Chang, Shu-Sen; Sterne, Jonathan A C; Lu, Tsung-Hsueh; Gunnell, David
2010-02-01
To identify cause-of-death categories in which suicides might be misclassified in Taiwan. We plotted secular trends (1971-2007) in sex- and method-specific rates of deaths classified as suicide, undetermined intent and accident for the Taiwanese population aged 15+ and compared the sex, age and marital status profiles of deaths in these three categories by method of death. The demographic profiles of registered suicides generally resembled those for deaths of undetermined intent and accidents by pesticide poisoning/suffocation but differed from those for accidents from non-pesticide poisoning/drowning/falling/poisoning by non-domestic gas. For the period 1990-2007, suicide rates based on suicides alone (14.8 per 100,000) would increase by 23, 7 and 1%, respectively, when including deaths of undetermined intent, accidental pesticide poisonings and accidental suffocations. Suicide rates may be underestimated by more than 30% in Taiwan because some suicides are 'hidden' amongst deaths certified as due to other causes.
Värnik, Peeter; Sisask, Merike; Värnik, Airi; Yur'yev, Andriy; Kõlves, Kairi; Leppik, Lauri; Nemtsov, Aleksander; Wasserman, Danuta
2010-06-01
Observed changes in subcategories of injury death were used to test the hypothesis that a sizeable proportion of ''injury deaths of undetermined intent'' (Y10-Y34 in ICD 10) in the Baltic and Slavic countries after the USSR dissolved in 1991 were hidden suicides. Using male age-adjusted suicide rates for two distinctly different periods, 1981-90 and 1992-2005, changes, ratios and correlations were calculated. The data were compared with the EU average. After the USSR broke up, the obligation to make a definitive diagnosis became less strict. A massive increase in ''injury deaths of undetermined intent'' resulted. The mean rate for the second period reached 52.8 per 100,000 males in Russia (the highest rate) and 12.9 in Lithuania (the lowest), against 3.2 in EU-15. The rise from the first to the second period was highest in Belarus (56%) and Russia (44%). The number of injury deaths of undetermined intent was almost equal to that of suicides in Russia in 2005 (ratio 1.0) and Ukraine in 2002 (1.1). In all the countries, especially the Slavic ones, prevalence trends of injury-death subcategories were uniform, i.e. strongly correlated over time. No direct substitution of one diagnosis for another was evident. There is no evidence that the category of ''injury deaths of undetermined intent'' in the Baltic and Slavic countries hides suicides alone. Aggregate level analysis indicates that accidents and homicides could sometimes be diagnosed as undetermined.
Variability of undetermined manner of death classification in the US.
Breiding, M J; Wiersema, B
2006-12-01
To better understand variations in classification of deaths of undetermined intent among states in the National Violent Death Reporting System (NVDRS). Data from the NVDRS and the National Vital Statistics System were used to compare differences among states. Percentages of deaths assigned undetermined intent, rates of deaths of undetermined intent, rates of fatal poisonings broken down by cause of death, composition of poison types within the undetermined-intent classification. Three states within NVDRS (Maryland, Massachusetts, and Rhode Island) evidenced increased numbers of deaths of undetermined intent. These same states exhibited high rates of undetermined death and, more specifically, high rates of undetermined poisoning deaths. Further, these three states evidenced correspondingly lower rates of unintentional poisonings. The types of undetermined poisonings present in these states, but not present in other states, are typically the result of a combination of recreational drugs, alcohol, or prescription drugs. The differing classification among states of many poisoning deaths has implications for the analysis of undetermined deaths within the NVDRS and for the examination of possible/probable suicides contained within the undetermined- or accidental-intent classifications. The NVDRS does not collect information on unintentional poisonings, so in most states data are not collected on these possible/probable suicides. The authors believe this is an opportunity missed to understand the full range of self-harm deaths in the greater detail provided by the NVDRS system. They advocate a broader interpretation of suicide to include the full continuum of deaths resulting from self-harm.
Martins, Christine Baccarat de Godoy; Jorge, Maria Helena Prado de Mello
2013-06-01
In view of the importance of knowing the circumstances associated with external causes (accidents and violence), this study analyzes the profile of the victims and their families as to the intentionality of the event (intentional or accidental). Cross-sectional study, which population comprise children, adolescents, and young people (age 0 to 24) who lived in Cuiabá, MT, and died from external causes in 2009. The data, processed by the Epi-Info software, were taken from the Declarations of Death and interviews with the families of the victims. The nonparametric chi-square test showed statistically significant differences between accidental and intentional deaths by sex and the type of accident or violence, the occurrence of the previous event external cause, parental education, family type, income, responsible for supporting the house, mother's age and caregiver. Among the victims, male participation (88.7 %) stands out compared to female (11.3 %). 50.0% of the deaths of females were accidental and 50.0% intentional; 68.2% of the deaths of males were intentional, 29.1% accidental and 2.7% from undetermined intent. Among the intentional deaths, 72.5% of the victims had already suffered violence. As the degree of instruction of the parents increases, intentional deaths decrease. The proportion of reconstituted/fragmented families is higher for fatal accidents. Intentional causes increase as family income decreases and the age of the parents increases. The agglomeration of people in the homes is higher for intentional deaths. Analizing the profiles of families and victims as to the intentionality of the event allows directing local prevention and control policies.
Tøllefsen, Ingvild Maria; Thiblin, Ingemar; Helweg-Larsen, Karin; Hem, Erlend; Kastrup, Marianne; Nyberg, Ullakarin; Rogde, Sidsel; Zahl, Per-Henrik; Østevold, Gunvor; Ekeberg, Øivind
2016-05-27
National mortality statistics should be comparable between countries that use the World Health Organization's International Classification of Diseases. Distinguishing between manners of death, especially suicides and accidents, is a challenge. Knowledge about accidents is important in prevention of both accidents and suicides. The aim of the present study was to assess the reliability of classifying deaths as accidents and undetermined manner of deaths in the three Scandinavian countries and to compare cross-national differences. The cause of death registers in Norway, Sweden and Denmark provided data from 2008 for samples of 600 deaths from each country, of which 200 were registered as suicides, 200 as accidents or undetermined manner of deaths and 200 as natural deaths. The information given to the eight experts was identical to the information used by the Cause of Death Register. This included death certificates, and if available external post-mortem examinations, forensic autopsy reports and police reports. In total, 69 % (Sweden and Norway) and 78 % (Denmark) of deaths registered in the official mortality statistics as accidents were confirmed by the experts. In the majority of the cases where disagreement was seen, the experts reclassified accidents to undetermined manner of death, in 26, 25 and 19 % of cases, respectively. Few cases were reclassified as suicides or natural deaths. Among the extracted accidents, the experts agreed least with the official mortality statistics concerning drowning and poisoning accidents. They also reported most uncertainty in these categories of accidents. In a second re-evaluation, where more information was made available, the Norwegian psychiatrist and forensic pathologist increased their agreement with the official mortality statistics from 76 to 87 %, and from 85 to 88 %, respectively, regarding the Norwegian and Swedish datasets. Among the extracted undetermined deaths in the Swedish dataset, the two experts reclassified 22 and 51 %, respectively, to accidents. There was moderate agreement in reclassification of accidents between the official mortality statistics and the experts. In the majority of cases where there was disagreement, accidents were reclassified as undetermined manner of death, and only a small proportion as suicides.
Subway train-related fatalities in New York City: accident versus suicide.
Lin, Peter T; Gill, James R
2009-11-01
We examined the characteristics of subway train-related fatalities in New York City between Jan. 1, 2003 and May 31, 2007 in order to determine which factors are useful in differentiating accident from suicide. Subway train-related deaths with homicide and undetermined manners also are included. During this period, there were 211 subway train-related fatalities. The manners of death were: suicide (n = 111), accident (n = 76), undetermined (n = 20), and homicide (n = 4). The causes of death were blunt trauma (n = 206) and electrocution (n = 5). Torso transection and extremity amputation were more frequent in suicides. Antidepressant medications were more frequently detected in suicides, whereas cocaine and ethanol were more frequent in accidents. However, autopsy findings should be weighed in the context of the entire evaluation along with other circumstantial and investigative findings. In unwitnessed deaths where additional information is unavailable or discrepant, the most appropriate manner of death usually is undetermined.
Olsson, Martin O; Bradvik, Louise; Öjehagen, Agneta; Hakansson, Anders
2016-05-01
Risk factors for suicide and fatal accidental intoxication are extensively studied, while risk factors for intoxications/injuries of undetermined intent are less well known. The latter have shown an overlap with suicides, but also with fatal accidental intoxications. The objective was to analyze potential differences and similarities in the patterns of risk factors for accidental intoxications, injuries/intoxications with undetermined intent, and suicides, respectively. A follow-up register study was conducted, using data from ASI interviews with clients in the criminal justice system in Sweden (n=6744), followed in the National Causes of Death Register. A set of risk factors from the ASI interview were tested in bivariate analysis with the respective cause of death, yielding significant risk factors further analyzed in three Cox regression models. In Cox regression analyses, death from fatal accidental intoxication was associated with male gender (HR 4.09), use of heroin (HR 2.86), and use of cannabis (HR 1.94), and death from intoxication/injury of undetermined intent was associated with use of heroin (HR 3.48), binge drinking of alcohol (HR 2.46) and previous psychiatric hospitalization (HR 2.41), while negatively associated with depression (HR 0.33). Death from suicide was associated with previous suicide attempts (HR 2.78) and use of sedatives (HR 2.17). In this population of criminal justice clients with reported substance use problems, fatal injuries/intoxications with undetermined intent - like fatal accidental intoxications - appear to be associated with substance use variables, and cannot readily be assumed to represent the same background factors as suicide. Copyright © 2016. Published by Elsevier Ireland Ltd.
Confronting Death From Drug Self-Intoxication (DDSI): Prevention Through a Better Definition
Smith, Gordon S.; Caine, Eric D.; Kapusta, Nestor D.; Hanzlick, Randy L.; Larkin, G. Luke; Naylor, Charles P. E.; Nolte, Kurt B.; Miller, Ted R.; Putnam, Sandra L.; De Leo, Diego; Kleinig, John; Stack, Steven; Todd, Knox H.; Fraser, David W.
2014-01-01
Suicide and other self-directed violence deaths are likely grossly underestimated, reflecting inappropriate classification of many drug intoxication deaths as accidents or unintentional and heterogeneous ascertainment and coding practices across states. As the tide of prescription and illicit drug-poisoning deaths is rising, public health and research needs would be better satisfied by considering most of these deaths a result of self-intoxication. Epidemiologists and prevention scientists could design better intervention strategies by focusing on premorbid behavior. We propose incorporating deaths from drug self-intoxication and investigations of all poisoning deaths into the National Violent Death Reporting System, which contains misclassified homicides and undetermined intent deaths, to facilitate efforts to comprehend and reverse the surging rate of drug intoxication fatalities. PMID:25320874
Medical Surveillance Monthly Report (MSMR). Volume 9, Number 1, January 2003
2003-01-01
undetermined/ pending circumstances accounted for the remainder (table 1). Accidents. Accident-related death rates were two to three times higher among...men than women; however, among both men and women, accident- related death rates declined with age (table 1). Relative to their counterparts...approximately five times higher among servicemembers older than 34 compared to those younger than 25. Illness-related death rates (unadjusted) were
McFaull, Steven; Rhodes, Anne E.; Bowes, Matthew; Rockett, Ian R. H.
2016-01-01
Objective: The aim of this study is to compare Canadian suicide rates with other external causes of death to examine potential poisoning misclassifications as a contributor to suicide underreporting. Method: The study used Statistics Canada mortality data from 2000 to 2011 to calculate sex-and age-specific ratios by external cause of injury codes. Results: The overall Canadian suicide rate, as well as the poisoning suicide rate, declined over the study timeframe by an average annual percentage change (AAPC) of 1.0% each year. However, unintentional and undetermined poisonings increased significantly during the timeframe. Unintentional poisoning mortality (primarily narcotics and hallucinogens, including opioids) increased in proportion to suicides for both sexes, although females were consistently higher. The undetermined death to suicide ratio was higher and increasing for females. Poisonings of undetermined intent increased over time to comprise 47% to 80% of the undetermined death category for males and females combined. Conclusions: Canadian poisoning suicide rates declined, in contrast to rising unintentional and undetermined poisoning mortality rates. This trend is similar to that of the United States, supporting the hypothesis that misclassification of poisoning deaths may also be an issue in Canada.
Regional Variations in Suicide and Undetermined Death Rates among Adolescents across Canada.
Renaud, Johanne; Lesage, Alain; Gagné, Mathieu; MacNeil, Sasha; Légaré, Gilles; Geoffroy, Marie-Claude; Skinner, Robin; McFaull, Steven
2018-04-01
Trends in rates of adolescent suicide and undetermined deaths in Canada from 1981 to 2012 were examined, focusing specifically on variations between Canadian regions. Exploratory hypotheses were formulated for regional variability in adolescent suicide rates over time in Canada. A descriptive time trend analysis using public domain vital statistics data was performed. All deaths from 1981 to 2012 among 15 to 19 year olds coded as suicides or undetermined intent according to the International Classification of Diseases, 9 th and 10 th Revisions were included. While there was an overall stability in adolescent suicide and undetermined death rates across Canada, regional analyses showed that Quebec experienced a 7.6% annual reduction between 2001 and 2012 while the Prairies and Atlantic provinces experienced significant annual increases since 2001. Ontario and British Columbia have had non-significant fluctuations since 2001. The trends remained similar overall when excluding undetermined deaths from the analyses. Variations in adolescent suicide trends across provinces were found. Factors such as provincial suicide action and prevention legislation contributing to these variations remain to be studied, but these regional differences point towards the need for better consistency of suicide prevention strategies across the country.
Regional Variations in Suicide and Undetermined Death Rates among Adolescents across Canada
Lesage, Alain; Gagné, Mathieu; MacNeil, Sasha; Légaré, Gilles; Geoffroy, Marie-Claude; Skinner, Robin; McFaull, Steven
2018-01-01
Objective Trends in rates of adolescent suicide and undetermined deaths in Canada from 1981 to 2012 were examined, focusing specifically on variations between Canadian regions. Exploratory hypotheses were formulated for regional variability in adolescent suicide rates over time in Canada. Methods A descriptive time trend analysis using public domain vital statistics data was performed. All deaths from 1981 to 2012 among 15 to 19 year olds coded as suicides or undetermined intent according to the International Classification of Diseases, 9th and 10th Revisions were included. Results While there was an overall stability in adolescent suicide and undetermined death rates across Canada, regional analyses showed that Quebec experienced a 7.6% annual reduction between 2001 and 2012 while the Prairies and Atlantic provinces experienced significant annual increases since 2001. Ontario and British Columbia have had non-significant fluctuations since 2001. The trends remained similar overall when excluding undetermined deaths from the analyses. Conclusions Variations in adolescent suicide trends across provinces were found. Factors such as provincial suicide action and prevention legislation contributing to these variations remain to be studied, but these regional differences point towards the need for better consistency of suicide prevention strategies across the country. PMID:29662522
Rockett, Ian R H; Hobbs, Gerald R; Wu, Dan; Jia, Haomiao; Nolte, Kurt B; Smith, Gordon S; Putnam, Sandra L; Caine, Eric D
2015-01-01
The 21st-century epidemic of pharmaceutical and other drug-intoxication deaths in the United States (US) has likely precipitated an increase in misclassified, undercounted suicides. Drug-intoxication suicides are highly prone to be misclassified as accident or undetermined. Misclassification adversely impacts suicide and other injury mortality surveillance, etiologic understanding, prevention, and hence clinical and public health policy formation and practice. To evaluate whether observed variation in the relative magnitude of drug-intoxication suicides across US states is a partial artifact of the scope and quality of toxicological testing and type of medicolegal death investigation system. This was a national, state-based, ecological study of 111,583 drug-intoxication fatalities, whose manner of death was suicide, accident, or undetermined. The proportion of (nonhomicide) drug-intoxication deaths classified by medical examiners and coroners as suicide was analyzed relative to the proportion of death certificates citing one or more specific drugs and two types of state death investigation systems. Our model incorporated five sociodemographic covariates. Data covered the period 2008-2010, and derived from NCHS's Multiple Cause-of-Death public use files. Across states, the proportion of drug-intoxication suicides ranged from 0.058 in Louisiana to 0.286 in South Dakota and the rate from 1 per 100,000 population in North Dakota to 4 in New Mexico. There was a low correlation between combined accident and undetermined drug-intoxication death rates and corresponding suicide rates (Spearman's rho = 0.38; p<0.01). Citation of 1 or more specific drugs on the death certificate was positively associated with the relative odds of a state classifying a nonhomicide drug-intoxication death as suicide rather than accident or undetermined, adjusting for region and type of state death investigation system (odds ratio, 1.062; 95% CI,1.016-1.110). Region, too, was a significant predictor. Relative to the South, a 10% increase in drug citation was associated with 43% (95% CI,11%-83%), 41% (95% CI,7%-85%), and 33% (95% CI,1%-76%) higher odds of a suicide classification in the West, Midwest, and Northeast, respectively. Large interstate variation in the relative magnitude of nonhomicide drug-intoxication deaths classified as suicide by medical examiners and coroners in the US appears partially an artifact of geographic region and degree of toxicological assessment in the case ascertainment process. Etiologic understanding and prevention of drug-induced suicides and other drug-intoxication deaths first require rigorous standardization involving accurate concepts, definitions, and case ascertainment.
Rockett, Ian R. H.; Hobbs, Gerald R.; Wu, Dan; Jia, Haomiao; Nolte, Kurt B.; Smith, Gordon S.; Putnam, Sandra L.; Caine, Eric D.
2015-01-01
Background The 21st-century epidemic of pharmaceutical and other drug-intoxication deaths in the United States (US) has likely precipitated an increase in misclassified, undercounted suicides. Drug-intoxication suicides are highly prone to be misclassified as accident or undetermined. Misclassification adversely impacts suicide and other injury mortality surveillance, etiologic understanding, prevention, and hence clinical and public health policy formation and practice. Objective To evaluate whether observed variation in the relative magnitude of drug-intoxication suicides across US states is a partial artifact of the scope and quality of toxicological testing and type of medicolegal death investigation system. Methods This was a national, state-based, ecological study of 111,583 drug-intoxication fatalities, whose manner of death was suicide, accident, or undetermined. The proportion of (nonhomicide) drug-intoxication deaths classified by medical examiners and coroners as suicide was analyzed relative to the proportion of death certificates citing one or more specific drugs and two types of state death investigation systems. Our model incorporated five sociodemographic covariates. Data covered the period 2008–2010, and derived from NCHS’s Multiple Cause-of-Death public use files. Results Across states, the proportion of drug-intoxication suicides ranged from 0.058 in Louisiana to 0.286 in South Dakota and the rate from 1 per 100,000 population in North Dakota to 4 in New Mexico. There was a low correlation between combined accident and undetermined drug-intoxication death rates and corresponding suicide rates (Spearman’s rho = 0.38; p<0.01). Citation of 1 or more specific drugs on the death certificate was positively associated with the relative odds of a state classifying a nonhomicide drug-intoxication death as suicide rather than accident or undetermined, adjusting for region and type of state death investigation system (odds ratio, 1.062; 95% CI,1.016–1.110). Region, too, was a significant predictor. Relative to the South, a 10% increase in drug citation was associated with 43% (95% CI,11%-83%), 41% (95% CI,7%-85%), and 33% (95% CI,1%-76%) higher odds of a suicide classification in the West, Midwest, and Northeast, respectively. Conclusion Large interstate variation in the relative magnitude of nonhomicide drug-intoxication deaths classified as suicide by medical examiners and coroners in the US appears partially an artifact of geographic region and degree of toxicological assessment in the case ascertainment process. Etiologic understanding and prevention of drug-induced suicides and other drug-intoxication deaths first require rigorous standardization involving accurate concepts, definitions, and case ascertainment. PMID:26295155
Sato, Yoshinobu; Hayashida, Naomi; Orita, Makiko; Urata, Hideko; Shinkawa, Tetsuko; Fukushima, Yoshiko; Nakashima, Yumiko; Kudo, Takashi; Yamashita, Shunichi; Takamura, Noboru
2015-01-01
We conducted a survey among nurses who were working at the Fukushima Medical University Hospital at the time of the Fukushima Daiichi Nuclear Power Plant accident to clarify the factors associated with their intention to leave their jobs during the radiation emergency. We asked 345 nurses (17 men and 328 women) about their intention to leave their jobs after the accident. We also asked about relevant factors including the participants' demographic factors, living situation, working status, and knowledge of radiation health effects. We found that living with preschoolers (OR = 1.87, 95%CI: 1.02-3.44, p = 0.042), anxiety about life in Fukushima City after the accident (OR = 5.55, 95%CI: 1.18-26.13, p = 0.030), consideration of evacuation from Fukushima after the accident (OR = 2.42, 95%CI: 1.45-4.06, p = 0.001), consideration of the possible radiation health effects in children (OR = 1.90, 95%CI: 1.02-3.44, p = 0.042), and anxiety about relationships with colleagues in the hospital after the accident (OR = 3.23, p = 0.001) were independently associated with the nurses' intention to leave their jobs after the accident. On the other hand, the percentage of nurses with knowledge on radiation health effects was relatively low among those who had the intention to leave the job and among those who did not have the intention to leave the job after the accident, with no significant differences between the two groups. Our results suggest the need for an education program for nurses regarding radiation health effects.
Sato, Yoshinobu; Hayashida, Naomi; Orita, Makiko; Urata, Hideko; Shinkawa, Tetsuko; Fukushima, Yoshiko; Nakashima, Yumiko; Kudo, Takashi; Yamashita, Shunichi; Takamura, Noboru
2015-01-01
We conducted a survey among nurses who were working at the Fukushima Medical University Hospital at the time of the Fukushima Daiichi Nuclear Power Plant accident to clarify the factors associated with their intention to leave their jobs during the radiation emergency. We asked 345 nurses (17 men and 328 women) about their intention to leave their jobs after the accident. We also asked about relevant factors including the participants’ demographic factors, living situation, working status, and knowledge of radiation health effects. We found that living with preschoolers (OR = 1.87, 95%CI: 1.02–3.44, p = 0.042), anxiety about life in Fukushima City after the accident (OR = 5.55, 95%CI: 1.18–26.13, p = 0.030), consideration of evacuation from Fukushima after the accident (OR = 2.42, 95%CI: 1.45–4.06, p = 0.001), consideration of the possible radiation health effects in children (OR = 1.90, 95%CI: 1.02–3.44, p = 0.042), and anxiety about relationships with colleagues in the hospital after the accident (OR = 3.23, p = 0.001) were independently associated with the nurses’ intention to leave their jobs after the accident. On the other hand, the percentage of nurses with knowledge on radiation health effects was relatively low among those who had the intention to leave the job and among those who did not have the intention to leave the job after the accident, with no significant differences between the two groups. Our results suggest the need for an education program for nurses regarding radiation health effects. PMID:25816345
Zambon, Francesco; Laflamme, Lucie; Spolaore, Paolo; Visentin, Cristiana; Hasselberg, Marie
2011-06-01
This study investigates the degree to which a previous hospitalisation for injury of any intent is a risk of subsequent youth suicide and whether this association is influenced by family socioeconomic status or economic stress. A nationwide register-based cohort study was conducted covering all Swedish subjects born between January 1977 and December 1991 (N=1,616,342, male/female ratio=1.05). The cohort subjects were followed-up from January 1998 to December 2003, when aged 7-26 years. Poisson regression and the likelihood ratio test (95% CI) were used to assess the age-adjusted effect of hospitalisation for injuries of various intent on youth suicide and its effect once adjusted for family sociodemographic and social circumstances. Each set of exposures was associated independently and significantly with suicide mortality. Being hospitalised for self-inflicted injuries or injuries of undetermined intent was associated with a risk of suicide 36 to 47 times, respectively, that of subjects never hospitalised in the period under study (95% CI 28.36 to 45.58 and 26.67 to 83.87 for self-inflicted injuries and for events of undetermined intent, respectively; overall p<0.01). Similarly, previous events of unintentional injury markedly increased the risk of suicide (RR 3.08; 95% CI 2.26 to 4.19). These effects were solid and not substantially altered after adjustment for family demographic and socioeconomic circumstances. A strong association exists between previous hospitalisation for injury of any intent and youth suicide. The association is robust and unaltered by family socioeconomic circumstances.
Accident or Suicide? Single-Vehicle Car Accidents and the Intent Hypothesis.
ERIC Educational Resources Information Center
Peck, Dennis L.; Warner, Kenneth
1995-01-01
Brief case studies of single-vehicle car crashes are used to explore the relationship between this method of death and the intent to commit suicide. The author attempts to determine what criteria can be used to determine whether suicide was the intent, and how death by automobile crash can be determined a suicide. (JPS)
Deckert, Andreas; Winkler, Volker; Meisinger, Christa; Heier, Margit; Becher, Heiko
2015-04-01
Mental health consequences of migration are manifold. Where some migrants experience migration as liberation from life threatening conditions, others suffer from hostility and social descent in the target country. This study investigates deaths due to external causes, suicides, and events of undetermined intent in German repatriates from the Former Soviet Union. The relation between age at migration and suicide mortality is also explored. A cohort of German repatriates who migrated between 1990 and 1999 was followed-up until 2010. Each individual accumulated time at risk, expressed in person years (PY). Standardized mortality ratios (SMR) were calculated, supplemented by subgroup analyses for age and calendar year strata, and immigration period. Multivariate Poisson models were used to investigate the influence of age, sex, calendar year, number of moves, and final move distance. A total of 6378 German repatriates (3031 men, 3347 women) accumulated 92,149 PY. Median age at immigration was 30 years in women and 27 years in men. Women's all-cause mortality was significantly lower (SMR = 0.85 [0.75; 0.97]). Men more often died from external causes (SMR = 1.58 [1.09; 2.23]), intentional self-harm (SMR = 1.68 [0.90; 2.88]), and events of undetermined intent such as poisoning by drugs (SMR = 8.07 [4.02; 14.44]). External cause mortality was significantly increased after 1995 (SMR = 1.87). In particular, men who migrated when they were 11-20 years old were at strongly increased risk of committing suicide (SMR = 3.84) or dying due to events of undetermined intent (SMR = 14.75). The most endangered subgroup is men who migrated at teenage age. Protective factors such as strong family bounds formerly present in the FSU failed in Germany, the higher population density caused intense friction. The changes in the families' ethnical composition from mostly ethnic German members in the early 90s' towards predominantly Russian members around the turn of the millennium complicated integration. Setting-oriented prevention measures should consider the families' migration history, their link to culture and religion, and the different concepts of mental health. Copyright © 2015 Elsevier Ltd. All rights reserved.
It's No Accident: Our Bias for Intentional Explanations
ERIC Educational Resources Information Center
Rosset, Evelyn
2008-01-01
Three studies tested the idea that our analyses of human behavior are guided by an "intentionality bias," an implicit bias where all actions are judged to be intentional by default. In Study 1 participants read a series of sentences describing actions that can be done either on purpose or by accident (e.g., "He set the house on fire") and had to…
Children's Trait and Emotion Attributions in Socially Ambiguous and Unambiguous Situations
ERIC Educational Resources Information Center
Boseovski, Janet J.; Lapan, Candace; Bosacki, Sandra
2013-01-01
Children's attributions about story characters in ambiguous and unambiguous social situations were assessed. One hundred and forty-four 6-7-year-olds and 10-11-year-olds heard about actors who slighted a recipient intentionally or for an undetermined reason and then made causal attributions about the events, an emotion attribution about the…
Maniam, T
1995-01-01
Suicide statistics are generally recognised to be unreliable. This study of the reported rates of suicide in West Malaysia between 1966-1990 shows that the mean crude suicide rate between 1966-1974 was 6.1 per 100,000, but had dropped drastically between 1975-1990 to a mean of 1.6 per 100,000. Three lines of evidence are presented to show that this reduction in the suicide rate is due to a systematic misclassification of medically certified suicides as deaths due to undetermined violent deaths (which refers to violent deaths not known to be accidentally or deliberately inflicted). Firstly, the large drop in reported suicide rates corresponds closely to an increase in the rate of deaths due to undetermined violent deaths. There is a highly positive negative correlation between the two rates (coefficient of correlation, r = -0.9). Secondly, the misclassification appears to be mainly a problem with the medically certified deaths which follow the ICD classification. The mean ratio of uncertified to certified suicides before 1975 was 0.8, but from 1975 onwards the mean was 3.1. This is in contrast to the corresponding ratio for deaths due to all accidents which has remained fairly constant throughout these years. Thirdly, the race and sex differences for the rates of undetermined violent deaths are identical to those of suicide. Taking the misclassification into account the corrected suicide rate for West Malaysia is estimated to be between 8-13 per 100,000 since 1982.
Suicide in the Philippines: time trend analysis (1974-2005) and literature review
2011-01-01
Background Suicide prevention is given a low priority in many Western Pacific countries due to competing health problems, stigma and poor understanding of its incidence and aetiology. Little is known about the epidemiology of suicide and suicidal behaviour in the Philippines and although its incidence is reported to be low, there is likely to be under-reporting because of its non-acceptance by the Catholic Church and the associated stigma to the family. This study aims to investigate trends in the incidence of suicide in the Philippines, assess possible underreporting and provide information on the methods used and the reasons for suicide. Methods Data for suicide deaths occurring between 1974 and 2005 were obtained from Philippine Health Statistics. Age- and sex-specific trends were examined graphically. Underreporting was investigated by comparing trends in suicides, accidents and deaths of undetermined intent. To provide a fuller picture of suicide in the Philippines, a comprehensive search for published papers, theses and reports on the epidemiology of suicide in the Philippines was undertaken. Results The incidence of suicide in males increased from 0.23 to 3.59 per 100,000 between 1984 and 2005. Similarly, rates rose from 0.12 to 1.09 per 100,000 in females. Amongst females, suicide rates were highest in 15-24 year olds, whilst in males rates were similar in all age groups throughout the study period. The most commonly used methods of suicide were hanging, shooting and organophosphate ingestion. In non-fatal attempts, the most common methods used were ingestion of drugs, specifically isoniazid and paracetamol, or organophosphate ingestion. Family and relationship problems were the most common precipitants. While rates were lower compared to other countries, there is suggestive evidence of underreporting and misclassification to undetermined injury. Recent increases may reflect either true increase or better reporting of suicides. Conclusions While suicide rates are low in the Philippines, increases in incidence and relatively high rates in adolescents and young adults point to the importance of focused suicide prevention programs. Improving data quality and better reporting of suicide deaths is likewise imperative to inform and evaluate prevention strategies. PMID:21733151
Woo, Brandon M; Steckler, Conor M; Le, Doan T; Hamlin, J Kiley
2017-11-01
Whereas adults largely base their evaluations of others' actions on others' intentions, a host of research in developmental psychology suggests that younger children privilege outcome over intention, leading them to condemn accidental harm. To date, this question has been examined only with children capable of language production. In the current studies, we utilized a non-linguistic puppet show paradigm to examine the evaluation of intentional and accidental acts of helping or harming in 10-month-old infants. In Experiment 1 (n=64), infants preferred intentional over accidental helpers but accidental over intentional harmers, suggestive that by this age infants incorporate information about others' intentions into their social evaluations. In Experiment 2 (n=64), infants did not distinguish "negligently" accidental from intentional helpers or harmers, suggestive that infants may find negligent accidents somewhat intentional. In Experiment 3 (n=64), we found that infants preferred truly accidental over negligently accidental harmers, but did not reliably distinguish negligently accidental from truly accidental helpers, consistent with past work with adults and children suggestive that humans are particularly sensitive to negligently accidental harm. Together, these results imply that infants engage in intention-based social evaluation of those who help and harm accidentally, so long as those accidents do not stem from negligence. Copyright © 2017 Elsevier B.V. All rights reserved.
Anxious temperament as a risk factor of suicide attempt.
Tanabe, Sanshi; Terao, Takeshi; Shiotsuki, Ippei; Kanehisa, Masayuki; Ishii, Keisuke; Shigemitsu, Osamu; Fujiki, Minoru; Hoaki, Nobuhiko
2016-07-01
Suicide has been reported to be associated with cyclothymic, irritable, depressive and anxious temperaments. In contrast, hyperthymic temperament has been reported to be protective against suicide. In the present study, we hypothesized that Japanese patients with suicide attempt may have higher scores of cyclothymic, irritable, depressive, and anxious temperaments but lower scores of hyperthymic temperament than non-suicidal patients. In order to examine this hypothesis, we investigated Japanese patients of a university emergency center. The association of temperament and suicide attempt was investigated in 116 patients referred to a university emergency center for intoxication or injury. Of them, 35 patients of suspected suicide attempt were categorized as 18 patients who intended to die with attempted suicide and suffered from self-inflicted but not fatal injury (Suicide Attempt II), 4 patients whose intention to die were undetermined although they suffered from self-inflicted injury (Undetermined Suicide-Related Behavior II), and 13 patients who had no intention to die although they suffered from self-inflicted injury (Self-Harm II). Logistic regression analyses and multiple regression analyses were used to identify factors associated with the present suicide attempt and the number of suicide attempts, respectively. Anxious temperament scores were significantly and directly associated with Suicide Attempt II group whereas irritable temperament scores were associated with Self-Harm II group. The present findings suggest that those with anxious temperament may have more suicide attempts than those with other temperaments, indicating anxious temperament as a risk factor of suicide attempt. Copyright © 2016 Elsevier Inc. All rights reserved.
Children's Moral Judgments as a Function of Intention, Damage, and an Actor's Physical Harm.
ERIC Educational Resources Information Center
Suls, Jerry; Kalle, Robert J.
