber ICDs that used two propensity score (PS) models: one specified by subject-matter experts (PS-SME), and the other one by machine learning-based selection (PS-ML). The first approach used PS-SME and cumulative incidence (time-to-event), the second approach used PS-SME and cumulative risk (Data Extraction and Longitudinal Trend Analysis [DELTA]), and the third approach used PS-ML and cumulative risk (embedded feature selection). Safety-signal surveillance was conducted for eleven dual-chamber ICD models implanted at least 2,000 times over 3 years. Between 2006 and 2010, there were 71,948 Medicare fee-for-service beneficiaries who received dual-chamber ICDs. Cumulative device-specific unadjusted 3-year event rates varied for three surveyed safety signals: death from any cause, 12.8%–20.9%; nonfatal ICD-related adverse events, 19.3%–26.3%; and death from any cause or nonfatal ICD-related adverse event, 27.1%–37.6%. Agreement among safety signals detected/not detected between the time-to-event and DELTA approaches was 90.9% (360 of 396, k=0.068), between the time-to-event and embedded feature-selection approaches was 91.7% (363 of 396, k=−0.028), and between the DELTA and embedded feature selection approaches was 88.1% (349 of 396, k=−0.042). Conclusion Three statistical approaches, including one machine learning method, identified important safety signals, but without exact agreement. Ensemble methods may be needed to detect all safety signals for further evaluation during medical device surveillance. PMID:28860874

Determining an appropriate integrated assessment model of tourism safety risk within the Changbai Mountain Scenic Area

NASA Astrophysics Data System (ADS)

Zhou, Lijun; Liu, Jisheng

2017-03-01

Tourism safety is gradually gaining more attention due to the rapid development of the tourism industry in China. Changbai Mountain is one of the most famous mountainous scenic areas in Northeast Asia. Assessment on Changbai Mountain scenic area’s tourism safety risk could do a favor in detecting influence factor of tourism safety risk and classifying tourism safety risk rank, thereby reducing and preventing associated tourism safety risks. This paper uses the Changbai Mountain scenic area as the study subject. By the means of experts scoring and analytic hierarchy process on quantified relevant evaluation indicator, the grid GIS method is used to vectorize the relevant data within a 1000m grid. It respectively analyzes main indicators associated tourism safety risk in Changbai Mountain scenic area, including hazard, exposure, vulnerability and ability to prevent and mitigate disasters. The integrated tourism safety risk model is used to comprehensively evaluate tourism safety risk in Changbai Mountain scenic area.

Self-Reported Changes in Food Safety Behaviors among Foodservice Employees: Impact of a Retail Food Safety Education Program

ERIC Educational Resources Information Center

Anding, Jenna D.; Boleman, Chris; Thompson, Britta

2007-01-01

A food safety education program developed for retail food establishments was evaluated to assess the extent to which participants were practicing selected behaviors linked to reducing the risk of foodborne disease both before and after the program. Scores from the state health department's Certified Food Manager (CFM) exam also were examined.…

Safety diagnosis: are we doing a good job?

PubMed

Park, Peter Y; Sahaji, Rajib

2013-03-01

Collision diagnosis is the second step in the six-step road safety management process described in the AASHTO Highway Safety Manual (HSM). Diagnosis is designed to identify a dominant or abnormally high proportion of particular collision configurations (e.g., rear end, right angle, etc.) at a target location. The primary diagnosis method suggested in the HSM is descriptive data analysis. This type of analysis relies on, for example, pie charts, histograms, and/or collision diagrams. Using location specific collision data (e.g., collision frequency per collision configuration for a target location), safety engineers identify (the most) frequent collision configurations. Safety countermeasures are then likely to concentrate on preventing the selected collision configurations. Although its real-world application in engineering practice is limited, an additional collision diagnosis method, known as the beta-binomial (BB) test, is also presented as the secondary diagnosis tool in the HSM. The BB test compares the proportion of a particular collision configuration observed at one location with the proportion of the same collision configuration found at other reference locations which are similar to the target location in terms of selected traffic and roadway characteristics (e.g., traffic volume, traffic control, and number of lanes). This study compared the outcomes obtained from descriptive data analysis and the BB test, and investigates two questions: (1) Do descriptive data analysis and the BB tests produce the same results (i.e., do they select the same collision configurations at the same locations)? and (2) If the tests produce different results, which result should be adopted in engineering practice? This study's analysis was based on a sample of the most recent five years (2005-2009) of collision and roadway configuration data for 143 signalized intersections in the City of Saskatoon, Saskatchewan. The study results show that the BB test's role in diagnosing safety concerns in road safety engineering projects such as safety review projects for existing roadways may be just as important as the descriptive data analysis method. Copyright © 2012 Elsevier Ltd. All rights reserved.

TU-C-201-03: The Use of Checklists and Audit Tools for Safety and QA

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

Prisciandaro, J.

Recent use of HDR has increased while planning has become more complex often necessitating 3D image-based planning. While many guidelines for the use of HDR exist, they have not kept pace with the increased complexity of 3D image-based planning. Furthermore, no comprehensive document exists to describe the wide variety of current HDR clinical indications. This educational session aims to summarize existing national and international guidelines for the safe implementation of an HDR program. A summary of HDR afterloaders available on the market and their existing applicators will be provided, with guidance on how to select the best fit for eachmore » institution’s needs. Finally, the use of checklists will be discussed as a means to implement a safe and efficient HDR program and as a method by which to verify the quality of an existing HDR program. This session will provide the perspective of expert HDR physicists as well as the perspective of a new HDR user. Learning Objectives: Summarize national and international safety and staffing guidelines for HDR implementation Discuss the process of afterloader and applicator selection for gynecologic, prostate, breast, interstitial, surface treatments Learn about the use of an audit checklist tool to measure of quality control of a new or existing HDR program Describe the evolving use of checklists within an HDR program.« less

[Microbiological quality of " ice, ice cream. sorbet" sold on the streets of Phnom Penh; April 1996-April 1997].

PubMed

Kruy, S L; Soares, J L; Ping, S; Sainte-Marie, F F

2001-12-01

A study of the microbiological quality of ice lice creams/sorbets sold on the streets of Phnom Penh city was conducted from April 1996 to April 1997. Socio-demographic and environmental characteristics with two ice/ice creams samples were collected from vendors selected in the city. A total of 105 vendors and 210 ice/ice creams samples were randomly selected for the study period. Ice/ice cream vendors in the streets of Phnom Penh were adults (mean age: 28 years old) with a male predominance (86.5%). Mean educational level of vendors was 5 years with no training in mass catering. Most ice creams and sorbets (81.7%) were made using traditional methods. Microbiological analysis performed in the laboratory of Pasteur Institute of Cambodia indicated the poor bacteriological quality of the samples. The proportions of samples classified unsafe according to microbiological criteria were 83.3% for total bacterial count at 30 degrees C, 70% for total coliforms, 30% for faecal coliforms, 12.2% for Staphylococcus aureus and 1.9% for presence of Salmonella spp. These bacterial results suggest that many other food products sold in the streets may be similarly poor. Safety measures should be undertaken to avoid potential threats. Regulation of the street food sector should be part of a larger strategy for enhanced food safety and environmental quality in the city.

Selective progesterone receptor modulators in reproductive medicine: pharmacology, clinical efficacy and safety.

PubMed

Bouchard, Philippe; Chabbert-Buffet, Nathalie; Fauser, Bart C J M

2011-11-01

To discuss the mechanism of action of selective progesterone receptor modulators (SPRMs) and summarize the preclinical and clinical efficacy and safety data supporting the potential use of these compounds for gynecologic indications. Relevant publications from 2005 onward were identified using a PubMed search. Additional relevant articles were identified from citations within these publications. None. None. None. None. Mifepristone was first developed as a progesterone receptor antagonist and licensed for pregnancy termination because of the unique property of this compound to terminate pregnancy when associated with prostaglandins. Then SPRMs were developed, and among those ulipristal acetate, an efficient emergency contraceptive. Because SPRMs effectively inhibit endometrial proliferation and reduce endometriotic lesions in animal models, this suggests a possible role in the treatment of endometriosis in humans. Finally, a number of double-blind, randomized, placebo-controlled trials have demonstrated the efficacy of asoprisnil, mifepristone, telapristone acetate, and ulipristal acetate in reducing leiomyoma and uterine volume, and suppressing bleeding in women with uterine fibroids. Mifepristone in combination with prostaglandins has been licensed for pregnancy termination because of its unique ability is this area. Ulipristal acetate is available for emergency contraception. Several SPRMs hold further promise as an effective medical therapy for patients suffering from endometriosis and leiomyoma. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Development of sensitive and selective food sensors using new Re(I)-Pt(II) bimetallic complexes to detect volatile biogenic sulfides formed by meat spoilage.

PubMed

Chow, Cheuk-Fai; Ho, Pui-Yu; Sun, Dong; Lu, Yu-Jing; Wong, Wing-Leung; Tang, Qian; Gong, Cheng-Bin

2017-02-01

Detection of volatile biogenic sulfides (VBS) plays a crucial role in food safety because the amounts of these compounds can reflect the freshness of meat. A new indicator-displacement assay with Re(I)-Pt(II) complexes, [Re(Lig)(CO)3(bridge)]-[Pt(DMSO)(Cl)2] (1: Lig=5-phenyl-1,10-phenanthroline and bridge=NCS(-); 2: Lig=5-phenyl-1,10-phenanthroline and bridge=CN(-); 3: Lig=2,2'-biquinoline and bridge=NCS(-)), was demonstrated to be a very effective sensing method to VBS. The results indicated that the control of Re(I)-bridge-Pt(II) and Re(I)-ligand combination are able to regulate their sensing selectivity and sensitivity. This system was successfully applied to detect CH3SCH3 in real rotten pork with a linear luminometric response up to 20.0mgkg(-1) (R=0.997) with the detection limit as 0.05 mgkg(-1). Complex 1 also gave comparable results on the detection of VBS with respect to those determined by GCMS with recovery range from 76% to 102% (RSD%=13.8). Copyright © 2016 Elsevier Ltd. All rights reserved.

The development and test of urban and rural pedestrian safety messages

DOT National Transportation Integrated Search

1985-01-01

The objective of this project was to identify, develop and produce public education messages for pedestrian safety. Pedestrian accident types and situations which had not been previously addressed through public education were selected. These include...

Assessment of elementary school safety restraint programs.

DOT National Transportation Integrated Search

1985-06-01

The purpose of this research was to identify elementary school (K-6) safety belt : education programs in use in the United States, to review their development, and : to make administrative and impact assessments of their use in selected States. : Six...

The transferability of safety-driven access management models for application to other sites.

DOT National Transportation Integrated Search

2001-01-01

Several research studies have produced mathematical models that predict the safety impacts of selected access management techniques. Since new models require substantial resources to construct, this study evaluated five existing models with regard to...

Global road safety online course development.

DOT National Transportation Integrated Search

2017-06-01

The Global Road Safety Online Curriculum Development project involved the adaptation of in-person classroom materials and development of new materials to be used in an online setting. A short-course format was selected to pilot the course, and four t...

Briefing sheets on safety and operations of rural two-lane highways.

DOT National Transportation Integrated Search

2016-11-01

The safety and operations of Texas rural two-lane highways are being affected by increased traffic associated : with the energy sector, including the unique characteristics of heavy trucks. Researchers reviewed existing : conditions on select rural t...

National Transportation Safety Board : weak internal control impaired financial accountability

DOT National Transportation Integrated Search

2001-09-28

The U. S. General Accounting Office (GAO) was asked to review the National Transportation Safety Board's (NTSB) internal controls over selected types of fiscal year expenditures. They were asked to determine whether internal control weaknesses were a...

Safety Behaviors among Parents of Preschoolers.

ERIC Educational Resources Information Center

Glik, Deborah; And Others

1993-01-01

Telephone survey examined relationships between safety behaviors to reduce the risk of childhood injury and parents' socioeconomic, psychosocial, and situational characteristics. Results indicated socioeconomic status and maternal stress negatively related to safety behaviors, and risk perceptions positively related to safety behaviors, suggesting…

Monitoring of International Space Station Telemetry Using Shewhart Control Charts

NASA Technical Reports Server (NTRS)

Fitch, Jeffery T.; Simon, Alan L.; Gouveia, John A.; Hillin, Andrew M.; Hernandez, Steve A.

2012-01-01

Shewhart control charts have been established as an expedient method for analyzing dynamic, trending data in order to identify anomalous subsystem performance as soon as such performance would exceed a statistically established baseline. Additionally, this leading indicator tool integrates a selection methodology that reduces false positive indications, optimizes true leading indicator events, minimizes computer processor unit duty cycles, and addresses human factor concerns (i.e., the potential for flight-controller data overload). This innovation leverages statistical process control, and provides a relatively simple way to allow flight controllers to focus their attention on subtle system changes that could lead to dramatic off-nominal system performance. Finally, this capability improves response time to potential hardware damage and/or crew injury, thereby improving space flight safety. Shewhart control charts require normalized data. However, the telemetry from the ISS Early External Thermal Control System (EETCS) was not normally distributed. A method for normalizing the data was implemented, as was a means of selecting data windows, the number of standard deviations (Sigma Level), the number of consecutive points out of limits (Sequence), and direction (increasing or decreasing trend data). By varying these options, and treating them like dial settings, the number of nuisance alerts and leading indicators were optimized. The goal was to capture all leading indicators while minimizing the number of nuisances. Lean Six Sigma (L6S) design of experiment methodologies were employed. To optimize the results, Perl programming language was used to automate the massive amounts of telemetry data, control chart plots, and the data analysis.

Patient safety culture assessment in oman.

PubMed

Al-Mandhari, Ahmed; Al-Zakwani, Ibrahim; Al-Kindi, Moosa; Tawilah, Jihane; Dorvlo, Atsu S S; Al-Adawi, Samir

2014-07-01

To illustrate the patient safety culture in Oman as gleaned via 12 indices of patient safety culture derived from the Hospital Survey on Patient Safety Culture (HSPSC) and to compare the average positive response rates in patient safety culture between Oman and the USA, Taiwan, and Lebanon. This was a cross-sectional research study employed to gauge the performance of HSPSC safety indices among health workers representing five secondary and tertiary care hospitals in the northern region of Oman. The participants (n=398) represented different professional designations of hospital staff. Analyses were performed using univariate statistics. The overall average positive response rate for the 12 patient safety culture dimensions of the HSPSC survey in Oman was 58%. The indices from HSPSC that were endorsed the highest included 'organizational learning and continuous improvement' while conversely, 'non-punitive response to errors' was ranked the least. There were no significant differences in average positive response rates between Oman and the United States (58% vs. 61%; p=0.666), Taiwan (58% vs. 64%; p=0.386), and Lebanon (58% vs. 61%; p=0.666). This study provides the first empirical study on patient safety culture in Oman which is similar to those rates reported elsewhere. It highlights the specific strengths and weaknesses which may stem from the specific milieu prevailing in Oman.

47 CFR 80.459 - Digital selective calling.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Digital selective calling. 80.459 Section 80.459 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Public Coast Stations Use of Telegraphy § 80.459 Digital selective...

47 CFR 80.459 - Digital selective calling.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Digital selective calling. 80.459 Section 80.459 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Public Coast Stations Use of Telegraphy § 80.459 Digital selective...

Comparison of outcomes of conventional WaveLight® Allegretto Wave® and Technolas® excimer lasers in myopic laser in situ keratomileusis

PubMed Central

Han, Daphne CY; Chen, Jean; Htoon, Hla Myint; Tan, Donald TH; Mehta, Jodhbir S

2012-01-01

Objective To compare the results of laser in situ keratomileusis for myopia using WaveLight® Allegretto Wave® Eye-Q® and Technolas® 217z excimer lasers. Method A retrospective, comparative case series of 442 eyes matched for age and myopia: half each were treated with Allegretto’s wavefront-optimized algorithm and Technolas PlanoScan. Outcome measures were postoperative mean logarithm of the minimum angle of resolution (logMAR) uncorrected visual acuity (UCVA), manifest refraction spherical equivalent (MRSE), cylinder, safety and efficacy indices, refractive predictability, and optical zone size selection. Refractive predictability of a subgroup treated for −2.50 to −4.0 diopter (D) was analyzed separately. Results At mean follow-up of 80.5 days, mean logMAR UCVA, mean MRSE and mean postoperative cylinder were 0.02 ± 0.07 (range −0.12 to 0.30), 0.27 ± 0.36 D (range −1.25 to 1.50 D) and −0.33 ± 0.30 D (range 0.00 to −1.50 D) for Allegretto versus 0.02 ± 0.08 (range −0.12 to 0.40), 0.095 ± 0.47 D (range −1.25 to 1.13 D) and −0.44 ± 0.5 2 D (range 0.00 to −2.25 D) for Technolas (P = 0.98, 0.80 and 0.006). Mean safety and efficacy indices were 1.05 ± 0.13 (0.75–1.33) and 0.97 ± 0.13 (0.50–1.33) for Allegretto and 1.07 ± 0.14 (0.75–1.49) and 0.97 ± 0.17 (0.40–1.49) for Technolas (P = 0.23 and 0.69). Proportions of eyes achieving postoperative MRSE within ±1.0 D, ±0.5 D, and ±0.25 D were 98.2%, 91.9% and 75.6% for Allegretto and 99.1%, 97.8% and 72.4% for Technolas (P = 0.68, 0.20 and 0.51). Mean optical zone size selected was 6.48 ± 0.10 mm (range 6.0–6.5 mm) for Allegretto and 6.38 ± 0.19 mm (range 5.6–6.6 mm) for Technolas (P < 0.001). Of the subgroup with treatment between −2.5 and −4.0 D, 86.8% and 58.5% of eyes treated with Allegretto achieved postoperative MRSE within ±0.50 D and ±0.25 D versus 70.4% and 44.4% for Technolas (P = 0.006 and 0.057). Conclusion No differences were seen in postoperative mean logMAR UCVA, MRSE, safety and efficacy indices between the two lasers. Allegretto produced less residual astigmatism, possibly improved refractive predictability, and required smaller optical zone selection. PMID:22888213

Characterization and in vitro properties of potentially probiotic Bifidobacterium strains isolated from breast-milk.

PubMed

Arboleya, Silvia; Ruas-Madiedo, Patricia; Margolles, Abelardo; Solís, Gonzalo; Salminen, Seppo; de Los Reyes-Gavilán, Clara G; Gueimonde, Miguel

2011-09-01

Most of the current commercial probiotic strains have not been selected for specific applications, but rather on the basis of their technological potential for use in diverse applications. Therefore, by selecting them from appropriate sources, depending on the target population, it is likely that better performing strains may be identified. Few strains have been specifically selected for human neonates, where the applications of probiotics may have a great positive impact. Breast-milk constitutes an interesting source of potentially probiotic bifidobacteria for inclusion in infant formulas and foods targeted to both pre-term and full-term infants. In this study six Bifidobacterium strains isolated from breast-milk were phenotypically and genotypically characterised according to international guidelines for probiotics. In addition, different in vitro tests were used to assess the safety and probiotic potential of the strains. Although clinical data would be needed before drawing any conclusion on the probiotic properties of the strains, our results indicate that some of them may have probiotic potential for their inclusion in products targeting infants. Copyright © 2010 Elsevier B.V. All rights reserved.

Transoral robotic resection of selected parapharyngeal space tumors.

PubMed

Arshad, Hassan; Durmus, Kasim; Ozer, Enver

2013-05-01

Currently, transoral robotic surgery (TORS) with the daVinci robot is mainly used for squamous cell carcinoma of the oropharynx and supraglottic larynx. The safety, efficacy, and functional outcomes regarding this approach have previously been described. In addition to transoral resection of squamous cell carcinoma, we have found use for this technique in removing selected tumors of the parapharyngeal space. Three patients with benign or malignant tumors of the parapharyngeal space who underwent successful transoral resection using the daVinci robot were included in the study. In all three cases, complete tumor excision was achieved without any complication. None required conversion to an open procedure. Mean TORS operative time and intraoperative blood loss were 16.3 min and 4.7 mL, respectively. Inadequate oral exposure, involvement of the internal carotid artery, limited cervical spine mobility and large tumor size are the main limitations of this approach. Result indicates that magnified view, 3D visualization with the combination of the transoral robotic experience, allow en bloc resection of selected parapharyngeal space tumors located medial to the carotid sheath.

Hydration: certain basic aspects for developing technical and scientific parameters into the nutrition knowledge

PubMed

Perales-García, Aránzazu; Estévez-Martínez, Isabel; Urrialde, Rafael

2016-07-12

Introduction: Hydration is defined as the water intake coming from food and beverages. Its study has become an area by itself, within the nutrition field. Meaning that in 2010 the European Food Safety Authority (EFSA) approved the water intake recommendations, but the study of this topic implies a rigorous methodology, which represents several issues. Objective: Showing as a glance the main methodological issues in hydration studies. Material and methods: Bibliographic revision of scientific literature. Results: The main methodological issues presented are: sample selection (investigation field and sample design), selection of the method to evaluate hydration status (dilution techniques, bioelectrical impedance, plasmatic and urinary indicators, changes in body composition, water losses and clinic symptoms) selection of the method to evaluate water intake (biomarker, questionnaires, informatics programs, smartphone use, 24-h register, dietary history and food frequency questionnaire), and the main sources of hydration. Conclusions: Hydration status should be understood as a routine model, with daily frequency, according to gender, age, physical activity and environmental conditions. Furthermore, the correct design of the methodology has a special importance in order to take into account all the aspects

Analysis of factors influencing safety management for metro construction in China.

PubMed

Yu, Q Z; Ding, L Y; Zhou, C; Luo, H B

2014-07-01

With the rapid development of urbanization in China, the number and size of metro construction projects are increasing quickly. At the same time, and increasing number of accidents in metro construction make it a disturbing focus of social attention. In order to improve safety management in metro construction, an investigation of the participants' perspectives on safety factors in China metro construction has been conducted to identify the key safety factors, and their ranking consistency among the main participants, including clients, consultants, designers, contractors and supervisors. The result of factor analysis indicates that there are five key factors which influence the safety of metro construction including safety attitude, construction site safety, government supervision, market restrictions and task unpredictability. In addition, ANOVA and Spearman rank correlation coefficients were performed to test the consistency of the means rating and the ranking of safety factors. The results indicated that the main participants have significant disagreement about the importance of safety factors on more than half of the items. Suggestions and recommendations on practical countermeasures to improve metro construction safety management in China are proposed. Copyright © 2013 Elsevier Ltd. All rights reserved.

A novel evaluation method for building construction project based on integrated information entropy with reliability theory.

PubMed

Bai, Xiao-ping; Zhang, Xi-wei

2013-01-01

Selecting construction schemes of the building engineering project is a complex multiobjective optimization decision process, in which many indexes need to be selected to find the optimum scheme. Aiming at this problem, this paper selects cost, progress, quality, and safety as the four first-order evaluation indexes, uses the quantitative method for the cost index, uses integrated qualitative and quantitative methodologies for progress, quality, and safety indexes, and integrates engineering economics, reliability theories, and information entropy theory to present a new evaluation method for building construction project. Combined with a practical case, this paper also presents detailed computing processes and steps, including selecting all order indexes, establishing the index matrix, computing score values of all order indexes, computing the synthesis score, sorting all selected schemes, and making analysis and decision. Presented method can offer valuable references for risk computing of building construction projects.

The Evaluation of the Safety Benefits of Combined Passive and On-Board Active Safety Applications

PubMed Central

Page, Yves; Cuny, Sophie; Zangmeister, Tobias; Kreiss, Jens-Peter; Hermitte, Thierry

2009-01-01

One of the objectives of the European TRACE project (TRaffic Accident Causation in Europe, 2006–2008) was to estimate the proportion of injury accidents that could be avoided and/or the proportion of injury accidents where the severity could be mitigated for on-the-market safety applications, if 100 % of the car fleet would be equipped with them. We have selected for evaluation the Electronic Stability Control (ESC) and the Emergency Brake Assist (EBA) applications. As for passive safety systems, recent cars are designed to offer overall safety protection. Car structure, load limiters, front airbags, side airbags, knee airbags, pretensioners, padding and non aggressive structures in the door panel, the dashboard, the windshield, the seats, and the head rest also contribute to applying more protection. The whole safety package is very difficult to evaluate separately, one element independently segmented from the others. We decided to consider evaluating the effectivenessof the whole passive safety package, This package,, for the sake of simplicity, was the number of stars awarded at the Euro NCAP testing. The challenges were to compare the effectiveness of some safety configuration SC I, with the effectiveness of a different safety configuration SC II. A safety configuration is understood as a package of safety functions. Ten comparisons have been carried out such as the evaluation of the safety benefit of a fifth star given that the car has four stars and an EBA. The main outcome of this analysis is that any addition of a passive or active safety function selected in this analysis is producing increased safety benefits. For example, if all cars were five stars fitted with EBA and ESC, instead of four stars without ESC and EBA, injury accidents would be reduced by 47.2% for severe injuries and 69.5% for fatal injuries. PMID:20184838

Prevalence of injections and knowledge of safe injections among rural residents in Central China.

PubMed

Yan, Y W; Yan, J; Zhang, G P; Gao, Z L; Jian, H X

2007-08-01

Abuse of the injection services, namely unnecessary injections and unsafe injections, exists extensively in developing countries. Unsafe injection practices contribute to the transmission of blood-borne pathogens. The aims of this study were to survey the prevalence of injections and knowledge of injection safety among the rural residents in Jingzhou district, Hubei, China and to provide scientific data for developing a health educational programme. A retrospective cross-sectional study was conducted in 12 villages, which were selected from the Jingzhou district by the random sampling method. 50 rural residents were interviewed per village using a questionnaire. Among the 595 residents studied, 192 had received at least one injection in the past three months, with an injection prevalence of 32.3 percent and an average of 0.93 injections. 90.3 percent of the rural residents knew that unsafe injections could transmit the following blood-borne pathogens: human immunodeficiency virus (74.4 percent), hepatitis B virus (55.8 percent) and hepatitis C virus (22.9 percent). Logistic regression analysis showed that the residents' age, educational level and residential area were important factors in influencing their knowledge about injection safety. The results indicated that the injection prevalence was high among rural residents in the study area, and their knowledge regarding injection safety should be further improved.

New Receptor Targets for Medical Therapy in Irritable Bowel Syndrome

PubMed Central

Camilleri, Michael

2010-01-01

Background Despite setbacks to the approval of new medications for the treatment of irritable bowel syndrome, interim guidelines on endpoints for IBS trials have enhanced interest as new targets for medical therapy are proposed based on novel mechanisms or chemical entities. Aim To review the approved lubiprostone, two targets that are not meeting expectations (tachykinins and corticotrophin-releasing hormone), the efficacy and safety of new 5-HT4 agonists, intestinal secretagogues (chloride channel activators, and guanylate cyclase-C agonists), bile acid modulation, anti-inflammatory agents and visceral analgesics. Methods Review of selected articles based on PubMed search and clinically relevant information on mechanism of action, safety, pharmacodynamics, and efficacy Conclusions The spectrum of peripheral targets of medical therapy address chiefly the bowel dysfunction of IBS, and these effects are associated with pain relief. There are less clear targets related to the abdominal pain or visceral sensation in IBS. The new 5-HT4 agonists are more specific than older agents, and show cardiovascular safety to date. Secretory agents have high specificity, low bioavailability, and efficacy. The potential risks of agents “borrowed” from other indications (like hyperlipidemia, inflammatory bowel disease or somatic pain) deserve further study. There is reason for optimism in medical treatment of IBS. PMID:19785622

Bullying in work groups: the impact of leadership.