1979-01-01
Examines children's moral judgments of story characters who accidently harm themselves. Children in kindergarten and in grades 3 and 5 rated actors in stories which varied in terms of intention, damage, and harm to the actor. (SS)
Social-cognitive correlates of risky adolescent cycling behavior
2010-01-01
Background Bicycle use entails high safety and health risks especially for adolescents. Most safety education programs aimed at adolescents focus on accident statistics and risk perceptions. This paper proposes the investigation of the social-cognitive correlates of risky cycling behaviors of adolescents prior to developing safety education programs. Method Secondary school students aged 13 to 18 years (n = 1446) filled out questionnaires regarding bicycle behavior, risky intentions, accident experience, and social-cognitive determinants as suggested by the theory of planned behavior. Results Regression analysis revealed that the proximal variables (i.e., self-efficacy, attitudes towards drunk driving, personal norm regarding safekeeping of self and others, and compared risk) were able to predict 17% of the variance of risky behavior and 23% of the variance of risky intentions. The full model explained respectively 29% and 37% of the variance in risky behavior and risky intentions. Adolescents with positive attitudes towards risky behavior and low sense of responsibility report risky behavior, even when having been (close to) an accident. Conclusions Adolescents realize whether they are risk takers or not. This implies that the focus of education programs should not be on risk perceptions, but on decreasing positive attitudes towards alcohol in traffic and increasing sense of responsibility instead. Cognitions regarding near accidents should be studied, the role of safe cycling self-efficacy is unclear. PMID:20624293
Coal Canyon Fire: Serious Accident Investigation Report
Charles L. Myers; Randy Draeger; Antoine Dixon; Cliff Dahl; Jim Saveland; Brad Mayhew; Gary Brown; Tony Petrilli; Ben Murphy; Erin Newman; Karen Mora; Tim Foley
2012-01-01
The purpose of this report is to present the facts proximal to the accident and share the Team's analysis in a way that enhances the reliability and resilience of Federal, State, and Local wildland fire organizations. The intent is to spur discussion and learning for those in the fire and safety community at all levels.
The National Violent Death Reporting System: an exciting new tool for public health surveillance.
Steenkamp, M; Frazier, L; Lipskiy, N; Deberry, M; Thomas, S; Barker, L; Karch, D
2006-12-01
The US does not have a unified system for surveillance of violent deaths. This report describes the National Violent Death Reporting System (NVDRS), a system for collecting data on all violent deaths (homicides, suicides, accidental firearms deaths, deaths of undetermined intent, and deaths from legal intervention, excluding legal executions) in participating states. The NVDRS centralizes data from many sources, providing a more comprehensive picture of violent deaths than would otherwise be available. The NVDRS collects data on victims, suspects, and circumstances related to the violent deaths. Currently, 17 US states participate in the NVDRS; the intention is for the NVDRS to become a truly national system, representing all 50 states, the District of Columbia, and the US territories. This report describes the history of the NVDRS, provides an overview of how the NVDRS functions, and describes future directions.
Takeda, Saeka; Orita, Makiko; Fukushima, Yoshiko; Kudo, Takashi; Takamura, Noboru
2016-01-01
Objective To conduct a survey among non-medical employees working at the time of the Fukushima Daiichi Nuclear Power Station accident, in order to determine the factors associated with their intentions to leave their jobs during the nuclear disaster. Participants We asked 287 employees (166 men and 121 women) in the study. Methods We asked about their intentions to leave their jobs after the nuclear disaster. We also asked about relevant factors, including the participants’ demographic factors, living situations and working environments. Results We found that in employees younger than 40 (OR=4.73, 95% CI 1.74 to 12.85, p=0.002), being married (OR=3.18, 95% CI 1.03 to 9.79, p=0.044), measurements of the ambient dose rates in their homes after the accident (OR=5.32, 95% CI 1.65 to 17.14, p=0.005), anxiety about their relationships with their colleagues after the accident (OR=3.91, 95% CI 1.51 to 10.16, p=0.005) and the influence of radiation on the workplace (OR=0.33, 95% CI 0.14 to 0.80, p=0.014) were independently associated with the non-medical employees’ intentions to leave their jobs after the nuclear disaster. Conclusions Our results suggest the need for continuous risk communication regarding such factors and the provision of information about the health effects of radiation exposure to non-medical employees after nuclear disasters. PMID:27436669
A 15-year review of railway-related deaths in Jefferson County, Alabama.
Davis, G G; Alexander, C B; Brissie, R M
1997-12-01
A retrospective computer search of the records of the Jefferson County Coroner/Medical Examiner Office covering the 15-year period from 1981 to 1995 revealed 86 cases in which either a train caused death or in which a body was found dead by the tracks. The average age of the decedents was 39 years (range, 3 weeks-87 years). Men accounted for 88% of the deaths. The manners of death were as follows: three natural, 64 accident, seven suicide, six homicide, and six undetermined. Six decedents were found dead by the tracks, but death was not caused by a train. Six decedents were railroad employees who died on the job. In 47 cases, the decedents were trespassing on railroad property. Five trespassers were riding the rails, and 42 were pedestrians struck by a train. Motor vehicle collisions with trains claimed 27 lives--19 drivers and eight passengers. All together, 45% of the decedents were intoxicated. Intoxication was greatest by far in individuals witnessed to have been lying on the tracks before being hit by a train. The nature of individuals riding the rails has changed in the past few decades. Freight trains today are being used by illegal immigrants as transportation within the United States. The majority of traffic fatalities occurred because the driver intentionally tried to beat the train to the crossing. These drivers were seldom intoxicated, and only two were teenagers. Lives of such impatient drivers might be spared by the installation of a crossing guard-rail that cannot be circumvented.
Barber, C; Hemenway, D; Hochstadt, J; Azrael, D
2002-01-01
Objective: A growing body of evidence suggests that the nation's vital statistics system undercounts unintentional firearm deaths that are not self inflicted. This issue was examined by comparing how unintentional firearm injuries identified in police Supplementary Homicide Report (SHR) data were coded in the National Vital Statistics System. Methods: National Vital Statistics System data are based on death certificates and divide firearm fatalities into six subcategories: homicide, suicide, accident, legal intervention, war operations, and undetermined. SHRs are completed by local police departments as part of the FBI's Uniform Crime Reports program. The SHR divides homicides into two categories: "murder and non-negligent manslaughter" (type A) and "negligent manslaughter" (type B). Type B shooting deaths are those that are inflicted by another person and that a police investigation determined were inflicted unintentionally, as in a child killing a playmate after mistaking a gun for a toy. In 1997, the SHR classified 168 shooting victims this way. Using probabilistic matching, 140 of these victims were linked to their death certificate records. Results: Among the 140 linked cases, 75% were recorded on the death certificate as homicides and only 23% as accidents. Conclusion: Official data from the National Vital Statistics System almost certainly undercount firearm accidents when the victim is shot by another person. PMID:12226128
[Trends in mortality by assault in women in selected countries of Latin America, 2001-2011].
Molinatti, Florencia; Acosta, Laura Débora
2015-05-01
Describe the trend in deaths by assault in women in Argentina, Brazil, Chile, Colombia, and Mexico between 2001 and 2011. Descriptive study. Mortality from assaults and undetermined intentional acts was calculated, adjusted for age, using the direct method and the World Health Organization's standard population. Joinpoint regression models were used to identify statistically significant changes. The male:female mortality ratio was compared and trends in the rates were calculated and adjusted for each of the two causes of death and the specific rates of mortality by assault in women by age group. The highest rates of assault of women were reported in Brazil, followed by Colombia, Mexico, Argentina, and Chile. Between 2001 and 2011, decreases were reported from Argentina and Colombia; in Brazil and Mexico the rates increased; and in Chile they remained stable. The highest specific rates were found in young women (15-29 years) and adults (30-44 and 45-59 years). In Colombia the rates declined in all groups, while in Mexico they increased in women aged 15 to 59 years. Only Colombia showed a decrease in mortality from undetermined intentional acts; in Argentina and Mexico there was a decrease at the beginning of the period with a later increase; in Brazil no variations were observed. Mortality from assaults on women in Brazil, Colombia, and Mexico between 2001 and 2011 was higher than the world average and the Latin American average; rates were lower in Argentina and Chile, with minor differences between the sexes. Progress must be made in terms of understanding the power relationships that underlie femicide, which should be included in national criminal legislation.
Rockett, Ian R H; Caine, Eric D; Connery, Hilary S; D'Onofrio, Gail; Gunnell, David J; Miller, Ted R; Nolte, Kurt B; Kaplan, Mark S; Kapusta, Nestor D; Lilly, Christa L; Nelson, Lewis S; Putnam, Sandra L; Stack, Steven; Värnik, Peeter; Webster, Lynn R; Jia, Haomiao
2018-01-01
A paucity of corroborative psychological and psychiatric evidence may be inhibiting detection of drug intoxication suicides in the United States. We evaluated the relative importance of suicide notes and psychiatric history in the classification of suicide by drug intoxication versus firearm (gunshot wound) plus hanging/suffocation-the other two major, but overtly violent methods. This observational multilevel (individual/county), multivariable study employed a generalized linear mixed model (GLMM) to analyze pooled suicides and undetermined intent deaths, as possible suicides, among the population aged 15 years and older in the 17 states participating in the National Violent Death Reporting System throughout 2011-2013. The outcome measure was relative odds of suicide versus undetermined classification, adjusted for demographics, precipitating circumstances, and investigation characteristics. A suicide note, prior suicide attempt, or affective disorder was documented in less than one-third of suicides and one-quarter of undetermined deaths. The prevalence gaps were larger among drug intoxication cases than gunshot/hanging cases. The latter were more likely than intoxication cases to be classified as suicide versus undetermined manner of death (adjusted odds ratio [OR], 41.14; 95% CI, 34.43-49.15), as were cases documenting a suicide note (OR, 33.90; 95% CI, 26.11-44.05), prior suicide attempt (OR, 2.42; 95% CI, 2.11-2.77), or depression (OR, 1.61; 95% CI, 1.38 to 1.88), or bipolar disorder (OR, 1.41; 95% CI, 1.10-1.81). Stratification by mechanism/cause intensified the association between a note and suicide classification for intoxication cases (OR, 45.43; 95% CI, 31.06-66.58). Prior suicide attempt (OR, 2.64; 95% CI, 2.19-3.18) and depression (OR, 1.48; 95% CI, 1.17-1.87) were associated with suicide classification in intoxication but not gunshot/hanging cases. Without psychological/psychiatric evidence contributing to manner of death classification, suicide by drug intoxication in the US is likely profoundly under-reported. Findings harbor adverse implications for surveillance, etiologic understanding, and prevention of suicides and drug deaths.
Caine, Eric D.; Connery, Hilary S.; D’Onofrio, Gail; Gunnell, David J.; Miller, Ted R.; Nolte, Kurt B.; Kaplan, Mark S.; Kapusta, Nestor D.; Lilly, Christa L.; Nelson, Lewis S.; Putnam, Sandra L.; Stack, Steven; Värnik, Peeter; Webster, Lynn R.; Jia, Haomiao
2018-01-01
Objective A paucity of corroborative psychological and psychiatric evidence may be inhibiting detection of drug intoxication suicides in the United States. We evaluated the relative importance of suicide notes and psychiatric history in the classification of suicide by drug intoxication versus firearm (gunshot wound) plus hanging/suffocation—the other two major, but overtly violent methods. Methods This observational multilevel (individual/county), multivariable study employed a generalized linear mixed model (GLMM) to analyze pooled suicides and undetermined intent deaths, as possible suicides, among the population aged 15 years and older in the 17 states participating in the National Violent Death Reporting System throughout 2011–2013. The outcome measure was relative odds of suicide versus undetermined classification, adjusted for demographics, precipitating circumstances, and investigation characteristics. Results A suicide note, prior suicide attempt, or affective disorder was documented in less than one-third of suicides and one-quarter of undetermined deaths. The prevalence gaps were larger among drug intoxication cases than gunshot/hanging cases. The latter were more likely than intoxication cases to be classified as suicide versus undetermined manner of death (adjusted odds ratio [OR], 41.14; 95% CI, 34.43–49.15), as were cases documenting a suicide note (OR, 33.90; 95% CI, 26.11–44.05), prior suicide attempt (OR, 2.42; 95% CI, 2.11–2.77), or depression (OR, 1.61; 95% CI, 1.38 to 1.88), or bipolar disorder (OR, 1.41; 95% CI, 1.10–1.81). Stratification by mechanism/cause intensified the association between a note and suicide classification for intoxication cases (OR, 45.43; 95% CI, 31.06–66.58). Prior suicide attempt (OR, 2.64; 95% CI, 2.19–3.18) and depression (OR, 1.48; 95% CI, 1.17–1.87) were associated with suicide classification in intoxication but not gunshot/hanging cases. Conclusions Without psychological/psychiatric evidence contributing to manner of death classification, suicide by drug intoxication in the US is likely profoundly under-reported. Findings harbor adverse implications for surveillance, etiologic understanding, and prevention of suicides and drug deaths. PMID:29320540
2011-01-01
Background Self-management is the cornerstone of diabetes control and prevention of complications; however, it is undetermined whether differences in intention to adopt healthy lifestyles and actual healthy behavior exist across race/ethnic groups. This study evaluated the differences across racial-ethnic groups in self-reported medical advice received and health intentions and behaviors among adults with type 2 diabetes mellitus. Methods A cross-sectional analysis of the 2007 SHIELD US survey ascertained self-reported health intentions and behaviors for regular exercise, diet, and weight management among Non-Hispanic Caucasian (n = 2526), Non-Hispanic African-American (n = 706), and Hispanic (n = 179) respondents with type 2 diabetes. Results A similar proportion of respondents from each race-gender group (43%-56%) reported receiving healthcare advice to increase their exercise (P = 0.32). Significantly more minorities reported an intention to follow the exercise recommendation compared with Non-Hispanic Caucasians (P = 0.03). More Non-Hispanic African-American (29%) and Hispanic (27%) men reported exercising regularly compared with other race-gender groups (P = 0.02). Significantly more Non-Hispanic Caucasian women (74%) and Hispanic women (79%) reported trying to lose weight compared with other groups (P < 0.0001). Conclusions Differences in health intentions and healthy behaviors were noted across race-gender groups. More Non-Hispanic African-American men reported an intention to follow advice on exercising and self-report of exercising regularly was also higher compared with other race-gender groups. More Hispanic men reported high physical activity levels than other groups. Despite an increased willingness to follow healthcare recommendations for diet, >50% of respondents were obese among all race-gender groups. PMID:21729303
Gavin, James R; Fox, Kathleen M; Grandy, Susan
2011-07-05
Self-management is the cornerstone of diabetes control and prevention of complications; however, it is undetermined whether differences in intention to adopt healthy lifestyles and actual healthy behavior exist across race/ethnic groups. This study evaluated the differences across racial-ethnic groups in self-reported medical advice received and health intentions and behaviors among adults with type 2 diabetes mellitus. A cross-sectional analysis of the 2007 SHIELD US survey ascertained self-reported health intentions and behaviors for regular exercise, diet, and weight management among Non-Hispanic Caucasian (n = 2526), Non-Hispanic African-American (n = 706), and Hispanic (n = 179) respondents with type 2 diabetes. A similar proportion of respondents from each race-gender group (43%-56%) reported receiving healthcare advice to increase their exercise (P = 0.32). Significantly more minorities reported an intention to follow the exercise recommendation compared with Non-Hispanic Caucasians (P = 0.03). More Non-Hispanic African-American (29%) and Hispanic (27%) men reported exercising regularly compared with other race-gender groups (P = 0.02). Significantly more Non-Hispanic Caucasian women (74%) and Hispanic women (79%) reported trying to lose weight compared with other groups (P < 0.0001). Differences in health intentions and healthy behaviors were noted across race-gender groups. More Non-Hispanic African-American men reported an intention to follow advice on exercising and self-report of exercising regularly was also higher compared with other race-gender groups. More Hispanic men reported high physical activity levels than other groups. Despite an increased willingness to follow healthcare recommendations for diet, >50% of respondents were obese among all race-gender groups.
78 FR 69854 - Agency Forms Undergoing Paperwork Reduction Act Review
Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-21
... undetermined agents, undetermined sources, undetermined transmission, or undetermined risk factors. These EEIs... transmission, or risk factors to effectively implement rapid prevention and control measures to protect the...; data are analyzed to determine the agents, sources, modes of transmission, or risk factors so that...
Híjar-Medina, M C
1990-01-01
This article presents the results of a retrospective analysis of unintentional and intentional injury mortality in México City for the period 1970-1986. The mortality rates and trends were obtained out of 73,197 registered deaths, (according to the 9th revision of the International Disease Classification). Deaths due to the earthquakes of 1985 were not included. The trend of mortality is undefined (r = -0.430). The most important causes of death were: traffic accidents, homicides, and others accidents. Males accounted 77 per cent of the deaths. The most affected age groups were 15-19 and 20-24 years. The potential years of life lost were analyzed. This study provides information for the prevention and control of injuries and for future research in this field.
Psychopathy Increases Perceived Moral Permissibility of Accidents
Young, Liane; Koenigs, Michael; Kruepke, Michael; Newman, Joseph P.
2015-01-01
Psychopaths are notorious for their antisocial and immoral behavior, yet experimental studies have typically failed to identify deficits in their capacities for explicit moral judgment. We tested 20 criminal psychopaths and 25 criminal nonpsychopaths on a moral judgment task featuring hypothetical scenarios that systematically varied an actor’s intention and the action’s outcome. Participants were instructed to evaluate four classes of actions: accidental harms, attempted harms, intentional harms, and neutral acts. Psychopaths showed a selective difference, compared with nonpsychopaths, in judging accidents, where one person harmed another unintentionally. Specifically, psychopaths judged these actions to be more morally permissible. We suggest that this pattern reflects psychopaths’ failure to appreciate the emotional aspect of the victim’s experience of harm. These findings provide direct evidence of abnormal moral judgment in psychopathy. PMID:22390288
Takeda, Saeka; Orita, Makiko; Fukushima, Yoshiko; Kudo, Takashi; Takamura, Noboru
2016-07-19
To conduct a survey among non-medical employees working at the time of the Fukushima Daiichi Nuclear Power Station accident, in order to determine the factors associated with their intentions to leave their jobs during the nuclear disaster. We asked 287 employees (166 men and 121 women) in the study. We asked about their intentions to leave their jobs after the nuclear disaster. We also asked about relevant factors, including the participants' demographic factors, living situations and working environments. We found that in employees younger than 40 (OR=4.73, 95% CI 1.74 to 12.85, p=0.002), being married (OR=3.18, 95% CI 1.03 to 9.79, p=0.044), measurements of the ambient dose rates in their homes after the accident (OR=5.32, 95% CI 1.65 to 17.14, p=0.005), anxiety about their relationships with their colleagues after the accident (OR=3.91, 95% CI 1.51 to 10.16, p=0.005) and the influence of radiation on the workplace (OR=0.33, 95% CI 0.14 to 0.80, p=0.014) were independently associated with the non-medical employees' intentions to leave their jobs after the nuclear disaster. Our results suggest the need for continuous risk communication regarding such factors and the provision of information about the health effects of radiation exposure to non-medical employees after nuclear disasters. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
... 7 [PDF – 2.7 MB] Leading causes of death Children aged 1-4 years Accidents (unintentional injuries) ... unintentional injuries) Cancer Intentional self-harm (suicide) Source: Deaths: Final Data for 2015, table 6 [PDF – 2. ...
Psychopathy increases perceived moral permissibility of accidents.
Young, Liane; Koenigs, Michael; Kruepke, Michael; Newman, Joseph P
2012-08-01
Psychopaths are notorious for their antisocial and immoral behavior, yet experimental studies have typically failed to identify deficits in their capacities for explicit moral judgment. We tested 20 criminal psychopaths and 25 criminal nonpsychopaths on a moral judgment task featuring hypothetical scenarios that systematically varied an actor's intention and the action's outcome. Participants were instructed to evaluate four classes of actions: accidental harms, attempted harms, intentional harms, and neutral acts. Psychopaths showed a selective difference, compared with nonpsychopaths, in judging accidents, where one person harmed another unintentionally. Specifically, psychopaths judged these actions to be more morally permissible. We suggest that this pattern reflects psychopaths' failure to appreciate the emotional aspect of the victim's experience of harm. These findings provide direct evidence of abnormal moral judgment in psychopathy. PsycINFO Database Record (c) 2012 APA, all rights reserved.
Accident rates for novice glider pilots vs. pilots with experience.
Jarvis, Steve; Harris, Don
2007-12-01
It is a popular notion in gliding that newly soloed pilots have a low accident rate. The intention of this study was to review the support for such a hypothesis from literature and to explore it using UK accident totals and measures of flying exposure. Log sheets from UK gliding clubs were used to estimate flying exposure for inexperienced glider pilots. This was used along with accident data and annual flight statistics for the period 2004-2006 in order to estimate accident rates that could be compared between the pilot groups. The UK accident rate for glider pilots from 2004-2006 was 1 accident in every 3534 launches and 1590 flying hours. The lowest estimated rate for pilots with up to 1 h of experience was 1 accident every 976 launches and 149 h flown. For pilots with up to 10 h of experience the figures were 1 accident in 1274 launches and 503 h. From 2004-2006 UK glider pilots with 10 h or less experience in command had twice the number of accidents per launch and three times as many accidents per hour flown than average for UK glider pilots. Pilots with only 1 h of experience or less were involved in at least 10 times the number of accidents per hour flown than the UK average and had more than 3.5 times the number of accidents per launch.
Cui, Jinshu; Rosoff, Heather; John, Richard S
2018-05-01
Many studies have investigated public reactions to nuclear accidents. However, few studies focused on more common events when a serious accident could have happened but did not. This study evaluated public response (emotional, cognitive, and behavioral) over three phases of a near-miss nuclear accident. Simulating a loss-of-coolant accident (LOCA) scenario, we manipulated (1) attribution for the initial cause of the incident (software failure vs. cyber terrorist attack vs. earthquake), (2) attribution for halting the incident (fail-safe system design vs. an intervention by an individual expert vs. a chance coincidence), and (3) level of uncertainty (certain vs. uncertain) about risk of a future radiation leak after the LOCA is halted. A total of 773 respondents were sampled using a 3 × 3 × 2 between-subjects design. Results from both MANCOVA and structural equation modeling (SEM) indicate that respondents experienced more negative affect, perceived more risk, and expressed more avoidance behavioral intention when the near-miss event was initiated by an external attributed source (e.g., earthquake) compared to an internally attributed source (e.g., software failure). Similarly, respondents also indicated greater negative affect, perceived risk, and avoidance behavioral intentions when the future impact of the near-miss incident on people and the environment remained uncertain. Results from SEM analyses also suggested that negative affect predicted risk perception, and both predicted avoidance behavior. Affect, risk perception, and avoidance behavior demonstrated high stability (i.e., reliability) from one phase to the next. © 2017 Society for Risk Analysis.
Vlahos, N P; Dragisic, K G; Wallach, E E; Burroughs, F H; Fluck, S; Rosenthal, D L
2000-04-01
This study was undertaken to evaluate the significance of further qualification of atypical squamous cells of undetermined significance in routine Papanicolaou smears. A retrospective medical records review was conducted on 316 women whose Papanicolaou smears yielded diagnoses of either atypical squamous cells of undetermined significance suggestive of the presence of an intraepithelial lesion or atypical squamous cells of undetermined significance suggestive of a reactive process. The overall incidence of a squamous intraepithelial lesion (cervical intraepithelial neoplasia grades I, II, and III) was higher in the group with atypical squamous cells of undetermined significance suggestive of the presence of an intraepithelial lesion than in the group with results suggestive of a reactive process (41.1% vs 22.3%; P =.0344). Women with atypical squamous cells of undetermined significance suggestive of the presence of an intraepithelial lesion were 9.7 times more likely to have high-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia III) develop than were women with atypical squamous cells of undetermined significance suggestive of a reactive process (95% confidence interval, 1.26-74.64). The incidence of high-grade squamous intraepithelial lesion was higher among women =35 years old than among women >35 years old (17.8% vs 6.3%; P =.0378). Women with a diagnosis of atypical squamous cells of undetermined significance suggestive of the presence of an intraepithelial lesion are more likely to have intraepithelial lesions develop than are those with atypical squamous cells of undetermined significance suggestive of a reactive process. Aggressive evaluation of cases of atypical squamous cells of undetermined significance suggestive of the presence of an intraepithelial lesion with colposcopy and cervical biopsies may be appropriate. Age should be considered as an independent factor in the plan of management.
Edwards, Phil; Roberts, Ian; Green, Judith; Lutchmun, Suzanne
2006-07-15
To examine socioeconomic inequalities in rates of death from injury in children in England and Wales. Analysis of rates of death from injury in children by the eight class version of the National Statistics Socio-Economic Classification (NS-SEC) and by the registrar general's social classification. England and Wales during periods of four years around the 1981, 1991, and 2001 censuses. Children aged 0-15 years. Death rates from injury and poisoning. Rates of death from injury in children fell from 11.1 deaths (95% confidence interval 10.8 to 11.5 deaths) per 100,000 children per year around the 1981 census to 4.0 deaths (3.8 to 4.2 deaths) per 100,000 children per year around the 2001 census. Socioeconomic inequalities remain: the death rate from all external causes for children of parents classified as never having worked or as long term unemployed (NS-SEC 8) was 13.1 (10.3 to 16.5) times that for children in NS-SEC 1(higher managerial/professional occupations). For deaths as pedestrians the rate in NS-SEC 8 was 20.6 (10.6 to 39.9) times higher than in NS-SEC 1; for deaths as cyclists it was 27.5 (6.4 to 118.2) times higher; for deaths due to fires it was 37.7 (11.6 to 121.9) times higher; and for deaths of undetermined intent it was 32.6 (15.8 to 67.2) times higher. Overall rates of death from injury and poisoning in children have fallen in England and Wales over the past 20 years, except for rates in children in families in which no adult is in paid employment. Serious inequalities in injury death rates remain, particularly for pedestrians, cyclists, house fires, and deaths of undetermined intent.
Monoclonal Gammopathy of Undetermined Significance (MGUS)
Monoclonal gammopathy of undetermined significance (MGUS) Overview Monoclonal gammopathy of undetermined significance (MGUS) is a condition in which an ... to have regular checkups to closely monitor monoclonal gammopathy so that if it does progress, you get ...
EEG-Based Detection of Braking Intention Under Different Car Driving Conditions
Hernández, Luis G.; Mozos, Oscar Martinez; Ferrández, José M.; Antelis, Javier M.
2018-01-01
The anticipatory recognition of braking is essential to prevent traffic accidents. For instance, driving assistance systems can be useful to properly respond to emergency braking situations. Moreover, the response time to emergency braking situations can be affected and even increased by different driver's cognitive states caused by stress, fatigue, and extra workload. This work investigates the detection of emergency braking from driver's electroencephalographic (EEG) signals that precede the brake pedal actuation. Bioelectrical signals were recorded while participants were driving in a car simulator while avoiding potential collisions by performing emergency braking. In addition, participants were subjected to stress, workload, and fatigue. EEG signals were classified using support vector machines (SVM) and convolutional neural networks (CNN) in order to discriminate between braking intention and normal driving. Results showed significant recognition of emergency braking intention which was on average 71.1% for SVM and 71.8% CNN. In addition, the classification accuracy for the best participant was 80.1 and 88.1% for SVM and CNN, respectively. These results show the feasibility of incorporating recognizable driver's bioelectrical responses into advanced driver-assistance systems to carry out early detection of emergency braking situations which could be useful to reduce car accidents. PMID:29910722
Raschka, C; Parzeller, M; Banzer, W
1999-03-01
The primary intention of this study is the grouping of sports accidents, being described by the athletes in their own words in a classification system of specific accident classes with regard to specific motions and topography. The investigation is based on the data of the sports insurance Gerling-Konzern during a 15-year period in Rhineland Palatinate (1981-1995). The study is based on the insurance documents and clinical protocols if available. 137 accident protocols were related to this 15-year period including weight lifting (n = 1) and martial arts (n = 136). Listed in hierarchical order we received the following results: judo (n = 47), karate (n = 44), wrestling (n = 22), taekwondo (n = 9), boxing (n = 7), ju-jutsu (n = 5), fencing (n = 1) and aikido (n = 1). In accordance to accident types there were no sex related differences. As special preventive measures we suggest the use of protective mouthguards and solid glasses, proprioceptive training and physiological taping for knee, ankle and elbow joints.
Radiation Emergencies | RadTown USA | US EPA
2018-05-01
Radiation emergencies can be intentional acts designed to hurt others, like a terrorist attack, or they can be accidents that occur when using radioactive material. During a radiation emergency, the goal is to keep your exposure to radiation as low as possible.
Stone, Deborah M; Holland, Kristin M; Bartholow, Brad; E Logan, Joseph; LiKamWa McIntosh, Wendy; Trudeau, Aimee; Rockett, Ian R H
2017-08-01
Manner of death (MOD) classification (i.e., natural, accident, suicide, homicide, or undetermined cause) affects mortality surveillance and public health research, policy, and practice. Determination of MOD in deaths caused by drug intoxication is challenging, with marked variability across states. The Centers for Disease Control and Prevention hosted a multidisciplinary meeting to discuss drug intoxication deaths as they relate to suicide and other MOD. The meeting objectives were to identify individual-level, system-level, and place-based factors affecting MOD classification and identify potential solutions to classification barriers. Suggested strategies included improved standardization in death scene investigation, toxicology, and autopsy practice; greater accountability; and creation of job aids for investigators. Continued collaboration and coordination of activities are needed among stakeholders to affect prevention efforts.
Gutiérrez, María Isabel
2014-01-01
Injuries are the result of an acute exposure to exhort of energy or a consequence of a deficiency in a vital element that exceeds physiological thresholds resulting threatens life. They are classified as intentional or unintentional. Injuries are considered a global health issue because they cause more than 5 million deaths per year worldwide and they are an important contributor to the burden of disease, especially affecting people of low socioeconomic status in low- and middle-income countries. A common misconception exists where injuries are thought to be the same as accidents; however, accidents are largely used as chance events, without taken in consideration that all these are preventable. This review discusses injuries and accidents in the context of road traffic and emphasizes injuries as preventable events. An understanding of the essence of injuries enables the standardization of terminology in public use and facilitates the development of a culture of prevention among all of us. PMID:25386040
Questioning the Role of Requirements Engineering in the Causes of Safety-Critical Software Failures
NASA Technical Reports Server (NTRS)
Johnson, C. W.; Holloway, C. M.
2006-01-01
Many software failures stem from inadequate requirements engineering. This view has been supported both by detailed accident investigations and by a number of empirical studies; however, such investigations can be misleading. It is often difficult to distinguish between failures in requirements engineering and problems elsewhere in the software development lifecycle. Further pitfalls arise from the assumption that inadequate requirements engineering is a cause of all software related accidents for which the system fails to meet its requirements. This paper identifies some of the problems that have arisen from an undue focus on the role of requirements engineering in the causes of major accidents. The intention is to provoke further debate within the emerging field of forensic software engineering.
16 CFR 300.28 - Undetermined quantities of reclaimed fibers.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Undetermined quantities of reclaimed fibers. 300.28 Section 300.28 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS RULES AND REGULATIONS UNDER THE WOOL PRODUCTS LABELING ACT OF 1939 Labeling § 300.28 Undetermined...
He, Meng; Li, Wen-Can; Sun, Da-Ming; Ma, Kai-Jun; Zhao, Zi-Qin; Li, Bei-Xu; Li, Ling
2014-09-01
The unnatural death investigation in China seems vague to the world. Shanghai is one of the largest city located in Yangtze River Delta in the East China. This study is committed to lift the veil of unnatural death investigation and describe the epitome of China's unnatural deaths. Based on the 7302 forensic report archives from 1990 to 1999 in Shanghai Public Security Bureau, statistics were carried out in 5 areas according to the manner of death. In 3502 accidental deaths, there was a rapid increase during the 1990s, and 71.6% were involved in traffic accidents whose major cause of death was head and neck injuries. The first 3 causes of death in nontraffic accidents (994) were head and neck injuries (42.8%), poisoning (11.8%), and drowning (9.0%). In 2456 homicides, sharp force injury (36.7%), blunt force injury (35.8%), and manual strangulation (12.9%) were the first 3 causes of death. In 563 suicides, drug/chemical intoxication (40.1%), hanging (23.4%), and injuries because of fall from height (11.4%) were the 3 leading causes of death, especially pesticides ingestion. The causes of natural deaths were diseases mainly in circulatory system (23.1%), central nervous system (12.8%), and respiratory system (6.4%). However, the cause of death remained undetermined in 500 victims. Childhood fatalities were different. The victims of accidents and homicides were nearly equal, and the main cause of homicide was manual strangulation. Besides, 1997 was the landmark year when drug abuse began to emerge in Shanghai.
ERIC Educational Resources Information Center
Huguet, Nathalie; Kaplan, Mark S.; McFarland, Bentson H.
2012-01-01
Little is known about the factors associated with undetermined death classifications among African Americans. In this study, the rates of undetermined deaths were assessed, the prevalence of missing information was estimated, and whether the circumstances preceding death differ by race were examined. Data were derived from the 2005-2008 National…
NASA Astrophysics Data System (ADS)
Yao, Hong; Zhang, Tongzhu; Liu, Bo; Lu, Feng; Fang, Shurong; You, Zhen
2016-04-01
Understanding historical accidents is important for accident prevention and risk mitigation; however, there are no public databases of pollution accidents in China, and no detailed information regarding such incidents is readily available. Thus, 653 representative cases of surface water pollution accidents in China were identified and described as a function of time, location, materials involved, origin, and causes. The severity and other features of the accidents, frequency and quantities of chemicals involved, frequency and number of people poisoned, frequency and number of people affected, frequency and time for which pollution lasted, and frequency and length of pollution zone were effectively used to value and estimate the accumulated probabilities. The probabilities of occurrences of various types based on origin and causes were also summarized based on these observations. The following conclusions can be drawn from these analyses: (1) There was a high proportion of accidents involving multi-district boundary regions and drinking water crises, indicating that more attention should be paid to environmental risk prevention and the mitigation of such incidents. (2) A high proportion of accidents originated from small-sized chemical plants, indicating that these types of enterprises should be considered during policy making. (3) The most common cause (49.8 % of the total) was intentional acts (illegal discharge); accordingly, efforts to increase environmental consciousness in China should be enhanced.
Yao, Hong; Zhang, Tongzhu; Liu, Bo; Lu, Feng; Fang, Shurong; You, Zhen
2016-04-01
Understanding historical accidents is important for accident prevention and risk mitigation; however, there are no public databases of pollution accidents in China, and no detailed information regarding such incidents is readily available. Thus, 653 representative cases of surface water pollution accidents in China were identified and described as a function of time, location, materials involved, origin, and causes. The severity and other features of the accidents, frequency and quantities of chemicals involved, frequency and number of people poisoned, frequency and number of people affected, frequency and time for which pollution lasted, and frequency and length of pollution zone were effectively used to value and estimate the accumulated probabilities. The probabilities of occurrences of various types based on origin and causes were also summarized based on these observations. The following conclusions can be drawn from these analyses: (1) There was a high proportion of accidents involving multi-district boundary regions and drinking water crises, indicating that more attention should be paid to environmental risk prevention and the mitigation of such incidents. (2) A high proportion of accidents originated from small-sized chemical plants, indicating that these types of enterprises should be considered during policy making. (3) The most common cause (49.8% of the total) was intentional acts (illegal discharge); accordingly, efforts to increase environmental consciousness in China should be enhanced.