PubMed

Nielsen, Morten Birkeland

2013-04-01

The aim of this study is to examine whether and how laissez-faire, transformational, and authentic leadership styles are related to the occurrence of bullying in work groups. It is hypothesized that the investigated leadership styles have direct associations, as well as indirect associations through group cohesion and safety perceptions, with indicators of bullying among subordinates. Using a cross-sectional survey design, the variables were assessed in a randomly selected sample comprising 594 seafarers from two Norwegian shipping companies. Laissez-faire leadership was associated with an increased risk of exposure to bullying behavior, self-labeled victimization from bullying, and perpetrated bullying. Transformational leadership and authentic leadership were related to decreased risk of exposure to bullying behavior. Authentic leadership contributed to the variance in bullying beyond laissez-faire and transformational leadership. Analyses of indirect effects showed that the association between transformational leadership and bullying was fully mediated through safety perceptions, whereas a partial indirect association through safety perceptions was found for authentic leadership. This study makes a significant contribution to the literature by providing evidence for how leadership styles predict workplace bullying. The findings highlight the importance of recruiting, developing, and training leaders who promote both positive psychological capacities and positive perceptions among their subordinates. © 2012 The Author. Scandinavian Journal of Psychology © 2012 The Scandinavian Psychological Associations.

Mechanical limits to maximum weapon size in a giant rhinoceros beetle.

PubMed

McCullough, Erin L

2014-07-07

The horns of giant rhinoceros beetles are a classic example of the elaborate morphologies that can result from sexual selection. Theory predicts that sexual traits will evolve to be increasingly exaggerated until survival costs balance the reproductive benefits of further trait elaboration. In Trypoxylus dichotomus, long horns confer a competitive advantage to males, yet previous studies have found that they do not incur survival costs. It is therefore unlikely that horn size is limited by the theoretical cost-benefit equilibrium. However, males sometimes fight vigorously enough to break their horns, so mechanical limits may set an upper bound on horn size. Here, I tested this mechanical limit hypothesis by measuring safety factors across the full range of horn sizes. Safety factors were calculated as the ratio between the force required to break a horn and the maximum force exerted on a horn during a typical fight. I found that safety factors decrease with increasing horn length, indicating that the risk of breakage is indeed highest for the longest horns. Structural failure of oversized horns may therefore oppose the continued exaggeration of horn length driven by male-male competition and set a mechanical limit on the maximum size of rhinoceros beetle horns. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Indicators of School Crime and Safety, 1999.

ERIC Educational Resources Information Center

Kaufman, Phillip; Chen, Xianglei; Choy, Susan P.; Ruddy, Sally A.; Miller, Amanda K.; Chandler, Kathryn A.; Chapman, Christopher D.; Rand, Michael R.; Klaus, Patsy

This report provides detailed statistical information on crime in schools. It is a companion document to the "Annual Report on School Safety: 1999," which offers an overview of the nature and scope of school crime. This report is organized as a series of indicators, with each indicator presenting data on a different aspect of school crime and…

Indicators of School Crime and Safety: 2010. NCES 2011-002/NCJ 230812

ERIC Educational Resources Information Center

Robers, Simone; Zhang, Jijun; Truman, Jennifer

2010-01-01

Ensuring safer schools requires establishing good indicators of the current state of school crime and safety across the nation and regularly updating and monitoring these indicators. This is the aim of this report. This report is the thirteenth in a series of annual publications produced jointly by the National Center for Education Statistics…

Effects of a team-based assessment and intervention on patient safety culture in general practice: an open randomised controlled trial.

PubMed

Hoffmann, B; Müller, V; Rochon, J; Gondan, M; Müller, B; Albay, Z; Weppler, K; Leifermann, M; Mießner, C; Güthlin, C; Parker, D; Hofinger, G; Gerlach, F M

2014-01-01

The measurement of safety culture in healthcare is generally regarded as a first step towards improvement. Based on a self-assessment of safety culture, the Frankfurt Patient Safety Matrix (FraTrix) aims to enable healthcare teams to improve safety culture in their organisations. In this study we assessed the effects of FraTrix on safety culture in general practice. We conducted an open randomised controlled trial in 60 general practices. FraTrix was applied over a period of 9 months during three facilitated team sessions in intervention practices. At baseline and after 12 months, scores were allocated for safety culture as expressed in practice structure and processes (indicators), in safety climate and in patient safety incident reporting. The primary outcome was the indicator error management. During the team sessions, practice teams reflected on their safety culture and decided on about 10 actions per practice to improve it. After 12 months, no significant differences were found between intervention and control groups in terms of error management (competing probability=0.48, 95% CI 0.34 to 0.63, p=0.823), 11 further patient safety culture indicators and safety climate scales. Intervention practices showed better reporting of patient safety incidents, reflected in a higher number of incident reports (mean (SD) 4.85 (4.94) vs 3.10 (5.42), p=0.045) and incident reports of higher quality (scoring 2.27 (1.93) vs 1.49 (1.67), p=0.038) than control practices. Applied as a team-based instrument to assess safety culture, FraTrix did not lead to measurable improvements in error management. Comparable studies with more positive results had less robust study designs. In future research, validated combined methods to measure safety culture will be required. In addition, more attention should be paid to evaluation of process parameters. Implemented actions and incident reporting may be more appropriate target endpoints. German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS) No. DRKS00000145.

2001 traffic safety issues opinion survey.

DOT National Transportation Integrated Search

2002-02-01

As a means of determining public opinion on specific traffic safety issues, a public opinion survey was conducted. A total of 4,500 mail surveys were sent to a stratified sample of drivers selected from the drivers license file. The state was divided...

Innovative intersection safety improvement strategies and management practices : a domestic scan.

DOT National Transportation Integrated Search

2006-09-01

Intersection safety is and has been a major program at the Federal Highway Administration (FHWA). : As a means to share best practices used in various locations, the FHWA and selected representatives : of the transportation community conducted a dome...

The public favors a strong government role in highway safety

DOT National Transportation Integrated Search

1996-08-01

This Traffic Tech summarizes the findings of a recent National Highway Traffic Safety Administration (NHTSA) customer satisfaction survey. In November and December of 1995, about 4,000 randomly selected persons aged 16 and older from across the natio...

2015 Accomplishments Report

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

None, None

This report covers selected highlights from the four research pathways in the LWRS Program: Materials Aging and Degradation; Risk-Informed Safety Margin Characterization; Advanced Instrumentation, Information, and Control Systems Technologies; and Reactor Safety Technologies, as well as a look-ahead at planned activities for 2017.

2016 Accomplishments Report

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

None, None

This report covers selected highlights from the four research pathways in the LWRS Program: Materials Aging and Degradation; Risk-Informed Safety Margin Characterization; Advanced Instrumentation, Information, and Control Systems Technologies; and Reactor Safety Technologies, as well as a look-ahead at planned activities for 2017.

A primer on safety performance measures for the transportation planning process

DOT National Transportation Integrated Search

2009-09-01

This Primer is a tool to help State and local practitioners, transportation planners, and decision-makers identify, select, and use safety performance measures as a part of the transportation planning process. The Primer draws from current literature...

Space station crew safety alternatives study. Volume 3: Safety impact of human factors

NASA Technical Reports Server (NTRS)

Rockoff, L. A.; Raasch, R. F.; Peercy, R. L., Jr.

1985-01-01

The first 15 years of accumulated space station concepts for Initial Operational Capability (IOC) during the early 1990's was considered. Twenty-five threats to the space station are identified and selected threats addressed as impacting safety criteria, escape and rescue, and human factors safety concerns. Of the 25 threats identified, eight are discussed including strategy options for threat control: fire, biological or toxic contamination, injury/illness, explosion, loss of pressurization, radiation, meteoroid penetration and debris. Of particular interest here is volume three (of five volumes) pertaining to the safety impact of human factors.

Vocabulary of aerospace safety terms pertaining to cryogenic safety, fires, explosions, and structure failure

NASA Technical Reports Server (NTRS)

Pelouch, J. J., Jr.; Mandel, G.; Ordin, P. M.

1976-01-01

This vocabulary listing characterizes the contents of over 10,000 documents of the NASA Aerospace Safety Research and Data Institute's (ASRDI) safety engineering collection. The ASRDI collection is now one of the series accessible on the NASA RECON data base. There are approximately 6,300 postable terms that describe literature in the areas of cryogenic fluid safety, specifically hydrogen, oxygen, liquified natural gas; fire and explosion technology; and the mechanics of structural failure. To facilitate the proper selection of information nonpostable, related and array terms have been included in this listing.

The blind men and the elephant: the impact of context and scale in evaluating conflicts between plant hydraulic safety and efficiency

Treesearch

Frederick C. Meinzer; Katherine A. McCulloh; Barbara Lachenbruch; David R. Woodruff; Daniel M. Johnson

2010-01-01

Given the fundamental importance of xylem safety and efficiency for plant survival and fitness, it is not surprising that these are among the most commonly studied features of hydraulic architecture. However, much remains to be learned about the nature and universality of conflicts between hydraulic safety and efficiency. Although selection for suites of hydraulic...

Development and Validation of Career Development Guidelines by Task/Activity Analysis of Occupational Safety and Health Professions: Industrial Hygiene and Safety Professional. Final Report. Technical Report XII.

ERIC Educational Resources Information Center

Vernon, Ralph J.; And Others

This report summarizes research findings which resulted in development of curricula for occupational safety and health professions based on task/activity analyses and related performance objectives. The first seven chapters focus on the seven objectives. Chapter 1, Literature Review and Selection of Employers, concerns tasks required for…

Establishing the need for an engineering standard for agricultural hitch pins.

PubMed

Deboy, G R; Knapp, W M; Field, W E; Krutz, G W; Corum, C L

2012-04-01

Documented incidents have occurred in which failure or unintentional disengagement of agricultural hitch pins has contributed to property damage and personal injury. An examination of current hitch pin use on a convenience sample of farm operations in Indiana revealed a variety of non-standard, worn and damaged, and inappropriately sized hitch pins in use. Informal interviews with the farm operators confirmed that hitch pin misuse, failure, or disengagement is a relatively widespread problem that remains largely unaddressed. On-site observations also suggested a low use of hitch pin retaining devices or safety chains. A review of prior research revealed that little attention has been given to this problem, and currently no documentation allows for an estimate of the frequency or severity of losses associated with hitch pin misuse, failure, or disengagement. No specific engineering standards were found that directly applied to the design, appropriate selection, or loading capacity of agricultural hitch pins. Major suppliers of replacement hitch pins currently provide little or no information on matching hitch pin size to intended applications, and most replacement hitch pins examined were of foreign origin, with the overwhelming majority imported from China or India. These replacement hitch pins provided no specifications other than diameter, length, and, in some cases, labeling that indicated that the pins had been "heat treated. " Testing of a sample of 11 commercially available replacement hitch pins found variation along the length of the pin shaft and between individual pins in surface hardness, a potential predictor of pin failure. Examination of 17 commercially available replacement pins also revealed a variety of identifiers used to describe pin composition and fabrication methods, e.g., "heat treated." None of the pins examined provided any specifications on loading capacity. It was therefore concluded that there is a need to develop an agricultural hitch pin engineering standard that would reflect current agricultural applications and practices and that would be promoted to both original equipment manufacturers and manufacturers and suppliers of replacement hitch pins. The standard should address the design of composite pins, heat treating, surface hardening, loading capacity and labeling of such, incorporation of unintentional disengagement prevention devices, indicators of the need for replacement due to wear, and safety information that should be included in operator instructions. ASABE is the most appropriate organization to develop such a standard. It was also concluded that agricultural safety and health programs and professionals need to raise the awareness of farmers concerning the appropriate selection and use of agricultural hitch pins, including the need to replace non-standard pins with pins less likely to fail or disengage during use, the need to replace hitch pins with indications of potential failure, and the importance of using appropriate safety chains, especially during transport of equipment behind tractors and trucks on public roads.

Deep Borehole Disposal Safety Analysis.

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

Freeze, Geoffrey A.; Stein, Emily; Price, Laura L.

This report presents a preliminary safety analysis for the deep borehole disposal (DBD) concept, using a safety case framework. A safety case is an integrated collection of qualitative and quantitative arguments, evidence, and analyses that substantiate the safety, and the level of confidence in the safety, of a geologic repository. This safety case framework for DBD follows the outline of the elements of a safety case, and identifies the types of information that will be required to satisfy these elements. At this very preliminary phase of development, the DBD safety case focuses on the generic feasibility of the DBD concept.more » It is based on potential system designs, waste forms, engineering, and geologic conditions; however, no specific site or regulatory framework exists. It will progress to a site-specific safety case as the DBD concept advances into a site-specific phase, progressing through consent-based site selection and site investigation and characterization.« less

Selecting an Architecture for a Safety-Critical Distributed Computer System with Power, Weight and Cost Considerations

NASA Technical Reports Server (NTRS)

Torres-Pomales, Wilfredo

2014-01-01

This report presents an example of the application of multi-criteria decision analysis to the selection of an architecture for a safety-critical distributed computer system. The design problem includes constraints on minimum system availability and integrity, and the decision is based on the optimal balance of power, weight and cost. The analysis process includes the generation of alternative architectures, evaluation of individual decision criteria, and the selection of an alternative based on overall value. In this example presented here, iterative application of the quantitative evaluation process made it possible to deliberately generate an alternative architecture that is superior to all others regardless of the relative importance of cost.

Repurposing drugs to treat l-DOPA-induced dyskinesia in Parkinson's disease.

PubMed

Johnston, Tom H; Lacoste, Alix M B; Visanji, Naomi P; Lang, Anthony E; Fox, Susan H; Brotchie, Jonathan M

2018-06-01

In this review, we discuss the opportunity for repurposing drugs for use in l-DOPA-induced dyskinesia (LID) in Parkinson's disease. LID is a particularly suitable indication for drug repurposing given its pharmacological diversity, translatability of animal-models, availability of Phase II proof-of-concept (PoC) methodologies and the indication-specific regulatory environment. A compound fit for repurposing is defined as one with appropriate human safety-data as well as animal safety, toxicology and pharmacokinetic data as found in an Investigational New Drug (IND) package for another indication. We first focus on how such repurposing candidates can be identified and then discuss development strategies that might progress such a candidate towards a Phase II clinical PoC. We discuss traditional means for identifying repurposing candidates and contrast these with newer approaches, especially focussing on the use of computational and artificial intelligence (AI) platforms. We discuss strategies that can be categorised broadly as: in vivo phenotypic screening in a hypothesis-free manner; in vivo phenotypic screening based on analogy to a related disorder; hypothesis-driven evaluation of candidates in vivo and in silico screening with a hypothesis-agnostic component to the selection. To highlight the power of AI approaches, we describe a case study using IBM Watson where a training set of compounds, with demonstrated ability to reduce LID, were employed to identify novel repurposing candidates. Using the approaches discussed, many diverse candidates for repurposing in LID, originally envisaged for other indications, will be described that have already been evaluated for efficacy in non-human primate models of LID and/or clinically. Copyright © 2018 Elsevier Ltd. All rights reserved.

Study of the Continuous Improvement Trend for Health, Safety and Environmental Indicators, after Establishment of Integrated Management System (IMS) in a Pharmaceutical Industry in Iran.

PubMed

Mariouryad, Pegah; Golbabaei, Farideh; Nasiri, Parvin; Mohammadfam, Iraj; Marioryad, Hossein

2015-10-01

Nowadays, organizations try to improve their services and consequently adopt management systems and standards which have become key parts in various industries. One of these management systems which have been noticed in the recent years is Integrated Management System that is the combination of quality, health, safety and environment management systems. This study was conducted with the aim of evaluating the improvement trend after establishment of integrated management system for health, safety and environment indicators, in a pharmaceutical industry in Iran. First, during several inspections in different parts of the industry, indicators that should have been noted were listed and then these indicators were organized in 3 domains of health, safety and environment in the form of a questionnaire that followed Likert method of scaling. Also, the weight of each index was resulted from averaging out of 30 managers and the viewpoints of the related experts in the field. Moreover, by checking the documents and evidence of different years (5 contemplation years of this study), the score of each indicator was determined by multiplying the weight and score of the indices and were finally analysed. Over 5 years, scores of health scope indicators, increased from 161.99 to 202.23. Score in the first year after applying the integrated management system establishment was 172.37 in safety part and in the final year increased to 197.57. The changes of environmental scope rates, from the beginning of the program up to the last year increased from 49.24 to 64.27. Integrated management systems help organizations to improve programs to achieve their objectives. Although in this study all trends of health, safety and environmental indicator changes were positive, but at the same time showed to be slow. So, one can suggest that the result of an annual evaluation should be applied in planning future activities for the years ahead.

Study of the Continuous Improvement Trend for Health, Safety and Environmental Indicators, after Establishment of Integrated Management System (IMS) in a Pharmaceutical Industry in Iran

PubMed Central

Mariouryad, Pegah; Golbabaei, Farideh; Nasiri, Parvin; Mohammadfam, Iraj

2015-01-01

Background Nowadays, organizations try to improve their services and consequently adopt management systems and standards which have become key parts in various industries. One of these management systems which have been noticed in the recent years is Integrated Management System that is the combination of quality, health, safety and environment management systems. Aim This study was conducted with the aim of evaluating the improvement trend after establishment of integrated management system for health, safety and environment indicators, in a pharmaceutical industry in Iran. Materials and Methods First, during several inspections in different parts of the industry, indicators that should have been noted were listed and then these indicators were organized in 3 domains of health, safety and environment in the form of a questionnaire that followed Likert method of scaling. Also, the weight of each index was resulted from averaging out of 30 managers and the viewpoints of the related experts in the field. Moreover, by checking the documents and evidence of different years (5 contemplation years of this study), the score of each indicator was determined by multiplying the weight and score of the indices and were finally analysed. Results Over 5 years, scores of health scope indicators, increased from 161.99 to 202.23. Score in the first year after applying the integrated management system establishment was 172.37 in safety part and in the final year increased to 197.57. The changes of environmental scope rates, from the beginning of the program up to the last year increased from 49.24 to 64.27. Conclusion Integrated management systems help organizations to improve programs to achieve their objectives. Although in this study all trends of health, safety and environmental indicator changes were positive, but at the same time showed to be slow. So, one can suggest that the result of an annual evaluation should be applied in planning future activities for the years ahead. PMID:26557547

Social media for arthritis-related comparative effectiveness and safety research and the impact of direct-to-consumer advertising.

PubMed

Curtis, Jeffrey R; Chen, Lang; Higginbotham, Phillip; Nowell, W Benjamin; Gal-Levy, Ronit; Willig, James; Safford, Monika; Coe, Joseph; O'Hara, Kaitlin; Sa'adon, Roee

2017-03-07

Social media may complement traditional data sources to answer comparative effectiveness/safety questions after medication licensure. The Treato platform was used to analyze all publicly available social media data including Facebook, blogs, and discussion boards for posts mentioning inflammatory arthritis (e.g. rheumatoid, psoriatic). Safety events were self-reported by patients and mapped to medical ontologies, resolving synonyms. Disease and symptom-related treatment indications were manually redacted. The units of analysis were unique terms in posts. Pre-specified conditions (e.g. herpes zoster (HZ)) were selected based upon safety signals from clinical trials and reported as pairwise odds ratios (ORs); drugs were compared with Fisher's exact test. Empirically identified events were analyzed using disproportionality analysis and reported as relative reporting ratios (RRRs). The accuracy of a natural language processing (NLP) classifier to identify cases of shingles associated with arthritis medications was assessed. As of October 2015, there were 785,656 arthritis-related posts. Posts were predominantly US posts (75%) from patient authors (87%) under 40 years of age (61%). For HZ posts (n = 1815), ORs were significantly increased with tofacitinib versus other rheumatoid arthritis therapies. ORs for mentions of perforated bowel (n = 13) were higher with tocilizumab versus other therapies. RRRs associated with tofacitinib were highest in conditions related to baldness and hair regrowth, infections and cancer. The NLP classifier had a positive predictive value of 91% to identify HZ. There was a threefold increase in posts following television direct-to-consumer advertisement (p = 0.04); posts expressing medication safety concerns were significantly more frequent than favorable posts. Social media is a challenging yet promising data source that may complement traditional approaches for comparative effectiveness research for new medications.

Semiquantitative analysis of gaps in microbiological performance of fish processing sector implementing current food safety management systems: a case study.

PubMed

Onjong, Hillary Adawo; Wangoh, John; Njage, Patrick Murigu Kamau

2014-08-01

Fish processing plants still face microbial food safety-related product rejections and the associated economic losses, although they implement legislation, with well-established quality assurance guidelines and standards. We assessed the microbial performance of core control and assurance activities of fish exporting processors to offer suggestions for improvement using a case study. A microbiological assessment scheme was used to systematically analyze microbial counts in six selected critical sampling locations (CSLs). Nine small-, medium- and large-sized companies implementing current food safety management systems (FSMS) were studied. Samples were collected three times on each occasion (n = 324). Microbial indicators representing food safety, plant and personnel hygiene, and overall microbiological performance were analyzed. Microbiological distribution and safety profile levels for the CSLs were calculated. Performance of core control and assurance activities of the FSMS was also diagnosed using an FSMS diagnostic instrument. Final fish products from 67% of the companies were within the legally accepted microbiological limits. Salmonella was absent in all CSLs. Hands or gloves of workers from the majority of companies were highly contaminated with Staphylococcus aureus at levels above the recommended limits. Large-sized companies performed better in Enterobacteriaceae, Escherichia coli, and S. aureus than medium- and small-sized ones in a majority of the CSLs, including receipt of raw fish material, heading and gutting, and the condition of the fish processing tables and facilities before cleaning and sanitation. Fish products of 33% (3 of 9) of the companies and handling surfaces of 22% (2 of 9) of the companies showed high variability in Enterobacteriaceae counts. High variability in total viable counts and Enterobacteriaceae was noted on fish products and handling surfaces. Specific recommendations were made in core control and assurance activities associated with sampling locations showing poor performance.

Preclinical good laboratory practice-compliant safety study to evaluate biodistribution and tumorigenicity of a cartilage advanced therapy medicinal product (ATMP).

PubMed

Zscharnack, Matthias; Krause, Christoph; Aust, Gabriela; Thümmler, Christian; Peinemann, Frank; Keller, Thomas; Smink, Jeske J; Holland, Heidrun; Somerson, Jeremy S; Knauer, Jens; Schulz, Ronny M; Lehmann, Jörg

2015-05-20

The clinical development of advanced therapy medicinal products (ATMPs), a new class of drugs, requires initial safety studies that deviate from standard non-clinical safety protocols. The study provides a strategy to address the safety aspects of biodistribution and tumorigenicity of ATMPs under good laboratory practice (GLP) conditions avoiding cell product manipulation. Moreover, the strategy was applied on a human ATMP for cartilage repair. The testing strategy addresses biodistribution and tumorigenicity using a multi-step analysis without any cell manipulation to exclude changes of test item characteristics. As a safeguard measurement for meeting regulatory expectations, the project design and goals were discussed continuously with the regulatory authority using a staggered scientific advice concept. Subsequently, the strategy was applied to co.don chondrosphere® (huChon spheroid), a tissue-engineered matrix-free ATMP of human normal chondrocytes. In both the biodistribution and tumorigenicity studies, huChon spheroids were implanted subcutaneously into 40 immunodeficient mice. Biodistribution was studied 1 month after implantation. A skin disc containing the huChon spheroid, two surrounding skin rings and selected organs were analyzed by validated, gender-specific, highly-sensitive triplex qPCR and by immunohistochemistry (IHC). No human DNA was detected in distant skin rings and analyzed organs. IHC revealed no direct or indirect indications of cell migration. Tumorigenicity was assessed 6 months after huChon spheroid implantation by palpation, macroscopic inspection, histology and IHC. No mice from the huChon spheroid group developed a tumor at the implantation site. In two mice, benign tumors were detected that were negative for HLA-ABC, suggesting that they were of spontaneous murine origin. In summary, the presented strategy using a multi-step analysis was confirmed to be suitable for safety studies of ATMPs.

Use of cultural consensus analysis to evaluate expert feedback of median safety.

PubMed

Kim, Tae-Gyu; Donnell, Eric T; Lee, Dongmin

2008-07-01

Cultural consensus analysis is a statistical method that can be used to assess participant responses to survey questions. The technique concurrently estimates the knowledge of each survey participant and estimates the culturally correct answer to each question asked, based on the existence of consensus among survey participants. The main objectives of this paper are to present the cultural consensus methodology and apply it to a set of median design and safety survey data that were collected using the Delphi method. A total of 21 Delphi survey participants were asked to answer research questions related to cross-median crashes. It was found that the Delphi panel had agreeable opinions with respect to the association of average daily traffic (ADT) and heavy vehicle percentage combination on the risk of cross-median crashes; relative importance of additional factors, other than ADT, median width, and crash history that may contribute to cross-median crashes; and, the relative importance of geometric factors that may be associated with the likelihood of cross-median crashes. Therefore, the findings from the cultural consensus analysis indicate that the expert panel selected to participate in the Delphi survey shared a common knowledge pool relative to the association between median design and safety. There were, however, diverse opinions regarding median barrier type and its preferred placement location. The panel showed a higher level of knowledge on the relative importance regarding the association of geometric factors on cross-median crashes likelihood than on other issues considered. The results of the cultural consensus analysis of the present median design and safety survey data could be used to design a focused field study of median safety.

Safety, tolerability, and risks associated with first- and second-generation antipsychotics: a state-of-the-art clinical review

PubMed Central

Solmi, Marco; Murru, Andrea; Pacchiarotti, Isabella; Undurraga, Juan; Veronese, Nicola; Fornaro, Michele; Stubbs, Brendon; Monaco, Francesco; Vieta, Eduard; Seeman, Mary V; Correll, Christoph U; Carvalho, André F

2017-01-01

Since the discovery of chlorpromazine (CPZ) in 1952, first-generation antipsychotics (FGAs) have revolutionized psychiatric care in terms of facilitating discharge from hospital and enabling large numbers of patients with severe mental illness (SMI) to be treated in the community. Second-generation antipsychotics (SGAs) ushered in a progressive shift from the paternalistic management of SMI symptoms to a patient-centered approach, which emphasized targets important to patients – psychosocial functioning, quality of life, and recovery. These drugs are no longer limited to specific Diagnostic and Statistical Manual of Mental Disorders (DSM) categories. Evidence indicates that SGAs show an improved safety and tolerability profile compared with FGAs. The incidence of treatment-emergent extrapyramidal side effects is lower, and there is less impairment of cognitive function and treatment-related negative symptoms. However, treatment with SGAs has been associated with a wide range of untoward effects, among which treatment-emergent weight gain and metabolic abnormalities are of notable concern. The present clinical review aims to summarize the safety and tolerability profile of selected FGAs and SGAs and to link treatment-related adverse effects to the pharmacodynamic profile of each drug. Evidence, predominantly derived from systematic reviews, meta-analyses, and clinical trials of the drugs amisulpride, aripiprazole, asenapine, brexpiprazole, cariprazine, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, sertindole, ziprasidone, CPZ, haloperidol, loxapine, and perphenazine, is summarized. In addition, the safety and tolerability profiles of antipsychotics are discussed in the context of the “behavioral toxicity” conceptual framework, which considers the longitudinal course and the clinical and therapeutic consequences of treatment-emergent side effects. In SMI, SGAs with safer metabolic profiles should ideally be prescribed first. However, alongside with safety, efficacy should also be considered on a patient-tailored basis. PMID:28721057

Microwave Sanitization of Color Additives Used in Cosmetics: Feasibility Study

PubMed Central

Jasnow, S. B.; Smith, J. L.