DOT National Transportation Integrated Search
2008-07-01
This study investigated the human factors issues related to the implementation of lane departure warning systems (LDWS) to reduce side collision and run-off-road crashes for heavy trucks. Lane departures can be either intentional (e.g., to pass anoth...
Traffic accident in Cuiabá-MT: an analysis through the data mining technology.
Galvão, Noemi Dreyer; de Fátima Marin, Heimar
2010-01-01
The traffic road accidents (ATT) are non-intentional events with an important magnitude worldwide, mainly in the urban centers. This article aims to analyzes data related to the victims of ATT recorded by the Justice Secretariat and Public Security (SEJUSP) in hospital morbidity and mortality incidence at the city of Cuiabá-MT during 2006, using data mining technology. An observational, retrospective and exploratory study of the secondary data bases was carried out. The three database selected were related using the probabilistic method, through the free software RecLink. One hundred and thirty-nine (139) real pairs of victims of ATT were obtained. In this related database the data mining technology was applied with the software WEKA using the Apriori algorithm. The result generated 10 best rules, six of them were considered according to the parameters established that indicated a useful and comprehensible knowledge to characterize the victims of accidents in Cuiabá. Finally, the findings of the associative rules showed peculiarities of the road traffic accident victims in Cuiabá and highlight the need of prevention measures in the collision accidents for males.
2013-01-01
Background Drowning deaths constitute a significant proportion of unnatural deaths globally. In Sweden and other high-income countries, drowning deaths have decreased. This study investigates the epidemiology and current trends of unintentional, intentional, and undetermined drowning deaths with emphasis on the presence of alcohol and other drugs. Methods During an 18-years period, 5,125 drowning deaths were autopsied in Sweden. Data on cases including toxicological analysis on alcohol, pharmaceutical drugs, and illicit drugs were obtained from the National Board of Forensic Medicine. Results During the study period, the annual incidence of drowning deaths in Sweden was 3.1/100,000 inhabitants and decreased on average by about 2% each year (p<0.001). The highest incidence was found among males and in middle/older age groups. The incidence increased 3% for each year of age. Children/adolescents (≤18 years) constituted 5% of all drowning deaths. Of all drowned females in the study, 55% (847/1,547) committed suicide, which was a significantly higher proportion compared with males (21%, 763/3,578) (p<0.001). In total, 38% (1,656/4,377) of tested drowned persons had alcohol in their blood and the mean concentration was 1.8 g/l. In the unintentional drowning group, intentional drowning group, and the undetermined group, the proportion of alcohol positive was 44%, 24%, and 45%, respectively. One or several psychoactive drugs were present in the blood in 40% (1,688 /4,181) of all tested persons and in 69% (965/1,394) of tested persons who died from suicidal drowning. The most common drug was benzodiazepines (21%, 891/4,181). Illicit drugs were detected in 10% (82/854) of tested persons. Conclusion Presence of alcohol and drugs were frequent and may have contributed to the drowning deaths. The incidence of drowning deaths significantly decreased during the study period. Males and the middle/older age groups had a higher incidence compared to females and children. Suicidal drowning was common especially among women. Alcohol and drugs are significant contributors in drowning deaths in Sweden and should be considered as part of a comprehensive prevention program. PMID:23497055
Learning from Tragedy: Student Affairs Leadership Following College Campus Disasters
ERIC Educational Resources Information Center
Treadwell, Katie L.
2017-01-01
The phenomenological study illuminated the lived experience of senior-level student affairs administrators who encountered high-profile crises, such as natural disasters, intentional violence, or accidents. In the midst of unimaginable tragedy, their lived experience was defined by: uncertainty and fear, heightened awareness, personal impact, and…
Haz-Mat Refresher: Chemical Precautions
ERIC Educational Resources Information Center
Caliendo, Louis A.
2012-01-01
It is important that first responders remain aware of the possible hazards resulting from chemical accidents or the intentional use of chemicals in destructive devices. Chemical components can be utilized in the manufacturing of improvised explosive devices (IEDs), can enhance the effect of a more conventional device, or can pose hazards based on…
Medical and policy considerations for nuclear and radiation accidents, incidents and terrorism.
Gale, Robert Peter
2017-11-01
The purpose of this review is to address the increasing medical and public concern regarding the health consequences of radiation exposure, a concern shaped not only by fear of another Chernobyl or Fukushima nuclear power facility accident but also by the intentional use of a nuclear weapon, a radiological dispersion device, a radiological exposure device, or an improved nuclear device by rogue states such as North Korea and terrorist organizations such as Al Qaeda and ISIS. The United States has the medical capacity to respond to a limited nuclear or radiation accident or incident but an effective medical response to a catastrophic nuclear event is impossible. Dealing effectively with nuclear and radiation accidents or incidents requires diverse strategies, including policy decisions, public education, and medical preparedness. I review medical consequences of exposures to ionizing radiations, likely concomitant injuries and potential medical intervention. These data should help haematologists and other healthcare professionals understand the principles of medical consequences of nuclear terrorism. However, the best strategy is prevention.
Deep Borehole Emplacement Mode Hazard Analysis Revision 0
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sevougian, S. David
This letter report outlines a methodology and provides resource information for the Deep Borehole Emplacement Mode Hazard Analysis (DBEMHA). The main purpose is identify the accident hazards and accident event sequences associated with the two emplacement mode options (wireline or drillstring), to outline a methodology for computing accident probabilities and frequencies, and to point to available databases on the nature and frequency of accidents typically associated with standard borehole drilling and nuclear handling operations. Risk mitigation and prevention measures, which have been incorporated into the two emplacement designs (see Cochran and Hardin 2015), are also discussed. A key intent ofmore » this report is to provide background information to brief subject matter experts involved in the Emplacement Mode Design Study. [Note: Revision 0 of this report is concentrated more on the wireline emplacement mode. It is expected that Revision 1 will contain further development of the preliminary fault and event trees for the drill string emplacement mode.]« less
Deaths from pesticide poisoning in South Korea: trends over 10 years.
Lee, Won Jin; Cha, Eun Shil; Park, Eun Sook; Kong, Kyoung Ae; Yi, Jun Hyeok; Son, Mia
2009-02-01
Pesticide poisoning is a major cause of death in the world. The objective of this study was to examine the trends of pesticide poisoning deaths and their epidemiologic characteristics in South Korea. We evaluated the age-standardized mortality rates from pesticide-related deaths (intentional self-poisoning, accidental poisoning, assault, undetermined intent poisoning) in South Korea from 1996 through 2005, using registered death data obtained from the Korea National Statistical Office. The regional rurality index was calculated and correlation analyses were used to estimate the association with pesticide poisoning mortality. The number of pesticide poisoning deaths from 1996 through 2005 was 25,360, which accounted for 58.3% of the total poisoning fatalities. The age-standardized mortality rates by pesticide poisoning significantly increased from 4.42 to 6.42 per 100,000 population, whereas the total death rate was decreased in the same period. Intentional self-poisoning was the majority cause of death from pesticides (84.8% of total pesticide poisoning deaths). The majority of the pesticide poisoning deaths were men, over 50 years old, with education less than middle school, and residing in rural areas. The rate of pesticide poisoning deaths was the highest in the farming period and was significantly correlated with the rurality index of each region. Pesticide poisoning deaths substantially increased during the 10-year study period, and showed demographic, seasonal and regional variations. More intensive intervention efforts to reduce pesticide mortality should become a public health priority in South Korea.
The Fukushima Dai-ichi Accident and its implications for the safety of nuclear power
NASA Astrophysics Data System (ADS)
Barletta, William
2016-05-01
Five years ago the dramatic events in Fukushima that followed the massive earthquake and subsequent tsunami that struck Japan on March 11, 2011 sharpened the focus of scientists, engineers and general public on the broad range of technical, environmental and societal issues involved in assuring the safety of the world's nuclear power complex. They also called into question the potential of nuclear power to provide a growing, sustainable resource of CO2-free energy. The issues raised by Fukushima Dai-ichi have provoked urgent concern, not only because of the potential harm that could result from severe accidents or from intentional damage to nuclear reactors or to facilities involved in the nuclear fuel cycle, but also because of the extensive economic impact of those accidents and of the measures taken to avoid them.
A 20 year retrospective analysis of medicolegal deaths in a tertiary hospital setting in Nigeria.
Akhiwu, W O; Nwafor, C C; Igbe, A P
2013-01-01
To determine and classify the various types of medicolegal deaths as seen at University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. This is a retrospective study of all the medicolegal deaths seen in the Department of Histopathology, (UBTH, Benin City over a 20 year period (January 1990-December 2009) as recorded in the autopsy registers of the department. A total of 5035 autopsies were done during the period, 89% of which were coroner cases. Four thousand, four hundred and eighty-one coroner cases representing 12.5% of all bodies received by the mortuary during the period were studied. The male to female ratio was 1.9:1, with an overall mean age of 38.3 years. The ages ranged from 1 day to 101 years with a peak incidence in the 25-44 years age group. A total of 553 children and 3928 adults were involved. The commonest indication for coroner's autopsy was sudden unexpected natural deaths (SUNDs) which accounted for 65.5% of the cases. Other causes of death were accidents, homicide, suicide, and undetermined causes representing 28.6, 5.0, 0.5, and 0.4%, respectively. Commonest cause of SUND was cardiovascular diseases with complications of hypertension being the most common CVS disease (26.9%). Road traffic accident was the commonest form of accident causing death (88.7%). Public enlightenment and health education about routine medical screening will help to reduce causes of natural deaths. This study shows the pattern of medicolegal autopsies in UBTH and this preliminary data will provide a baseline for future research and help in formulating policies to help in reduction of preventable causes of death.
Otaki, Yasuhiro; DaSilva, Makiko Ishida; Saito, Yuichi; Oyama, Yasuaki; Oiso, Giichiro; Yoshida, Tomohiko; Fukuhara, Masakazu; Moriyama, Mitsuru
2018-03-01
Septic arthritis (SA) cases can result in claims or litigation because of poor prognosis even if it is unavoidable. Although these claims or litigation are useful for understanding causes and background factors of medical errors, the characteristics of malpractice claims associated with SA remain undetermined in Japan. This study aimed to increase our understanding of malpractice claims in the clinical management of SA. We analyzed 6 civil precedents and 16 closed claims of SA from 8530 malpractice claims processed between July 2004 and June 2014 by the Tokyo office of Sompo Japan Nipponkoa Insurance, Incorporated. We also studied 5 accident and 21 incident reports of SA based on project data compiled by the Japan Council for Quality Health Care. The rate of negligence was 83.3% in the precedents and 75.0% in closed claims. Two main malpractice claim patterns were revealed: SA in a lower extremity joint following sepsis caused by methicillin-resistant Staphylococcus aureus in newborns and SA in an injection site following joint injection. These two patterns accounted for 83.3% and 56.3% of judicial cases and closed claim cases, respectively. Breakdowns in care process of accident and incident reports were clearly differentiated from judicial cases or closed claim cases (Fisher's exact test, p < 0.001). It is important to pay particular attention to SA following sepsis in newborns and to monitor for any signs of SA after joint injection to ensure early diagnosis. Analysis of both malpractice claims and accident and incident reports is essential to ensure a full understanding of the situation in Japan. Copyright © 2017. Published by Elsevier Taiwan LLC.
Teenage Suicide in Oregon 1983-1985.
ERIC Educational Resources Information Center
Oregon State Dept. of Human Resources, Portland.
During the 3-year period from 1983 through 1985, 80 Oregon teenagers intentionally took their own lives, making suicide second only to accidents as the leading cause of death among Oregon teenagers. Data on suicides committed by individuals between the ages of 10 and 19 were retrieved from death certificates on file with the Oregon Health Division…
Using Triage Figuratively to Describe Effective Teaching in Physical Education
ERIC Educational Resources Information Center
Henkel, Steven A.
2016-01-01
This article presents critical outcomes for physical education in a "triage" framework by comparing the process of determining the severity of injuries at the scene of an accident to the process of prioritizing decisions in the classroom. The intent is to reduce all possible outcomes of effective teaching to six nonnegotiable outcomes…
Teacher Liability in School-Shop Accidents.
ERIC Educational Resources Information Center
Kegin, Denis J.
The intent of the book is to stimulate interest in the problem of shop-teacher liability and to identify certain needs which have not been adequately met by existing laws and statutes. Chapter 1, The Significance of Teacher Liability, discusses basic legal considerations, the environment of the school shop, and the possibility of liability.…
A Non-Mentalistic Cause-Based Heuristic in Human Social Evaluations
ERIC Educational Resources Information Center
Buon, Marine; Jacob, Pierre; Loissel, Elsa; Dupoux, Emmanuel
2013-01-01
In situations where an agent unintentionally causes harm to a victim, the agent's (harmless) intention typically carries "more" weight than his/her (harmful) causal role. Therefore, healthy adults typically judge leniently agents responsible for an accident. Using animated cartoons, we show, however, that in the presence of a difficult concurrent…
2012-01-01
Objective In the present paper, we describe suicide in youths under 16 years of age and compare their risk factors for suicide to those of older adolescents as described in the literature. Furthermore, we evaluate the possible mislabeling of suicides as accidents, and vice versa. Method We used the data from a nationwide psychological autopsy of youths 15 years and younger who had committed suicide or died in accidents in Norway from 1993 to 2004 (n = 84). We additionally constructed a suicide index to distinguish between the two causes of death. Results The young suicide victims presented, with little gender difference, fewer obvious risk factors and less suicide intent than commonly described for older adolescents. The suicide index distinguished quite well between suicides and accidents, with few cases indicating a possible mislabeling, although some suicide cases could have been labeled as uncertain. Conclusion In line with previous research, suicides in 11-15-year-olds have many similarities to suicides in older adolescents in terms of external circumstances, but they present less apparent warning signs. In our total sample of 84 deaths, there were few indications of incorrect labeling. PMID:22971572
Kang, Byeong Keun; Kim, June Sic; Ryun, Seokyun; Chung, Chun Kee
2018-01-01
Most brain-machine interface (BMI) studies have focused only on the active state of which a BMI user performs specific movement tasks. Therefore, models developed for predicting movements were optimized only for the active state. The models may not be suitable in the idle state during resting. This potential maladaptation could lead to a sudden accident or unintended movement resulting from prediction error. Prediction of movement intention is important to develop a more efficient and reasonable BMI system which could be selectively operated depending on the user's intention. Physical movement is performed through the serial change of brain states: idle, planning, execution, and recovery. The motor networks in the primary motor cortex and the dorsolateral prefrontal cortex are involved in these movement states. Neuronal communication differs between the states. Therefore, connectivity may change depending on the states. In this study, we investigated the temporal dynamics of connectivity in dorsolateral prefrontal cortex and primary motor cortex to predict movement intention. Movement intention was successfully predicted by connectivity dynamics which may reflect changes in movement states. Furthermore, dorsolateral prefrontal cortex is crucial in predicting movement intention to which primary motor cortex contributes. These results suggest that brain connectivity is an excellent approach in predicting movement intention.
Fonseca, Ana Catarina; Alves, Pedro; Inácio, Nuno; Marto, João Pedro; Viana-Baptista, Miguel; Pinho-E-Melo, Teresa; Ferro, José M; Almeida, Ana G
2018-03-01
Some patients with ischemic strokes that are currently classified as having an undetermined cause may have structural or functional changes of the left atrium (LA) and left atrial appendage, which increase their risk of thromboembolism. We compared the LA and left atrial appendage of patients with different ischemic stroke causes using cardiac magnetic resonance imaging. We prospectively included a consecutive sample of ischemic stroke patients. Patients with structural changes on echocardiography currently considered as causal for stroke in the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification were excluded. A 3-T cardiac magnetic resonance imaging was performed. One hundred and eleven patients were evaluated. Patients with an undetermined cause had a higher percentage of LA fibrosis ( P =0.03) than patients with other stroke causes and lower, although not statistically significant, values of LA ejection fraction. Patients with atrial fibrillation and undetermined stroke cause showed a similar value of atrial fibrosis. The LA phenotype that was found in patients with undetermined cause supports the hypothesis that an atrial disease may be associated with stroke. © 2018 American Heart Association, Inc.
"Pursuing a Lifetime of Healthful Physical Activity" through Falling and Rolling
ERIC Educational Resources Information Center
Kozub, Francis M.; Hogan, John T.
2013-01-01
The basic movement concepts associated with falling and rolling are needed for many dynamic adult activities. This is the case any time the activity, either by intent or accident, involves safely transitioning from a standing position to the ground quickly. Failure to teach these skills in school physical education could result in a barrier to…
The “eye avoidance” hypothesis of autism face processing
Tanaka, James W.; Sung, Andrew
2013-01-01
Although a growing body of research indicates that children with autism spectrum disorder (ASD) exhibit selective deficits in their ability to recognize facial identities and expressions, the source of their face impairment is, as yet, undetermined. In this paper, we consider three possible accounts of the autism face deficit: 1) the holistic hypothesis, 2) the local perceptual bias hypothesis and 3) the eye avoidance hypothesis. A review of the literature indicates that contrary to the holistic hypothesis, there is little evidence to suggest that individuals with autism do not perceive faces holistically. The local perceptual bias account also fails to explain the selective advantage that ASD individuals demonstrate for objects and their selective disadvantage for faces. The eye avoidance hypothesis provides a plausible explanation of face recognition deficits where individuals with ASD avoid the eye region because it is perceived as socially threatening. Direct eye contact elicits a heightened physiological response as indicated by heightened skin conductance and increased amgydala activity. For individuals with autism, avoiding the eyes is an adaptive strategy, however, this approach interferes with the ability to process facial cues of identity, expressions and intentions, The “eye avoidance” strategy has negative effects on the ability to decode facial information about identity, expression, and intentions, exacerbating the social challenges for persons with ASD. PMID:24150885
DOE Office of Scientific and Technical Information (OSTI.GOV)
Gauntt, Randall O.; Mattie, Patrick D.
Sandia National Laboratories (SNL) has conducted an uncertainty analysis (UA) on the Fukushima Daiichi unit (1F1) accident progression with the MELCOR code. The model used was developed for a previous accident reconstruction investigation jointly sponsored by the US Department of Energy (DOE) and Nuclear Regulatory Commission (NRC). That study focused on reconstructing the accident progressions, as postulated by the limited plant data. This work was focused evaluation of uncertainty in core damage progression behavior and its effect on key figures-of-merit (e.g., hydrogen production, reactor damage state, fraction of intact fuel, vessel lower head failure). The primary intent of this studymore » was to characterize the range of predicted damage states in the 1F1 reactor considering state of knowledge uncertainties associated with MELCOR modeling of core damage progression and to generate information that may be useful in informing the decommissioning activities that will be employed to defuel the damaged reactors at the Fukushima Daiichi Nuclear Power Plant. Additionally, core damage progression variability inherent in MELCOR modeling numerics is investigated.« less
Huguet, Nathalie; Kaplan, Mark S; McFarland, Bentson H
2012-04-01
Little is known about the factors associated with undetermined death classifications among African Americans. In this study, the rates of undetermined deaths were assessed, the prevalence of missing information was estimated, and whether the circumstances preceding death differ by race were examined. Data were derived from the 2005-2008 National Violent Death Reporting System. African Americans had higher prevalence of missing information than Whites. African Americans classified as undetermined deaths were more likely to be older, women, never married/single, to have had a blood alcohol content at or above the legal limit, and to have had a substance abuse problem. The results suggest that racial differences in the preponderance and the type of evidence surrounding the death may affect death classification. © 2012 The American Association of Suicidology.
NASA Technical Reports Server (NTRS)
2005-01-01
It has been 29 months since Columbia was lost over East Texas in February 2003. Seven months after the accident, the Columbia Accident Investigation Board (CAIB) released the first volume of its final report, citing a variety of technical, managerial, and cultural issues within NASA and the Space Shuttle Program. To their credit, NASA offered few excuses, embraced the report, and set about correcting the deficiencies noted by the accident board. Of the 29 recommendations issued by the CAIB, 15 were deemed critical enough that the accident board believed they should be implemented prior to returning the Space Shuttle to flight. Some of these recommendations were relatively easy, most were straightforward, a few bordered on the impossible, and others were largely overcome by events, particularly the decision by the President to retire the Space Shuttle by 2010. The Return to Flight Task Group (RTF TG, or simply, the Task Group) was chartered by the NASA Administrator in July 2003 to provide an independent assessment of the implementation of the 15 CAIB return-to-flight recommendations. An important observation must be stated up-front: neither the CAIB nor the RTF TG believes that all risk can be eliminated from Space Shuttle operations; nor do we believe that the Space Shuttle is inherently unsafe. What the CAIB and RTF TG do believe, however, is that NASA and the American public need to understand the risks associated with space travel, and that NASA must make every reasonable effort to minimize such risk. Since the release of the CAIB report, NASA and the Space Shuttle Program expended enormous effort and resources toward correcting the causes of the accident and preparing to fly again. Relative to the 15 specific recommendations that the CAIB indicated should be implemented prior to returning to flight, NASA has met or exceeded most of them the Task Group believes that NASA met the intent of the CAIB for 12 of these recommendations. The remaining three recommendations were so challenging that NASA could not comply completely with the intent of the CAIB.
Goldstone, Stephen E; Kawalek, Adam Z; Goldstone, Robert N; Goldstone, Andrew B
2008-07-01
In the cervix and anus, patients with atypical squamous cells of undetermined significance often do not have high-grade squamous intraepithelial lesions. In women with atypical squamous cells of undetermined significance, Hybrid-Capture II testing for oncogenic high-risk human papillomavirus is performed and those without high-risk human papillomavirus often are observed. We endeavored to determine whether Hybrid-Capture II testing would be beneficial in men who have sex with men with atypical squamous cells of undetermined significance. We performed a retrospective chart review of men who have sex with men with atypical squamous cells of undetermined significance who had high-resolution anoscopy and Hybrid-Capture II. A total of 290 men were identified (mean age, 42 years), and 212 (73 percent) were HIV-negative. High-grade squamous intraepithelial lesions were found in 50 (17 percent): 23 (10 percent) who were HIV-negative and 27 (35 percent) who were HIV-positive men. High-risk human papillomavirus was found in 138 (48 percent); 91 (43 percent) of HIV-negative and 47 (60 percent) of HIV-positive men. The sensitivity, specificity, positive predictive value, and negative predictive value of atypical cells of undetermined significance cytology combined with Hybrid-Capture II were 84, 60, 30, and 95 percent, respectively. There was no significant difference between all men vs. those who were HIV-positive or HIV-negative except for the positive predictive value. Hybrid-Capture II testing for high-risk human papillomavirus in men who have sex with men with atypical cells of undetermined significance and referring only those with high-risk human papillomavirus reduces the number who require high-resolution anoscopy by more than half. Five percent with high-grade squamous intraepithelial lesions would be missed.
F-35 Joint Strike Fighter: Preliminary Observations on Program Progress
2016-03-23
partners are the United Kingdom, Italy, the Netherlands, Turkey , Canada, Australia, Denmark, and Norway. These nations contributed funds for system...Estimated delivery and production dates Initial operational capability 2010-2012 Undetermined 2015- 2018 undetermined 5-6 years Full-rate
Bonzanini, Mariella; Amadori, Pierluigi; Morelli, Luca; Fasanella, Silvia; Pertile, Riccardo; Mattiuzzi, Angela; Marini, Giorgio; Niccolini, Mauro; Tirone, Giuseppe; Rigamonti, Marco; Dalla Palma, Paolo
2011-01-01
Undetermined thyroid cytology precludes any definitive distinction between malignant and benign lesions. Recently several classifications have been proposed to split this category into two or more cytological subcategories related to different malignancy risk rates. The current study was performed retrospectively to investigate the results obtained separating "undetermined" cytologic reports into two categories: "follicular lesion" (FL) and "atypia of undetermined significance" (AUS). Biochemical, clinical, and echographic features of each category were also retrospectively analyzed. Altogether, 316 undetermined fine-needle aspirated cytologies (FNACs) were reclassified as 74 FL and 242 AUS. Histological control leads to a diagnosis of carcinomas, adenomas, and nonneoplastic lesions, respectively, in 42.2%, 20%, and 37.8% of AUS and in 8.3%, 69.4%, and 22.2% of FL. Among biochemical, clinical, cytological, and echographic outcomes, altered thyroid autoantibodies, multiple versus single nodule, AUS versus FL, and presence of intranodular vascular flow were statistically significant to differentiate adenoma from carcinoma and from nonneoplastic lesions, whereas no significant differences were found between carcinomas and nonneoplastic lesions for these parameters. The results of this retrospective study show that undetermined FNAC category can further be subclassified in AUS and FL, the former showing higher malignancy rate. Further prospective studies are needed to confirm our results.
Impulsivity, risky behaviors and accidents in alcohol-dependent patients
Jakubczyk, Andrzej; Klimkiewicz, Anna; Wnorowska, Anna; Mika, Katarzyna; Bugaj, Marcin; Podgórska, Anna; Barry, Kristen; Blow, Frederic C.; Brower, Kirk J.; Wojnar, Marcin
2013-01-01
Impulsivity and alcohol drinking are both considered as important predictors of unintentional as well as intentional injuries. However, relationships of impulsivity with risky behaviors and a history of accidents have not been investigated in alcohol dependence. The aim of this study was to analyze relationships between the frequency of risky behaviors and level of behavioral as well as cognitive impulsivity in alcohol-dependent patients. By means of Barratt’s Impulsiveness Scale (BIS) and stop-signal task, the levels of cognitive and behavioral impulsivity among 304 alcohol-dependent patients were measured. Also, patients were asked to answer questions from the Short Inventory of Problems applying to risky behaviors and accidents after alcohol drinking. In addition participants completed a questionnaire to assess frequency of other behaviors from the analyzed spectrum (use of other drugs, driving or aggressive behavior after alcohol drinking). The statistical analysis revealed a significant association between impulsivity and frequency of risky behaviors in alcohol-dependent patients. Individuals with higher scores in BIS behaved more frequently in a risky way and had significantly more accidents after alcohol drinking. The association with risky behaviors was strongest for non-planning and attentional impulsivity subscales, whereas frequency of accidents was particularly associated with motor impulsivity. A multivariate analysis revealed that impulsivity was the most important predictor of risky behaviors, but did not significantly predict a history of accidents. Our study confirms that impulsivity is an important correlate of risky behaviors in alcohol-dependent individuals, along with global psychopathology and severity of alcohol dependence. PMID:23246707
[Post-traumatic coma and pre-traumatic memory].
Malacrida, R; Piazza, J; Abraham, G
1990-01-01
Instead of thinking that it is impossible to enter in the internal world of a comatose patient, we are now put before a new and encouraging prospective, that of the possibility, even though minimal, of influencing the vital residual organisation of the patient and to induce him perhaps to accept again external stimulations, which previously were too intense. As loss of conscience often causes loss of memory, our intention was to examine the problem of memory loss in comatose patients after accidents. The analysis of 50 questionnaires distributed to trauma-patients awakening from a comatose state and interviews give clear indications that: 1) the patients remember absolutely nothing during the time of the coma; 2) in the majority of cases (34) the patients remember in the moment preceding the accident a clear autodestructive tendency especially if they were the cause of the accident; and 3) almost all patients (41) agree to have benefited greatly from the trauma itself and from its memory.
Ali, Mehri; Saeed, Mazloomy Mahmoodabad Seyed; Ali, Morowatisharifabad Mohammad; Haidar, Nadrian
2011-09-01
This paper reports on predictors of helmet use behaviour, using variables based on the theory of planned behaviour model among the employed motorcycle riders in Yazd-Iran, in an attempt to identify influential factors that may be addressed through intervention efforts. In 2007, a cluster random sample of 130 employed motorcycle riders in the city of Yazd in central Iran, participated in the study. Appropriate instruments were designed to measure the variables of interest (attitude, subjective norms, perceived behaviour control, intention along with helmet use behaviour). Reliability and validity of the instruments were examined and approved. The statistical analysis of the data included descriptive statistics, bivariate correlations, and multiple regression. Based on the results, 56 out of all the respondents (43.1%) had history of accident by motorcycle. Of these motorcycle riders only 10.7% were wearing their helmet at the time of their accident. Intention and perceived behavioural control showed a significant relationship with helmet use behaviour and perceived behaviour control was the strongest predictor of helmet use intention, followed by subjective norms, and attitude. It was found that that helmet use rate among motorcycle riders was very low. The findings of present study provide a preliminary support for the TPB model as an effective framework for examining helmet use in motorcycle riders. Understanding motorcycle rider's thoughts, feelings and beliefs about helmet use behaviour can assist intervention specialists to develop and implement effective programs in order to promote helmet use among motorcycle riders. Copyright © 2010 Elsevier Ltd. All rights reserved.
Defense Science Board Task Force on The Future of the Global Positioning System
2005-10-01
interference. Incorporate a fully reprogrammable Navigation Payload aboard GPS satellites as soon as practicable to enable future flexibility in signal...its use increases in automobiles , it is becoming a significant factor in E-911-type situations, where emergency vehicles are dispatched to accident...mitigation for GPS against both intentional and unintentional interference. Incorporate a fully reprogrammable Navigation Payload aboard GPS
Contejean, Adrien; Lemiale, Virginie; Resche-Rigon, Matthieu; Mokart, Djamel; Pène, Frédéric; Kouatchet, Achille; Mayaux, Julien; Vincent, François; Nyunga, Martine; Bruneel, Fabrice; Rabbat, Antoine; Perez, Pierre; Meert, Anne-Pascale; Benoit, Dominique; Hamidfar, Rebecca; Darmon, Michael; Jourdain, Mercé; Renault, Anne; Schlemmer, Benoît; Azoulay, Elie
2016-12-01
Acute respiratory failure (ARF) is the most frequent complication in patients with hematological malignancies and is associated with high morbidity and mortality. ARF etiologies are numerous, and despite extensive diagnostic workflow, some patients remain with undetermined ARF etiology. This is a post-hoc study of a prospective multicenter cohort performed on 1011 critically ill hematological patients. Relationship between ARF etiology and hospital mortality was assessed using a multivariable regression model adjusting for confounders. This study included 604 patients with ARF. All patients underwent noninvasive diagnostic tests, and a bronchoscopy and bronchoalveolar lavage (BAL) was performed in 155 (25.6%). Definite diagnoses were classified into four exclusive etiological categories: pneumonia (44.4%), non-infectious diagnoses (32.6%), opportunistic infection (10.1%) and undetermined (12.9%), with corresponding hospital mortality rates of 40, 35, 55 and 59%, respectively. Overall hospital mortality was 42%. By multivariable analysis, factors associated with hospital mortality were invasive pulmonary aspergillosis (OR 7.57 (95% CI 3.06-21.62); p < 0.005), use of invasive mechanical ventilation (OR 1.65 (95% CI 1.07-2.55); p = 0.02), a SOFA score >7 (OR 3.32 (95% CI 2.15-5.15); p < 0.005) and an undetermined ARF etiology (OR 2.92 (95% CI 1.71-5.07); p < 0.005). In patients with hematological malignancies and ARF, up to 13% remain with undetermined ARF etiology despite comprehensive diagnostic workup. Undetermined ARF etiology is independently associated with hospital mortality. Studies to guide second-line diagnostic strategies are warranted. ClinicalTrials.Gov NCT01172132.
Sundström, Karin; Lu, Donghao; Elfström, K Miriam; Wang, Jiangrong; Andrae, Bengt; Dillner, Joakim; Sparén, Pär
2017-01-01
Atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion in abnormal cervical cytology among young women in cervical cancer screening is an increasing health burden, and comparative effectiveness studies of different management options for such diagnoses are needed. The objective of the study was to compare the incidence of invasive cervical cancer, following different management options pursued after an atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion index smear. In this nationwide cohort study, we included all women aged 22-50 years and resident in Sweden 1989-2011 and with at least 1 cervical smear registered during the study period (n = 2,466,671). Follow-up of a first atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion cytological diagnosis within 25 months was classified as repeat cytology, colposcopy/biopsy, or without further assessment. Incidence rate ratios and 95% confidence intervals of subsequent cervical cancer within 6.5 years following atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion were estimated using Poisson regression by age group and management strategy. Women managed with repeat cytology within 6 months after atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion cytology had a similar risk of cervical cancer compared with colposcopy/biopsy (incidence rate ratio, 1.1, 95% confidence interval, 0.5-2.5, and incidence rate ratio, 2.0, 95% confidence interval, 0.6-6.5, respectively) among women aged 22-27 years. For women aged 28 years and older, women managed with repeat cytology had a higher risk for cervical cancer than women managed with colposcopy/biopsy. Our findings suggest that women with a first cytological diagnosis of atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion up to age 27 years may indeed be safely followed up with repeat cytology within 6 months. A large amount of colposcopies that are currently performed in this group, therefore, could safely be discontinued. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Opioid Overdose Prevention Programs Providing Naloxone to Laypersons - United States, 2014.
Wheeler, Eliza; Jones, T Stephen; Gilbert, Michael K; Davidson, Peter J
2015-06-19
Drug overdose deaths in the United States have more than doubled since 1999. During 2013, 43,982 drug overdose deaths (unintentional, intentional [suicide or homicide], or undetermined intent) were reported. Among these, 16,235 (37%) were associated with prescription opioid analgesics (e.g., oxycodone and hydrocodone) and 8,257 (19%) with heroin. For many years, community-based programs have offered opioid overdose prevention services to laypersons who might witness an overdose, including persons who use drugs, their families and friends, and service providers. Since 1996, an increasing number of programs provide laypersons with training and kits containing the opioid antagonist naloxone hydrochloride (naloxone) to reverse the potentially fatal respiratory depression caused by heroin and other opioids. In July 2014, the Harm Reduction Coalition (HRC), a national advocacy and capacity-building organization, surveyed 140 managers of organizations in the United States known to provide naloxone kits to laypersons. Managers at 136 organizations completed the survey, reporting on the amount of naloxone distributed, overdose reversals by bystanders, and other program data for 644 sites that were providing naloxone kits to laypersons as of June 2014. From 1996 through June 2014, surveyed organizations provided naloxone kits to 152,283 laypersons and received reports of 26,463 overdose reversals. Providing opioid overdose training and naloxone kits to laypersons who might witness an opioid overdose can help reduce opioid overdose mortality.
Atombo, Charles; Wu, Chaozhong; Zhang, Hui; Wemegah, Tina D
2017-10-03
Road accidents are an important public health concern, and speeding is a major contributor. Although flow theory (FLT) is a valid model for understanding behavior, currently the nature of the roles and interplay of FLT constructs within the theory of planned behavior (TPB) framework when attempting to explain the determinants of motivations for intention to speed and speeding behavior of car drivers is not yet known. The study aims to synthesize TPB and FLT in explaining drivers of advanced vehicles intentions to speed and speed violation behaviors and evaluate factors that are critical for explaining intention and behavior. The hypothesized model was validated using a sample collected from 354 fully licensed drivers of advanced vehicles, involving 278 males and 76 females on 2 occasions separated by a 3-month interval. During the first of the 2 occasions, participants completed questionnaire measures of TPB and FLT variables. Three months later, participants' speed violation behaviors were assessed. The study observed a significant positive relationship between the constructs. The proposed model accounted for 51 and 45% of the variance in intention to speed and speed violation behavior, respectively. The independent predictors of intention were enjoyment, attitude, and subjective norm. The independent predictors of speed violation behavior were enjoyment, concentration, intention, and perceived behavioral control. The findings suggest that safety interventions for preventing speed violation behaviors should be aimed at underlying beliefs influencing the speeding behaviors of drivers of advanced vehicles. Furthermore, perceived enjoyment is of equal importance to driver's intention, influencing speed violation behavior.
Thakur, P; Lemons, B G; White, C R
2016-09-15
After almost fifteen years of successful waste disposal operations, the first unambiguous airborne radiation release from the Waste Isolation Pilot Plant (WIPP) was detected beyond the site boundary on February 14, 2014. It was the first accident of its kind in the 15-year operating history of the WIPP. The accident released moderate levels of radioactivity into the underground air. A small but measurable amount of radioactivity also escaped to the surface through the ventilation system and was detected above ground. The dominant radionuclides released were americium and plutonium, in a ratio consistent with the known content of a breached drum. The radiation release was caused by a runaway chemical reaction inside a transuranic (TRU) waste drum which experienced a seal and lid failure, spewing radioactive materials into the repository. According to source-term estimation, approximately 2 to 10Ci of radioactivity was released from the breached drum into the underground, and an undetermined fraction of that source term became airborne, setting off an alarm and triggering the closure of seals designed to force exhausting air through a system of filters including high-efficiency-particulate-air (HEPA) filters. Air monitoring across the WIPP site intensified following the first reports of radiation detection underground to determine the extent of impact to WIPP personnel, the public, and the environment, if any. This article attempts to compile and interpret analytical data collected by an independent monitoring program conducted by the Carlsbad Environmental Monitoring & Research Center (CEMRC) and by a compliance-monitoring program conducted by the WIPP's management and operating contractor, the Nuclear Waste Partnership (NWP), LLC., in response to the accident. Both the independent and the WIPP monitoring efforts concluded that the levels detected were very low and localized, and no radiation-related health effects among local workers or the public would be expected. Published by Elsevier B.V.
Relationship between Recent Flight Experience and Pilot Error General Aviation Accidents
NASA Astrophysics Data System (ADS)
Nilsson, Sarah J.
Aviation insurance agents and fixed-base operation (FBO) owners use recent flight experience, as implied by the 90-day rule, to measure pilot proficiency in physical airplane skills, and to assess the likelihood of a pilot error accident. The generally accepted premise is that more experience in a recent timeframe predicts less of a propensity for an accident, all other factors excluded. Some of these aviation industry stakeholders measure pilot proficiency solely by using time flown within the past 90, 60, or even 30 days, not accounting for extensive research showing aeronautical decision-making and situational awareness training decrease the likelihood of a pilot error accident. In an effort to reduce the pilot error accident rate, the Federal Aviation Administration (FAA) has seen the need to shift pilot training emphasis from proficiency in physical airplane skills to aeronautical decision-making and situational awareness skills. However, current pilot training standards still focus more on the former than on the latter. The relationship between pilot error accidents and recent flight experience implied by the FAA's 90-day rule has not been rigorously assessed using empirical data. The intent of this research was to relate recent flight experience, in terms of time flown in the past 90 days, to pilot error accidents. A quantitative ex post facto approach, focusing on private pilots of single-engine general aviation (GA) fixed-wing aircraft, was used to analyze National Transportation Safety Board (NTSB) accident investigation archival data. The data were analyzed using t-tests and binary logistic regression. T-tests between the mean number of hours of recent flight experience of tricycle gear pilots involved in pilot error accidents (TPE) and non-pilot error accidents (TNPE), t(202) = -.200, p = .842, and conventional gear pilots involved in pilot error accidents (CPE) and non-pilot error accidents (CNPE), t(111) = -.271, p = .787, indicate there is no statistically significant relationship between groups. Binary logistic regression indicate that recent flight experience does not reliably distinguish between pilot error and non-pilot error accidents for TPE/TNPE, chi2 = 0.040 (df=1, p = .841) and CPE/CNPE, chi2= 0.074 (df =1, p = .786). Future research could focus on different pilot populations, and to broaden the scope, analyze several years of data.
78 FR 41930 - Proposed Data Collections Submitted for Public Comment and Recommendations
Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-12
... sources, undetermined transmission, or undetermined risk factors. These EEIs represent a subset of those... transmission, or risk factors to effectively implement rapid prevention and control measures to protect the...; data are analyzed to determine the agents, sources, modes of transmission, or risk factors so that...
Generation and communication of dynamic maps using light projection
NASA Astrophysics Data System (ADS)
Busch, Steffen; Schlichting, Alexander; Brenner, Claus
2018-05-01
Many accidents are caused by miscommunication between traffic participants. Much research is being conducted in the area of car to car and car to infrastructure communication in order to eliminate this cause of accidents. How-ever, less attention is paid to the question how the behavior of a car can be communicated to pedestrians. Especially considering automated traffic, there is a lack of communication between cars and pedestrians. In this paper, we address the question how an autonomously driving car can inform pedestrians about its intentions. Especially in case of highly automated driving, making eye contact with a driver will give no clue about his or her intensions. We developed a prototype which continuously informs pedestrians about the intentions of the vehicle by projecting visual patterns onto the ground. Furthermore, the system communicates its interpretation of the observed situation to the pedestrians to warn them or to encourage them to perform a certain action. In order to communicate adaptively, the vehicle needs to develop an understanding of the dynamics of a city to know what to expect in certain situations and what speed is appropriate. To support this, we created a dynamic map, which estimates the number of pedestrians and cyclists in a certain area, which is then used to determine how `hazardous' the area is. This dynamic map is obtained from measurement data from many time instances, in contrast to the static car navigation maps, which are prevalent today. Apart from being used for communication purposes, the dynamic map can also influence the speed of a car, be it manually or autonomously driven. Adapting the speed in hazardous areas will avoid accidents where a car drives too fast, so that neither a human nor a computer-operated system would be able to stop in time.
Forensic Pathology of Traumatic Brain Injury.
Finnie, J W
2016-09-01
Traumatic brain injury constitutes a significant proportion of cases requiring forensic examination, and it encompasses (1) blunt, nonmissile head injury, especially involving motor vehicle accidents, and (2) penetrating, missile injury produced by a range of high- and lower-velocity projectiles. This review examines the complex pathophysiology and biomechanics of both types of neurotrauma and assesses the macroscopic and histologic features of component lesions, which may be used to determine the cause and manner of death resulting from an intentional assault or accident. Estimation of the survival time postinjury by pathologic examination is also important where malicious head injury is suspected, in an attempt to ascertain a time at which the traumatic event might have been committed, thereby evaluating the authenticity of statements made by the alleged perpetrator. © The Author(s) 2015.
Kao, S S; Micklem, J; Ofo, E; Edwards, S; Dhatrak, D; Foreman, A; Krishnan, S; Hodge, J-C
2018-04-01
The incidence of oropharyngeal squamous cell carcinoma in the Western world is increasing, with the human papillomavirus epidemic implicated in this observed trend. The optimal treatment modality is yet undetermined regarding oncological outcomes. This study comprised 98 patients with oropharyngeal squamous cell carcinoma, treated with either primary transoral surgery with adjuvant therapy or primary chemoradiotherapy with curative intent, between 2008 and 2012. Clinicopathological characteristics including tumour-node-metastasis stage, human papillomavirus status, treatment modality, recurrence and overall survival were collated. Five per cent of primary surgical patients had locoregional recurrences compared with 25 per cent of primary chemoradiotherapy patients. A lower rate of locoregional recurrence was observed in the human papillomavirus positive group. This paper reports higher rates of overall survival and local control for oropharyngeal squamous cell carcinoma treated with primary surgery compared with primary chemoradiotherapy. This reflects overall lower tumour stage and higher human papillomavirus status in this group.
The effects of misclassification biases on veteran suicide rate estimates.
Huguet, Nathalie; Kaplan, Mark S; McFarland, Bentson H
2014-01-01
We assessed the impact that possible veteran suicide misclassification biases (i.e., inaccuracy in ascertainment of veteran status on the death certificate and misclassification of suicide as other manner of death) have on veteran suicide rate estimates. We obtained suicide mortality data from the 2003-2010 National Violent Death Reporting System and the 2003-2010 Department of Defense Casualty Analysis System. We derived population estimates from the 2003-2010 American Community Survey and 2003-2010 Department of Veterans Affairs data. We computed veteran and nonveteran suicide rates. The results showed that suicide rates were minimally affected by the adjustment for the misclassification of current military personnel suicides as veterans. Moreover, combining suicides and deaths by injury of undetermined intent did not alter the conclusions. The National Violent Death Reporting System is a valid surveillance system for veteran suicide. However, more than half of younger (< 25 years) male and female suicides, labeled as veterans, were likely to have been current military personnel at the time of their death and misclassified on the death certificate.
Study of Psycho-Social Factors Affecting Traffic Accidents Among Young Boys in Tehran
Javadi, Seyyed Mohammad Hossein; Fekr Azad, Hossein; Tahmasebi, Siyamak; Rafiei, Hassan; Rahgozar, Mehdi; Tajlili, Alireza
2015-01-01
Background: Unprecedented growth of fatalities due to traffic accidents in the recent years has raised great concerns and efforts of authorities in order to identify and control the causes of these accidents. Objectives: In the present study, the contribution of psychological, social, demographic, environmental and behavioral factors on traffic accidents was studied for young boys in Tehran, emphasizing the importance of psychosocial factors. Patients and Methods: The design of the present study was quantitative (correlational) in which a sample population including 253 boys from Tehran (Iran) with an age range of 18 to 24 who had been referred to insurance institutions, hospitals, correctional facilities as well as prisons, were selected using stratified cluster sampling during the year 2013.The subjects completed the following questionnaires: demographic, general health, lifestyle, Manchester Driving Behavior Questionnaire (MDBQ), young parenting, and NEO-Five Factor Inventory (NEO-FFI). For data analysis, descriptive statistics, correlation coefficient, and inferential statistics including simultaneous regression, stepwise regression, and structural equations modeling were used. Results: The findings indicated that in the psychosocial model of driving behavior (including lapses, mistakes, and intentional violations) and accidents, psychological factors, depression (P < 0.02), personality trait of conscientiousness (P < 0.02), failure schema due to the parenting style of mother (P = 0.001), and perception of police commands (P < 0.002), played an important role in predicting driving behavior. Among social factors, perception of police regulations (P = 0.003), had an important effect on violations and mistakes. Among environmental and behavioral factors, major factors such as driving age (P = 0.001), drug and alcohol use (P = 0.001), having driver’s license (P = 0.013), records of imprisonment or committing a crime (P = 0.012) were also able to predict occurrence of accidents. Conclusions: As the results of this study show, different factors contribute to different driving behaviors and accidents. The broad scope of these factors links accidents to other social issues and damages. PMID:26421169
Study of Psycho-Social Factors Affecting Traffic Accidents Among Young Boys in Tehran.
Javadi, Seyyed Mohammad Hossein; Fekr Azad, Hossein; Tahmasebi, Siyamak; Rafiei, Hassan; Rahgozar, Mehdi; Tajlili, Alireza
2015-07-01
Unprecedented growth of fatalities due to traffic accidents in the recent years has raised great concerns and efforts of authorities in order to identify and control the causes of these accidents. In the present study, the contribution of psychological, social, demographic, environmental and behavioral factors on traffic accidents was studied for young boys in Tehran, emphasizing the importance of psychosocial factors. The design of the present study was quantitative (correlational) in which a sample population including 253 boys from Tehran (Iran) with an age range of 18 to 24 who had been referred to insurance institutions, hospitals, correctional facilities as well as prisons, were selected using stratified cluster sampling during the year 2013.The subjects completed the following questionnaires: demographic, general health, lifestyle, Manchester Driving Behavior Questionnaire (MDBQ), young parenting, and NEO-Five Factor Inventory (NEO-FFI). For data analysis, descriptive statistics, correlation coefficient, and inferential statistics including simultaneous regression, stepwise regression, and structural equations modeling were used. The findings indicated that in the psychosocial model of driving behavior (including lapses, mistakes, and intentional violations) and accidents, psychological factors, depression (P < 0.02), personality trait of conscientiousness (P < 0.02), failure schema due to the parenting style of mother (P = 0.001), and perception of police commands (P < 0.002), played an important role in predicting driving behavior. Among social factors, perception of police regulations (P = 0.003), had an important effect on violations and mistakes. Among environmental and behavioral factors, major factors such as driving age (P = 0.001), drug and alcohol use (P = 0.001), having driver's license (P = 0.013), records of imprisonment or committing a crime (P = 0.012) were also able to predict occurrence of accidents. As the results of this study show, different factors contribute to different driving behaviors and accidents. The broad scope of these factors links accidents to other social issues and damages.
Simulation of internal contamination screening with dose rate meters
NASA Astrophysics Data System (ADS)
Fonseca, T. C. F.; Mendes, B. M.; Hunt, J. G.
2017-11-01
Assessing the intake of radionuclides after an accident in a nuclear power plant or after the intentional release of radionuclides in public places allows dose calculations and triage actions to be carried out for members of the public and for emergency response teams. Gamma emitters in the lung, thyroid or the whole body may be detected and quantified by making dose rate measurements at the surface of the internally contaminated person. In an accident scenario, quick measurements made with readily available portable equipment are a key factor for success. In this paper, the Monte Carlo program Visual Monte Carlo (VMC) and MCNPx code are used in conjunction with voxel phantoms to calculate the dose rate at the surface of a contaminated person due to internally deposited radionuclides. A whole body contamination with 137Cs and a thyroid contamination with 131I were simulated and the calibration factors in kBq per μSv/h were calculated. The calculated calibration factors were compared with real data obtained from the Goiania accident in the case of 137Cs and the Chernobyl accident in terms of the 131I. The close comparison of the calculated and real measurements indicates that the method may be applied to other radionuclides. Minimum detectable activities are discussed.
Skin Dose Assessment Methodology for Military Personnel at McMurdo Station, Antarctica (1962-1979)
2014-06-01
made at distances of 3-6 inches (Rathbun et al., 1984). And surveys done during general decontamination work at the Chernobyl site resulted in ratios...Regulatory Commission, Rockville, MD. May 20. WHO (World Health Organization), 2005. Health Effects of the Chernobyl Accident and Special Health Care...Programmes, Report of the UN Chernobyl Forum Expert Group “Health” (EGH), World Health Organization, Geneva. August 31. 18 This page intentionally
Psychological models for development of motorcycle helmet use among students in Vietnam
NASA Astrophysics Data System (ADS)
Kumphong, J.; Satiennam, T.; Satiennam, W.; Trinh, Tu Anh
2018-04-01
A helmet can reduce head accident severity. The aim of this research study was to study the intention for helmet use of students who ride motorcycles in Vietnam, by Structural Equation Modeling (SEM). Questionnaires developed by several traffic psychology modules, including the Theory of Planned Behaviour (TPB), Traffic Locus of Control (T-LOC), and Health Belief Model (HBM), were distributed to students at Ton Thang University and University of Architecture, Ho Chi Minh City. SEM was used to explain helmet use behaviour. The results indicate that TPB, T-LOC and HBM could explain the variance in helmet use behaviour. However, TPB can explain behaviour (helmet use intention) better than T-LOC and HBM. The outcome of this study is useful for the agencies responsible to improve motorcycle safety.
Analysis of the SL-1 Accident Using RELAPS5-3D
DOE Office of Scientific and Technical Information (OSTI.GOV)
Francisco, A.D. and Tomlinson, E. T.
2007-11-08
On January 3, 1961, at the National Reactor Testing Station, in Idaho Falls, Idaho, the Stationary Low Power Reactor No. 1 (SL-1) experienced a major nuclear excursion, killing three people, and destroying the reactor core. The SL-1 reactor, a 3 MW{sub t} boiling water reactor, was shut down and undergoing routine maintenance work at the time. This paper presents an analysis of the SL-1 reactor excursion using the RELAP5-3D thermal-hydraulic and nuclear analysis code, with the intent of simulating the accident from the point of reactivity insertion to destruction and vaporization of the fuel. Results are presented, along with amore » discussion of sensitivity to some reactor and transient parameters (many of the details are only known with a high level of uncertainty).« less
Choi, Young Jun; Baek, Jung Hwan; Shin, Jung Hee; Shim, Woo Hyun; Kim, Seon-Ok; Lee, Won-Hong; Song, Dong Eun; Kim, Tae Yong; Chung, Ki-Wook; Lee, Jeong Hyun
2018-05-13
The purpose of this study was to construct a web-based predictive model using ultrasound characteristics and subcategorized biopsy results for thyroid nodules of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) to stratify the risk of malignancy. Data included 672 thyroid nodules from 656 patients from a historical cohort. We analyzed ultrasound images of thyroid nodules and biopsy results according to nuclear atypia and architectural atypia. Multivariate logistic regression analysis was performed to predict whether nodules were diagnosed as malignant or benign. The ultrasound features, including spiculated margin, marked hypoechogenicity, calcifications, biopsy results, and cytologic atypia, showed significant differences between groups. A 13-point risk scoring system was developed, and the area under the curve (AUC) of the receiver operating characteristic (ROC) curve of the development and validation sets were 0.837 and 0.830, respectively (http://www.gap.kr/thyroidnodule_b3.php). We devised a web-based predictive model using the combined information of ultrasound characteristics and biopsy results for AUS/FLUS thyroid nodules to stratify the malignant risk. © 2018 Wiley Periodicals, Inc.
Feenstra, Hans; Ruiter, Robert A C; Kok, Gerjo
2014-12-01
In The Netherlands, 12-24 years old are over-represented in the total number of traffic fatalities and injuries. In this study, the traffic informer program - designed to promote safe traffic behavior in the pre-driver population - was experimentally evaluated, with a specific focus on bicycle use. Students were subjected to graphic videos of traffic accidents and listened to a first-person narrative provided by a traffic accident victim. The influence of the program on concepts derived from the theory of planned behavior and protection motivation theory (attitudes, norms, self-efficacy, risk-perception, intention and behavior) was assessed. Students from various schools (N=1593;M age=15 years, SD=.84) participated in a quasi-experimental study, either in an experimental or a control group, completing self-report questionnaires one week prior to the program implementation and approximately one month after the program implementation. Mixed regression analyses showed significant positive and negative time × intervention interaction effects on attitude toward traffic violations, relative attitude toward traffic safety, and risk comparison, but not on intention and behavior. More research is needed to find effective behavioral change techniques (other than increasing risk awareness) for promoting safe traffic behavior in adolescents. Research is also needed to address how these can be translated into effective interventions and educational programs. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
Accidental Outcomes Guide Punishment in a “Trembling Hand” Game
Cushman, Fiery; Dreber, Anna; Wang, Ying; Costa, Jay
2009-01-01
How do people respond to others' accidental behaviors? Reward and punishment for an accident might depend on the actor's intentions, or instead on the unintended outcomes she brings about. Yet, existing paradigms in experimental economics do not include the possibility of accidental monetary allocations. We explore the balance of outcomes and intentions in a two-player economic game where monetary allocations are made with a “trembling hand”: that is, intentions and outcomes are sometimes mismatched. Player 1 allocates $10 between herself and Player 2 by rolling one of three dice. One die has a high probability of a selfish outcome, another has a high probability of a fair outcome, and the third has a high probability of a generous outcome. Based on Player 1's choice of die, Player 2 can infer her intentions. However, any of the three die can yield any of the three possible outcomes. Player 2 is given the opportunity to respond to Player 1's allocation by adding to or subtracting from Player 1's payoff. We find that Player 2's responses are influenced substantially by the accidental outcome of Player 1's roll of the die. Comparison to control conditions suggests that in contexts where the allocation is at least partially under the control of Player 1, Player 2 will punish Player 1 accountable for unintentional negative outcomes. In addition, Player 2's responses are influenced by Player 1's intention. However, Player 2 tends to modulate his responses substantially more for selfish intentions than for generous intentions. This novel economic game provides new insight into the psychological mechanisms underlying social preferences for fairness and retribution. PMID:19707578
Assessment of the Emerging Biocruise Threat
2000-08-01
navigation and guidance system is located in the front; and the fuel and warhead are typically located in the midbody .66 (See Figure 1.) Guidance of a...unitary or submunitions Undetermined Undetermined MUPSOW South Africa Air & ground Conventional/ unitary or submunitions 200+ 2002 Storm Shadow ...replicating agents, bacteria or viruses, or nonreplicating materials, toxins or physiologically active proteins or peptides, that can be produced by living
Surveillance for Violent Deaths - National Violent Death Reporting System, 17 States, 2013.
Lyons, Bridget H; Fowler, Katherine A; Jack, Shane P D; Betz, Carter J; Blair, Janet M
2016-08-19
In 2013, more than 57,000 persons died in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 17 U.S. states for 2013. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. 2013. NVDRS collects data from participating states regarding violent deaths obtained from death certificates, coroner/medical examiner reports, law enforcement reports, and secondary sources (e.g., child fatality review team data, supplemental homicide reports, hospital data, and crime laboratory data). This report includes data from 17 states that collected statewide data for 2013 (Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, North Carolina, New Jersey, New Mexico, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin). NVDRS collates documents for each death and links deaths that are related (e.g., multiple homicides, a homicide followed by a suicide, or multiple suicides) from a single incident. For 2013, a total of 18,765 fatal incidents involving 19,251 deaths were captured by NVDRS in the 17 states included in this report. The majority (66.2%) of deaths were suicides, followed by homicides (23.2%), deaths of undetermined intent (8.8%), deaths involving legal intervention (1.2%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force, excluding legal executions), and unintentional firearm deaths (<1%). (The term legal intervention is a classification incorporated into the International Classification of Diseases, Tenth Revision [ICD-10] and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement.) Suicides occurred at higher rates among males, non-Hispanic whites, American Indian/Alaska Natives, persons aged 45-64 years, and males aged ≥75 years. Suicides were preceded primarily by a mental health, intimate partner, or physical health problem or a crisis during the previous or upcoming 2 weeks. Homicide rates were higher among males and persons aged 15-44 years; rates were highest among non-Hispanic black males. Homicides primarily were precipitated by arguments and interpersonal conflicts, occurrence in conjunction with another crime, or were related to intimate partner violence (particularly for females). A known relationship between a homicide victim and a suspected perpetrator was most likely either that of an acquaintance or friend or an intimate partner. Legal intervention death rates were highest among males and persons aged 20-24 years and 30-34 years; rates were highest among non-Hispanic black males. Precipitating factors for the majority of legal intervention deaths were another crime, a mental health problem, or a recent crisis. Deaths of undetermined intent occurred at the highest rates among males and persons aged <1 year and 45-54 years. Substance abuse and mental or physical health problems were the most common circumstances preceding deaths of undetermined intent. Unintentional firearm death rates were higher among males, non-Hispanic whites, and persons aged persons aged 15-19 and 55-64 years; these deaths were most often precipitated by a person unintentionally pulling the trigger while playing with a firearm or while hunting. This report provides a detailed summary of data from NVDRS for 2013. The results indicate that violent deaths resulting from self-inflicted or interpersonal violence disproportionately affected persons aged <65 years, males, and certain minority populations. For homicides and suicides, intimate partner problems, interpersonal conflicts, mental health problems, and recent crises were primary precipitating factors. NVDRS data are used to monitor the occurrence of violence-related fatal injuries and assist public health authorities in the development, implementation, and evaluation of programs and policies to reduce and prevent violent deaths. For example, Utah Violent Death Reporting System (VDRS) data were used to develop policies that support children of intimate partner homicide victims, Colorado VDRS data to develop a web-based suicide prevention program targeting middle-aged men, and Rhode Island VDRS data to help guide suicide prevention efforts at workplaces. The continued development and expansion of NVDRS to include all U.S. states, territories, and the District of Columbia are essential to public health efforts to reduce the impact of violence.
Young, Liane; Scholz, Jonathan; Saxe, Rebecca
2011-01-01
Moral judgment depends critically on theory of mind (ToM), reasoning about mental states such as beliefs and intentions. People assign blame for failed attempts to harm and offer forgiveness in the case of accidents. Here we use fMRI to investigate the role of ToM in moral judgment of harmful vs. helpful actions. Is ToM deployed differently for judgments of blame vs. praise? Participants evaluated agents who produced a harmful, helpful, or neutral outcome, based on a harmful, helpful, or neutral intention; participants made blame and praise judgments. In the right temporo-parietal junction (right TPJ), and, to a lesser extent, the left TPJ and medial prefrontal cortex, the neural response reflected an interaction between belief and outcome factors, for both blame and praise judgments: The response in these regions was highest when participants delivered a negative moral judgment, i.e., assigned blame or withheld praise, based solely on the agent's intent (attempted harm, accidental help). These results show enhanced attention to mental states for negative moral verdicts based exclusively on mental state information.
2003-03-25
KENNEDY SPACE CENTER, FLA. - At the third public hearing of the Columbia Accident Investigation Board, held in Cape Canaveral, Fla., reporters listen intently to Center Director Roy Bridges (background, right). Board members are in the background, left. Over the course of two days, the Board's chairman, retired Navy Admiral Harold W. "Hal" Gehman Jr., and other board members would hear from experts discussing the role of the Kennedy Space Center in the Shuttle Program, Shuttle Safety and Debris Collection, Layout and Analysis and Forensic Metallurgy.
NASA Technical Reports Server (NTRS)
2003-01-01
KENNEDY SPACE CENTER, FLA. - At the third public hearing of the Columbia Accident Investigation Board, held in Cape Canaveral, Fla., reporters listen intently to Center Director Roy Bridges (background, right). Board members are in the background, left. Over the course of two days, the Board's chairman, retired Navy Admiral Harold W. 'Hal' Gehman Jr., and other board members would hear from experts discussing the role of the Kennedy Space Center in the Shuttle Program, Shuttle Safety and Debris Collection, Layout and Analysis and Forensic Metallurgy.
He, Meng; Fang, You-Xin; Lin, Jun-Yi; Ma, Kai-Jun; Li, Bei-Xu
2015-01-01
Shanghai is the most developed city in China and has a soaring population. This study uses forensic epidemiology to determine the relationship between unnatural deaths and the development in Shanghai, based on recently released forensic autopsy cases from the 2000s at the Shanghai Public Security Bureau (SPSB). There were 5425 accidental deaths, 2696 homicides, 429 suicides, 186 natural deaths, and 1399 deaths of undetermined cause. There was a male-to-female ratio of 2.02:1, and the average age was 40.9±18.7 years. Traffic accidents (84.2%) were the number one cause of accidental deaths, which decreased during the study period. Sharp force injury (50.6%) was the leading cause of homicides, different from Western countries, where firearms are the leading cause. Hanging (24.5%) was the leading cause of suicides, whereas drug and chemical intoxication was the leading cause in the previous decade; pesticide ingestion decreased in the 2000s. In addition to traffic accidents, manual strangulation was the leading cause of death in childhood fatalities. Children under age 2 were vulnerable to homicides. In the 2000s, there were a large number of drug overdoses, and illegal medical practices and subway-related deaths first appeared in Shanghai. A new type of terrorist attack that involved injecting people with syringes in public places was reflected in the SPSB archives. The forensic epidemiology and changes in unnatural deaths in this decade reflected their relationship with the law, policy and changes in Shanghai. Illegal medical practices, subway-related deaths and terrorist attacks were closely related to the development in Shanghai. Identifying the risks of unnatural deaths will improve public health.
Lin, Jun-Yi; Ma, Kai-Jun; Li, Bei-Xu
2015-01-01
Shanghai is the most developed city in China and has a soaring population. This study uses forensic epidemiology to determine the relationship between unnatural deaths and the development in Shanghai, based on recently released forensic autopsy cases from the 2000s at the Shanghai Public Security Bureau (SPSB). There were 5425 accidental deaths, 2696 homicides, 429 suicides, 186 natural deaths, and 1399 deaths of undetermined cause. There was a male-to-female ratio of 2.02:1, and the average age was 40.9±18.7 years. Traffic accidents (84.2%) were the number one cause of accidental deaths, which decreased during the study period. Sharp force injury (50.6%) was the leading cause of homicides, different from Western countries, where firearms are the leading cause. Hanging (24.5%) was the leading cause of suicides, whereas drug and chemical intoxication was the leading cause in the previous decade; pesticide ingestion decreased in the 2000s. In addition to traffic accidents, manual strangulation was the leading cause of death in childhood fatalities. Children under age 2 were vulnerable to homicides. In the 2000s, there were a large number of drug overdoses, and illegal medical practices and subway-related deaths first appeared in Shanghai. A new type of terrorist attack that involved injecting people with syringes in public places was reflected in the SPSB archives. The forensic epidemiology and changes in unnatural deaths in this decade reflected their relationship with the law, policy and changes in Shanghai. Illegal medical practices, subway-related deaths and terrorist attacks were closely related to the development in Shanghai. Identifying the risks of unnatural deaths will improve public health. PMID:26110435
Interim Status Report for Risk Management for SFRs
DOE Office of Scientific and Technical Information (OSTI.GOV)
Jankovsky, Zachary Kyle; Denman, Matthew R.; Groth, Katrina
2015-10-01
Accident management is an important component to maintaining risk at acceptable levels for all complex systems, such as nuclear power plants. With the introduction of passive, or inherently safe, reactor designs the focus has shifted from management by operators to allowing the system's design to take advantage of natural phenomena to manage the accident. Inherently and passively safe designs are laudable, but nonetheless extreme boundary conditions can interfere with the design attributes which facilitate inherent safety, thus resulting in unanticipated and undesirable end states. This report examines an inherently safe and small sodium fast reactor experiencing a variety of beyondmore » design basis events with the intent of exploring the utility of a Dynamic Bayesian Network to infer the state of the reactor to inform the operator's corrective actions. These inferences also serve to identify the instruments most critical to informing an operator's actions as candidates for hardening against radiation and other extreme environmental conditions that may exist in an accident. This reduction in uncertainty serves to inform ongoing discussions of how small sodium reactors would be licensed and may serve to reduce regulatory risk and cost for such reactors.« less
Takebayashi, Yoshitake; Lyamzina, Yuliya; Suzuki, Yuriko; Murakami, Michio
2017-10-27
The purpose of this study was to provide a review of the publications of the risk perceptions or anxiety regarding radiation among people living in Japan after the 2011 Fukushima nuclear power plant accident. Two database (MEDLINE and PsycINFO) and hand-searched the references in identified publications were searched. For each identified publication, the measurements and time related-change of risk perception and anxiety regarding radiation were summarized. Twenty-four publications were identified. Quantitative measures of risk perception or anxiety were roughly divided into two types: single-item Likert scales that measure anxiety about radiation; and theoretical, or model-based measures. Rates of Fukushima residents with radiation-related anxiety decreased from 2012 to 2015. Factors governing risk perception or radiation-related anxiety were summarized by demographics, disaster-related stressors, trusted information, and radiation-related variables. The effects of risk perception or anxiety regarding radiation were summarized as severe distress, intention to leave employment or not to return home, or other dimensions. This review provides summary of current findings on risk perception or anxiety regarding radiation in Japan after the accident. Further researches are needed about detailed statistical analysis for time-related change and causality among variables.
The National Violent Death Reporting System: overview and future directions.
Blair, Janet M; Fowler, Katherine A; Jack, Shane P D; Crosby, Alexander E
2016-04-01
To describe the National Violent Death Reporting System (NVDRS). This is a surveillance system for monitoring the occurrence of homicides, suicides, unintentional firearm deaths, deaths of undetermined intent, and deaths from legal intervention (excluding legal executions) in the US. This report provides information about the history, scope, data variables, processes, utility, limitations, and future directions of the NVDRS. The NVDRS currently operates in 32 states, with the goal of future expansion to all 50 states, the District of Columbia, and US territories. The system uses existing primary data sources (death certificates, coroner/medical examiner reports, and law enforcement reports), and links them together to provide a comprehensive picture of the circumstances surrounding violent deaths. This report provides an overview of the NVDRS including a description of the system, discussion of its expanded capability, the use of new technologies as the system has evolved, how the data are being used for violence prevention efforts, and future directions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Missoni, Eduard; Bozić, Boris; Missoni, Ivan
2012-12-01
The aim of this study was to gather enough data in order to formulate theory- and research-based recommendations to policy makers with the intention of decreasing the number of alcohol-related accidents and victims on Croatian roads. The data on the injured traffic participants and the share of participants under the influence of alcohol were collected from the police reports of the Traffic Police Department, Ministry of the Interior, written at the scene of the respective accidents. This documentation was then processed by descriptive epidemiology and analysed through a four-year period, before and after the passing of the New Road Traffic Safety Act in the Republic of Croatia, on 20 August 2004. In the first six months of 2005, after the passing of the Act, there were 3,275 accidents caused by the motorists under the influence of alcohol (12.5% of all the accidents), with 64 persons killed. Only 5 fatalities (8%) were caused by the drivers with measured blood alcohol concentration of up to 0.5 per thousand. As much as 27 fatalities (42%) were caused by the drivers with measured more than 1.5 per thousand, while half of the fatalities, 32 (50%), were caused by drivers with 0.5-1.5 per thousand. In this period, more than 451,000 violations were recorded, whereas in the same period of the previous year, the number of violations was about 519,000. A reduction of the total number of accidents is the result of the new regulation provision, according to which the incidents without human victims do not have to be reported to the police. The number of traffic accidents caused by drivers under the influence of alcohol had increased by some dozen per cents, namely: 2005 - 6,219 persons, 2006- 6,590 persons, noting that in 2006 one less person was killed (123) compared to 2005. In 2005, drivers with alcohol concentration of 0-0.5 per thousand caused 1,096 accidents, with 14 fatalities, whereas in 2006 there were 1,164 accidents with 9 fatalities. A total of 2,314 accidents were caused by drivers with more than 0.5 per thousand and up to 1.5 per thousand in 2005 (in 2006 - 2,582), along with 53 fatalities (1 fewer than in 2006). Drivers with more than 1.5 per thousand participated in 2,809 accidents (2006 - 2,844), with the number of killed drivers amounting to 57, three fewer than in 2006. In light of these facts, alcohol use still remains a significant factor in road traffic accidents and is an important area for injury prevention efforts.