1975-01-01

Microwave exposure has been explored as a method of microbiologically sanitizing color additives used in cosmetic products. Selected microbiologically unacceptable cosmetic color additives, D&C red no. 7 Ca lake (certified synthetic organic color), carmine (natural organic color not subject to certification), and chromium hydroxide green (inorganic color not subject to certification), were submitted to microwave exposure. Gram-negative bacteria were eliminated, as verified by enrichment procedures, and levels of gram-positive bacteria were reduced. Generally, analytical and dermal safety studies indicated no significant alterations in physical, chemical, and toxicological properties of the colors. Sanitization was also successfully performed on other colors (D&C red no. 9 Ba lake, D&C red no. 12 Ba lake, D&C green no. 5, and FD&C red no. 4); initial physical and chemical tests were satisfactory. Results indicated that this method of sanitization is feasible and warrants further investigation. PMID:1164010

Analysis of the causes and consequences of falls from scaffolding using the Polish construction industry as an example

NASA Astrophysics Data System (ADS)

Hoła, A.; Hoła, B.; Szóstak, M.

2017-10-01

The results of research published in many publications indicate that the scale of the problem of accidents at work in the construction industry is significant. Fatal and serious accidents, which in the construction industry are often a result of a fall from a height and associated with working on scaffolding, have a particularly strong impact on society. Systematic controls carried out on Polish construction sites indicate irregularities in the area of ensuring safety on scaffolding. As a result of conducted own studies, dozens of accidents caused by falls from scaffolding were selected from the total number of accidents at work in the construction industry and then analysed. The aim of the research was to identify the causes of these accidents and their consequences. The results of studies conducted in this area will be the content of the article.

Effects of geometric characteristics of interchanges on truck safety

DOT National Transportation Integrated Search

1999-01-18

Relationships between truck accidents and selected geometric characteristics of interchanges are examined. Datasets containing information on truck accident at interchanges, traffic exposure and selected geometric characteristics are analyzed with an...

Patient safety culture in China: a case study in an outpatient setting in Beijing

PubMed Central

Liu, Chaojie; Liu, Weiwei; Wang, Yuanyuan; Zhang, Zhihong; Wang, Peng

2014-01-01

Objectives To investigate the patient safety culture in an outpatient setting in Beijing and explore the meaning and implications of the safety culture from the perspective of health workers and patients. Methods A mixed methods approach involving a questionnaire survey and in-depth interviews was adopted. Among the 410 invited staff members, 318 completed the Hospital Survey of Patient Safety Culture (HSOPC). Patient safety culture was described using 12 subscale scores. Inter-subscale correlation analysis, ANOVA and stepwise multivariate regression analyses were performed to identify the determinants of the patient safety culture scores. Interviewees included 22 patients selected through opportunity sampling and 27 staff members selected through purposive sampling. The interview data were analysed thematically. Results The survey respondents perceived high levels of unsafe care but had personally reported few events. Lack of ‘communication openness’ was identified as a major safety culture problem, and a perception of ‘penalty’ was the greatest barrier to the encouragement of error reporting. Cohesive ‘teamwork within units’, while found to be an area of strength, conversely served as a protective and defensive mechanism for medical practice. Low levels of trust between providers and consumers and lack of management support constituted an obstacle to building a positive patient safety culture. Conclusions This study in China demonstrates that a punitive approach to error is still widespread despite increasing awareness of unsafe care, and managers have been slow in acknowledging the importance of building a positive patient safety culture. Strong ‘teamwork within units’, a common area of strength, could fuel the concealment of errors. PMID:24351971

Report to Congress on innovative safety and security technology solutions for alternative transportation facilities

DOT National Transportation Integrated Search

2017-05-01

This research collected information on the frequency and impact of safety and security incidents (threats) at selected facilities and identified priority incidents at each facility. A customized all hazards approach was used to determine the ha...

Installation of child safety seats in selected 1988-1989 model year automobiles

DOT National Transportation Integrated Search

1989-06-01

The study tested whether currently marketed child safety seats are difficult to install in current model automobiles. The study also tested whether once installed, the child seats remain securely fastened when rocked or tilted. Thirteen toddler and f...

1998 motor vehicle occupant safety survey. Volume 1, methodology report

DOT National Transportation Integrated Search

2000-03-01

This is the Methodology Report for the 1998 Motor Vehicle Occupant Safety Survey. The survey is conducted on a biennial basis (initiated in 1994), and is administered by telephone to a randomly selected national sample. Two questionnaires are used, e...

Occupational hazards and safety measures amongst the paint factory workers in lagos, Nigeria.

PubMed

Awodele, Olufunsho; Popoola, Temidayo D; Ogbudu, Bawo S; Akinyede, Akin; Coker, Herbert A B; Akintonwa, Alade

2014-06-01

The manufacture of paint involves a variety of processes that present with medical hazards. Safety initiatives are hence introduced to limit hazard exposures and promote workplace safety. This aim of this study is to assess the use of available control measures/initiatives in selected paint factories in Lagos West Senatorial District, Nigeria. A total of 400 randomly selected paint factory workers were involved in the study. A well-structured World Health Organization standard questionnaire was designed and distributed to the workers to elicit information on awareness to occupational hazards, use of personal protective devices, and commonly experienced adverse symptoms. Urine samples were obtained from 50 workers randomly selected from these 400 participants, and the concentrations of the heavy metals (lead, cadmium, arsenic, and chromium) were determined using atomic absorption spectroscopy. The results show that 72.5% of the respondents are aware of the hazards associated with their jobs; 30% have had formal training on hazards and safety measures; 40% do not use personal protective devices, and 90% of the respondents reported symptoms relating to hazard exposure. There was a statistically significant (p < 0.05) increase in the mean heavy metal concentrations in the urine samples obtained from paint factory workers as compared with nonfactory workers. The need to develop effective frameworks that will initiate the integration and ensure implementation of safety regulations in paint factories is evident. Where these exist, there is a need to promote adherence to these practice guidelines.

Applications of aerospace technology in industry, a technology transfer profile: Fire safety

NASA Technical Reports Server (NTRS)

Kottenstette, J. P.; Freeman, J. E.; Heins, C. R.; Hildred, W. M.; Johnson, F. D.; Staskin, E. R.

1971-01-01

The fire safety field is considered as being composed of three parts: an industry, a technology base, and a user base. An overview of the field is presented, including a perspective on the magnitude of the national fire safety problem. Selected NASA contributions to the technology of fire safety are considered. Communication mechanisms, particularly conferences and publications, used by NASA to alert the community to new developments in the fire safety field, are reviewed. Several examples of nonaerospace applications of NASA-generated fire safety technology are also presented. Issues associated with attempts to transfer this technology from the space program to other sectors of the American economy are outlined.

Safety Training--A Special Case?

ERIC Educational Resources Information Center

Cooper, Mark; Cotton, David

2000-01-01

Review of research on industrial training and occupational safety and health did not find materials on training safely or risk assessment for training. A study of 34 safety inspectors indicated that risk decision making and assessment are serious concerns that should be addressed in safety training. (Contains 56 references.) (SK)

Selection of the Mars Exploration Rover landing sites

NASA Astrophysics Data System (ADS)

Golombek, M. P.; Grant, J. A.; Parker, T. J.; Kass, D. M.; Crisp, J. A.; Squyres, S. W.; Haldemann, A. F. C.; Adler, M.; Lee, W. J.; Bridges, N. T.; Arvidson, R. E.; Carr, M. H.; Kirk, R. L.; Knocke, P. C.; Roncoli, R. B.; Weitz, C. M.; Schofield, J. T.; Zurek, R. W.; Christensen, P. R.; Fergason, R. L.; Anderson, F. S.; Rice, J. W.

2003-12-01

The selection of Meridiani Planum and Gusev crater as the Mars Exploration Rover landing sites took over 2 years, involved broad participation of the science community via four open workshops, and narrowed an initial ~155 potential sites (80-300 × 30 km) to four finalists based on science and safety. Engineering constraints important to the selection included (1) latitude (10°N-15°S) for maximum solar power, (2) elevation (less than -1.3 km) for sufficient atmosphere to slow the lander, (3) low horizontal winds, shear, and turbulence in the last few kilometers to minimize horizontal velocity, (4) low 10-m-scale slopes to reduce airbag spin-up and bounce, (5) moderate rock abundance to reduce abrasion or strokeout of the airbags, and (6) a radar-reflective, load-bearing, and trafficable surface safe for landing and roving that is not dominated by fine-grained dust. The evaluation of sites utilized existing as well as targeted orbital information acquired from the Mars Global Surveyor and Mars Odyssey. Three of the final four landing sites show strong evidence for surface processes involving water and appear capable of addressing the science objectives of the missions, which are to determine the aqueous, climatic, and geologic history of sites on Mars where conditions may have been favorable to the preservation of evidence of possible prebiotic or biotic processes. The evaluation of science criteria placed Meridiani and Gusev as the highest-priority sites. The evaluation of the three most critical safety criteria (10-m-scale slopes, rocks, and winds) and landing simulation results indicated that Meridiani and Elysium Planitia are the safest sites, followed by Gusev and Isidis Planitia.

Selection of the Mars Exploration Rover landing sites

USGS Publications Warehouse

Golombek, M.P.; Grant, J. A.; Parker, T.J.; Kass, D.M.; Crisp, J.A.; Squyres, S. W.; Haldemann, A.F.C.; Adler, M.; Lee, W.J.; Bridges, N.T.; Arvidson, R. E.; Carr, M.H.; Kirk, R.L.; Knocke, P.C.; Roncoli, R.B.; Weitz, C.M.; Schofield, J.T.; Zurek, R.W.; Christensen, P.R.; Fergason, R.L.; Anderson, F.S.; Rice, J. W.

2003-01-01

The selection of Meridiani Planum and Gusev crater as the Mars Exploration Rover landing sites took over 2 years, involved broad participation of the science community via four open workshops, and narrowed an initial ???155 potential sites (80-300 ?? 30 km) to four finalists based on science and safety. Engineering constraints important to the selection included (1) latitude (10??N- 15??S) for maximum solar power, (2) elevation (less than - 1.3 km) for sufficient atmosphere to slow the lander, (3) low horizontal winds, shear, and turbulence in the last few kilometers to minimize horizontal velocity, (4) low 10-m-scale slopes to reduce airbag spin-up and bounce, (5) moderate rock abundance to reduce abrasion or strokeout of the airbags, and (6) a radar-reflective, load-bearing, and trafficable surface safe for landing and roving that is not dominated by fine-grained dust. The evaluation of sites utilized existing as well as targeted orbital information acquired from the Mars Global Surveyor and Mars Odyssey. Three of the final four landing sites show strong evidence for surface processes involving water and appear capable of addressing the science objectives of the missions, which are to determine the aqueous, climatic, and geologic history of sites on Mars where conditions may have been favorable to the preservation of evidence of possible prebiotic or biotic processes. The evaluation of science criteria placed Meridiani and Gusev as the highest-priority sites. The evaluation of the three most critical safety criteria (10-m-scale slopes, rocks, and winds) and landing simulation results indicated that Meridiani and Elysium Planitia are the safest sites, followed by Gusev and Isidis Planitia. Copyright 2003 by the American Geophysical Union.

Software Safety Risk in Legacy Safety-Critical Computer Systems

NASA Technical Reports Server (NTRS)

Hill, Janice; Baggs, Rhoda

2007-01-01

Safety-critical computer systems must be engineered to meet system and software safety requirements. For legacy safety-critical computer systems, software safety requirements may not have been formally specified during development. When process-oriented software safety requirements are levied on a legacy system after the fact, where software development artifacts don't exist or are incomplete, the question becomes 'how can this be done?' The risks associated with only meeting certain software safety requirements in a legacy safety-critical computer system must be addressed should such systems be selected as candidates for reuse. This paper proposes a method for ascertaining formally, a software safety risk assessment, that provides measurements for software safety for legacy systems which may or may not have a suite of software engineering documentation that is now normally required. It relies upon the NASA Software Safety Standard, risk assessment methods based upon the Taxonomy-Based Questionnaire, and the application of reverse engineering CASE tools to produce original design documents for legacy systems.

[Determinants in an occupational health and safety program implementation].

PubMed

Chaves, Sonia Cristina Lima; Santana, Vilma Sousa; de Leão, Inez Cristina Martins; de Santana, Jusiene Nogueira; de Almeida Lacerda, Lívia Maria Aragão

2009-03-01

To identify predictors for the degree to which a program that integrates occupational health surveillance with labor safety, and involves occupational health/safety specialists, company management, and employees, is implemented. This ecological study evaluated companies implementing the occupational health and safety program (OHSP) proposed by the state of Bahia's regional department of Serviço Social da Indústria (Social Services for Industry, SESI) during the 2005-2006 cycle. The companies that participated were randomly selected. Data were collected through interviews with key contacts within the companies and from technical reports issued by SESI. Multiple linear regression was used to identify factors related to the company, employee, occupational/safety specialist, and any subdimensions that might promote OHSP implementation. Of the 78 companies selected (3 384 employees), the degree to which OHSP was implemented was "advanced" in 24.4%, "intermediate" in 53.8%, and "initial" in 19.3%. Company-related, employee-related and specialist-related factors were positively associated with OHSP implementation (P < 0.001). The most important factor overall was the program's financial autonomy (beta = 4.40; P < 0.001). Bivariate analysis revealed that the degree of implementation was associated with the employees' level of health/safety knowledge (beta = 1.58; P < 0.05) and training (beta = 0.40; P < 0.001) and with communication between the occupational safety team (beta = 1.89; P < 0.01) and the health team (beta = 0.58; P < 0.05). These findings remained unchanged after adjustment for levels of education among managers and employees, salary/wages, company size, and risk. The time and resources available for employees to dedicate to occupational health and safety, the integration and reinforcement of employee and manager training programs, and improved relationship between occupational health and safety teams may contribute to the success of health and safety promotion efforts among employees.

Patient safety culture and job stress among nurses in Mazandaran, Iran.

PubMed

Asefzadeh, Saeed; Kalhor, Rohollah; Tir, Mohammad

2017-12-01

Paying attention to patient safety is a basic right and a necessary issue in providing medical care, and failure to observe it leads to irreparable damage. One of the factors affecting an individuals' performance in an organization is stress, which also endangers their health. To determine the relationship between patient safety culture and levels of job stress among the nurses working in the hospitals affiliated with Mazandaran University of Medical Sciences. The present study was carried out using a cross-sectional method in the hospitals affiliated with Mazandaran University of Medical Sciences in 2016. A multistage stratified sampling method using a Morgan Table was employed to select 380 nurses as the study sample from among 3,180 nurses. They were selected by a multistage stratified sampling method. The study instruments were Stinemetz Standard Job Stress Questionnaire and Hospital Survey on Patient Safety Culture (HSOPSC). After the required data were collected, they were analyzed using descriptive and inferential statistical methods (Pearson correlation, independent-samples t-test, and ANOVA) through SPSS version 23. The results of the present study showed that 75% of the nurses experienced average and high levels of stress. Among different dimensions of safety culture, organizational learning and handoffs and transitions obtained the highest and the lowest scores, respectively (72.5 and 24.5). The mean score of safety culture dimensions was 51.52. The results of the Pearson correlation test showed that there was a direct significant relationship between different dimensions of safety culture among nurses and the level of stress (p≤0.05). According to the findings, patient safety should be considered as a strategic priority for the senior managers of the health system. In order to enhance patient safety, managers should pay special attention to evaluating safety culture in organizations that deliver health service, especially hospitals.

Monitoring circuit for reactor safety systems

DOEpatents

Keefe, Donald J.

1976-01-01

The ratio between the output signals of a pair of reactor safety channels is monitored. When ratio falls outside of a predetermined range, it indicates that one or more of the safety channels has malfunctioned.

Young Age as a Predictor of Poor Road Safety Practices of Commercial Motorcyclists in Oyo State, Nigeria.

PubMed

Olumide, Adesola O; Owoaje, Eme T

2015-01-01

This study examined the association between young age and poor road safety practices of commercial motorcyclists in Oyo state, Nigeria. A cross-sectional study of 371 commercial motorcyclists selected via a multistage sampling technique was conducted. Information on sociodemographic characteristics and road safety practices (possession of a valid license, helmet use, number of passengers carried per trip, and compliance with 10 selected traffic signs) was obtained with the aid of an interviewer-administered questionnaire. Individual road safety practice items were scored and a total score was obtained giving minimum and maximum obtainable scores of 0 and 35. Respondents with scores ≤ 17.5 (i.e., less than or equal to half of the maximum obtainable score of 35) were categorized as having poor road safety practices. Descriptive statistics, chi-square, and multiple logistic regression tests were conducted. Selected sociodemographic and occupation-related factors were controlled for in the logistic regression analysis. All respondents were male, 80.1% had been riding for commercial purposes for less than 5 years, and 73.0% had other jobs in addition to commercial riding. Road safety practices were generally poor; that is, 84.4% of commercial riders were categorized as having poor road safety practices. Almost all (98.6%) respondents aged < 25 years compared to 84.3% of those aged 25 to <35 years and 76.8% of those ≥35 years had poor road safety practices. This difference was statistically significant. Following logistic regression, younger age (<25 years) remained predictive of poor road safety practices. Motorcyclists aged < 25 years had about 16 times higher odds of having poor road safety practices compared to those aged 35 years and more (odds ratio = 15.72, 95% confidence interval, 1.82-135.91). Most studies conduct only bivariate analysis to test the association between age and road practices of commercial motorcyclists; however, we investigated the influence of potential confounding variables using multivariate analysis. Our findings confirmed young age as a predictor of poor road safety practices among our sample of commercial motorcyclists and emphasizes the need for road safety programs to target this category of riders. The current minimum age for obtaining a rider's license in Nigeria is 18 years; our findings suggest that it might be beneficial to increase the age at which riders in our study area can obtain a commercial rider's license to above 25 years.

[Study on the occupational stress norm and it's application for the marketing group, public service/safety group and production laborer group].

PubMed

Yang, Xin-Wei; Wang, Zhi-Ming; Jin, Tai-Yi; Lan, Ya-Jia

2006-09-01

A study of the occupational stress norm and it's application for the marketing group, public service/safety group and production laborer group. In this study, cross-sectional study method is used, and a synthetic way of sorting and randomized sampling is adopted to deal with research targets (36 marketing group, 331 public service/safety group, 903 production laborer group). Descriptive statistics for OSI-R scale scores for the marketing group, public service/safety group and production laborer group were modulated. Scale raw score to T-score conversion tables derived from the OSI-R normative sample for marketing group public service/safety group and production laborer group were established. OSI-R profile from for marketing group, public service/safety group and production laborer group were established. For the ORQ and PSQ scales, scores at or above 70 indicate a strong levels of maladaptive stress and strain. Score in the range of 60 to 69 suggest middle levels of maladaptive stress and strain. Score in the range of 40 to 59 indicate normal levels of stress and strain. Score below 40 indicate a relative absence of occupational stress and strain. For the PRQ scales, score below 30 indicate a significant lack of coping resources. Score in the range of 30 to 39 suggest middle deficits in coping resources. Score in the range of 40 to 59 indicate average coping resources. Scores at or above 60 indicate a strong levels of coping resources. The authors combined subjective and objective environment match model of occupational stress. Different intervention measure should be take to reduce the occupational stress so as to improve the work ability.

The role of microbiological testing in systems for assuring the safety of beef.

PubMed

Brown, M H; Gill, C O; Hollingsworth, J; Nickelson, R; Seward, S; Sheridan, J J; Stevenson, T; Sumner, J L; Theno, D M; Usborne, W R; Zink, D

2000-12-05

The use of microbiological testing in systems for assuring the safety of beef was considered at a meeting arranged by the International Livestock Educational Foundation as part of the International Livestock Congress, TX, USA, during February, 2000. The 11 invited participants from industry and government research organizations concurred in concluding that microbiological testing is necessary for the implementation and maintenance of effective Hazard Analysis Critical Control Point (HACCP) systems, which are the only means of assuring the microbiological safety of beef; that microbiological testing for HACCP purposes must involve the enumeration of indicator organisms rather than the detection of pathogens; that the efficacy of process control should be assessed against performance criteria and food safety objectives that refer to the numbers of indicator organisms in product; that sampling procedures should allow indicator organisms to be enumerated at very low numbers; and that food safety objectives and microbiological criteria are better related to variables, rather than attributes sampling plans.

The Use of Crow-AMSAA Plots to Assess Mishap Trends

NASA Technical Reports Server (NTRS)

Dawson, Jeffrey W.

2011-01-01

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

Patient Safety Culture Assessment in Oman

PubMed Central

Al-Mandhari, Ahmed; Al-Zakwani, Ibrahim; Al-Kindi, Moosa; Tawilah, Jihane; Dorvlo, Atsu S.S.; Al-Adawi, Samir

2014-01-01

Objective To illustrate the patient safety culture in Oman as gleaned via 12 indices of patient safety culture derived from the Hospital Survey on Patient Safety Culture (HSPSC) and to compare the average positive response rates in patient safety culture between Oman and the USA, Taiwan, and Lebanon. Methods This was a cross-sectional research study employed to gauge the performance of HSPSC safety indices among health workers representing five secondary and tertiary care hospitals in the northern region of Oman. The participants (n=398) represented different professional designations of hospital staff. Analyses were performed using univariate statistics. Results The overall average positive response rate for the 12 patient safety culture dimensions of the HSPSC survey in Oman was 58%. The indices from HSPSC that were endorsed the highest included ‘organizational learning and continuous improvement’ while conversely, ‘non-punitive response to errors’ was ranked the least. There were no significant differences in average positive response rates between Oman and the United States (58% vs. 61%; p=0.666), Taiwan (58% vs. 64%; p=0.386), and Lebanon (58% vs. 61%; p=0.666). Conclusion This study provides the first empirical study on patient safety culture in Oman which is similar to those rates reported elsewhere. It highlights the specific strengths and weaknesses which may stem from the specific milieu prevailing in Oman. PMID:25170407

Targeting the cyclin D–cyclin-dependent kinase (CDK)4/6–retinoblastoma pathway with selective CDK 4/6 inhibitors in hormone receptor-positive breast cancer: rationale, current status, and future directions

PubMed Central

Spring, Laura; Bardia, Aditya; Modi, Shanu

2017-01-01

Dysregulation of the cyclin D–cyclin-dependent kinase (CDK)4/6–INK4–retinoblastoma (Rb) pathway is an important contributor to endocrine therapy resistance. Recent clinical development of selective inhibitors of CDK4 and CDK6 kinases has led to renewed interest in cell cycle regulators, following experience with relatively nonselective pan-CDK inhibitors that often resulted in limited activity and poor safety profiles in the clinic. The highly selective oral CDK 4/6 inhibitors palbociclib (PD0332991), ribociclib (LEE011), and abemaciclib (LY2835219) are able to inhibit the proliferation of Rb-positive tumor cells and have demonstrated dose-dependent growth inhibition in ER+ breast cancer models. In metastatic breast cancer, all three agents are being explored in combination with endocrine therapy in Phase III studies. Results so far indicate promising efficacy and manageable safety profiles, and led to the FDA approval of palbociclib. Phase II–III studies of these agents, in combination with endocrine therapy, are also underway in early breast cancer in the neoadjuvant and adjuvant settings. Selective CDK 4/6 inhibitors are also being investigated with other targeted agents or chemotherapy in the advanced setting. This article reviews the rationale for targeting cyclin D–CDK 4/6 in hormone receptor-positive (HR+) breast cancer, provides an overview of the available preclinical and clinical data with CDK 4/6 inhibitors in breast cancer to date, and summarizes the main features of ongoing clinical trials of these new agents in breast cancer. Future trials evaluating further combinations strategies with CDK 4/6 backbone and translational studies refining predictive biomarkers are needed to help personalize the optimal treatment regimen for individual patients with ER+ breast cancer. PMID:26896604

A chemical risk ranking and scoring method for the selection of harmful substances to be specially controlled in occupational environments.

PubMed

Shin, Saemi; Moon, Hyung-Il; Lee, Kwon Seob; Hong, Mun Ki; Byeon, Sang-Hoon

2014-11-20

This study aimed to devise a method for prioritizing hazardous chemicals for further regulatory action. To accomplish this objective, we chose appropriate indicators and algorithms. Nine indicators from the Globally Harmonized System of Classification and Labeling of Chemicals were used to identify categories to which the authors assigned numerical scores. Exposure indicators included handling volume, distribution, and exposure level. To test the method devised by this study, sixty-two harmful substances controlled by the Occupational Safety and Health Act in Korea, including acrylamide, acrylonitrile, and styrene were ranked using this proposed method. The correlation coefficients between total score and each indicator ranged from 0.160 to 0.641, and those between total score and hazard indicators ranged from 0.603 to 0.641. The latter were higher than the correlation coefficients between total score and exposure indicators, which ranged from 0.160 to 0.421. Correlations between individual indicators were low (-0.240 to 0.376), except for those between handling volume and distribution (0.613), suggesting that each indicator was not strongly correlated. The low correlations between each indicator mean that the indicators and independent and were well chosen for prioritizing harmful chemicals. This method proposed by this study can improve the cost efficiency of chemical management as utilized in occupational regulatory systems.

EMS helicopter incidents reported to the NASA Aviation Safety Reporting System

NASA Technical Reports Server (NTRS)

Connell, Linda J.; Reynard, William D.

1993-01-01

The objectives of this evaluation were to: Identify the types of safety-related incidents reported to the Aviation Safety Reporting System (ASRS) in Emergency Medical Service (EMS) helicopter operations; Describe the operational conditions surrounding these incidents, such as weather, airspace, flight phase, time of day; and Assess the contribution to these incidents of selected human factors considerations, such as communication, distraction, time pressure, workload, and flight/duty impact.

46 CFR 63.15-7 - Alarms.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING AUTOMATIC AUXILIARY BOILERS General Requirements § 63.15-7 Alarms. (a) An audible alarm must automatically sound when a flame safety system shutdown occurs. A visible indicator must indicate that the shutdown was caused by the flame safety system...

46 CFR 63.15-7 - Alarms.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING AUTOMATIC AUXILIARY BOILERS General Requirements § 63.15-7 Alarms. (a) An audible alarm must automatically sound when a flame safety system shutdown occurs. A visible indicator must indicate that the shutdown was caused by the flame safety system...