[Mortality from violent causes in the Americas].
Yunes, J
1993-04-01
With a view to assembling information to aid in decision-making with regard to prevention policies, a study of mortality from violent causes and its trends in the countries of the Americas was carried out. The study focused on persons under 24 years of age and utilized information from 1980 and 1986 taken from the data base of the Pan American Health Organization. The causes of death were grouped in accordance with the International Classification of Diseases, Ninth Revision. Accidental deaths were separated from intentional deaths by means of the following classification: traffic accidents, other accidents, homicides, suicides, and "unknown causes." The information on violent deaths was compared with information on deaths from infectious diseases during the same period. The results indicate that in 1986, 517,465 deaths from violent causes were recorded in the 28 countries of the Region. Violent deaths as a proportion of total deaths ranged from 3.7% in Jamaica to 26.8% in El Salvador. It was observed that between 1980 and 1986 traffic accidents and "other accidents" tended to diminish but there was a moderate increase in suicides. Homicide rates varied markedly between the countries. In the under-1 and 1-4 year age groups, the highest rates corresponded to "other accidents," except in Chile, where among children aged 1-4 the largest proportion of deaths were attributed to "unknown causes." Comparative analysis of deaths from violent causes and from infectious diseases in the population aged 0-24 years showed that the former increase whereas the latter decrease as age increases. The study pointed up the need to promote further research on these phenomena in order to develop appropriate prevention strategies.
Community-based opioid overdose prevention programs providing naloxone - United States, 2010.
2012-02-17
Drug overdose death rates have increased steadily in the United States since 1979. In 2008, a total of 36,450 drug overdose deaths (i.e., unintentional, intentional [suicide or homicide], or undetermined intent) were reported, with prescription opioid analgesics (e.g., oxycodone, hydrocodone, and methadone), cocaine, and heroin the drugs most commonly involved . Since the mid-1990s, community-based programs have offered opioid overdose prevention services to persons who use drugs, their families and friends, and service providers. Since 1996, an increasing number of these programs have provided the opioid antagonist naloxone hydrochloride, the treatment of choice to reverse the potentially fatal respiratory depression caused by overdose of heroin and other opioids. Naloxone has no effect on non-opioid overdoses (e.g., cocaine, benzodiazepines, or alcohol) . In October 2010, the Harm Reduction Coalition, a national advocacy and capacity-building organization, surveyed 50 programs known to distribute naloxone in the United States, to collect data on local program locations, naloxone distribution, and overdose reversals. This report summarizes the findings for the 48 programs that completed the survey and the 188 local programs represented by the responses. Since the first opioid overdose prevention program began distributing naloxone in 1996, the respondent programs reported training and distributing naloxone to 53,032 persons and receiving reports of 10,171 overdose reversals. Providing opioid overdose education and naloxone to persons who use drugs and to persons who might be present at an opioid overdose can help reduce opioid overdose mortality, a rapidly growing public health concern.
Desai, Jamsheed A; Abuzinadah, Ahmad R; Imoukhuede, Oje; Bernbaum, Manya L; Modi, Jayesh; Demchuk, Andrew M; Coutts, Shelagh B
2014-01-01
The assortment of patients based on the underlying pathophysiology is central to preventing recurrent stroke after a transient ischemic attack and minor stroke (TIA-MS). The causative classification of stroke (CCS) and the A-S-C-O (A for atherosclerosis, S for small vessel disease, C for Cardiac source, O for other cause) classification schemes have recently been developed. These systems have not been specifically applied to the TIA-MS population. We hypothesized that both CCS and A-S-C-O would increase the proportion of patients with a definitive etiologic mechanism for TIA-MS as compared with TOAST. Patients were analyzed from the CATCH study. A single-stroke physician assigned all patients to an etiologic subtype using published algorithms for TOAST, CCS and ASCO. We compared the proportions in the various categories for each classification scheme and then the association with stroke progression or recurrence was assessed. TOAST, CCS and A-S-C-O classification schemes were applied in 469 TIA-MS patients. When compared to TOAST both CCS (58.0 vs. 65.3%; p < 0.0001) and ASCO grade 1 or 2 (37.5 vs. 65.3%; p < 0.0001) assigned fewer patients as cause undetermined. CCS had increased assignment of cardioembolism (+3.8%, p = 0.0001) as compared with TOAST. ASCO grade 1 or 2 had increased assignment of cardioembolism (+8.5%, p < 0.0001), large artery atherosclerosis (+14.9%, p < 0.0001) and small artery occlusion (+4.3%, p < 0.0001) as compared with TOAST. Compared with CCS, using ASCO resulted in a 20.5% absolute reduction in patients assigned to the 'cause undetermined' category (p < 0.0001). Patients who had multiple high-risk etiologies either by CCS or ASCO classification or an ASCO undetermined classification had a higher chance of having a recurrent event. Both CCS and ASCO schemes reduce the proportion of TIA and minor stroke patients classified as 'cause undetermined.' ASCO resulted in the fewest patients classified as cause undetermined. Stroke recurrence after TIA-MS is highest in patients with multiple high-risk etiologies or cryptogenic stroke classified by ASCO. © 2014 S. Karger AG, Basel.
Keeping Up with Healthcare Trends: IcHeart as a Medication Management Application
NASA Astrophysics Data System (ADS)
Kasinathan, Vinothini; Mustapha, Aida; Azah Samsudin, Noor
2016-11-01
According to the US governments, more than 125,000 people die each year due to failure to manage their medications, leading to approximately USD100 billion in preventable costs to healthcare systems. The core failure in medication management is attributed by patients failing to adhere their medication regimens, whether by accident, negligence, or intentional. Recognizing the importants of vigilant monitoring in medication management, this paper is set to review the latest android-based healthcare trends and propose a new mobile medication reminder application called IcHeart.
Interventions to reduce accidents in childhood: a systematic review.
Barcelos, Raquel S; Del-Ponte, Bianca; Santos, Iná S
2017-12-30
To review the literature on interventions planned to prevent the incidence of injuries in childhood. The PubMed, Web of Science, and Bireme databases were searched by two independent reviewers, employing the single terms accidents, accident, injuries, injury, clinical trial, intervention, educational intervention, and multiple interventions, and their combinations, present in the article title or abstract, with no limits except period of publication (2006-2016) and studies in human subjects. Initially, 11,097 titles were located. Fifteen articles were selected for the review. Eleven were randomized trials (four carried out at the children's households, five in pediatric healthcare services, and two at schools), and four were non-randomized trials carried out at the children's households. Four of the randomized trials were analyzed by intention-to-treat and a protective effect of the intervention was observed: decrease in the number of risk factors, decrease in the number of medical consultations due to injuries, decrease in the prevalence of risk behaviors, and increase of the parents' knowledge regarding injury prevention in childhood. Traumatic injuries in childhood are amenable to primary prevention through strategies that consider the child's age and level of development, as well as structural aspects of the environment. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.
Lyamzina, Yuliya; Suzuki, Yuriko; Murakami, Michio
2017-01-01
The purpose of this study was to provide a review of the publications of the risk perceptions or anxiety regarding radiation among people living in Japan after the 2011 Fukushima nuclear power plant accident. Two database (MEDLINE and PsycINFO) and hand-searched the references in identified publications were searched. For each identified publication, the measurements and time related-change of risk perception and anxiety regarding radiation were summarized. Twenty-four publications were identified. Quantitative measures of risk perception or anxiety were roughly divided into two types: single-item Likert scales that measure anxiety about radiation; and theoretical, or model-based measures. Rates of Fukushima residents with radiation-related anxiety decreased from 2012 to 2015. Factors governing risk perception or radiation-related anxiety were summarized by demographics, disaster-related stressors, trusted information, and radiation-related variables. The effects of risk perception or anxiety regarding radiation were summarized as severe distress, intention to leave employment or not to return home, or other dimensions. This review provides summary of current findings on risk perception or anxiety regarding radiation in Japan after the accident. Further researches are needed about detailed statistical analysis for time-related change and causality among variables. PMID:29077045
Yarandi, Fariba; Izadi Mood, Narges; Mirashrafi, Fatemeh; Eftekhar, Zahra
2004-12-01
The optimal method for managing a patient diagnosed with atypical squamous cells of undetermined significance (ASCUS) has not yet been established. The interim guidelines published by the National Cancer Institute suggest that a patient should be referred for colposcopy after the second ASCUS diagnosis within 2 years. To assess the significance of ASCUS in predicting the presence of underlying squamous intraepithelial lesion (SIL) of the uterine cervix. Women undergoing colposcopy for ASCUS cytology at a teaching hospital in Tehran University, in the years 1998-2001, considered eligible to enter this retrospective study. Of the 266 patients who underwent colposcopy, 28 (11%) had low-grade squamous intraepithelial lesion (LSIL), 16 (6.3%) had high-grade squamous intraepithelial lesion (HSIL) two (0.8%) had squamous cell carcinoma (SCC), and 48 (18.8%) had flat condyloma. Atypical squamous cells of undetermined significance (ASCUS) on a cervical smear is a good marker for detecting underlying SIL and condyloma. Thus, immediate colposcopy and directed biopsy are appropriate follow-up procedures.
Teratogenicity of recently introduced medications in human pregnancy.
Lo, W Y; Friedman, J M
2002-09-01
To determine how long it takes after a new drug is marketed to establish whether or not its use by pregnant women is likely to pose a substantial teratogenic risk. We used standard clinical teratology resources to assess the teratogenic risks in human pregnancy of therapeutic treatment with 468 drugs approved by the US Food and Drug Administration between 1980 and 2000. The teratogenic risk of each treatment was classified using the current online version of TERIS into one of three categories: 1) no risk, minimal risk, or unlikely to produce an increased risk; 2) associated with a small, moderate, or high risk; or 3) risk undetermined. We found that the teratogenic risk in human pregnancy was still undetermined for 91.2% of drug treatments approved in the United States between 1980 and 2000. The proportion of treatments classified as having an "undetermined" teratogenic risk was more than 80% for drugs approved for marketing 0-4, 5-9, 10-14, or 15-20 years ago, but the highest proportion of drugs with an "undetermined" teratogenic risk was found among those approved 15-20 years ago. The agreement between TERIS risk ratings and Food and Drug Administration Use-in-Pregnancy Categories for 163 drugs that had been assessed by both systems was poor (kappa +/- standard error = 0.082 +/- 0.042). We conclude that inadequate information is available for pregnant women and their physicians to determine whether the benefits exceed the teratogenic risks for most drug treatments introduced in the past 20 years.
NASA Astrophysics Data System (ADS)
Kiso, Atsushi; Murakami, Hiroki; Seki, Hirokazu
This paper describes a novel obstacle avoidance control scheme of electric powered wheelchairs for realizing the safe driving in various environments. The “electric powered wheelchair” which generates the driving force by electric motors is expected to be widely used as a mobility support system for elderly people and disabled people; however, the driving performance must be further improved because the number of driving accidents caused by elderly operator's narrow sight and joystick operation errors is increasing. This paper proposes a novel obstacle avoidance control scheme based on fuzzy algorithm to prevent driving accidents. The proposed control system determines the driving direction by fuzzy algorithm based on the information of the joystick operation and distance to obstacles measured by ultrasonic sensors. Fuzzy rules to determine the driving direction are designed surely to avoid passers-by and walls considering the human's intent and driving environments. Some driving experiments on the practical situations show the effectiveness of the proposed control system.
A Web-based survey on students' conceptions of 'accident'.
Blank, Danilo; Hohgraefe Neto, Guilherme; Grando, Elisa; Siqueira, Pauline Z; Lunkes, Roberta P; Pietrobeli, João Leonardo; Marzola, Norma Regina; Goldani, Marcelo Z
2009-12-01
To report the implementation of an open source web survey application and a case study of its first utilisation, particularly as to aspects of logistics and response behaviour, in a survey of Brazilian university students' conceptions about injury causing events. We developed an original application capable of recruiting respondents, sending personal e-mail invitations, storing responses and exporting data. Students of medical, law, communication and education schools were asked about personal attributes and conceptions of the term accident, as to associations and preventability. The response rate was 34.5%. Half of the subjects responded by the second day, 66.3% during the first week. Subjects around 4.2% (95% CI 3.3-5.4) refused to disclose religious persuasion, and 19.2% (95% CI 17.2-21.3) refused to disclose political persuasion, whereas only 2.8% (95% CI 2.1-3.8), on average, refused to answer questions on conceptions and attitudes. There was no significant difference between early and late respondents in respect to selected attributes and conceptions of accident (P-value varied from 0.145 to 0.971). The word accident evoked the notion of preventability to 85.1% (95% CI 83.2 to 87.0) of the subjects, foreseeability to 50.3% (95% CI 47.7-53.0), fatality to 15.1% (95% CI 13.3-17.1) and intentionality to 2.3% (95% CI 1.6-3.2). Web surveying university students' conceptions about injuries is feasible in a middle-income country setting, yielding response rates similar to those found in the literature.
1984-02-24
of body fat appeared to be reasonably normal in its distribu- tion. No signif icant differences were detected between the variances (P- 0.34) or the...a minor or undetermined nature , that require detailed fol.low-up. In full context, the baseline study results should be viewed as reassuring to the...The study has disclosed numerous medical findings, mostly of a minor or undetermined nature , that require " detailed follow-up. in full context, the
Moral empiricism and the bias for act-based rules.
Ayars, Alisabeth; Nichols, Shaun
2017-10-01
Previous studies on rule learning show a bias in favor of act-based rules, which prohibit intentionally producing an outcome but not merely allowing the outcome. Nichols, Kumar, Lopez, Ayars, and Chan (2016) found that exposure to a single sample violation in which an agent intentionally causes the outcome was sufficient for participants to infer that the rule was act-based. One explanation is that people have an innate bias to think rules are act-based. We suggest an alternative empiricist account: since most rules that people learn are act-based, people form an overhypothesis (Goodman, 1955) that rules are typically act-based. We report three studies that indicate that people can use information about violations to form overhypotheses about rules. In study 1, participants learned either three "consequence-based" rules that prohibited allowing an outcome or three "act-based" rules that prohibiting producing the outcome; in a subsequent learning task, we found that participants who had learned three consequence-based rules were more likely to think that the new rule prohibited allowing an outcome. In study 2, we presented participants with either 1 consequence-based rule or 3 consequence-based rules, and we found that those exposed to 3 such rules were more likely to think that a new rule was also consequence based. Thus, in both studies, it seems that learning 3 consequence-based rules generates an overhypothesis to expect new rules to be consequence-based. In a final study, we used a more subtle manipulation. We exposed participants to examples act-based or accident-based (strict liability) laws and then had them learn a novel rule. We found that participants who were exposed to the accident-based laws were more likely to think a new rule was accident-based. The fact that participants' bias for act-based rules can be shaped by evidence from other rules supports the idea that the bias for act-based rules might be acquired as an overhypothesis from the preponderance of act-based rules. Copyright © 2017 Elsevier B.V. All rights reserved.
The Psychosemantics of Free Riding: Dissecting the Architecture of a Moral Concept
Delton, Andrew W.; Cosmides, Leda; Guemo, Marvin; Robertson, Theresa E.; Tooby, John
2012-01-01
For collective action to evolve and be maintained by selection, the mind must be equipped with mechanisms designed to identify free riders—individuals who do not contribute to a collective project but still benefit from it. Once identified, free riders must be either punished or excluded from future collective actions. But what criteria does the mind use to categorize someone as a free rider? An evolutionary analysis suggests that failure to contribute is not sufficient. Failure to contribute can occur by intention or accident, but the adaptive threat is posed by those who are motivated to benefit themselves at the expense of cooperators. In 6 experiments, we show that only individuals with exploitive intentions were categorized as free riders, even when holding their actual level of contribution constant (Studies 1 and 2). In contrast to an evolutionary model, rational choice and reinforcement theory suggest that different contribution levels (leading to different payoffs for their cooperative partners) should be key. When intentions were held constant, however, differences in contribution level were not used to categorize individuals as free riders, although some categorization occurred along a competence dimension (Study 3). Free rider categorization was not due to general tendencies to categorize (Study 4) or to mechanisms that track a broader class of intentional moral violations (Studies 5A and 5B). The results reveal the operation of an evolved concept with features tailored for solving the collective action problems faced by ancestral hunter-gatherers. PMID:22268815
Association Between Swimming Lessons and Drowning in Childhood
Brenner, Ruth A.; Taneja, Gitanjali Saluja; Haynie, Denise L.; Trumble, Ann C.; Qian, Cong; Klinger, Ron M.; Klebanoff, Mark A.
2014-01-01
Objective To estimate the association between swimming lessons and the risk of drowning among children aged 1 to 19 years. Design Case-control study. Setting Cases were identified from medical examiners’/ coroners’ offices between mid-2003 and mid-2005. Jurisdictions included the states of Maryland and North Carolina, 14 districts (33 counties) in Florida, 3 counties in California, 1 county in Texas, and 1 county in New York. Participants Cases were children and adolescents aged 1 to 19 years who died of unintentional drowning. Interviews were conducted with 88 families of children who drowned and 213 matched controls. Main Exposure Swimming lessons. Main Outcome Measure Death due to unintentional drowning. Drownings that were intentional, of undetermined intent, or that occurred under conditions in which swimming ability was unlikely to impact risk (eg, in ice water or bathtubs) were excluded. Results Of the 61 cases in the 1- to 4-year age group, 2 (3%) had participated in formal swimming lessons vs 35 of 134 matched controls (26%) (adjusted odds ratio [OR], 0.12; 95% confidence interval [CI], 0.01–0.97). Among the 27 cases aged 5 to 19 years, 7 (27%) had ever taken formal swimming lessons vs 42 of 79 matched controls (53%) (adjusted OR, 0.36; 95% CI, 0.09–1.51). In adjusted analyses, there was no statistically significant association between informal instruction and drowning risk. Conclusions Participation in formal swimming lessons was associated with an 88% reduction in the risk of drowning in the 1- to 4-year-old children, although our estimates were imprecise and 95% CIs included risk reductions ranging from 3% to 99%. PMID:19255386
Agricultural and horticultural chemical poisonings: mortality and morbidity in the United States.
Klein-Schwartz, W; Smith, G S
1997-02-01
To provide a comprehensive analysis of morbidity and mortality from poisoning by agricultural and horticultural chemicals in the United States. Descriptive analysis of national mortality data, National Hospital Discharge Survey data, and American Association of Poison Control Centers national data for 1985 through 1990. There were 341 fatalities from agricultural and horticultural chemicals over the 6-year period, of which 64% were suicides, 28% were unintentional, and 8% were of undetermined intent. There were 25,418 hospitalizations; 78% were reported to be unintentional. Both deaths and hospitalizations occurred more frequently in males, and rates were higher in nonwhites than in whites. There were 338,170 poison exposures reported to poison centers for fungicides, herbicides, pesticides/insecticides, and rodenticides. Life-threatening manifestations or long-term sequelae occurred in 782 cases, and 97 deaths were reported. Pesticides and insecticides accounted for 72% of the poison center cases and 63% of the fatalities. Although they accounted for only 8% of poison exposures, herbicide deaths were disproportionately high (25%). Poisonings with agricultural and horticultural chemicals are an important public health problem. Prevention efforts need to incorporate the fact that many serious cases, such as paraquat poisonings, are suicidal in nature.
The "Eye Avoidance" Hypothesis of Autism Face Processing.
Tanaka, James W; Sung, Andrew
2016-05-01
Although a growing body of research indicates that children with autism spectrum disorder (ASD) exhibit selective deficits in their ability to recognize facial identities and expressions, the source of their face impairment is, as yet, undetermined. In this paper, we consider three possible accounts of the autism face deficit: (1) the holistic hypothesis, (2) the local perceptual bias hypothesis and (3) the eye avoidance hypothesis. A review of the literature indicates that contrary to the holistic hypothesis, there is little evidence to suggest that individuals with autism do perceive faces holistically. The local perceptual bias account also fails to explain the selective advantage that ASD individuals demonstrate for objects and their selective disadvantage for faces. The eye avoidance hypothesis provides a plausible explanation of face recognition deficits where individuals with ASD avoid the eye region because it is perceived as socially threatening. Direct eye contact elicits a increased physiological response as indicated by heightened skin conductance and amygdala activity. For individuals with autism, avoiding the eyes is an adaptive strategy, however, this approach interferes with the ability to process facial cues of identity, expressions and intentions, exacerbating the social challenges for persons with ASD.
Differing Procedures for Recording Mortality Statistics in Scandinavia.
Tøllefsen, Ingvild M; Hem, Erlend; Ekeberg, Øivind; Zahl, Per-Henrik; Helweg-Larsen, Karin
2017-03-01
There may be various reasons for differences in suicide rates between countries and over time within a country. One reason can be different registration practices. The purpose of this study was to describe and compare the present procedures for mortality and suicide registration in the three Scandinavian countries and to illustrate potential sources of error in the registration of suicide. Information about registration practices and classification procedures was obtained from the cause of death registers in Norway, Sweden, and Denmark. In addition, we received information from experts in the field in each country. Sweden uses event of undetermined intent more frequently than Denmark does, and Denmark more frequently than Norway. There seems to be somewhat more uncertainty among deaths classified as ill-defined and unknown cause of mortality in Norway, compared with the other two countries. Sweden performs more forensic autopsies than Norway, and Norway more than Denmark. In Denmark, in cases of a suspected unnatural manner of death, a thorough external examination of the deceased is performed. Differences in the classification of causes of death and in postmortem examinations exist in Scandinavian countries. These differences might influence the suicide statistics in Scandinavia.
Surveillance for Violent Deaths — National Violent Death Reporting System, 18 States, 2014
Jack, Shane P.D.; Lyons, Bridget H.; Betz, Carter J.; Petrosky, Emiko
2018-01-01
Problem/Condition In 2014, approximately 59,000 persons died in the United States as a result of violence-related injuries. This report summarizes data from CDC’s National Violent Death Reporting System (NVDRS) regarding violent deaths from 18 U.S. states for 2014. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. Reporting Period Covered 2014. Description of System NVDRS collects data from participating states regarding violent deaths. Data are obtained from death certificates, coroner/medical examiner reports, law enforcement reports, and secondary sources (e.g., child fatality review team data, supplemental homicide reports, hospital data, and crime laboratory data). This report includes data from 18 states that collected statewide data for 2014 (Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, Michigan, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin). NVDRS collates documents for each death and links deaths that are related (e.g., multiple homicides, a homicide followed by a suicide, or multiple suicides) into a single incident. Results For 2014, a total of 22,098 fatal incidents involving 22,618 deaths were captured by NVDRS in the 18 states included in this report. The majority of deaths were suicides (65.6%), followed by homicides (22.5%), deaths of undetermined intent (10.0%), deaths involving legal intervention (1.3%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force, excluding legal executions), and unintentional firearm deaths (<1%). The term “legal intervention” is a classification incorporated into the International Classification of Diseases, Tenth Revision (ICD-10) and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement. Suicides occurred at higher rates among males, non-Hispanic American Indian/Alaska Natives (AI/AN), non-Hispanic whites, persons aged 45–54 years, and males aged ≥75 years. Suicides were preceded primarily by a mental health, intimate partner, substance abuse, or physical health problem or a crisis during the previous or upcoming 2 weeks. Homicide rates were higher among males and persons aged <1 year and 15–44 years; rates were highest among non-Hispanic black and AI/AN males. Homicides primarily were precipitated by arguments and interpersonal conflicts, occurrence in conjunction with another crime, or related to intimate partner violence (particularly for females). When the relationship between a homicide victim and a suspected perpetrator was known, it was most often either an acquaintance/friend or an intimate partner. Legal intervention death rates were highest among males and persons aged 20–44 years; rates were highest among non-Hispanic black males and Hispanic males. Precipitating factors for the majority of legal intervention deaths were alleged criminal activity in progress, the victim reportedly using a weapon in the incident, a mental health or substance abuse problem, an argument or conflict, or a recent crisis. Deaths of undetermined intent occurred more frequently among males, particularly non-Hispanic black and AI/AN males, and persons aged 30–54 years. Substance abuse, mental health problems, physical health problems, and a recent crisis were the most common circumstances preceding deaths of undetermined intent. Unintentional firearm deaths were more frequent among males, non-Hispanic whites, and persons aged 10–24 years; these deaths most often occurred while the shooter was playing with a firearm and were most often precipitated by a person unintentionally pulling the trigger or mistakenly thinking the firearm was unloaded. Interpretation This report provides a detailed summary of data from NVDRS for 2014. The results indicate that violent deaths resulting from self-inflicted or interpersonal violence disproportionately affected persons aged <65 years, males, and certain minority populations. The primary precipitating factors for homicides and suicides were intimate partner problems, interpersonal conflicts, mental health and substance abuse problems, and recent crises. Public Health Action NVDRS data are used to monitor the occurrence of violence-related fatal injuries and assist public health authorities in the development, implementation, and evaluation of programs and policies to reduce and prevent violent deaths. For example, North Carolina VDRS data were used to improve case ascertainment of pregnancy-associated suicides, Wisconsin VDRS data were used to develop the statewide suicide prevention strategy, and Colorado VDRS data were used to develop programs and prevention strategies for suicide among veterans. The continued development and expansion of NVDRS to include all U.S. states, territories, and the District of Columbia are essential to public health efforts to reduce the impact of violence. PMID:29389917
Surveillance for Violent Deaths - National Violent Death Reporting System, 18 States, 2014.
Fowler, Katherine A; Jack, Shane P D; Lyons, Bridget H; Betz, Carter J; Petrosky, Emiko
2018-02-02
In 2014, approximately 59,000 persons died in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 18 U.S. states for 2014. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. 2014. NVDRS collects data from participating states regarding violent deaths. Data are obtained from death certificates, coroner/medical examiner reports, law enforcement reports, and secondary sources (e.g., child fatality review team data, supplemental homicide reports, hospital data, and crime laboratory data). This report includes data from 18 states that collected statewide data for 2014 (Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, Michigan, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin). NVDRS collates documents for each death and links deaths that are related (e.g., multiple homicides, a homicide followed by a suicide, or multiple suicides) into a single incident. For 2014, a total of 22,098 fatal incidents involving 22,618 deaths were captured by NVDRS in the 18 states included in this report. The majority of deaths were suicides (65.6%), followed by homicides (22.5%), deaths of undetermined intent (10.0%), deaths involving legal intervention (1.3%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force, excluding legal executions), and unintentional firearm deaths (<1%). The term "legal intervention" is a classification incorporated into the International Classification of Diseases, Tenth Revision (ICD-10) and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement. Suicides occurred at higher rates among males, non-Hispanic American Indian/Alaska Natives (AI/AN), non-Hispanic whites, persons aged 45-54 years, and males aged ≥75 years. Suicides were preceded primarily by a mental health, intimate partner, substance abuse, or physical health problem or a crisis during the previous or upcoming 2 weeks. Homicide rates were higher among males and persons aged <1 year and 15-44 years; rates were highest among non-Hispanic black and AI/AN males. Homicides primarily were precipitated by arguments and interpersonal conflicts, occurrence in conjunction with another crime, or related to intimate partner violence (particularly for females). When the relationship between a homicide victim and a suspected perpetrator was known, it was most often either an acquaintance/friend or an intimate partner. Legal intervention death rates were highest among males and persons aged 20-44 years; rates were highest among non-Hispanic black males and Hispanic males. Precipitating factors for the majority of legal intervention deaths were alleged criminal activity in progress, the victim reportedly using a weapon in the incident, a mental health or substance abuse problem, an argument or conflict, or a recent crisis. Deaths of undetermined intent occurred more frequently among males, particularly non-Hispanic black and AI/AN males, and persons aged 30-54 years. Substance abuse, mental health problems, physical health problems, and a recent crisis were the most common circumstances preceding deaths of undetermined intent. Unintentional firearm deaths were more frequent among males, non-Hispanic whites, and persons aged 10-24 years; these deaths most often occurred while the shooter was playing with a firearm and were most often precipitated by a person unintentionally pulling the trigger or mistakenly thinking the firearm was unloaded. This report provides a detailed summary of data from NVDRS for 2014. The results indicate that violent deaths resulting from self-inflicted or interpersonal violence disproportionately affected persons aged <65 years, males, and certain minority populations. The primary precipitating factors for homicides and suicides were intimate partner problems, interpersonal conflicts, mental health and substance abuse problems, and recent crises. NVDRS data are used to monitor the occurrence of violence-related fatal injuries and assist public health authorities in the development, implementation, and evaluation of programs and policies to reduce and prevent violent deaths. For example, North Carolina VDRS data were used to improve case ascertainment of pregnancy-associated suicides, Wisconsin VDRS data were used to develop the statewide suicide prevention strategy, and Colorado VDRS data were used to develop programs and prevention strategies for suicide among veterans. The continued development and expansion of NVDRS to include all U.S. states, territories, and the District of Columbia are essential to public health efforts to reduce the impact of violence.
Embolic strokes of undetermined source in a cohort of Polish stroke patients.
Bembenek, Jan Pawel; Karlinski, Michal Adam; Kurkowska-Jastrzebska, Iwona; Czlonkowska, Anna
2018-03-19
We aimed to provide a descriptive analysis of embolic stroke of undetermined etiology (ESUS) population based on a long-term prospective stroke registry. We retrospectively analyzed data collected in a detailed registry regarding consecutive patients admitted for first-ever ischemic stroke (IS) between January 2001 and December 2015. We used Org 10172 in Acute Stroke Treatment classification supplemented with ESUS criteria proposed by the Cryptogenic Stroke/ESUS International Working Group. Within the ESUS group, we additionally compared patients ≤ 60 and > 60 years of age. During the study period, there was a total of 3008 (1615 females and 1393 males) admissions of first-ever strokes. The most frequent cause was undetermined (38.7%), followed by cardioembolic (27.7%), large artery atherosclerosis (18.2%), small vessel disease (11.9%), and other determined (3.6%). We identified 326 patients as ESUS, which accounted for 10.8% of all strokes and 28% of strokes of undetermined etiology. ESUS patients were the youngest. Compared to all types of stroke but for those with small vessel disease, ESUS patients were most often independent before stroke and had the least severe neurological deficit at admission and the best outcome at discharge. ESUS patients ≤ 60 years were more frequently independent at discharge than ESUS patients > 60 years. Approximately 11% of patients from our registry met ESUS criteria. ESUS patients were younger when compared to all other stroke etiologies, suffered less severe strokes, and had more favorable outcome at discharge than other groups except for those with small vessel disease strokes.
Cooperative biological effects between ionizing radiation and other physical and chemical agents.
Manti, Lorenzo; D'Arco, Annalisa
2010-01-01
Exposure to ionizing radiation (IR), at environmentally and therapeutically relevant doses or as a result of diagnostics or accidents, causes cyto- and genotoxic damage. However, exposure to IR alone is a rare event as it occurs in spatial and temporal combination with several physico-chemical agents. Some of these are of known noxiousness, as is the case with chemical compounds at high dose, hence additive/synergistic effects can be expected or have been demonstrated. Conversely, the cellular toxicity of other agents, such as non-ionizing electromagnetic fields (EMFs), is only presumed and their short- and long-term cooperation on IR-induced damage remains undetermined. In this review, we shall examine evidence in support of the interplay between spatially and/or temporally related environmentally relevant stressors. In vitro or animal-based studies as well as epidemiological surveys have generally examined the combined action of no more than a couple of known or potentially DNA-damaging agents. Moreover, most existing research mainly focused on short-term effects of combined exposures. Hence, it is important that quantitative research addresses the issue of the possible cooperation between chronic exposure to environmental trace contaminants and exposure to EMFs, examining not only the modulation of damage acutely induced by IR but also long-term genome stability. 2010 Elsevier B.V. All rights reserved.
Holakouie-Naieni, Kourosh; Koehler, Steven A; Karimi, Roya; Mardani, Fardin; Karimi, Jalal
2016-01-01
The issue of child and adolescent injury and violence is often absent from discussions and is largely invisible in public health policies. The purpose of this study was to describe the frequency and pattern of unnatural deaths during childhood and adolescence in Isfahan province in Iran. This retrospective, descriptive study involved unnatural deaths among individuals under the age of 20 years who died from unnatural causes as determined by a forensic autopsy at the Legal Medicine Center of Isfahan. During the study period, 8,010 unnatural deaths occurred, 1,222 of which were individuals under 20 years old. All 1,222 of these unnatural deaths were identified through autopsy. Among the 1,222 cases, 895 (73.2%) were male, and 327 were female (26.8%). Accidental deaths were found to be the most frequent manner of death comprising 1,029 (83.96%) cases, followed by suicide (120, 9.82%), undetermined cause of death (39, 3.19%), and homicide (9, 2.86%) cases. Road traffic accidents were the number 1 cause of death (597, 49%), followed by burns (122, 10%) and hanging (90, 7.4%). Injuries and violence that occur during childhood and adolescence represent a global public health problem, especially in low- and middle-income regions, and require urgent action.
NASA-Langley Research Center's Aircraft Condition Analysis and Management System Implementation
NASA Technical Reports Server (NTRS)
Frye, Mark W.; Bailey, Roger M.; Jessup, Artie D.
2004-01-01
This document describes the hardware implementation design and architecture of Aeronautical Radio Incorporated (ARINC)'s Aircraft Condition Analysis and Management System (ACAMS), which was developed at NASA-Langley Research Center (LaRC) for use in its Airborne Research Integrated Experiments System (ARIES) Laboratory. This activity is part of NASA's Aviation Safety Program (AvSP), the Single Aircraft Accident Prevention (SAAP) project to develop safety-enabling technologies for aircraft and airborne systems. The fundamental intent of these technologies is to allow timely intervention or remediation to improve unsafe conditions before they become life threatening.
Jiang, Kang; Ling, Feiyang; Feng, Zhongxiang; Wang, Kun; Guo, Lei
2017-02-17
As the prevalence of mobile phone use has increased globally, experts have verified the effects of mobile phone distraction on traffic safety. However, the psychological factors underlying pedestrians' decisions to use their mobile phones while crossing the street have received little attention. The present study employed the theory of planned behavior (TPB) to investigate the psychological factors that influence pedestrians' intentions to use a mobile phone while crossing the street. The additional predictors of descriptive norms, moral norms, risk perception, mobile phone involvement, and perceived ability to compensate are included. Approximately 40% of participants reported having used a mobile phone while crossing during the previous week and 5.4% had been involved in crossing accidents due to mobile phone distractions. Hierarchical multiple regression analyses revealed overall support for the predictive utility of the TPB. The standard TPB variables accounted for 13.3% of variance in intentions after demographic variables were controlled, and the extended predictors contributed an additional 7.6% beyond the standard constructs. The current study revealed that attitude, perceived behavior control, descriptive norms, mobile phone involvement, and perceived ability to compensate all emerged as significant predictors of intentions. The findings could support the design of more effective safety campaigns and interventions to reduce pedestrians' distracted crossing behaviors.