46 CFR 63.15-7 - Alarms.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING AUTOMATIC AUXILIARY BOILERS General Requirements § 63.15-7 Alarms. (a) An audible alarm must automatically sound when a flame safety system shutdown occurs. A visible indicator must indicate that the shutdown was caused by the flame safety system...

46 CFR 63.15-7 - Alarms.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING AUTOMATIC AUXILIARY BOILERS General Requirements § 63.15-7 Alarms. (a) An audible alarm must automatically sound when a flame safety system shutdown occurs. A visible indicator must indicate that the shutdown was caused by the flame safety system...

46 CFR 63.15-7 - Alarms.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING AUTOMATIC AUXILIARY BOILERS General Requirements § 63.15-7 Alarms. (a) An audible alarm must automatically sound when a flame safety system shutdown occurs. A visible indicator must indicate that the shutdown was caused by the flame safety system...

42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

Code of Federal Regulations, 2013 CFR

2013-10-01

... outcomes, patient safety, and quality of care. (2) Performance improvement activities must track adverse... improves patient safety by using quality indicators or performance measures associated with improved health... incorporate quality indicator data, including patient care and other relevant data regarding services...

42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

Code of Federal Regulations, 2012 CFR

2012-10-01

... outcomes, patient safety, and quality of care. (2) Performance improvement activities must track adverse... improves patient safety by using quality indicators or performance measures associated with improved health... incorporate quality indicator data, including patient care and other relevant data regarding services...

42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

Code of Federal Regulations, 2014 CFR

2014-10-01

... outcomes, patient safety, and quality of care. (2) Performance improvement activities must track adverse... improves patient safety by using quality indicators or performance measures associated with improved health... incorporate quality indicator data, including patient care and other relevant data regarding services...

Saudi Arabian ICU safety culture and nurses' attitudes.

PubMed

Alayed, Abdulrahman S; Lööf, Helena; Johansson, Unn-Britt

2014-01-01

The purpose of this paper is to examine nurses' attitudes towards safety culture in six Saudi Arabian intensive care units (ICUs). The study is descriptive with a cross-sectional design. The Safety Attitude Questionnaire (SAQ)-ICU version was distributed and 216 completed questionnaires were returned. The findings provide a basis for further research on Saudi Arabian ICU safety culture. This study showed that the SAQ-ICU can be used to measure safety climate to identify areas for improvement according to nurse attitudes and perceptions. Findings indicate that ICU safety culture is an important issue that hospital managers should prioritise. The SAQ-ICU questionnaire, used to measure safety climate in Saudi Arabian ICUs, identifies service strengths and improvement areas according to attitudes and perceptions. To the knowledge, this is the first study to use SAQ to examine nurses' safety culture attitudes in Saudi Arabian ICUs. The present findings provide a baseline and further details about Saudi Arabian ICU safety. Study participants represented nine nationalities, indicating the nursing workforce's diversity, which is expected to continue in the future. Such a nursing cultural heterogeneity calls for further studies to examine and evaluate attitudes and values to improve ICU safety culture.

Protecting Students on the Job.

ERIC Educational Resources Information Center

Rockefeller, Debra J.; Zikmund, Dale G.

1990-01-01

Cooperative education instructor-coordinators are responsible for the safety of student workers. They must be cognizant of employment laws and regulations; careful to select safe, well-supervised training sites; and, together with employers, they must document how safety instruction is to be carried out in the workplace. (SK)

Lower Mississippi River Ports and Waterways Safety System (PAWSS) RF coverage test results

DOT National Transportation Integrated Search

1999-11-01

The Coast Guard plans to operate an Automatic Identification System (AID) Digital Selective Calling (DSC) based transponder system as part of the Ports and Waterways Safety System (PAWSS) in the lower Mississippi River. the AIS uses two duplex channe...

Prepare Your Children to Eat 80,000 Meals Safely!

ERIC Educational Resources Information Center

Petrak, Lynn

1994-01-01

Children need to be taught about food safety. The paper includes safety tips to remember when selecting, cooking, and eating meals, both at home and away from home. Information is included on grocery shopping, home storage, food preparation, cooking, serving, and leftovers. (SM)

Helicopter Operations and Personnel Safety (Helirescue Manual). Fourth Edition.

ERIC Educational Resources Information Center

Dalle-Molle, John

The illustrated manual includes information on various aspects of helicopter rescue missions, including mission management roles for key personnel, safety rules around helicopters, requests for helicopter support, sample military air support forms, selection of landing zones, helicopter evacuations, rescuer delivery, passenger unloading, crash…

Administering Safety: Challenge Courses and Climbing Walls.

ERIC Educational Resources Information Center

Evans, Will

1996-01-01

A camp that is establishing a challenge course or climbing wall must ensure program safety. Discusses financial planning, selecting a contractor, adhering to standards for construction, inspections, staff training, screening of participants, and the administrative challenge of implementing and documenting proper actions. Sidebar discusses a study…

Establishing a store baseline during interim storage of waste packages and a review of potential technologies for base-lining

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

McTeer, Jennifer; Morris, Jenny; Wickham, Stephen

Interim storage is an essential component of the waste management lifecycle, providing a safe, secure environment for waste packages awaiting final disposal. In order to be able to monitor and detect change or degradation of the waste packages, storage building or equipment, it is necessary to know the original condition of these components (the 'waste storage system'). This paper presents an approach to establishing the baseline for a waste-storage system, and provides guidance on the selection and implementation of potential base-lining technologies. The approach is made up of two sections; assessment of base-lining needs and definition of base-lining approach. Duringmore » the assessment of base-lining needs a review of available monitoring data and store/package records should be undertaken (if the store is operational). Evolutionary processes (affecting safety functions), and their corresponding indicators, that can be measured to provide a baseline for the waste-storage system should then be identified in order for the most suitable indicators to be selected for base-lining. In defining the approach, identification of opportunities to collect data and constraints is undertaken before selecting the techniques for base-lining and developing a base-lining plan. Base-lining data may be used to establish that the state of the packages is consistent with the waste acceptance criteria for the storage facility and to support the interpretation of monitoring and inspection data collected during store operations. Opportunities and constraints are identified for different store and package types. Technologies that could potentially be used to measure baseline indicators are also reviewed. (authors)« less

47 CFR 90.723 - Selection and assignment of frequencies.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Selection and assignment of frequencies. 90.723... 220-222 MHz Band § 90.723 Selection and assignment of frequencies. (a) Phase II applications for... systems, 10-channel EA systems, 15-channel Regional systems, public safety/mutual aid use, or emergency...

Nursing work environment, patient safety and quality of care in pediatric hospital.

PubMed

Alves, Daniela Fernanda Dos Santos; Guirardello, Edinêis de Brito

2016-06-01

Objectives To describe the characteristics of the nursing work environment, safety attitudes, quality of care, measured by the nursing staff of the pediatric units, as well as to analyze the evolution of quality of care and hospital indicators. Methods Descriptive study with 136 nursing professionals at a paediatric hospital, conducted through personal and professional characterization form, Nursing Work Index - Revised, Safety Attitudes Questionnaire - Short Form 2006 and quality indicators. Results The professionals perceive the environment as favourable to professional practice, and consider good quality care that is also observed by reducing the incidence of adverse events and decreased length of stay. The domain job satisfaction was considered favourable to patient safety. Conclusions The work environment is favourable to nursing practice, the professionals nursing approve the quality of care and the indicators tended reducing adverse events and length of stay.

Emerging Minimally Invasive Treatment Options for Male Lower Urinary Tract Symptoms.

PubMed

Magistro, Giuseppe; Chapple, Christopher R; Elhilali, Mostafa; Gilling, Peter; McVary, Kevin T; Roehrborn, Claus G; Stief, Christian G; Woo, Henry H; Gratzke, Christian

2017-12-01

Lower urinary tract symptoms (LUTS) are one of the most common and troublesome nonmalignant conditions affecting quality of life in aging men. A spectrum of established medical and surgical options is available to provide relief of bothersome LUTS. Both the adverse events of medication and the morbidity with surgical treatment modalities have to be counterbalanced against efficacy. Novel minimally invasive treatment options aim to be effective, ideally to be performed in an ambulatory setting under local anaesthesia and to offer a more favourable safety profile than existing reference techniques. A comprehensive, narrative review of novel minimally invasive treatment modalities for the management of male LUTS due to benign prostatic enlargement is presented. Medline, PubMed, Cochrane database, and Embase were screened for randomised controlled trials (RCTs), clinical trials, and reviews on novel minimally invasive treatment options for male LUTS due to benign prostatic enlargement. With regard to newly devised intraprostatic injectables (botulinum neurotoxin A, NX1207, PRX302), PRX302 is currently the only substance that was superior to placebo in a phase 3 RCT providing proof of efficacy and safety. The prostatic urethral lift technique has been evaluated in several phase 3 trials showing rapid and durable relief of LUTS without compromising sexual function in carefully selected patients without a prominent median lobe. The first clinical experience of the temporary implantable nitinol device demonstrated that implantation of this novel device is a safe procedure, easy, and fast to perform. Further studies are required to evaluate efficacy, durability, and to define appropriate patient selection. New ablative approaches like the image guided robotic waterjet ablation (AquaBeam) or procedures based on convective water vapour energy (Rezūm) are in the early stages of development. Prostatic artery embolization performed by interventional radiologists at specialised centres shows a high technical success rate in the treatment of bothersome LUTS. However, a substantial clinical failure rate and a particular spectrum of complications not commonly seen after urologic interventions do occur and need to be critically evaluated. Initial promising clinical results on novel minimally invasive treatment options indicate efficacy comparable to standard techniques, often associated with a more favourable safety profile, in particular with preservation of sexual function. Many of these techniques are in their infancy and based on experience of new developments in the past. Further RCTs are required to evaluate efficacy, safety, and durability of novel techniques with long-term follow-up and careful evaluation of the selection criteria, which have been applied in clinical trials. The prostatic urethral lift is the only procedure with Level 1 evidence data and that can therefore be recommended for treatment of male LUTS in clinical practice for selected patients. Minimally invasive treatment options have been developed to provide relief of lower urinary tract symptoms comparable to standard surgical techniques with a more favourable safety profile. However, long-term clinical evaluation is still needed for most of these innovations before they can be recommended to be an effective replacement for standard surgical treatment. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Medication safety--reliability of preference cards.

PubMed

Dawson, Anthony; Orsini, Michael J; Cooper, Mary R; Wollenburg, Karol

2005-09-01

A CLINICAL ANALYSIS of surgeons' preference cards was initiated in one hospital as part of a comprehensive analysis to reduce medication-error risks by standardizing and simplifying the intraoperative medication-use process specific to the sterile field. THE PREFERENCE CARD ANALYSIS involved two subanalyses: a review of the information as it appeared on the cards and a failure mode and effects analysis of the process involved in using and maintaining the cards. THE ANALYSIS FOUND that the preference card system in use at this hospital is outdated. Variations and inconsistencies within the preference card system indicate that the use of preference cards as guides for medication selection for surgical procedures presents an opportunity for medication errors to occur.

Bacterial adhesion capacity on food service contact surfaces.

PubMed

Fink, Rok; Okanovič, Denis; Dražič, Goran; Abram, Anže; Oder, Martina; Jevšnik, Mojca; Bohinc, Klemen

2017-06-01

The aim of this study was to analyse the adhesion of E. coli, P. aeruginosa and S. aureus on food contact materials, such as polyethylene terephthalate, silicone, aluminium, Teflon and glass. Surface roughness, streaming potential and contact angle were measured. Bacterial properties by contact angle and specific charge density were characterised. The bacterial adhesion analysis using staining method and scanning electron microscopy showed the lowest adhesion on smooth aluminium and hydrophobic Teflon for most of the bacteria. However, our study indicates that hydrophobic bacteria with high specific charge density attach to those surfaces more intensively. In food services, safety could be increased by selecting material with low adhesion to prevent cross contamination.

Risk of Performance Decrement and Crew Illness Due to an Inadequate Food System

NASA Technical Reports Server (NTRS)

Douglas, Grace L.; Cooper, Maya; Bermudez-Aguirre, Daniela; Sirmons, Takiyah

2016-01-01

NASA is preparing for long duration manned missions beyond low-Earth orbit that will be challenged in several ways, including long-term exposure to the space environment, impacts to crew physiological and psychological health, limited resources, and no resupply. The food system is one of the most significant daily factors that can be altered to improve human health, and performance during space exploration. Therefore, the paramount importance of determining the methods, technologies, and requirements to provide a safe, nutritious, and acceptable food system that promotes crew health and performance cannot be underestimated. The processed and prepackaged food system is the main source of nutrition to the crew, therefore significant losses in nutrition, either through degradation of nutrients during processing and storage or inadequate food intake due to low acceptability, variety, or usability, may significantly compromise the crew's health and performance. Shelf life studies indicate that key nutrients and quality factors in many space foods degrade to concerning levels within three years, suggesting that food system will not meet the nutrition and acceptability requirements of a long duration mission beyond low-Earth orbit. Likewise, mass and volume evaluations indicate that the current food system is a significant resource burden. Alternative provisioning strategies, such as inclusion of bioregenerative foods, are challenged with resource requirements, and food safety and scarcity concerns. Ensuring provisioning of an adequate food system relies not only upon determining technologies, and requirements for nutrition, quality, and safety, but upon establishing a food system that will support nutritional adequacy, even with individual crew preference and self-selection. In short, the space food system is challenged to maintain safety, nutrition, and acceptability for all phases of an exploration mission within resource constraints. This document presents the evidence for the Risk of Performance Decrement and Crew Illness Due to an Inadequate Food System and the gaps in relation to exploration, as identified by the NASA Human Research Program (HRP). The research reviewed here indicates strategies to establish methods, technologies, and requirements that increase food stability, support adequate nutrition, quality, and variety, enable supplementation with grow-pick-and-eat salad crops, ensure safety, and reduce resource use. Obtaining the evidence to establish an adequate food system is essential, as the resources allocated to the food system may be defined based on the data relating nutritional stability and food quality requirements to crew performance and health.

Analysis of Salmonella control performance in U.S. young chicken slaughter and pork slaughter establishments.

PubMed

Muth, Mary K; Fahimi, Mansour; Karns, Shawn A

2009-01-01

In the 1996 U.S. Food Safety and Inspection Service's (FSIS) "Pathogen Reduction; Hazard Analysis and Critical Control Point (PR/HACCP) Systems, Final Rule," Salmonella was selected for microbiological testing and monitoring. Using data from an FSIS-sponsored survey of meat and poultry slaughter establishments, inspection results, and other establishment characteristics, potential variables affecting pathogen control, as measured by Salmonella test results, were investigated. The analysis data sets included 153 federally inspected young chicken slaughter establishments, of which 111 exceeded half the Salmonella performance standard at least once from 2003 through 2005, and 121 federally inspected pork slaughter establishments, of which 28 exceeded half the Salmonella performance standard. Logistic regression results for young chicken slaughter establishments indicate they were more likely to exceed half the standard if they had higher inspection noncompliance rates (P = 0.10) and older production space (P = 0.10), and were less likely to exceed it if they used a higher percentage of raw poultry inputs purchased from outside sources (P = 0.10). Results for pork slaughter establishments indicate they were more likely to exceed half the standard if they had a higher rate of voluntary microbiological testing (P = 0.08), and were less likely to exceed it if they were larger (P = 0.08) and used a higher percentage of raw pork inputs purchased from outside sources (P = 0.02). In general, indicators of plant characteristics, food safety practices, and management philosophy are associated with different levels of pathogen control performance that vary by species slaughtered.

Herbal medicines supplied by community pharmacies in Lagos, Nigeria: pharmacists’ knowledge

PubMed Central

Oshikoya, Kazeem Adeola; Oreagba, Ibrahim A.; Ogunleye, Olayinka O.; Oluwa, Rashidat; Senbanjo, Idowu O.; Olayemi, Sunday O.

Background The use of herbal medicines is on the increase globally and they are usually supplied in pharmacies as non-prescription medicines. Pharmacists are, therefore, responsible for educating and informing the consumers about rational use of herbal medicines. Objective To evaluate the knowledge of pharmacists in Lagos, Nigeria with regards to the herbal medicines they supplied by their pharmacies. Methods Pharmacists in charge of randomly selected 140 community pharmacies from 20 Local Government Areas in Lagos were required to fill out a self-administered questionnaire. We gathered information on their knowledge of the indications, adverse effects, potential drug-herb interactions and contraindications of the herbal medicines they supply in their pharmacies. Results Of the 140 questionnaires distributed, 103 (72.9%) participants completed the questionnaire appropriately. The majority (74; 71.8%) of the participants were males and 36-50 years (56; 54.4%). The pharmacies supplied mostly Yoyo cleanser bitters® (101; 98.5%), ginseng (97; 98.5%), Jobelyn® (91; 88.3%), Ciklavit® (68; 66.6%), gingko (66; 64.1%), herbal tea (66; 64.1%), and Aloe vera (57; 55.3%). The pharmacists self-rated their knowledge of herbal medicines mostly as fair (39%) and good (42%), but they exhibited poor knowledge with regards to the indications, contraindications and safety profiles. Seventy participants consulted reference materials such as leaflet insert in the herbal medicines (56%) and internet (20%) before supplying herbal medicines. The information most frequently sought was herb-drug interactions (85%), contraindications (75%) and adverse effects (70%). Conclusions Community pharmacists need to be informed about the indications and safety profiles of herbal medicines. PMID:24367462

29 CFR 1926.1415 - Safety devices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR CONSTRUCTION Cranes and Derricks in Construction § 1926.1415... this subpart, unless otherwise specified: (1) Crane level indicator. (i) The equipment must have a crane level indicator that is either built into the equipment or is available on the equipment. (ii) If...

47 CFR 80.148 - Watch on 156.8 MHz (Channel 16).

Code of Federal Regulations, 2010 CFR

2010-10-01

... exchanging communications. For GMDSS ships, 156.525 MHz is the calling frequency for distress, safety, and general communications using digital selective calling and the watch on 156.800 MHz is provided so that... 80.148 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO...

Enforcement, adjudication and public information strategies for the general deterrence of driving while intoxicated : information for potential field site participants

DOT National Transportation Integrated Search

1982-10-01

The National Highway Traffic Safety Administration (NHTSA) through a contract with the University of North Carolina Highway Safety Research Center (HSRC) is intending to field test the effectiveness of selected general deterrence programs directed at...

Development of safety performance functions and other decision support tools to assess pedestrian and bicycle safety : final report.

DOT National Transportation Integrated Search

2016-09-30

field study was performed at 40 uncontrolled midblock crosswalks and 26 signalized intersections on low-speed roadways selected from the areas surrounding three major urban college campuses across lower Michigan. An array of existing traffic control ...

The comprehensive community-based traffic safety program : phase I, problem identification for District 2 and District 7.

DOT National Transportation Integrated Search

1986-01-01

This report contains the initial Problem Identification for the Comprehensive Community-Based Traffic Safety Program (CCBP). Two DMV districts, District 2 and District 7, have been selected as the pilot areas for the CCBP, and because both districts ...

A comparison of the comfort and convenience of automatic safety belt systems among selected 1988-1989 model year automobiles

DOT National Transportation Integrated Search

1989-06-01

Author's abstract: A nonrandom sample of 120 disproportionately short, tall, and overweight drivers compared the comfort and convenience of the automatic safety belt systems used in seventeen automobiles. Nine vehicles had motorized shoulder belts wi...

Eye Safety. Mississippi Industrial Arts.

ERIC Educational Resources Information Center

Mississippi State Dept. of Education, Jackson. Div. of Vocational and Technical Education.

This manual is designed to help industrial arts teachers eliminate student eye injuries within industrial arts programs. Presented first is Mississippi eye safety law. Following a discussion of eye protection equipment, illustrations of eye protection devices are provided. Guidelines are set forth for selecting shade numbers for welding filters.…

Transporting Your Children Safely: Traffic Safety Tips

DOT National Transportation Integrated Search

1996-01-01

This fact sheet from NHTSA Facts: Summer 1996 discusses the use of child safety seats in cars. It describes the proper use of the seats, how to select one that fits both your child and the car, and lists problems to avoid. It mentions where to place ...

Patterns of analgesic and anti-inflammatory medicine use by Australian veterans.

PubMed

Pearson, S-A; Ringland, C; Kelman, C; Mant, A; Lowinger, J; Stark, H; Nichol, G; Day, R; Henry, D

2007-12-01

We examined analgesic and anti-inflammatory medicine use by Australian veterans before and after the introduction of selective Cox-2 inhibitors. We studied cohorts of Gold Card-holding veterans using prescription data held by the Department of Veterans' Affairs for the period 1 July 1998 to 30 June 2004. Outcomes were volume dispensed, average daily quantity and cumulative incidence of use of paracetamol-containing and aspirin-containing medicines, non-selective and Cox-2-selective non-steroidal anti-inflammatory drugs (NSAIDs), tramadol and dextropropoxyphene. Overall, we found high levels of use of analgesic and anti-inflammatory medicines, which increased by 43% over the study period. Use of paracetamol-containing medicines was overtaken by NSAIDs in 1999/2000, corresponding to the introduction of the Cox-2-selective agents. Between 12 and 17% of Cox-2-selective medicine recipients were supplied amounts indicative of continuous use in relatively high doses and 51% of veterans received at least one relatively Cox-2-selective medicine (celecoxib, rofecoxib, meloxicam, diclofenac) by the end of the study period. Dextropropoxyphene use declined during the study and tramadol use increased 10-fold. This study shows very high levels of Cox-2 inhibitor use during the 6-year period. Cox-2-selective agents were more likely to be taken continuously and at higher doses than non-selective NSAIDs. This is relevant in view of the cardiovascular toxicity of this group of medicines. The study shows the value of using unit record dispensing data to assess drug use patterns. Linking dispensing records to hospital separation and mortality data will further enhance our ability to monitor drug safety.

Are selective serotonin reuptake inhibitors safe for drivers? What is the evidence?

PubMed

Ravera, Silvia; Ramaekers, Johannes G; de Jong-van den Berg, Lolkje T W; de Gier, Johan J

2012-05-01

Selective serotonin reuptake inhibitors (SSRIs) are widely used medications to treat several psychiatric diseases and, above all, depression. They seem to be as effective as older antidepressants but have a different adverse effect profile. Despite their favorable safety profile, little is known about their influence on traffic safety. To conduct a literature review to summarize the current evidence on the role of SSRIs in traffic safety, particularly concerning undesirable effects that could potentially impair fitness to drive, experimental and pharmacoepidemiologic studies on driving impairment, 2 existing categorization systems for driving-impairing medications, and the European legislative procedures for assessing fitness to drive before issuing a driver's license and driving under the influence of medicines. The article search was performed in the following electronic databases: MEDLINE, PsycINFO, ScienceDirect, and SafetyLit. The English-language scientific literature was searched using key words such as SSRIs and psychomotor performance, car crash or traffic accident, and adverse effects. For inclusion in this review, papers had to be full-text articles, refer to possible driving-related adverse effects, and be experimental or pharmacoepidemiologic studies on SSRIs and traffic accident risks. No restrictions concerning publication year were applied. Ten articles were selected as background information on driving-related adverse effects, and 15 articles were selected regarding experimental and pharmacoepidemiologic work. Regarding SSRI adverse effects, the most reported undesirable effects referring to driving impairment were anxiety, agitation, sleep disturbances, headache, increased risk of suicidal behavior, and deliberate self-harm. Regarding the remaining issues addressed in this article, inconsistencies were found between the outcomes of the selected experimental and epidemiologic studies and between the 2 existing categorization systems under evaluation. Some pitfalls of the current legislative scenario were identified as well. Based on the current evidence, it was concluded that more experimental and epidemiologic research is needed to elucidate the relationship between SSRI use and traffic safety. Furthermore, a revision of the existing categorization systems and harmonized European legislation in the field of medication use and driving were highly recommended. Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved.

Nutraceuticals in the management of osteoarthritis : a critical review.

PubMed

Ragle, Ryan L; Sawitzke, Allen D

2012-09-01

Osteoarthritis (OA) is a chronic, highly prevalent and disabling disease that is expected to increase in prevalence secondary to longer life expectancy and a disproportionately aging population. Treatment of OA is only marginally effective and has been focused primarily on symptom control using weight loss, physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, intra-articular steroids or viscosupplementation, topical NSAIDs and analgesics, diacerein (an oral interleukin-1β inhibitor) and finally joint replacement surgery. The use of nutraceuticals in the treatment of OA is common, and scientific studies examining the effects of nutraceuticals on the pathogenesis and treatment of OA are increasing. This review examines the efficacy and safety of select nutraceuticals for the treatment of OA. The reviewed nutraceuticals include glucosamine, chondroitin, collagen hydrolysates (CHs) and avocado-soybean unsaponifiables (ASUs). There have been several clinical trials examining the efficacy of these products and the results demonstrate significant heterogeneity. Significant improvements in pain, function and structural outcomes have been shown for some of the treatment arms or subgroups of patients, but the effects are not consistent across the studies. Glucosamine, chondroitin and the two in combination have been the most extensively studied. Significant improvement in pain and functional indices and a decrease in the loss of joint space width were demonstrated in some but not all studies. CHs showed significant improvement in pain and functional indices for several subgroups of patients, but these findings were not pervasive amongst the treatment arms. ASU has demonstrated positive results with respect to decreased NSAID use in several studies and functional and pain end points in most of the reviewed studies; however, in the two studies examining structural end points, the results were mixed. The safety of these nutraceuticals has been demonstrated across all of the reviewed trials, and there were no significant issues with tolerance. Given the good safety profile of nutraceuticals, the marginal efficacy of conventional treatments, the high prevalence and rate of disability from OA and the possible benefit of nutraceuticals to patients with OA, use of nutraceuticals in select patients is appropriate. An overall recommendation to use nutraceuticals in the treatment of all patients with OA is not strongly supported by the available data. Future studies should focus on standardization of symptomatic and structural outcome measures, be of longer duration and pay careful attention to the content of the investigational product.

A Taxonomy of Fallacies in System Safety Arguments

NASA Technical Reports Server (NTRS)

Greenwell, William S.; Knight, John C.; Holloway, C. Michael; Pease, Jacob J.

2006-01-01

Safety cases are gaining acceptance as assurance vehicles for safety-related systems. A safety case documents the evidence and argument that a system is safe to operate; however, logical fallacies in the underlying argument may undermine a system s safety claims. Removing these fallacies is essential to reduce the risk of safety-related system failure. We present a taxonomy of common fallacies in safety arguments that is intended to assist safety professionals in avoiding and detecting fallacious reasoning in the arguments they develop and review. The taxonomy derives from a survey of general argument fallacies and a separate survey of fallacies in real-world safety arguments. Our taxonomy is specific to safety argumentation, and it is targeted at professionals who work with safety arguments but may lack formal training in logic or argumentation. We discuss the rationale for the selection and categorization of fallacies in the taxonomy. In addition to its applications to the development and review of safety cases, our taxonomy could also support the analysis of system failures and promote the development of more robust safety case patterns.