McClung, R Paul; Roth, David M; Vigar, Marissa; Roberts, Virginia A; Kahler, Amy M; Cooley, Laura A; Hilborn, Elizabeth D; Wade, Timothy J; Fullerton, Kathleen E; Yoder, Jonathan S; Hill, Vincent R
2017-11-10
Waterborne disease outbreaks in the United States are associated with a wide variety of water exposures and are reported annually to CDC on a voluntary basis by state and territorial health departments through the National Outbreak Reporting System (NORS). A majority of outbreaks arise from exposure to drinking water (1) or recreational water (2), whereas others are caused by an environmental exposure to water or an undetermined exposure to water. During 2013-2014, 15 outbreaks associated with an environmental exposure to water and 12 outbreaks with an undetermined exposure to water were reported, resulting in at least 289 cases of illness, 108 hospitalizations, and 17 deaths. Legionella was responsible for 63% of the outbreaks, 94% of hospitalizations, and all deaths. Outbreaks were also caused by Cryptosporidium, Pseudomonas, and Giardia, including six outbreaks of giardiasis caused by ingestion of water from a river, stream, or spring. Water management programs can effectively prevent outbreaks caused by environmental exposure to water from human-made water systems, while proper point-of-use treatment of water can prevent outbreaks caused by ingestion of water from natural water systems.
Gelaye, Kassahun Alemu; Tessema, Fasil; Tariku, Befikadu; Abera, Semaw Ferede; Gebru, Alemseged Aregay; Assefa, Nega; Zelalem, Desalew; Dedefo, Melkamu; Kondal, Mekdes; Kote, Mesfin; Sisay, Mitike Molla; Mekonnen, Wubegzier; Terefe, Mamo Wubshet; Biks, Gashaw Andargie; Eshetu, Firehywot; Abera, Mulumebet; Fekadu, Yoseph; Hailu, Gessessew Bugssa; Tilahun, Etsehiwot; Lakew, Yihunie
2018-01-01
ABSTRACT Background: In Ethiopia, though all kinds of mortality due to external causes are an important component of overall mortality often not counted or documented on an individual basis. Objective: The aim of this study was to describe the patterns of mortality from external causes using verbal autopsy (VA) method at the Ethiopian HDSS Network sites. Methods: All deaths at Ethiopian HDSS sites were routinely registered and followed up with VA interviews. The VA forms comprised deaths up to 28 days, between four weeks and 14 years and 15 years and above. The cause of a death was ascertained based on an interview with next of families or other caregivers using a standardized questionnaire that draws information on signs, symptoms, medical history and circumstances preceding death after 45 days mourning period. Two physician assigned probable causes of death as underlying, immediate and contributing factors independently using information in VA forms based on the WHO ICD-10 and VA code system. Disagreed cases sent to third physician for independent review and diagnosis. The final cause of death considered when two of the three physicians assigned underlying cause of death; otherwise, labeled as undetermined. Results: In the period from 2009 to 2013, a total of 9719 deaths were registered. Of the total deaths, 623 (6.4%) were from external causes. Of these, accidental drowning and submersion, 136 (21.8%), accidental fall, 113 (18.1%) and transport-related accidents, 112 (18.0%) were the topmost three leading external causes of deaths. About 436 (70.0%) of deaths were from the age group above 15 years old. Drowning and submersion and transport-related accidents were high in age group between 5 and 14 years old. Conclusion: In this study, external causes of death are significant public health problems and require attention as one of prior health agenda. PMID:29471744
Padmanabhan, Vijayalakshmi; Marshall, Carrie B; Akdas Barkan, Guliz; Ghofrani, Mohiedean; Laser, Alice; Tolgay Ocal, Idris; David Sturgis, Charles; Souers, Rhona; Kurtycz, Daniel F I
2017-05-01
The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) offers a six-tiered diagnostic scheme for thyroid Fine Needle Aspiration (FNA): Benign, Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance (AUS/FLUS), suspicious for follicular neoplasm, suspicious for malignancy, malignant, and unsatisfactory with an aim to standardize diagnostic criteria. Reported rate of AUS/FLUS category in the literature has varied from 3% to 20.5%. The aim of this study was to assess interobserver variability among cytopathologists to assess reproducibility of the AUS/FLUS category. Seven cytopathologists brought FNA cases (a mixture of atypical and non-atypical FNA diagnosis) diagnosed using TBSRTC from their respective institutions which were reviewed and diagnosed by the participants. The analysis assessed interobserver variability among 7 cytopathologists and determined characteristics on the slides which were associated with concordance to the institutional diagnosis. Seventy eight of 125 (62.4%) benign cases were classified as benign by the reviewers and 26 (21%) were called AUS/FLUS on review. A third of the AUS/FLUS cases were called benign on review and 28.2% were classified as suspicious for neoplasia/malignancy. Roughly a third each of the suspicious for follicular neoplasm/suspicious for malignancy cases were classified as AUS/FLUS. When pathologists from different institutions shared their slides, concordance was high for specimens with adequate cellularity and those that were clearly benign but thresholds varied for the other indeterminate categories. Most definite categorization of the AUS/FLUS category was seen on review. Diagn. Cytopathol. 2017;45:399-405. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.
Ischemic stroke classification and risk of embolism in patients with Chagas disease.
Montanaro, Vinícius Viana Abreu; da Silva, Creuza Maria; de Viana Santos, Carla Verônica; Lima, Maria Inacia Ruas; Negrão, Edson Marcio; de Freitas, Gabriel R
2016-12-01
Ischemic stroke (IS) and Chagas disease are strongly related. Nevertheless, little attention has been paid to this association and its natural history. The current guidelines concerning the management and secondary prevention of IS are largely based on the incomplete information or extrapolation of knowledge from other stroke etiologies. We performed a retrospective study which compared stroke etiologies among a cohort of hospitalized patients with IS and Chagas disease. The Instituto de Pesquisa Evandro Chagas/Fundação Oswaldo Cruz (IPEC/FIOCRUZ) embolic score was also used to identify and evaluate the risk of embolism in this population. A total of 86 patients were included in the analysis. The mean age of the study population was 58 years, and 60 % were men. According to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) Classification, 45 % of the strokes were of undetermined etiology and 45 % of cardioembolic origin, while the Stop Stroke Study/Causative Classification System (SSS/CCS) TOAST indicated that 34 % were undetermined and 50 % cardioembolic (p < 0.01); 44 % of these patients were classified as having a high embolic risk according to the IPEC/FIOCRUZ score. Among the undetermined causes, 83.3 % fulfilled the criteria for embolic stroke of undetermined source (ESUS). The SSS/CCS TOAST etiological classification system was superior to the classical TOAST criteria in identifying a cardioembolic etiology in patients with ischemic stroke and Chagas disease. The IPEC/FIOCRUZ score did not correlate with the number of patients who were determined to have cardioembolic stroke etiologies. The current guidelines for stroke prevention should be reviewed in this population.
Zhou, Hongmei; Romero, Stephanie Ballon; Qin, Xiao
2016-10-01
This paper aimed to examine pedestrians' self-reported violating crossing behavior intentions by applying the theory of planned behavior (TPB). We studied the behavior intentions regarding instrumental attitude, subjective norm, perceived behavioral control, the three basic components of TPB, and extended the theory by adding new factors including descriptive norm, perceived risk and conformity tendency to evaluate their respective impacts on pedestrians' behavior intentions. A questionnaire presented with a scenario that pedestrians crossed the road violating the pedestrian lights at an intersection was designed, and the survey was conducted in Dalian, China. Based on the 260 complete and valid responses, reliability and validity of the data for each question was evaluated. The data were then analyzed by using the structural equation modeling (SEM). The results showed that people had a negative attitude toward the behavior of violating road-crossing rules; they perceived social influences from their family and friends; and they believed that this kind of risky behavior would potentially harm them in a traffic accident. The results also showed that instrumental attitude and subjective norm were significant in the basic TPB model. After adding descriptive norm, subjective norm was no more significant. Other models showed that conformity tendency was a strong predictor, indicating that the presence of other pedestrians would influence behavioral intention. The findings could help to design more effective interventions and safety campaigns, such as changing people's attitude toward this violation behavior, correcting the social norms, increasing their safety awareness, etc. in order to reduce pedestrians' road crossing violations. Copyright © 2015 Elsevier Ltd. All rights reserved.
Proactive strategy for long-term biological research aimed at low-dose radiation risk in Korea.
Seong, Ki Moon; Kwon, TaeWoo; Park, Jina; Youn, BuHyun; Cha, Hyuk-Jin; Kim, Yonghwan; Moon, Changjong; Lee, Seung-Sook; Jin, Young Woo
2018-06-19
Since the 2011 Fukushima nuclear power plant accident, Korean radiation experts have agreed that reliable data on health risks of low-dose radiation (LDR) are needed to ease the anxiety of lay people. The intent of this study was to devise a sustainable biological program suited for the research environment in Korea and aimed at the health effects of radiation exposures <100 millisieverts (mSv). To address pressing public concerns over LDR risk, we investigated the current understanding of LDR effects by analyzing the previous reports of international authorities for radiation protection and research publications that appeared after the Chernobyl accident. A research program appropriate for societal and scientific inclinations of Korea was then devised based on input from Korean radiation scientists. After review by our advisory committee, program priorities were set, calling for an agenda that focused on dose-response relationships in carcinogenesis, health span responses to lifestyle variations, and systemic metabolic changes. Our long-term biological research program may contribute scientific evidence to reduce the uncertainties of LDR health risks and help stakeholders formulate policies for radiation protection.
A Game-Theoretical Model to Improve Process Plant Protection from Terrorist Attacks.
Zhang, Laobing; Reniers, Genserik
2016-12-01
The New York City 9/11 terrorist attacks urged people from academia as well as from industry to pay more attention to operational security research. The required focus in this type of research is human intention. Unlike safety-related accidents, security-related accidents have a deliberate nature, and one has to face intelligent adversaries with characteristics that traditional probabilistic risk assessment techniques are not capable of dealing with. In recent years, the mathematical tool of game theory, being capable to handle intelligent players, has been used in a variety of ways in terrorism risk assessment. In this article, we analyze the general intrusion detection system in process plants, and propose a game-theoretical model for security management in such plants. Players in our model are assumed to be rational and they play the game with complete information. Both the pure strategy and the mixed strategy solutions are explored and explained. We illustrate our model by an illustrative case, and find that in our case, no pure strategy but, instead, a mixed strategy Nash equilibrium exists. © 2016 Society for Risk Analysis.
Taylor, Christopher A.; Bell, Jeneita M.; Xu, Likang
2017-01-01
Problem/Condition Traumatic brain injury (TBI) has short- and long-term adverse clinical outcomes, including death and disability. TBI can be caused by a number of principal mechanisms, including motor-vehicle crashes, falls, and assaults. This report describes the estimated incidence of TBI-related emergency department (ED) visits, hospitalizations, and deaths during 2013 and makes comparisons to similar estimates from 2007. Reporting Period 2007 and 2013. Description of System State-based administrative health care data were used to calculate estimates of TBI-related ED visits and hospitalizations by principal mechanism of injury, age group, sex, and injury intent. Categories of injury intent included unintentional (motor-vehicle crashes, falls, being struck by or against an object, mechanism unspecified), intentional (self-harm and assault/homicide), and undetermined intent. These health records come from the Healthcare Cost and Utilization Project’s National Emergency Department Sample and National Inpatient Sample. TBI-related death analyses used CDC multiple-cause-of-death public-use data files, which contain death certificate data from all 50 states and the District of Columbia. Results In 2013, a total of approximately 2.8 million TBI-related ED visits, hospitalizations, and deaths (TBI-EDHDs) occurred in the United States. This consisted of approximately 2.5 million TBI-related ED visits, approximately 282,000 TBI-related hospitalizations, and approximately 56,000 TBI-related deaths. TBIs were diagnosed in nearly 2.8 million (1.9%) of the approximately 149 million total injury- and noninjury-related EDHDs that occurred in the United States during 2013. Rates of TBI-EDHDs varied by age, with the highest rates observed among persons aged ≥75 years (2,232.2 per 100,000 population), 0–4 years (1,591.5), and 15–24 years (1,080.7). Overall, males had higher age-adjusted rates of TBI-EDHDs (959.0) compared with females (810.8) and the most common principal mechanisms of injury for all age groups included falls (413.2, age-adjusted), being struck by or against an object (142.1, age-adjusted), and motor-vehicle crashes (121.7, age-adjusted). The age-adjusted rate of ED visits was higher in 2013 (787.1) versus 2007 (534.4), with fall-related TBIs among persons aged ≥75 years accounting for 17.9% of the increase in the number of TBI-related ED visits. The number and rate of TBI-related hospitalizations also increased among persons aged ≥75 years (from 356.9 in 2007 to 454.4 in 2013), primarily because of falls. Whereas motor-vehicle crashes were the leading cause of TBI-related deaths in 2007 in both number and rate, in 2013, intentional self-harm was the leading cause in number and rate. The overall age-adjusted rate of TBI-related deaths for all ages decreased from 17.9 in 2007 to 17.0 in 2013; however, age-adjusted TBI-related death rates attributable to falls increased from 3.8 in 2007 to 4.5 in 2013, primarily among older adults. Although the age-adjusted rate of TBI-related deaths attributable to motor-vehicle crashes decreased from 5.0 in 2007 to 3.4 in 2013, the age-adjusted rate of TBI-related ED visits attributable to motor-vehicle crashes increased from 83.8 in 2007 to 99.5 in 2013. The age-adjusted rate of TBI-related hospitalizations attributable to motor-vehicle crashes decreased from 23.5 in 2007 to 18.8 in 2013. Interpretation Progress has been made to prevent motor-vehicle crashes, resulting in a decrease in the number of TBI-related hospitalizations and deaths from 2007 to 2013. However, during the same time, the number and rate of older adult fall-related TBIs have increased substantially. Although considerable public interest has focused on sports-related concussion in youth, the findings in this report suggest that TBIs attributable to older adult falls, many of which result in hospitalization and death, should receive public health attention. Public Health Actions The increase in the number of fall-related TBIs in older adults suggests an urgent need to enhance fall-prevention efforts in that population. Multiple effective interventions have been identified, and CDC has developed the STEADI initiative (Stopping Elderly Accidents Deaths and Injuries) as a comprehensive strategy that incorporates empirically supported clinical guidelines and scientifically tested interventions to help primary care providers address their patients’ fall risk through the identification of modifiable risk factors and implementation of effective interventions (e.g., exercise, medication management, and Vitamin D supplementation). PMID:28301451
Trifa, Adrian; Selicean, Cristina; Moisoiu, Vlad; Frinc, Ioana; Zdrenghea, Mihnea; Tomuleasa, Ciprian
2017-01-01
Acute megakaryocytic leukemia (M7-AML) is a rare form of acute myeloid leukemia (AML), which is associated with poor prognosis. The case presented in the current report is a statement for the difficult diagnosis and clinical management of M7-AML in the context of a previous hematologic disorder of undetermined significance and associated genetic abnormalities. Probably, following the complete hematologic remission and further with induction chemotherapy plus tyrosine kinase inhibitor therapy, the clinical management of this case will be followed by a allogeneic bone marrow transplantation, the only proven therapy to improve overall survival. PMID:29089774
Cenci, M; Vecchione, A
2000-01-01
ASCUS (Atypical Squamous Cells of Undetermined Significance) and AGUS (Atypical Glandular Cells of Undetermined Significance), or AGCUS, are two acronyms introduced in 1988 by The Bethesda System (TBS) for reporting borderline cytological changes in cervical cytology. ASCUS and AGUS categories should be subclassified. Five ASCUS subgroups were proposed: 1) ASCUS due to processing defects, 2) with "mature" cytoplasm, 3) in post-menopausal women (a--in the setting of atrophy and b--with estrogen stimulation), 4) atypical metaplasia, and 5) ASCUS with keratinized cytoplasm. AGUS subgroups may be subcategorized in endometrial or endocervical on the basis of origin. Endocervical AGUS should be further qualified, but the analysis of atypical glandular cells may be really difficult and the conclusive diagnosis is frequently "AGUS not otherwise specified". The subclassification of ASCUS and AGUS is useful for an appropriate clinical management, but pertinent patient information (such as age, date of last menstrual period, mechanical therapies, tamoxifen therapy, and others) is needed to avoid an overdiagnosis and consequently an overtreatment. In fact various subgroups require different clinical management. Therefore, an effective communication between cytopathologists and referring physicians is essential in the analysis of squamous and glandular atypias.
Garstang, Joanna; Ellis, Catherine; Griffiths, Frances; Sidebotham, Peter
2016-12-01
A comprehensive child death review (CDR) program was introduced in England and Wales in 2008, but as yet data have only been analyzed at a local level, limiting the learning from deaths. The aim of this study is to describe the profile of causes and risk factors for sudden unexpected death in infancy (SUDI) as determined by the new CDR program. This was a descriptive outcome study using data from child death overview panel Form C for SUDI cases dying during 2010-2012 in the West Midlands region of England. The main outcome measures were: cause of death, risk factors and potential preventability of death, and determination of deaths probably due to unintentional asphyxia. Data were obtained for 65/70 (93 %) SUDI cases. 20/65 (31 %) deaths were initially categorized as due to medical causes; 21/65 (32 %) as SIDS; and 24/65 (37 %) as undetermined. Reanalysis suggested that 2/21 SIDS and 7/24 undetermined deaths were probably due to unintentional asphyxia, with 6 of these involving co-sleeping and excessive parental alcohol consumption. Deaths classified as "undetermined" had significantly higher total family and environmental risk factor scores (mean 2.6, 95 % CI 2.0-3.3) compared to those classified as SIDS (mean 1.6, 95 % CI 1.2-1.9), or medical causes for death (mean 1.1, 95 % CI 0.8-1.3). 9/20 (47 %) of medical deaths, 19/21 (90 %) SIDS, and 23/24 (96 %) undetermined deaths were considered to be potentially preventable. There were inadequacies in medical provision identified in 5/20 (25 %) of medically explained deaths. The CDR program results in detailed information about risk factors for SUDI cases but failed to recognize deaths probably due to unintentional asphyxia. The misclassification of probable unintentional asphyxial deaths and SIDS as "undetermined deaths" is likely to limit learning from these deaths and inhibit prevention strategies. Many SUDI occurred in families with mental illness, substance misuse and chaotic lifestyles and most in unsafe sleep environments. This knowledge could be used to better target safe sleep advice for vulnerable families and prevent SUDI in the future.
Bache, J.
2000-01-01
Working in an accident and emergency (A&E) department inevitably involves dealing with the consequences of violence, and a knowledge of the laws of violence is a useful adjunct to the clinical practice of A&E medicine. The police and the Crown Prosecution Service decide whether or not to charge a suspect, and which charge is appropriate. All criminal offences are initially considered in the magistrates' court but the more serious offences may be committed to crown court. Specific offences include common assault, actual bodily harm, grievous bodily harm, and grievous bodily harm with intent. If the defendant is found guilty, an appropriate sentence is imposed. PMID:11104238
Henderson, Antony F; Joseph, Anthony P
2012-01-01
Many authors have suggested that some road traffic crashes are disguised suicide attempts. A case report and literature review is used to explore this claim and to examine the frequency and risk factors associated with driver suicide. The author concludes the methodological difficulty of establishing the driver's intent of suicide accounts for an under-estimation of the frequency of this event and that many cases of driver suicide go unrecognised. Familiarity with the risk factors associated with driver suicide may assist in the identification of cases of failed driver suicide and referral to psychiatric services. Copyright © 2011 Elsevier Ltd. All rights reserved.
Silla, Anne; Kallberg, Veli-Pekka
2016-04-01
This study was designed to evaluate whether railway safety lessons are effective in increasing schoolchildren's safety knowledge and behaviour intention. The railway safety education in schools included a 45-min lesson on safe behaviour in a railway environment directed at 8-11 year old schoolchildren. The lessons were held in four schools located near railway lines in Finland. The effectiveness of this measure was evaluated based on a short survey directed at pupils before the lesson (base level) and around 2-3 months later (post-lesson) based on three variables which are considered as strong determinants of actual behaviour: behaviour intention, estimated dangerousness of the behaviour, and level of knowledge on the legality of the behaviour. The results show that the change in the share of correct answers was positive regarding all questions except for one question in which the difference was not significant. Based on this we can reasonably assume that railway safety education in schools can have a positive effect for all the measured variables, although the effect is not necessarily large. The results indicate that these positive changes can have a positive effect on the frequency of trespassing (i.e. fewer unsafe crossings in the future). We can further assume that reduction in the frequency of trespassing would reduce the frequency of trespassing accidents. Copyright © 2015 Elsevier Ltd. All rights reserved.
B-Cell Hematologic Malignancy Vaccination Registry
2017-12-29
Monoclonal Gammopathy of Undetermined Significance; Multiple Myeloma; Waldenstrom Macroglobulinemia; Lymphocytosis; Lymphoma, Non-Hodgkin; B-Cell Chronic Lymphocytic Leukemia; Hematological Malignancies
Bipolar Disorder in Aviation Medicine.
Vuorio, Alpo; Laukkala, Tanja; Navathe, Pooshan; Budowle, Bruce; Bor, Robert; Sajantila, Antti
2017-01-01
One of the most difficult challenges in aviation medicine is to diagnose, as early as possible, pilots with psychiatric disorders that may impair pilot performance and increase the risk of incidents and accidents. This diagnosis applies particularly to bipolar disorder (BD), where return to flying duty is not an option in the majority of cases. BD is a long-term mental disorder presenting remittent depressive, hypomanic, manic, or mixed episodes between low symptomatic or asymptomatic intermediate periods. Onset in most cases is in late teen or early adult years. Suicidal intentions and suicide risk are significantly elevated in individuals with BD compared to the general population. A systematic literature search was performed of BD and aviation accidents and the National Transportation Safety Board database of fatal general aviation accidents was searched. One case report and two database reports of interest from 1994 to 2014 were identified. The findings set a minimum frequency of BD in general aviation fatalities to be approximately 2 out of 8648 (0.023%) in the United States. The reported incidence may underestimate the real number of BD cases for several reasons, including the fact that the medical history of pilots is not always available or is sometimes not the primary interest of a safety investigation. This study suggests that the demarcation of psychiatric disorder related to fitness to fly is an important step in safety.Vuorio A, Laukkala T, Navathe P, Budowle B, Bor R, Sajantila A. Bipolar disorder in aviation medicine. Aerosp Med Hum Perform. 2017; 88(1):42-47.
Targeted violence against law enforcement officers.
Schouten, Ronald; Brennan, Douglas V
2016-09-01
As highly visible representatives and guardians of society, law enforcement officers (LEOs) are very public figures. Injury or death in the line of duty, whether due to accidents or intentional acts of violence, is an occupational hazard for LEOs. Targeted assaults on police officers, referred to as ambushes in previous literature, are a particularly perplexing problem with significant implications for society at large. In the summer of 2016, the latest in a series of high-profile acts of violence aimed at police occurred, leading to increased examination of the acts themselves and their causes. This article examines recent trends in assaults on LEOs, focusing on predatory rather than reactive attacks, and applies a threat assessment model to a case of targeted violence against police. We use State of Washington v. Christopher Monfort (2015), a prosecution for arson, assault with intent to murder, and murder, as a case example, to examine how the threat assessment model, and the concepts of affective versus predatory violence help in understanding targeted violence against LEOs, assessing its risk, and managing it. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Epidemiology of Pediatric Trauma and Its Patterns in Western Iran: A Hospital Based Experience
Jalalvandi, Fereshteh; Arasteh, Peyman; Faramani, Roya Safari; Esmaeilivand, Masoumeh
2016-01-01
Background and Objective: Trauma is a major cause of mortality in children aged 1 to 14 years old and its patterns differs from country to country. In this study we investigated the epidemiology and distribution of non-intentional trauma in the pediatric population. Materials and Methods: The archives of 304 children below 10 years old who presented to Taleghani trauma care center in Kermanshah, Iran from March to September 2008, were reviewed. Patients’ demographic and injury related information were registered. The participants were categorized into three age groups of 0-2, 3-6 and 7-10 years old and the data was compared among age groups and between both sexes. Findings: The most common cause for trauma was falling from heights (65.5%) and road traffic accidents (16.4%). The most common anatomical sites of injury were the upper limbs followed by the head and neck (36.8% and 31.2%, respectively). Injuries mostly occurred in homes (67.4%). The injuries were mostly related to the orthopedics and the neurosurgery division (84.1% and 13.1%, respectively). Accident rates peaked during the hours of 18-24 (41.3%). Male and female patients did display any difference regarding the variables. Children between the ages of 0-2 years old had the highest rate of injury to the head and neck area (40.3%) (p=0.024). Falls and road traffic accidents displayed increasing rates from the ages of 0-2 to 3-6 and decreasing rates to the ages of 7-10 years old (p=0.013). From the ages of 0-2 to 3-6 years old, street accidents increased and household traumas decreased. After that age household trauma rates increased and street accidents decreased (p=0.005). Children between the ages of 7-10 years old had the highest rate of orthopedic injury (p=0.029). Conclusion: Special planning and health policies are needed to prevent road accidents especially in children between the ages of 3-6 years old. Since homes were the place where children between the ages of 0-2 were mostly injured, parents should be educated about the correct safety measures that they need to take regarding their children’s environments. The orthopedics department needs to receive the most training and resources for the management of pediatric trauma. PMID:26755468
The impact of fatal pediatric trauma on aboriginal children.
Bratu, Ioana; Lowe, Danielle; Phillips, Leah
2013-05-01
Injuries are the leading cause of death in young people. Our aim is to examine the differences between aboriginal and non-aboriginal pediatric trauma mortality as a means to focus on prevention strategies. The records for all traumatic pediatric (0-18 years) deaths between 1996 and 2010 were reviewed from the regional Medical Examiner's office. The majority of the total 932 pediatric deaths were the result of non-intentional injuries (640) followed by suicide (195), homicide (65), child abuse (15), and undetermined (17). Despite being only 3.3% of the provincial population, Aboriginals represented 30.9% of pediatric trauma fatalities. Aboriginal fatalities occurred most commonly in the home, with males and females equally affected. Road related events were the main causes of injury overall. Up to three-quarters of Aboriginal children who died in a non-pedestrian road related event did not wear an indicated protective device. Pedestrian deaths were over-represented in Aboriginal children. The second most common cause of death was suicide for both non-Aboriginal and Aboriginal children. Almost half of all of the suicides were Aboriginal. Homicide and child abuse had similar proportions for both non-Aboriginal and Aboriginal children. Pediatric Aboriginal injury prevention should be a priority and tailored for Aboriginal communities. Copyright © 2013 Elsevier Inc. All rights reserved.
Greening, Steven; Norton, Loretta; Virani, Karim; Ty, Ambrose; Mitchell, Derek; Finger, Elizabeth
2014-03-01
The neural basis of individual differences in positive and negative social decisions and behaviors in healthy populations is yet undetermined. Recent work has focused on the potential role of the anterior insula in guiding social and nonsocial decision making, but the specific nature of its activation during such decision making remains unclear. To identify the neural regions mediating individual differences in helpful and harmful decisions and to assess the nature of insula activation during such decisions, in the present study we used a novel fMRI task featuring intentional and unintentional decisions to financially harm or help persons in need. Based on a whole-brain, unbiased approach, our findings indicate that individual differences in dorsal anterior insula, anterior cingulate cortex (ACC), and right temporo-parietal junction activation are associated with behavioral tendencies to financially harm or help another. Furthermore, activity in the dorsal anterior insula and ACC was greatest during unintended outcomes, whether these were gains or losses for a charity or for oneself, supporting models of the role of these regions in salience prediction error signaling. Together, the results suggest that individual differences in risk anticipation, as reflected in the dorsal anterior insula and dorsal ACC, guide social decisions to refrain from harming others.
Lee, Yong Sang; Kim, Hyeung Kyoo; Chang, Hojin; Kim, Seok Mo; Kim, Bup-Woo; Chang, Hang-Seok; Park, Cheong Soo
2015-01-01
Abstract Atypia/follicular lesion of undetermined significance (AUS/FLUS) is a new category in the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) for which repeat fine-needle aspiration cytology (FNAC) is recommended. The aim of this study was to identify specific ultrasonography and clinical predictors of malignancy in a subset of thyroid nodules associated with cytology diagnoses of AUS/FLUS. Between January 2011 and December 2102, 5440 patients underwent thyroid surgery at our institution. Of these, 213 patients were diagnosed AUS/FLUS at the preoperative cytopathology diagnosis. The frequency of FNAC and ultrasonography images was compared between patients with cancerous and benign tumors based on their final pathology. Of the 213 patients, 158 (74.2%) were diagnosed with thyroid carcinoma in their final pathology reports. In univariate and multivariate analyses, the frequency of FNAC was not significantly correlated with the cancer diagnosis. Hypoechogenicity (odds ratio 2.521, P = 0.007) and microcalcification (odds ratio 3.247, P = 0.005) were statistically correlated with cancer risk. Although AUS/FLUS in cytopathology is recommended for repeating FNAC in BSRTC, we proposed that thyroid nodules with ultrasonography findings that suggest the possibility of cancer should undergo thyroidectomy with diagnostic intent. PMID:26705204
Pediatric facial fractures: evolving patterns of treatment.
Posnick, J C; Wells, M; Pron, G E
1993-08-01
This study reviews the treatment of facial trauma between October 1986 and December 1990 at a major pediatric referral center. The mechanism of injury, location and pattern of facial fractures, pattern of facial injury, soft tissue injuries, and any associated injuries to other organ systems were recorded, and fracture management and perioperative complications reviewed. The study population consisted of 137 patients who sustained 318 facial fractures. Eighty-one patients (171 fractures) were seen in the acute stage, and 56 patients (147 fractures) were seen for reconstruction of a secondary deformity. Injuries in boys were more prevalent than in girls (63% versus 37%), and the 6- to 12-year cohort made up the largest group (42%). Most fractures resulted from traffic-related accidents (50%), falls (23%), or sports-related injuries (15%). Mandibular (34%) and orbital fractures (23%) predominated; fewer midfacial fractures (7%) were sustained than would be expected in a similar adult population. Three quarters of the patients with acute fractures required operative intervention. Closed reduction techniques with maxillomandibular fixation were frequently chosen for mandibular condyle fractures and open reduction techniques (35%) for other regions of the facial skeleton. When open reduction was indicated, plate-and-screw fixation was the preferred method of stabilization (65%). The long-term effects of the injuries and the treatment given on facial growth remain undetermined. Perioperative complication rates directly related to the surgery were low.
Tian, Niu; Shaw, Esther C; Zack, Matthew; Kobau, Rosemarie; Dykstra, Heather; Covington, Theresa M
2015-04-01
We investigated causes of death in children and young adults with epilepsy by using data from the U.S. National Child Death Review Case Reporting System (NCDR-CRS), a passive surveillance system composed of comprehensive information related to deaths reviewed by local child death review teams. Information on a total of 48,697 deaths in children and young adults 28days to 24years of age, including 551 deaths with epilepsy and 48,146 deaths without epilepsy, was collected from 2004 through 2012 in 32 states. In a proportionate mortality analysis by official manner of death, decedents with epilepsy had a significantly higher percentage of natural deaths but significantly lower percentages of deaths due to accidents, homicide, and undetermined causes compared with persons without epilepsy. With respect to underlying causes of death, decedents with epilepsy had significantly higher percentages of deaths due to drowning and most medical conditions including pneumonia and congenital anomalies but lower percentages of deaths due to asphyxia, weapon use, and unknown causes compared with decedents without epilepsy. The increased percentages of deaths due to pneumonia and drowning in children and young adults with epilepsy suggest preventive interventions including immunization and better instruction and monitoring before or during swimming. State-specific and national population-based mortality studies of children and young adults with epilepsy are recommended. Published by Elsevier Inc.
Tian, Niu; Shaw, Esther C.; Zack, Matthew; Kobau, Rosemarie; Dykstra, Heather; Covington, Theresa M.
2015-01-01
We investigated causes of death in children and young adults with epilepsy by using data from the U.S. National Child Death Review Case Reporting System (NCDR-CRS), a passive surveillance system composed of comprehensive information related to deaths reviewed by local child death review teams. Information on a total of 48,697 deaths in children and young adults 28 days to 24 years of age, including 551 deaths with epilepsy and 48,146 deaths without epilepsy, was collected from 2004 through 2012 in 32 states. In a proportionate mortality analysis by official manner of death, decedents with epilepsy had a significantly higher percentage of natural deaths but significantly lower percentages of deaths due to accidents, homicide, and undetermined causes compared with persons without epilepsy. With respect to underlying causes of death, decedents with epilepsy had significantly higher percentages of deaths due to drowning and most medical conditions including pneumonia and congenital anomalies but lower percentages of deaths due to asphyxia, weapon use, and unknown causes compared with decedents without epilepsy. The increased percentages of deaths due to pneumonia and drowning in children and young adults with epilepsy suggest preventive interventions including immunization and better instruction and monitoring before or during swimming. State-specific and national population-based mortality studies of children and young adults with epilepsy are recommended. PMID:25794682
Embolic Strokes of Unknown Source and Cryptogenic Stroke: Implications in Clinical Practice
Nouh, Amre; Hussain, Mohammed; Mehta, Tapan; Yaghi, Shadi
2016-01-01
Up to a third of strokes are rendered cryptogenic or of undetermined etiology. This number is specifically higher in younger patients. At times, inadequate diagnostic workups, multiple causes, or an under-recognized etiology contributes to this statistic. Embolic stroke of undetermined source, a new clinical entity particularly refers to patients with embolic stroke for whom the etiology of embolism remains unidentified despite through investigations ruling out established cardiac and vascular sources. In this article, we review current classification and discuss important clinical considerations in these patients; highlighting cardiac arrhythmias and structural abnormalities, patent foramen ovale, paradoxical sources, and potentially under-recognized, vascular, inflammatory, autoimmune, and hematologic sources in relation to clinical practice. PMID:27047443
Ozturk, Sami; Caliskaner, Zafer; Karaayvaz, Mehmet; Dede, Murat; Gulec, Mustafa
2007-08-01
Recent findings show that the vaginal mucosa can develop an allergic response to environmental allergens and there is a strong association between atopy and some recurrent vulvovaginal infections. In this study, we investigated prospectively the rate of atopy in patients with recurrent vulvovaginitis of undetermined etiology (RVV). After being investigated by a gynecologist, 35 patients with RVV who were considered as undetermined etiology formed the study group. The control group consisted of 150 healthy females. Study and control groups were investigated for atopy by means of skin prick test for common aeroallergens. Associated allergic disease and familial atopy history of the subjects were recorded. The rate of atopy (11/35; 31.4% vs 9/150; 6%) was significantly higher (P < 0.001) in the study group than in the controls. Familial history of atopy was significantly more frequent in the study group than in the controls (10/35; 28.6% vs 8/150; 5.3%, P < 0.05). RVV in atopics is more associated with seasonal rhinitis than in nonatopics (5/11; 45.4% vs 2/24; 8.3%, P < 0.05). We concluded that a significant number of RVV is associated with atopy. Although the exact mechanism(s) of this relationship remains to be investigated atopy might be a causative and/or contributing factor in the pathogenesis of RVV.
Osman, Mugtaba; Parnell, Andrew C; Haley, Clifford
2017-02-01
Suicide is criminalized in more than 100 countries around the world. A dearth of research exists into the effect of suicide legislation on suicide rates and available statistics are mixed. This study investigates 10,353 suicide deaths in Ireland that took place between 1970 and 2000. Irish 1970-2000 annual suicide data were obtained from the Central Statistics Office and modelled via a negative binomial regression approach. We examined the effect of suicide legislation on different age groups and on both sexes. We used Bonferroni correction for multiple modelling. Statistical analysis was performed using the R statistical package version 3.1.2. The coefficient for the effect of suicide act on overall suicide deaths was -9.094 (95 % confidence interval (CI) -34.086 to 15.899), statistically non-significant (p = 0.476). The coefficient for the effect suicide act on undetermined deaths was statistically significant (p < 0.001) and was estimated to be -644.4 (95 % CI -818.6 to -469.9). The results of our study indicate that legalization of suicide is not associated with a significant increase in subsequent suicide deaths. However, undetermined death verdict rates have significantly dropped following legalization of suicide.
Mao, Feng; Dong, Yi; Ji, Zhengbiao; Cao, Jiaying; Wang, Wen-Ping
2017-01-01
Aim. To investigate the value of contrast-enhanced ultrasound (CEUS) guided biopsy of undetermined abdominal lesions in multidisciplinary treatment (MDT) decision-making approach. Methods. Between Jan 2012 and Dec 2015, 60 consecutive patients (male, 37; female, 23; mean age, 51.3 years ± 14.6) who presented with undetermined abdominal lesions were included. CEUS and core needle percutaneous biopsy was performed under real-time CEUS guidance in all lesions. Data were recorded and compared with conventional ultrasound (US) guidance group ( n = 75). All CEUS findings and clinical data were evaluated in MDT. Results. CEUS enabled the delimitation of more (88.3% versus 41.3%) and larger (14.1 ± 10.7 mm versus 32.3 ± 18.5 mm) nonenhanced necrotic areas. More inner (20.0% versus 6.7%) and surrounding (18.3% versus 2.7%) major vessels were visualized and avoided during biopsies. CEUS-guided biopsy increased the diagnostic accuracy from 93.3% to 98.3%, with correct diagnosis in 57 of 60 lesions (95.0%). The therapeutic plan was influenced by CEUS guided biopsies findings in the majority of patients (98.3%). Conclusion. The combination of CEUS guided biopsy and MDT decision-making approach is useful in the diagnostic work-up and therapeutic management.
Non-specific vaginitis or vaginitis of undetermined aetiology.
Faro, S; Phillips, L E
1987-01-01
Vaginitis is a complex syndrome that is probably the most common outpatient disease seen by the gynaecologist. The specific aetiologies of vaginitis are many. One of the most common entities, however, is "non-specific vaginitis" which can be subdivided into: Gardnerella vaginitis, anaerobic vaginosis, and vaginitis of undetermined aetiology. The role of Gardnerella as a causative agent for vaginitis has been studied in depth but its specific role remains controversial. Anaerobic vaginosis can be diagnosed by noting on microscopic examination the presence of clue cells, free-floating bacteria and numerous white blood cells (WBC's). Culturing an aliquot of the vaginal discharge reveals a high number of anaerobes. In addition, this condition responds to antibiotics effective against anaerobes, e.g., metronidazole. Vaginitis of undetermined aetiology is more complex and is characterized by a purulent vaginal discharge, a pH of 4.0-4.6, numerous WBC's, and a high concentration of bacteria. The microbiology of this vaginitis includes many facultative Gram-negative rods and Gram-positive cocci. Anaerobes may be present but do not make up a large component of the endogenous microflora. This condition does not respond to the usual antibiotic therapies employed in treating bacterial vaginitis. Since this condition appears to be primarily an inflammatory reaction, it may be responsive to topical antiinflammatory agents such as benzydamine.
Progressive myoclonic epilepsies: definitive and still undetermined causes.
Franceschetti, Silvana; Michelucci, Roberto; Canafoglia, Laura; Striano, Pasquale; Gambardella, Antonio; Magaudda, Adriana; Tinuper, Paolo; La Neve, Angela; Ferlazzo, Edoardo; Gobbi, Giuseppe; Giallonardo, Anna Teresa; Capovilla, Giuseppe; Visani, Elisa; Panzica, Ferruccio; Avanzini, Giuliano; Tassinari, Carlo Alberto; Bianchi, Amedeo; Zara, Federico
2014-02-04
To define the clinical spectrum and etiology of progressive myoclonic epilepsies (PMEs) in Italy using a database developed by the Genetics Commission of the Italian League against Epilepsy. We collected clinical and laboratory data from patients referred to 25 Italian epilepsy centers regardless of whether a positive causative factor was identified. PMEs of undetermined origins were grouped using 2-step cluster analysis. We collected clinical data from 204 patients, including 77 with a diagnosis of Unverricht-Lundborg disease and 37 with a diagnosis of Lafora body disease; 31 patients had PMEs due to rarer genetic causes, mainly neuronal ceroid lipofuscinoses. Two more patients had celiac disease. Despite extensive investigation, we found no definitive etiology for 57 patients. Cluster analysis indicated that these patients could be grouped into 2 clusters defined by age at disease onset, age at myoclonus onset, previous psychomotor delay, seizure characteristics, photosensitivity, associated signs other than those included in the cardinal definition of PME, and pathologic MRI findings. Information concerning the distribution of different genetic causes of PMEs may provide a framework for an updated diagnostic workup. Phenotypes of the patients with PME of undetermined cause varied widely. The presence of separate clusters suggests that novel forms of PME are yet to be clinically and genetically characterized.
Population density and suicide in Scotland.
Stark, Cameron; Hopkins, Paddy; Gibbs, Diane; Belbin, Alan; Hay, Alistair
2007-01-01
Suicide rates among men have increased in Scotland while falling in neighbouring countries. A national suicide prevention strategy has been produced. Previous work found that some rural areas of Scotland had higher than average rates of male suicide and undetermined deaths. This article describes the association between population density and suicide and undetermined death rates in Scotland. Anonymised information on deaths from suicide and undetermined cause in Scotland were obtained from the General Registrar Office for 1981-1999, including information on postcode sector. Each postcode sector was assigned a deprivation and population density score. Loglinear models were used to examine the effects of time period (grouped into four periods), deprivation quintiles, population density (grouped into four categories) and their interactions in each sex in three age groups. A significance level of 5% was used throughout. Adjusted rate ratios and 95% confidence intervals were based on models that included only significant factors and interactions. In men, there were higher rate ratios in the most densely populated and least densely populated quartiles, with intermediate rate ratios in other areas. There was no association with population density in women aged less than 25 years, a similar pattern to men in 25-44 year old women, and lower rates in rural areas in older women. Higher levels of deprivation were associated with higher rate ratios of suicide in both sexes and all age groups. Rate ratios over time increased in younger men and women, remained stable in older men, and declined in older women. Deprivation is associated with higher rates of suicide and undetermined deaths at all levels of population density and in all age groups. The highest rates of suicide among men are in the most and least densely populated areas, after adjusting for deprivation. The effect is different among women, with no effect among younger women, and lower rates among older women in areas with lower population density.
Pessoa de Magalhães, Roberto J.; Vidriales, María-Belén; Paiva, Bruno; Fernandez-Gimenez, Carlos; García-Sanz, Ramón; Mateos, Maria-Victoria; Gutierrez, Norma C.; Lecrevisse, Quentin; Blanco, Juan F; Hernández, Jose; de las Heras, Natalia; Martinez-Lopez, Joaquin; Roig, Monica; Costa, Elaine Sobral; Ocio, Enrique M.; Perez-Andres, Martin; Maiolino, Angelo; Nucci, Marcio; De La Rubia, Javier; Lahuerta, Juan-Jose; San-Miguel, Jesús F.; Orfao, Alberto
2013-01-01
Multiple myeloma remains largely incurable. However, a few patients experience more than 10 years of relapse-free survival and can be considered as operationally cured. Interestingly, long-term disease control in multiple myeloma is not restricted to patients with a complete response, since some patients revert to having a profile of monoclonal gammopathy of undetermined significance. We compared the distribution of multiple compartments of lymphocytes and dendritic cells in the bone marrow and peripheral blood of multiple myeloma patients with long-term disease control (n=28), patients with newly diagnosed monoclonal gammopathy of undetermined significance (n=23), patients with symptomatic multiple myeloma (n=23), and age-matched healthy adults (n=10). Similarly to the patients with monoclonal gammopathy of undetermined significance and symptomatic multiple myeloma, patients with long-term disease control showed an expansion of cytotoxic CD8+ T cells and natural killer cells. However, the numbers of bone marrow T-regulatory cells were lower in patients with long-term disease control than in those with symptomatic multiple myeloma. It is noteworthy that B cells were depleted in patients with monoclonal gammopathy of undetermined significance and in those with symptomatic multiple myeloma, but recovered in both the bone marrow and peripheral blood of patients with long-term disease control, due to an increase in normal bone marrow B-cell precursors and plasma cells, as well as pre-germinal center peripheral blood B cells. The number of bone marrow dendritic cells and tissue macrophages differed significantly between patients with long-term disease control and those with symptomatic multiple myeloma, with a trend to cell count recovering in the former group of patients towards levels similar to those found in healthy adults. In summary, our results indicate that multiple myeloma patients with long-term disease control have a constellation of unique immune changes favoring both immune cytotoxicity and recovery of B-cell production and homing, suggesting improved immune surveillance. PMID:22773604
Samir, Anthony E; Dhyani, Manish; Anvari, Arash; Prescott, Jason; Halpern, Elkan F; Faquin, William C; Stephen, Antonia
2015-11-01
To evaluate the diagnostic accuracy of shear-wave elastography (SWE) for the diagnosis of malignancy in follicular lesions and to identify the optimal SWE measurement plane. The institutional review board approved this HIPAA-compliant, single-institution, prospective pilot study. Subjects scheduled for surgery after a previous fine-needle aspiration report of "atypia of undetermined significance" or "follicular lesion of undetermined significance," "suspicion for follicular neoplasm," or "suspicion for Hurthle cell neoplasm," were enrolled after obtaining informed consent. Subjects underwent conventional ultrasonography (US), Doppler evaluation, and SWE preoperatively, and their predictive value for thyroid malignancy was evaluated relative to the reference standard of surgical pathologic findings. Thirty-five patients (12 men, 23 women) with a mean age of 55 years (range, 23-85 years) and a fine-needle aspiration diagnosis of atypia of undetermined significance or follicular lesion of undetermined significance (n = 16), suspicion for follicular neoplasm (n = 14), and suspicion for Hurthle cell neoplasm (n = 5) were enrolled in the study. Male sex was a statistically significant (P = .02) predictor of malignancy, but age was not. No sonographic morphologic parameter, including nodule size, microcalcification, macrocalcification, halo sign, taller than wide dimension, or hypoechogenicity, was associated with malignancy. Similarly, no Doppler feature, including intranodular vascularity, pulsatility index, resistive index, or peak-systolic velocity, was associated with malignancy. Higher median SWE tissue Young modulus estimates from the transverse insonation plane were associated with malignancy, yielding an area under the receiver operating characteristic curve of 0.81 (95% confidence interval: 0.62, 1.00) for differentiation of malignant from benign nodules. At a cutoff value of 22.3 kPa, sensitivity, specificity, positive predictive value, and negative predictive value of 82%, 88%, 75%, and 91%, respectively, were observed. This prospective pilot study indicates that SWE may be a valuable tool in preoperative malignancy risk assessment of follicular-patterned thyroid nodules. © RSNA, 2015
A methodology for modeling regional terrorism risk.
Chatterjee, Samrat; Abkowitz, Mark D
2011-07-01
Over the past decade, terrorism risk has become a prominent consideration in protecting the well-being of individuals and organizations. More recently, there has been interest in not only quantifying terrorism risk, but also placing it in the context of an all-hazards environment in which consideration is given to accidents and natural hazards, as well as intentional acts. This article discusses the development of a regional terrorism risk assessment model designed for this purpose. The approach taken is to model terrorism risk as a dependent variable, expressed in expected annual monetary terms, as a function of attributes of population concentration and critical infrastructure. This allows for an assessment of regional terrorism risk in and of itself, as well as in relation to man-made accident and natural hazard risks, so that mitigation resources can be allocated in an effective manner. The adopted methodology incorporates elements of two terrorism risk modeling approaches (event-based models and risk indicators), producing results that can be utilized at various jurisdictional levels. The validity, strengths, and limitations of the model are discussed in the context of a case study application within the United States. © 2011 Society for Risk Analysis.
Acoustical features of two Mayan monuments at Chichen Itza: Accident or design?
NASA Astrophysics Data System (ADS)
Lubman, David
2002-11-01
Chichen Itza dominated the early postclassic Maya world, ca. 900-1200 C.E. Two of its colossal monuments, the Great Ball Court and the temple of Kukulkan, reflect the sophisticated, hybrid culture of a Mexicanized Maya civilization. The architecture seems intended for ceremony and ritual drama. Deducing ritual practices will advance the understanding of a lost civilization, but what took place there is largely unknown. Perhaps acoustical science can add value. Unexpected and unusual acoustical features can be interpreted as intriguing clues or irrelevant accidents. Acoustical advocates believe that, when combined with an understanding of the Maya worldview, acoustical features can provide unique insights into how the Maya designed and used theater spaces. At Chichen Itza's monuments, sound reinforcement features improve rulers and priests ability to address large crowds, and Ball Court whispering galleries permit speech communication over unexpectedly large distances. Handclaps at Kukulkan stimulate chirps that mimic a revered bird (''Kukul''), thus reinforcing cultic beliefs. A ball striking playing field wall stimulates flutter echoes at the Great Ball Court; their strength and duration arguably had dramatic, mythic, and practical significance. Interpretations of the possible mythic, magic, and political significance of sound phenomena at these Maya monuments strongly suggests intentional design.
Steel, Emily J
2018-06-08
Reforms to Australia's disability and rehabilitation sectors have espoused the potential of assistive technology as an enabler. As new insurance systems are being developed it is timely to examine the structure of existing systems. This exploratory study examined the policies guiding assistive technology provision in the motor accident insurance sector of one Australian state. Policy documents were analyzed iteratively with set of qualitative questions to understand the intent and interpretation of policies guiding assistive technology provision. Content analysis identified relevant sections and meaningful terminology, and context analysis explored the dominant perspectives informing policy. The concepts and language of assistive technology are not part of the policy frameworks guiding rehabilitation practice in Queensland's motor accident insurance sector. The definition of rehabilitation in the legislation is consistent contemporary international interpretations that focus on optimizing functioning in interaction with the environment. However, the supporting documents are focused on recovery from injuries where decisions are guided by clinical need and affordability. The policies frame rehabilitation in a medical model that assistive technology provision from the rehabilitation plan. The legislative framework provides opportunities to develop and improve assistive technology provision as part of an integrated approach to rehabilitation.
Hatamabadi, Hamidreza; Arhami Dolatabadi, Ali; Atighinasab, Batoul; Safari, Saeed
2017-01-01
Trauma due to accidents or fall from height is a major cause of disability and mortality. The present study was designed aiming to evaluate the baseline characteristics of fall from height victims presenting to emergency department (ED). This prospective cross-sectional study evaluates the baseline characteristics of fall from height cases presenting to EDs of three educational Hospitals, Tehran, Iran, during one year. Data were analyzed using SPSS 21 and presented using descriptive statistics. 460 patients with the mean age of 27.89 ± 20.95 years were evaluated (76.5% male). 191 (41.5%) falls occurred when working, 27 (5.9%) during play, and 242 (52.6%) in other times. Among construction workers, 166 (81.4%) had not used any safety equipment. Fracture and dislocation with 180 (39.1%) cases and soft tissue injury with 166 (36.1%) were the most common injuries inflicted. Mean height of falling was 3.41 ± 0.34 (range: 0.5 - 20) meters. Finally, 8 (1.7%) of the patients died (50% intentional) and 63% were discharged from ED. A significant correlation was detected between mortality and the falls being intentional (p < 0.0001) as well as greater height of fall (p < 0.0001). Based on the findings, most fall from height victims in the present study were young men, single, construction workers, with less than high school diploma education level. Intentional fall and greater height of falling significantly correlated with mortality.
Cowman, James G; Bakheet, Manuel
2017-01-01
Background A student-selected component (SSC) of the medical curriculum requires the student to be self-directed in locating and undertaking a placement in a clinical specialty of their choosing and completing a project. The clinical area for experience was an accident and emergency department, and our topic was a focused audit on the investigations and referral for paracetamol overdose. The purpose of this paper is twofold: to reflect on the education value to medical students of an SSC in a medical curriculum, and to highlight learning and understanding through completion of an audit. Materials and methods An audit approach was applied. The aim of the project study was to investigate the level of compliance with best-practice guidelines for investigations and psychiatric referral in paracetamol overdose. Results A total of 40 cases meeting the inclusion criteria were randomly selected. The sample had a mean age of 27 years, of whom 70.5% were female, and the ingested dose of paracetamol ranged from 0.864 to 80 g. Paracetamol abuse may present as intentional and unintentional overdose. In our study, 85% of cases were identified as intentional overdose and 76% had a history of psychiatric illness. Generally, medical management was compliant with guidelines, with some minor irregularities. The international normalized ratio was the most underperformed test. Conclusion Our choice of topic, paracetamol overdose, contributed to our understanding of the breadth of factors to be considered in the emergency medical management of a patient. In this regard, we had the benefit of understanding how the diagnostic and therapeutic factors, when applied in accordance with best-practice guidelines, work very effectively. The SSC impacted positively on our cognitive, personal, and professional development. In facilitating the student with choice, the SSC encouraged self-direction and proactivity. We gained experience in the discipline of research and acquired some skills in independent thinking and analysis. PMID:28883749
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kunsman, David Marvin; Aldemir, Tunc; Rutt, Benjamin
2008-05-01
This LDRD project has produced a tool that makes probabilistic risk assessments (PRAs) of nuclear reactors - analyses which are very resource intensive - more efficient. PRAs of nuclear reactors are being increasingly relied on by the United States Nuclear Regulatory Commission (U.S.N.R.C.) for licensing decisions for current and advanced reactors. Yet, PRAs are produced much as they were 20 years ago. The work here applied a modern systems analysis technique to the accident progression analysis portion of the PRA; the technique was a system-independent multi-task computer driver routine. Initially, the objective of the work was to fuse the accidentmore » progression event tree (APET) portion of a PRA to the dynamic system doctor (DSD) created by Ohio State University. Instead, during the initial efforts, it was found that the DSD could be linked directly to a detailed accident progression phenomenological simulation code - the type on which APET construction and analysis relies, albeit indirectly - and thereby directly create and analyze the APET. The expanded DSD computational architecture and infrastructure that was created during this effort is called ADAPT (Analysis of Dynamic Accident Progression Trees). ADAPT is a system software infrastructure that supports execution and analysis of multiple dynamic event-tree simulations on distributed environments. A simulator abstraction layer was developed, and a generic driver was implemented for executing simulators on a distributed environment. As a demonstration of the use of the methodological tool, ADAPT was applied to quantify the likelihood of competing accident progression pathways occurring for a particular accident scenario in a particular reactor type using MELCOR, an integrated severe accident analysis code developed at Sandia. (ADAPT was intentionally created with flexibility, however, and is not limited to interacting with only one code. With minor coding changes to input files, ADAPT can be linked to other such codes.) The results of this demonstration indicate that the approach can significantly reduce the resources required for Level 2 PRAs. From the phenomenological viewpoint, ADAPT can also treat the associated epistemic and aleatory uncertainties. This methodology can also be used for analyses of other complex systems. Any complex system can be analyzed using ADAPT if the workings of that system can be displayed as an event tree, there is a computer code that simulates how those events could progress, and that simulator code has switches to turn on and off system events, phenomena, etc. Using and applying ADAPT to particular problems is not human independent. While the human resources for the creation and analysis of the accident progression are significantly decreased, knowledgeable analysts are still necessary for a given project to apply ADAPT successfully. This research and development effort has met its original goals and then exceeded them.« less
Characterizing the food environment: Pitfalls and future directions
Vernez Moudon, Anne; Drewnowski, Adam; Duncan, Glen E; Hurvitz, Philip M; Saelens, Brian E; Scharnhorst, Eric
2014-01-01
Objective: To assess a county population’s exposure to different types of food sources reported to affect both diet quality and obesity rates. Design: Food permit records obtained from the local health department served to establish the full census of food stores and restaurants. Employing prior categorization schemes which classified the relative healthfulness of food sources based on establishment type (i.e. supermarkets versus convenience stores, or full-service versus fast food restaurants), food establishments were assigned to the healthy, unhealthy, or undetermined groups. Setting: King County, WA. Subjects: Full census of food sources. Results: According to all categorization schemes, most food establishments in King County fell into the unhealthy and undetermined groups. The use of the food permit data showed that large stores, which included supermarkets as healthy food establishments, contained a sizeable number of bakery/delis, fish/meat, ethnic and standard quick service restaurants, and coffee shops, all food sources that, when housed in a separate venue or owned by a different business establishment, were classified as either unhealthy or of undetermined value to health. Conclusions: To fully assess the potential health effects of exposure to the extant food environment, future research would need to establish the health value of foods in the many such common establishments as individually owned grocery stores and ethnic food stores and restaurants. Within- venue exposure to foods should also be investigated. PMID:23570695
Inherent safety, ethics and human error.
Papadaki, Maria
2008-02-11
A patient is to have the damaged left kidney removed. To safeguard correctness of action several layers of expert checks have been performed prior to the operation, which results in the removal of the fully functional right kidney. Nobody asked the patient. The patient did not volunteer providing "unnecessary" information. The experts know everything ... An untidy house made out of flammable materials. A careless smoker left his lit cigarette unattended. A blow of wind and the house comes in flames. Would better construction materials have prevented the accident in spite of the carelessness of the inhabitant? A tricky medical condition which is expected to provoke a patient's fast health deterioration and their slow death. The doctor takes the initiative and responsibility of performing a risky operation. The patient's life is saved and their health is re-established. This work is not, as initially intended, the result of a thorough investigation of accidents, neither contains a systematic collection of data that can support the conclusions or the suggestions made. It is in the main a compilation of personal views. These views have been established from the correlation of the results of numerous accident investigation reports with the causes of small and insignificant incidents. These incidents are related with the education of university students, regulations within an academic environment and from independent personal experience working in different countries and with people of different cultures. The analysis that follows, however, should not be perceived as a mere reference to university students and/or to a university environment. University is the place where the fundamental scientific and engineering principles are germinated while current and past university students are the future and current production and design engineers, respectively. The places where the presented incidents have occurred are not always relevant with the conclusions, thus they are not stated. The reason this article is presented here is that I believe that often, complex accidents, similarly to insignificant ones, often demonstrate an attitude which can be characterized as "inherently unsafe". I take the view that the enormous human potential and the human ability to minimize accidents needs to become a focal point towards inherent safety. Restricting ourselves to human limitations and how we could "treat" or prevent humans from not making accidents needs to be re-addressed. The purpose of this presentation is to highlight observations and provoke a discussion on how we could possibly improve the understanding of safety related issues. I do not intent to reject or criticize existing methodologies. (The entire presentation is strongly influenced by Trevor Kletz's work although our views are often different.).
Health of nations: lessons from Victoria, Australia.
Powles, J W; Gifford, S
1993-01-09
In its white paper The Health of the Nation the government has announced its intention to give more priority to preventive health care. Two examples from Victoria, Australia, show how coordinated legislative and voluntary sector action can have a substantial impact on public behaviour. The introduction and enforcement of strict drink-driving laws and speed limits backed up by forceful television advertisements produced a large reduction in deaths from road traffic accidents, the death rate in relation to the number of vehicles in 1991 being among the lowest in the world. Smoking has also declined in parallel with a phased ban on advertising and use of taxes from tobacco sales to replace tobacco sponsorship of sports and arts and fund health promotion.
Violence deaths and its impact on life expectancy: a comparison between Mexico and Brazil.
González-Pérez, Guillermo Julián; Vega-López, María Guadalupe; Souza, Edinilsa Ramos de; Pinto, Liana Wernersbach
2017-09-01
Using official data, this study analyzed violent deaths (homicide, suicide, events of undetermined intent and deaths due to legal intervention) in Brazil and Mexico in the three-year periods 2002-2004 and 2012-14, the impact of these causes of death on life expectancy in both countries and the role of the different age groups in years of life expectancy lost (YLEL). Abridged life tables were constructed for both countries for both periods. Temporary life expectancy and YLEL between zero and 80 years by selected causes and age groups were calculated for each triennium. The leading cause of YLEL among men was homicide in both periods in Brazil (1.5 years) and in the second period in Mexico (one year). Violent deaths (VD) accounted for around 16% of YLEL in Brazil and 13% in Mexico in 2012-2014. Among women, YLEL due to homicides and suicides showed the greatest relative increase in both countries, although VD accounted for barely 3% of total YLEL. The highest percentage of YLEL due to VDwas found among the 15 to 29 year age groups in both countries and for both sexes. The increase in rates of VD in Mexico, above all among young people, has curbed further increases in life expectancy in recent years, especially among men. Likewise, the high rates of VD in Brazil in both periods have hindered the growth of life expectancy.
Morphology combined with ancillary techniques: An algorithm approach for thyroid nodules.
Rossi, E D; Martini, M; Capodimonti, S; Cenci, T; Bilotta, M; Pierconti, F; Pontecorvi, A; Lombardi, C P; Fadda, G; Larocca, L M
2018-04-23
Several authors have underlined the limits of morphological analysis mostly in the diagnosis of follicular neoplasms (FN). The application of ancillary techniques, including immunocytochemistry (ICC) and molecular testing, contributes to a better definition of the risk of malignancy (ROM) and management of FN. According to literature, the application of models, including the evaluation of ICC, somatic mutations (ie, BRAF V 600E ), micro RNA analysis is proposed for FNs. This study discusses the validation of a diagnostic algorithm in FN with a special focus on the role of morphology then followed by ancillary techniques. From June 2014 to January 2016, we enrolled 37 FNs with histological follow-up. In the same reference period, 20 benign nodules and 20 positive for malignancy were selected as control. ICC, BRAF V 600E mutation and miR-375 were carried out on LBC. The 37 FNs included 14 atypia of undetermined significance/follicular lesion of undetermined significance and 23 FN. Specifically, atypia of undetermined significance/follicular lesion of undetermined significance resulted in three goitres, 10 follicular adenomas and one NIFTP whereas FN/suspicious for FN by seven follicular adenomas and 16 malignancies (nine non-invasive follicular thyroid neoplasms with papillary-like nuclear features, two invasive follicular variant of papillary thyroid carcinoma [PTC] and five PTC). The 20 positive for malignancy samples included two invasive follicular variant of PTC, 16 PTCs and two medullary carcinomas. The morphological features of BRAF V 600E mutation (nuclear features of PTC and moderate/abundant eosinophilic cytoplasms) were associated with 100% ROM. In the wild type cases, ROM was 83.3% in presence of a concordant positive ICC panel whilst significantly lower (10.5%) in a negative concordant ICC. High expression values of MirR-375 provided 100% ROM. The adoption of an algorithm might represent the best choice for the correct diagnosis of FNs. The morphological detection of BRAF V 600E represents the first step for the identification of malignant FNs. A significant reduction of unnecessary thyroidectomies is the goal of this application. © 2018 John Wiley & Sons Ltd.
Krishnamurthi, Rita V; Barker-Collo, Suzanne; Parag, Varsha; Parmar, Priyakumari; Witt, Emma; Jones, Amy; Mahon, Susan; Anderson, Craig S; Barber, P Alan; Feigin, Valery L
2018-01-01
Major pathological stroke types (ischemic stroke [IS], primary intracerebral hemorrhage [ICH], and subarachnoid hemorrhage) and IS subtypes, have differing risk factors, management, and prognosis. We report changes in major stroke types and IS subtypes incidence during 10 years using data from the ARCOS (Auckland Regional Community Stroke Study) III performed during 12 months in 2002 to 2003 and the fourth ARCOS study (ARCOS-IV) performed in 2011 to 2012. ARCOS-III and ARCOS-IV were population-based registers of all new strokes in the greater Auckland region (population aged >15 years, 1 119 192). Strokes were classified into major pathological types (IS, ICH, subarachnoid hemorrhage, and undetermined type). Crude annual age-, sex-, and ethnic-specific stroke incidence with 95% confidence intervals was calculated. ISs were subclassified using TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria into 5 etiologic groups. Rate ratios with 95% confidence intervals were calculated for differences in age-standardized rates between the 2 studies. In ARCOS-IV, there were 1329 (81%) ISs, 211 (13%) ICHs, 79 (5%) subarachnoid hemorrhages, and 24 (1%) undetermined type strokes. The proportional distribution of IS subtypes was 29% cardioembolism, 21% small-vessel occlusion, 15% large-artery atherosclerosis, 5% other determined etiology, and 31% undetermined type. Between 2002 and 2011, age-standardized incidence decreased for subarachnoid hemorrhage (rate ratios, 0.73; 95% confidence intervals, 0.54-0.99) and undetermined type (rate ratios, 0.14; 95% confidence intervals, 0.09-0.22). Rates were stable for IS and ICH. Among IS subtypes, large-artery atherosclerosis and small-vessel occlusion rates increased significantly. The frequency of all risk factors increased in IS. Ethnic differences were observed for both stroke subtype rates and their risk factor frequencies. A lack of change in IS and ICH incidence may reflect a trend toward increased incidence of younger strokes. Increased rates of large-artery atherosclerosis and small-vessel occlusion are associated with increased smoking and high blood pressure. Ethnic differences in the proportional distribution of pathological stroke subtypes suggest differential exposure and susceptibility to risk factors. © 2017 American Heart Association, Inc.
NASA Astrophysics Data System (ADS)
Chang, Ni-Bin; Weng, Yu-Chi
2013-03-01
Short-term predictions of potential impacts from accidental release of various radionuclides at nuclear power plants are acutely needed, especially after the Fukushima accident in Japan. An integrated modeling system that provides expert services to assess the consequences of accidental or intentional releases of radioactive materials to the atmosphere has received wide attention. These scenarios can be initiated either by accident due to human, software, or mechanical failures, or from intentional acts such as sabotage and radiological dispersal devices. Stringent action might be required just minutes after the occurrence of accidental or intentional release. To fulfill the basic functions of emergency preparedness and response systems, previous studies seldom consider the suitability of air pollutant dispersion models or the connectivity between source term, dispersion, and exposure assessment models in a holistic context for decision support. Therefore, the Gaussian plume and puff models, which are only suitable for illustrating neutral air pollutants in flat terrain conditional to limited meteorological situations, are frequently used to predict the impact from accidental release of industrial sources. In situations with complex terrain or special meteorological conditions, the proposing emergency response actions might be questionable and even intractable to decisionmakers responsible for maintaining public health and environmental quality. This study is a preliminary effort to integrate the source term, dispersion, and exposure assessment models into a Spatial Decision Support System (SDSS) to tackle the complex issues for short-term emergency response planning and risk assessment at nuclear power plants. Through a series model screening procedures, we found that the diagnostic (objective) wind field model with the aid of sufficient on-site meteorological monitoring data was the most applicable model to promptly address the trend of local wind field patterns. However, most of the hazardous materials being released into the environment from nuclear power plants are not neutral pollutants, so the particle and multi-segment puff models can be regarded as the most suitable models to incorporate into the output of the diagnostic wind field model in a modern emergency preparedness and response system. The proposed SDSS illustrates the state-of-the-art system design based on the situation of complex terrain in South Taiwan. This system design of SDSS with 3-dimensional animation capability using a tailored source term model in connection with ArcView® Geographical Information System map layers and remote sensing images is useful for meeting the design goal of nuclear power plants located in complex terrain.
Home-Based or Clinic-Based Human Papillomavirus (HPV) Screening
2018-04-16
Atypical Squamous Cell of Undetermined Significance; Cervical Carcinoma; Cervical Intraepithelial Neoplasia Grade 2/3; Health Status Unknown; Human Papillomavirus Infection; Low Grade Cervical Squamous Intraepithelial Neoplasia; Stage 0 Cervical Cancer
... to the development of genital warts, abnormal cervical cells or cervical cancer. Your doctor might recommend the HPV test if: Your Pap test was abnormal, showing atypical squamous cells of undetermined significance (ASCUS) You're age 30 ...
Code of Federal Regulations, 2014 CFR
2014-01-01
... the trimmings, which may include, but are not limited to, brains, thymus, pancreas, liver, heart... undetermined risk for BSE are considered SRMs if they are derived from bovines over 12 months of age: Brain...
Otte im Kampe, Eveline; Kovats, Sari; Hajat, Shakoor
2016-01-01
Objectives Given the likelihood of increased hot weather due to climate change, it is crucial to have prevention measures in place to reduce the health burden of high temperatures and heat waves. The aim of this review is to summarise and evaluate the evidence on the effects of summertime weather on unintentional injuries in high-income countries. Design 3 databases (Global Public Health, EMBASE and MEDLINE) were searched by using related keywords and their truncations in the title and abstract, and reference lists of key studies were scanned. Studies reporting heatstroke and intentional injuries were excluded. Results 13 studies met our inclusion criteria. 11 out of 13 studies showed that the risk of unintentional injuries increases with increasing ambient temperatures. On days with moderate temperatures, the increased risk varied between 0.4% and 5.3% for each 1°C increase in ambient temperature. On extreme temperature days, the risk of injuries decreased. 2 out of 3 studies on occupational accidents found an increase in work-related accidents during high temperatures. For trauma hospital admissions, 6 studies reported an increase during hot weather, whereas 1 study found no association. The evidence for impacts on injuries by subgroups such as children, the elderly and drug users was limited and inconsistent. Conclusions The present review describes a broader range of types of unintentional fatal and non-fatal injuries (occupational, trauma hospital admissions, traffic, fire entrapments, poisoning and drug overdose) than has previously been reported. Our review confirms that hot weather can increase the risk of unintentional injuries and accidents in high-income countries. The results are useful for injury prevention strategies. PMID:26868947
Arseneault, Louise; Cannon, Mary; Fisher, Helen L; Polanczyk, Guilherme; Moffitt, Terrie E; Caspi, Avshalom
2011-01-01
Using longitudinal and prospective measures of trauma during childhood, the authors assessed the risk of developing psychotic symptoms associated with maltreatment, bullying, and accidents in a nationally representative U.K. cohort of young twins. Data were from the Environmental Risk Longitudinal Twin Study, which follows 2,232 twin children and their families. Mothers were interviewed during home visits when children were ages 5, 7, 10, and 12 on whether the children had experienced maltreatment by an adult, bullying by peers, or involvement in an accident. At age 12, children were asked about bullying experiences and psychotic symptoms. Children's reports of psychotic symptoms were verified by clinicians. Children who experienced mal-treatment by an adult (relative risk=3.16, 95% CI=1.92-5.19) or bullying by peers (relative risk=2.47, 95% CI=1.74-3.52) were more likely to report psychotic symptoms at age 12 than were children who did not experience such traumatic events. The higher risk for psychotic symptoms was observed whether these events occurred early in life or later in childhood. The risk associated with childhood trauma remained significant in analyses controlling for children's gender, socioeconomic deprivation, and IQ; for children's early symptoms of internalizing or externalizing problems; and for children's genetic liability to developing psychosis. In contrast, the risk associated with accidents was small (relative risk=1.47, 95% CI=1.02-2.13) and inconsistent across ages. Trauma characterized by intention to harm is associated with children's reports of psychotic symptoms. Clinicians working with children who report early symptoms of psychosis should inquire about traumatic events such as maltreatment and bullying.
Gesser-Edelsburg, Anat; Zemach, Mina; Lotan, Tsippy; Elias, Wafa; Grimberg, Einat
2018-02-01
The present study examines reported pre-license driving among youth from the population of Arab citizens of Israel. The purpose of the present study is to examine which sociodemographic variables, attitudes and perceptions about safe driving and individual and societal behavioral norms are associated with pre-license driving. The research distinguished between the factors that actually contribute to pre-license driving (reported behavior, peer norms, gender and parents' messages) and the factors that explain the intention (parental authority, social norms, parents' messages and fear of road crashes). Even though there was a significant partial overlap (84%) between those who intend to drive without a license and those who reported driving without a license, the main factors that distinguish pre-license driving groups are different from the factors that distinguish the intention to drive before receiving a license. What is unique about the findings is the identification of the context in which social norms are influential and that in which parental authority is influential. The study indicated that in the case of pre-license driving, the main motivating factor is subjective norms, whereas in the case of expecting to drive without a license, the main motivating factor is the interaction between parental authority and the messages that parents convey. While actual behavior pertains to the behavioral level, we argue that intended behavior pertains to the cognitive level. At this level, rational considerations arise, such as fear of parental punishment and fear of accidents. These considerations compete with the influence of friends and their norms, and may outweigh them. The findings suggest that it is important to safeguard youth against the influence of peer pressure as early as the stage of behavioral intentions. Follow-up studies can simulate situations of pre-license driving due to social pressure and identify the factors that might affect young people's decision-making. Moreover, providing parents with training before the accompaniment period is highly recommended. Copyright © 2017 Elsevier Ltd. All rights reserved.
Matsumoto, Hideyuki; Terao, Yasuo; Yugeta, Akihiro; Fukuda, Hideki; Emoto, Masaki; Furubayashi, Toshiaki; Okano, Tomoko; Hanajima, Ritsuko; Ugawa, Yoshikazu
2011-01-01
The aim of this study was to investigate where neurologists look when they view brain computed tomography (CT) images and to evaluate how they deploy their visual attention by comparing their gaze distribution with saliency maps. Brain CT images showing cerebrovascular accidents were presented to 12 neurologists and 12 control subjects. The subjects' ocular fixation positions were recorded using an eye-tracking device (Eyelink 1000). Heat maps were created based on the eye-fixation patterns of each group and compared between the two groups. The heat maps revealed that the areas on which control subjects frequently fixated often coincided with areas identified as outstanding in saliency maps, while the areas on which neurologists frequently fixated often did not. Dwell time in regions of interest (ROI) was likewise compared between the two groups, revealing that, although dwell time on large lesions was not different between the two groups, dwell time in clinically important areas with low salience was longer in neurologists than in controls. Therefore it appears that neurologists intentionally scan clinically important areas when reading brain CT images showing cerebrovascular accidents. Both neurologists and control subjects used the “bottom-up salience” form of visual attention, although the neurologists more effectively used the “top-down instruction” form. PMID:22174928
U.S. Department of Energy Accident Resistant SiC Clad Nuclear Fuel Development
DOE Office of Scientific and Technical Information (OSTI.GOV)
George W. Griffith
2011-10-01
A significant effort is being placed on silicon carbide ceramic matrix composite (SiC CMC) nuclear fuel cladding by Light Water Reactor Sustainability (LWRS) Advanced Light Water Reactor Nuclear Fuels Pathway. The intent of this work is to invest in a high-risk, high-reward technology that can be introduced in a relatively short time. The LWRS goal is to demonstrate successful advanced fuels technology that suitable for commercial development to support nuclear relicensing. Ceramic matrix composites are an established non-nuclear technology that utilizes ceramic fibers embedded in a ceramic matrix. A thin interfacial layer between the fibers and the matrix allows formore » ductile behavior. The SiC CMC has relatively high strength at high reactor accident temperatures when compared to metallic cladding. SiC also has a very low chemical reactivity and doesn't react exothermically with the reactor cooling water. The radiation behavior of SiC has also been studied extensively as structural fusion system components. The SiC CMC technology is in the early stages of development and will need to mature before confidence in the developed designs can created. The advanced SiC CMC materials do offer the potential for greatly improved safety because of their high temperature strength, chemical stability and reduced hydrogen generation.« less
Heller, Michael; Zanocco, Kyle; Zydowicz, Sara; Elaraj, Dina; Nayar, Ritu; Sturgeon, Cord
2012-09-01
The 2007 National Cancer Institute (NCI) conference on Thyroid Fine-Needle Aspiration (FNA) introduced the category atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS). Repeat FNA in 3 to 6 months was recommended for low-risk patients. Compliance with these recommendations has been suboptimal. We hypothesized that repeat FNA would be more effective than diagnostic lobectomy, with decreased costs and improved rates of cancer detection. Cost-effectiveness analysis was performed in which we compared diagnostic lobectomy with repeat FNA. A Markov model was developed. Outcomes and probabilities were identified from literature review. Third-party payer costs were estimated in 2010 US dollars. Outcomes were weighted by use of the quality-of-life utility factors, yielding quality-adjusted life years (QALYs). Monte Carlo simulation and sensitivity analysis were used to examine the uncertainty of probability, cost, and utility estimates. The diagnostic lobectomy strategy cost $8,057 and produced 23.99 QALYs. Repeat FNA cost $2,462 and produced 24.05 QALYs. Repeat FNA was dominant until the cost of FNA increased to $6,091. Dominance of the repeat FNA strategy was not sensitive to the cost of operation or the complication rate. The NCI recommendations for repeat FNA regarding follow-up of AUS/FLUS results are cost-effective. Improving compliance with these guidelines should lead to less overall costs, greater quality of life, and fewer unnecessary operations. Copyright © 2012 Mosby, Inc. All rights reserved.
Cognitive simulation as a tool for cognitive task analysis.
Roth, E M; Woods, D D; Pople, H E
1992-10-01
Cognitive simulations are runnable computer programs that represent models of human cognitive activities. We show how one cognitive simulation built as a model of some of the cognitive processes involved in dynamic fault management can be used in conjunction with small-scale empirical data on human performance to uncover the cognitive demands of a task, to identify where intention errors are likely to occur, and to point to improvements in the person-machine system. The simulation, called Cognitive Environment Simulation or CES, has been exercised on several nuclear power plant accident scenarios. Here we report one case to illustrate how a cognitive simulation tool such as CES can be used to clarify the cognitive demands of a problem-solving situation as part of a cognitive task analysis.
Diffuse axonal injury by assault.
Imajo, T; Challener, R C; Roessmann, U
1987-09-01
A case of diffuse axonal injury (DAI) by assault is reported. The majority of DAI cases documented have been due to traffic accidents and some due to falls from height. DAI is caused by angular or rotational acceleration of the victim's head. The condition is common and is the second most important head injury after subdural hematoma with regard to death. Its clinical picture is characterized by immediate and prolonged coma or demented state. Because of the subtle nature of histological changes in DAI, awareness and intentional search for the lesion is essential. The triad of DAI is as follows: focal lesions (hemorrhages and/or lacerations) in the corpus callosum and brain stem, and microscopic demonstration of axonal damage--retraction balls. The concept of DAI will elucidate and enhance the understanding of many head trauma cases.
Health of nations: lessons from Victoria, Australia.
Powles, J. W.; Gifford, S.
1993-01-01
In its white paper The Health of the Nation the government has announced its intention to give more priority to preventive health care. Two examples from Victoria, Australia, show how coordinated legislative and voluntary sector action can have a substantial impact on public behaviour. The introduction and enforcement of strict drink-driving laws and speed limits backed up by forceful television advertisements produced a large reduction in deaths from road traffic accidents, the death rate in relation to the number of vehicles in 1991 being among the lowest in the world. Smoking has also declined in parallel with a phased ban on advertising and use of taxes from tobacco sales to replace tobacco sponsorship of sports and arts and fund health promotion. Images p125-a p126-a PMID:8435611
Gijzen, Sandra; Boere-Boonekamp, Magda M; L'Hoir, Monique P; Need, Ariana
2014-02-01
Among European countries, the Netherlands has the second lowest child mortality rate from external causes. We present an overview, discuss possible explanations, and suggest prevention measures. We analyzed mortality data from all deceased children aged 0-19 years for the period 1969-2011. Child mortality declined in the past decades, largely from decreases in road traffic accidents that followed government action on traffic safety. Accidental drowning also showed a downward trend. Although intentional self-harm showed a significant increase, other external causes of mortality, including assault and fatal child abuse, remained constant. Securing existing preventive measures and analyzing the circumstances of each child's death systematically through Child Death Review may guide further reduction in child mortality.
[Cases of poisoning in Germany. Disease entity, documentation, and aspects of the event].
Hahn, A; Begemann, K; Stürer, A
2014-06-01
Cases of poisoning account for a distinct share of accidents in Germany, which is particularly high for accidents involving children. Cases of poisoning resulting from suicidal intent or abuse are not counted as accidents. Compared to other cases of disease and accidents, the numerical documentation of cases of poisoning is inadequate. Presently, there is no institution in Germany that could make available representative and meaningful data on the current state of poisoning. Owing to intensive scientific cooperation between the poison information centers (funded by the federal states) and the Poison and Product Documentation Center at the Federal Institute for Risk Assessment (BfR DocCenter) as well as to international cooperation, harmonized and standardized tools have been developed for the appropriate documentation and reporting of procedures to account for poisoning accidents. The first evaluation for 2005-2012 based on published and processed figures for the Federal Republic of Germany yielded the following results: Of approximately 230,000 telephone inquiries received in 2012, about 207,000 involved exposure of humans to different noxae. An annual increase of 3-5 % was recorded. For 2011, analyses of subsets processed by means of standardized methods yielded the following results: Medicines were involved in about 39 % of the cases recorded (of these, medicinal products for humans in 99 %); chemical/physicochemical agents in about 26 % (of these, cleaning and maintenance products in 46 %); products of daily use in about 14 % (of these, cosmetics in 40 %); and plants in about 10 %. More than 90 % of cases were acute poisoning and less than 5 %, chronic poisoning. Regarding the degree of severity of poisoning, an asymptomatic course was reported for 44 % of the cases; minor manifestations were experienced in 30 %, moderate ones in 6 %, and severe manifestations in 2 % of the cases recorded. Fatal cases were rare (< 0.1 %). The majority of cases (67 %) were caused by poisoning accidents, followed by suicidal action (20 %), with abuse and industrial poisoning (4 %) in third position; 1 % of the cases of poisoning were attributed to adverse drug reactions (ADR) and mistaking a medicinal product for another one. Infants aged 1-2 years have the highest risk of poisoning. A panel of the BfR Committee for the Assessment of Poisonings has already developed proposals for a national monitoring scheme of poisoning incidents. The aim is to prepare annual reports similar to the report of the National Poison Data System (NPDS) maintained by the American Association of Poison Control Centers (AAPCC) in the USA.
Deaths involving 1,1-difluoroethane at the San Diego County Medical Examiner's Office.
Vance, Chris; Swalwell, Christopher; McIntyre, Iain M
2012-01-01
Intentional abuse of 1,1-difluoroethane has been reported to cause transient symptoms such as confusion, tremors, pulmonary irritation, loss of consciousness and, rarely, coma. In the last five years, 17 cases from the San Diego County Medical Examiner's Office showed the presence of 1,1-difluoroethane in postmortem tissues, and the gas was cited in the cause of death in 13 of those cases. Detected during routine ethanol screening, 1,1-difluoroethane was evaluated for concentrations in peripheral blood, central blood and vitreous humor by a slightly modified method published by Avella et al. In many cases, death from abuse of 1,1-difluoroethane seemed to occur within minutes of intentional abuse; large concentrations (>100 mg/L) of the gas were still in the blood. It is important that forensic toxicology laboratories have routine screening procedures to detect 1,1-difluoroethane because cases exist in which evidence of use from cans may not be present in proximity to the decedent, or may be undiscovered in the debris of a motor vehicle accident. It is also important to quantify concentrations of 1,1-difluoroethane in both peripheral blood and central blood, whose ratio may be useful in interpreting how recently the use of the 1,1-difluoroethane occurred.
The Application of the Haddon Matrix to Public Health Readiness and Response Planning
Barnett, Daniel J.; Balicer, Ran D.; Blodgett, David; Fews, Ayanna L.; Parker, Cindy L.; Links, Jonathan M.
2005-01-01
State and local health departments continue to face unprecedented challenges in preparing for, recognizing, and responding to threats to the public’s health. The attacks of 11 September 2001 and the ensuing anthrax mailings of 2001 highlighted the public health readiness and response hurdles posed by intentionally caused injury and illness. At the same time, recent natural disasters have highlighted the need for comparable public health readiness and response capabilities. Public health readiness and response activities can be conceptualized similarly for intentional attacks, natural disasters, and human-caused accidents. Consistent with this view, the federal government has adopted the all-hazards response model as its fundamental paradigm. Adoption of this paradigm provides powerful improvements in efficiency and efficacy, because it reduces the need to create a complex family of situation-specific preparedness and response activities. However, in practice, public health preparedness requires additional models and tools to provide a framework to better understand and prioritize emergency readiness and response needs, as well as to facilitate solutions; this is particularly true at the local health department level. Here, we propose to extend the use of the Haddon matrix—a conceptual model used for more than two decades in injury prevention and response strategies—for this purpose. PMID:15866764
Trends in the leading causes of death in Korea, 1983-2012.
Lim, Daroh; Ha, Mina; Song, Inmyung
2014-12-01
This study aimed to analyze trends in the 10 leading causes of death in Korea from 1983 to 2012. Death rates were derived from the Korean Statistics Information Service database and age-adjusted to the 2010 population. Joinpoint regression analysis was used to identify the points when statistically significant changes occurred in the trends. Between 1983 and 2012, the age-standardized death rate (ASR) from all causes decreased by 61.6% for men and 51.2% for women. ASRs from malignant neoplasms, diabetes mellitus, and transport accidents increased initially before decreasing. ASRs from hypertensive diseases, heart diseases, cerebrovascular diseases and diseases of the liver showed favorable trends (ASR % change: -94.4%, -53.8%, -76.0%, and -78.9% for men, and -77.1%, -36.5%, -67.8%, and -79.9% for women, respectively). ASRs from pneumonia decreased until the mid-1990s and thereafter increased. ASRs from intentional self-harm increased persistently since around 1990 (ASR % change: 122.0% for men and 217.4% for women). In conclusion, death rates from all causes in Korea decreased significantly in the last three decades except in the late 1990s. Despite the great strides made in the overall mortality, temporal trends varied widely by cause. Mortality trends for malignant neoplasms, diabetes mellitus, pneumonia and intentional self-harm were unfavorable.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sofu, Tanju; LaChance, Jeffrey L.; Bari, R.
This report proposes potential research priorities for the Department of Energy (DOE) with the intent of improving the licensability of the Sodium Fast Reactor (SFR). In support of this project, five panels were tasked with identifying potential safety-related gaps in available information, data, and models needed to support the licensing of a SFR. The areas examined were sodium technology, accident sequences and initiators, source term characterization, codes and methods, and fuels and materials. It is the intent of this report to utilize a structured and transparent process that incorporates feedback from all interested stakeholders to suggest future funding priorities formore » the SFR research and development. While numerous gaps were identified, two cross-cutting gaps related to knowledge preservation were agreed upon by all panels and should be addressed in the near future. The first gap is a need to re-evaluate the current procedures for removing the Applied Technology designation from old documents. The second cross-cutting gap is the need for a robust Knowledge Management and Preservation system in all SFR research areas. Closure of these and the other identified gaps will require both a reprioritization of funding within DOE as well as a re-evaluation of existing bureaucratic procedures within the DOE associated with Applied Technology and Knowledge Management.« less
Safety climate and the theory of planned behavior: towards the prediction of unsafe behavior.
Fogarty, Gerard J; Shaw, Andrew
2010-09-01
The present study is concerned with the human factors that contribute to violations in aviation maintenance. Much of our previous research in this area has been based on safety climate surveys and the analysis of relations among core dimensions of climate. In this study, we tap into mainstream psychological theory to help clarify the mechanisms underlying the links between climate and behavior. Specifically, we demonstrate the usefulness of Ajzen's (1991, 2001) Theory of Planned Behavior (TPB) to understanding violation behaviors in aircraft maintenance. A questionnaire was administered to 307 aircraft maintenance workers. Constructs measured by the survey included perceptions of management attitudes to safety, own attitudes to violations, intention to violate, group norms, workplace pressures, and violations. A model based on the TPB illustrated hypothetical connections among these variables. Path analyses using AMOS suggested some theoretically justifiable modifications to the model. Fit statistics of the revised model were excellent with intentions, group norms, and personal attitudes combining to explain 50% of the variance in self-reported violations. The model highlighted the importance of management attitudes and group norms as direct and indirect predictors of violation behavior. We conclude that the TPB is a useful tool for understanding the psychological background to the procedural violations so often associated with incidents and accidents. 2009 Elsevier Ltd. All rights reserved.
A behavioral economic analysis of the effect of next-day responsibilities on drinking.
Gilbert, Lindsey J; Murphy, James G; Dennhardt, Ashley A
2014-12-01
Approximately 37% of college students report heavy episodic drinking (5 or more drinks in an occasion for men and 4 or more for women) in the past month. This pattern of drinking is often associated with high blood alcohol levels, accidents, injuries, and negative social and academic outcomes. There is a need for novel theoretical approaches to guide prevention efforts. Behavioral economics emphasizes the role of contextual determinants, such as drink price and the presence and amount of alternative reinforcement as determinants of drinking levels and has received strong empirical support in basic laboratory research. This translational research study used a hypothetical behavioral economic measure to investigate the impact of a variety of next-day responsibilities on night-before drinking intentions in a sample of first-year college students (N = 80; 50% female) who reported recent heavy episodic drinking. Drinking estimates were significantly lower in all of the responsibility conditions relative to the no-responsibility condition; internships were associated with the greatest reduction (d(rm) = 1.72), and earlier class times were associated with greater reductions in drinking intentions (d(rm) range = 1.22-1.35) than later class times (d(rm) range = 0.83-1.00). These results suggest that increasing morning responsibilities should be further investigated as a potential strategy to reduce drinking in college students.
Nagao, Tomoaki; Okura, Takafumi; Miyoshi, Ken-Ichi; Watanabe, Sanae; Manabe, Seiko; Kurata, Mie; Irita, Jun; Fukuoka, Tomikazu; Higaki, Jitsuo
2005-09-01
A 79-year-old woman was admitted to our hospital because of leg edema due to a nephrotic syndrome. Urinary and serum immunoelectrophoresis showed positive for the lambda type of Bence Jones protein. A bone marrow aspiration test revealed mild plasmacytosis (6.4% of the total cells). These findings confirmed her diagnosis of monoclonal gammopathy of undetermined significance (MGUS). Her renal biopsy specimen revealed mild mesangial cell proliferation and an increase in the mesangial matrix. Immunofluorescence studies showed positive staining for IgG, IgA, C3, and kappa and lambda light chains in the capillary wall and mesangium area. Electron microscopy showed that the electron deposits in the thickened basement membrane were formed by randomly arranged 16- to 18-nm nonbranching fibrils. A Congo red stain for amyloid was negative. These findings corresponded with the diagnosis of fibrillary glomerulonephritis. Therefore, this case showed a rare combination of fibrillary glomerulonephritis and MGUS.
Monoclonal Gammopathy Associated Peripheral Neuropathy: Diagnosis and Management
Chaudhry, Hafsa M.; Mauermann, Michelle L.; Rajkumar, S. Vincent
2017-01-01
Monoclonal gammopathies consist of a spectrum of clonal plasma cell disorders that includes monoclonal gammopathy of undetermined significance (MGUS), multiple myeloma (MM) and Waldenstrom Macroglobulinemia (WM). In this review, we outline the epidemiology, etiology, classification, diagnosis, and treatment of monoclonal gammopathy associated peripheral neuropathy. Monoclonal gammopathy of undetermined significance (MGUS) is relatively common in the general population, with a prevalence of 3–4% among those over the age of 50. Therefore, the presence of M protein in a patient with neuropathy does not automatically indicate a causal relationship. Monoclonal gammopathy associated peripheral neuropathy is often a difficult diagnosis with limited treatment options. Studies addressing the optimal approach to diagnosis and management of this entity are limited. In addition to a review of the literature, we present a diagnostic approach to patients with monoclonal gammopathy associated peripheral neuropathy and discuss available data and options for treatment. PMID:28473042
Sun, L L; Chen, W; Fan, Y Y; Wang, M L; Wang, L N
2015-01-01
To characterize histopathological status, high-risk human papillomavirus (hr-HPV) infection status, and associated risk factors in patients with atypical squamous cells of undetermined significance (ASCUS). Cervical biopsies obtained from 130 ASCUS patients were subjected to histopathological examination and hr-HPV testing. Associations between advanced lesions and hr-HPV load or age were analyzed, and the confounding factors for high-grade cervical lesions were identified. Cervical biopsies from ASCUS patients had a wide range of pathological states, ranging from normal to invasive cervical carcinoma. High-risk HPV infection was significantly associated with advanced cervical lesions in ASCUS patients; hr-HPV infection and the number of gestations were risk factors for developing advanced cervical disease. A significant portion of ASCUS patients harbor advanced cervical lesions. The number of gestations and hr-HPV infection can increase the risk of developing advanced cervical lesions in ASCUS patients.
Maciocia, Nicola; Wechalekar, Ashutosh; Yong, Kwee
2017-12-01
Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma are precursor conditions of symptomatic multiple myeloma (MM). Diagnostic principles are aimed at excluding MM requiring therapy, other conditions associated with paraproteins that may require different management, and risk stratifying patients for the purposes of tailored follow-up and investigation. The International Myeloma Working Group have recently published a revised definition of MM, which singles out a small group of patients with smoldering multiple myeloma who are at very high risk of progression and organ damage; such patients are now included under the definition of MM and recommended to start anti-myeloma treatment. Furthermore, the recently published National Institute of Health and Care Excellence guideline recommends cross-sectional imaging techniques in place of skeletal survey. These recent recommendations are discussed, and practical guidance for investigation and management are presented. Copyright © 2016 John Wiley & Sons, Ltd.
Vernick, J S; O'Brien, M; Hepburn, L M; Johnson, S B; Webster, D W; Hargarten, S W
2003-12-01
To determine the proportion of unintentional and undetermined firearm related deaths preventable by three safety devices: personalization devices, loaded chamber indicators (LCIs), and magazine safeties. A personalized gun will operate only for an authorized user, a LCI indicates when the gun contains ammunition, and a magazine safety prevents the gun from firing when the ammunition magazine is removed. Information about all unintentional and undetermined firearm deaths from 1991-98 was obtained from the Office of the Chief Medical Examiner for Maryland, and from the Wisconsin Firearm Injury Reporting System for Milwaukee. Data regarding the victim, shooter, weapon, and circumstances were abstracted. Coding rules to classify each death as preventable, possibly preventable, or not preventable by each of the three safety devices were also applied. There were a total of 117 firearm related deaths in our sample, 95 (81%) involving handguns. Forty three deaths (37%) were classified as preventable by a personalized gun, 23 (20%) by a LCI, and five (4%) by a magazine safety. Overall, 52 deaths (44%) were preventable by at least one safety device. Deaths involving children 0-17 (relative risk (RR) 3.3, 95% confidence interval (CI) 2.1 to 5.1) and handguns (RR 8.1, 95% CI 1.2 to 53.5) were more likely to be preventable. Projecting the findings to the entire United States, an estimated 442 deaths might have been prevented in 2000 had all guns been equipped with these safety devices. Incorporating safety devices into firearms is an important injury intervention, with the potential to save hundreds of lives each year.
Nkoke, Clovis; Lekoubou, Alain; Balti, Eric; Kengne, Andre Pascal
2015-11-15
About three quarters of stroke deaths occur in developing countries including those in sub-Saharan African. Short and long-term stroke fatality data are needed for health service and policy formulation. We prospectively followed up from stroke onset, 254 patients recruited from the largest reference hospitals in Yaounde (Cameroon). Mortality and determinants were investigated using the accelerated failure time regression analysis. Stroke mortality rates at one-, six- and 12 months were respectively 23.2% (Ischemic strokes: 20.4%, hemorrhagic strokes: 26.1%, and undetermined strokes: 34.8, p=0.219), 31.5% (ischemic strokes: 31.5%, hemorrhagic strokes: 30.4%, and undetermined strokes: 34.8%, p=0.927), and 32.7% (ischemic strokes: 32.1%, hemorrhagic strokes: 30.4%, undetermined strokes: 43.5%, p=0.496). Fever, swallowing difficulties, and admission NIHSS independently predicted mortality at one month, six and 12 months. Elevated systolic blood pressure (BP) predicted mortality at one month. Elevated diastolic blood pressure was a predictor of mortality at one month in participants with hemorrhagic stroke. Low hemoglobin level on admission only predicted long term mortality. In this resource-limited setting, post-stroke mortality was high with 1 out of 5 deaths occurring at one month and up to 30% deaths at six and twelve months after the index event. Fever, stroke severity, elevated BP and anemia increased the risk of death. Our findings add to the body of evidence for the poor outcome after stroke in resource limited environments. Copyright © 2015 Elsevier B.V. All rights reserved.
John, Ann; Dennis, M; Kosnes, L; Gunnell, D; Scourfield, J; Ford, D V; Lloyd, K
2014-01-01
Introduction Prevention of suicide is a global public health challenge extending beyond mental health services. Linking routinely collected health and social care system data records for the same individual across different services and over time has enormous potential in suicide research. Most previous research linking suicide mortality data with routinely collected electronic health records involves only one or two domains of healthcare provision such as psychiatric inpatient care. This protocol paper describes the development of a population-based, routinely collected data linkage study: the Suicide Information Database Cymru (SID-Cymru). SID-Cymru aims to contribute to the information available on people who complete suicide. Methods and analysis SID-Cymru will facilitate a series of electronic case–control studies based in the Secure Anonymised Information Linkage (SAIL) Databank. We have identified 2664 cases of suicide in Wales between 2003 and 2011 from routinely collected mortality data using International Classification of Diseases, Tenth Revision, codes X60–X84 (intentional self-harm) and Y10–Y34 (undetermined intent). Each case will be matched by age and sex to at least five controls. Records will be collated and linked from routinely collected health and social data in Wales for each individual. Conditional logistic regression will be applied to produce crude and confounder (including general practice, socioeconomic status) adjusted ORs. Ethics and dissemination The SAIL Databank has the required ethical permissions in place to analyse anonymised data. Ethical approval has been granted by the Information Governance Review Panel (IGRP). Findings will be disseminated through peer-reviewed publications, consultations with stakeholders and national/international conference presentations. The improved understanding of the prior health, nature of previous contacts with services and wider social circumstances of those who complete suicide will assist in prevention policy, service organisation and delivery. SID-Cymru is funded through the National Institute for Social Care and Health Research, Welsh Government (RFS-12-25). PMID:25424996
Risk factors for severe respiratory depression from prescription opioid overdose.
Fox, Lindsay M; Hoffman, Robert S; Vlahov, David; Manini, Alex F
2018-01-01
Prescription opioid overdose is a leading cause of injury-related morbidity and mortality in the United States. We aimed to identify characteristics associated with clinical severity in emergency department patients with prescription opioid overdose. This was a secondary data analysis of adult prescription opioid overdoses from a large prospective cohort of acute overdoses. We examined elements of a typical emergency department evaluation using a multivariable model to determine which characteristics were associated with clinical severity, specifically severe respiratory depression (SRD). This study was conducted at two urban academic emergency departments in New York City, USA. Adult patients who presented with acute prescription opioid overdose between 2009 and 2013 were included in the current study. We analyzed 307 patients (mean age = 44.7, 42% female, 2.0% mortality). Patient demographics, reported substances ingested, suspected intent for ingesting the substance, vital signs, laboratory data, treatments including antidotes and intubation and outcome of death were recorded by trained research assistants. Intent was categorized into four mutually exclusive categories: suicide, misuse, therapeutic error and undetermined. The primary outcome was SRD, defined as administration of either (a) naloxone or (b) endotracheal intubation (ETI). A total of 109 patients suffered SRD with 90 patients receiving naloxone alone, nine ETI alone and 10 both naloxone and ETI. The most common opioids were oxycodone (n = 124) and methadone (n = 116). Mean age was higher in patients with SRD (51.1 versus 41.1, P < 0.001). Opioid misuse was associated with SRD in the multivariable analysis [odds ratio (OR) = 2.07, 95% confidence interval (CI) = 1.21-3.55]. The unadjusted relative risk of SRD was high for fentanyl (83.3% SRD) and lowest for codeine (3.6% SRD). In emergency department patients in the United States with prescription opioid overdose, worse clinical severity was associated with opioid misuse, increased with age and was widely variable, depending on the specific opioid medication involved. © 2017 Society for the Study of Addiction.
USDA-ARS?s Scientific Manuscript database
Corynebacterium pseudotuberculosis (Actinomycetales: Corynebacteriaceae) infection in horses causes three different disease syndromes: external abscesses, infection of internal organs and ulcerative lymphangitis. The route of infection in horses remains undetermined, but transmission by insect vecto...
Plasma Cell Neoplasms (Including Multiple Myeloma)—Health Professional Version
There are several types of plasma cell neoplasms, including monoclonal gammopathy of undetermined significance (MGUS), isolated plasmacytoma of the bone, extramedullary plasmacytoma, and multiple myeloma. Find evidence-based information on plasma cell neoplasms treatment, research, and statistics.
Stroke subtyping for genetic association studies? A comparison of the CCS and TOAST classifications.
Lanfranconi, Silvia; Markus, Hugh S
2013-12-01
A reliable and reproducible classification system of stroke subtype is essential for epidemiological and genetic studies. The Causative Classification of Stroke system is an evidence-based computerized algorithm with excellent inter-rater reliability. It has been suggested that, compared to the Trial of ORG 10172 in Acute Stroke Treatment classification, it increases the proportion of cases with defined subtype that may increase power in genetic association studies. We compared Trial of ORG 10172 in Acute Stroke Treatment and Causative Classification of Stroke system classifications in a large cohort of well-phenotyped stroke patients. Six hundred ninety consecutively recruited patients with first-ever ischemic stroke were classified, using review of clinical data and original imaging, according to the Trial of ORG 10172 in Acute Stroke Treatment and Causative Classification of Stroke system classifications. There was excellent agreement subtype assigned by between Trial of ORG 10172 in Acute Stroke Treatment and Causative Classification of Stroke system (kappa = 0·85). The agreement was excellent for the major individual subtypes: large artery atherosclerosis kappa = 0·888, small-artery occlusion kappa = 0·869, cardiac embolism kappa = 0·89, and undetermined category kappa = 0·884. There was only moderate agreement (kappa = 0·41) for the subjects with at least two competing underlying mechanism. Thirty-five (5·8%) patients classified as undetermined by Trial of ORG 10172 in Acute Stroke Treatment were assigned to a definite subtype by Causative Classification of Stroke system. Thirty-two subjects assigned to a definite subtype by Trial of ORG 10172 in Acute Stroke Treatment were classified as undetermined by Causative Classification of Stroke system. There is excellent agreement between classification using Trial of ORG 10172 in Acute Stroke Treatment and Causative Classification of Stroke systems but no evidence that Causative Classification of Stroke system reduced the proportion of patients classified to undetermined subtypes. The excellent inter-rater reproducibility and web-based semiautomated nature make Causative Classification of Stroke system suitable for multicenter studies, but the benefit of reclassifying cases already classified using the Trial of ORG 10172 in Acute Stroke Treatment system on existing databases is likely to be small. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.
Reliability of postmortem fentanyl concentrations in determining the cause of death.
Gill, James R; Lin, Peter T; Nelson, Lewis
2013-03-01
Transdermal fentanyl, an opioid used for management of marked pain, also is abused and may cause death. We reviewed medical examiner reports of 92 decedents who had one or more fentanyl transdermal patches on their body and had fentanyl detected in their postmortem toxicology analysis. The manners of death included 40 accidents, 36 natural, 8 suicides, 5 therapeutic complications, and 3 undetermined deaths. Among the accidental fentanyl intoxication deaths, 32 of 37 involved substance abuse. The majority (95 %) of the 37 accidental deaths involving fentanyl were multi-drug intoxications. The substance abuse deaths had a mean fentanyl blood concentration (26.4 ng/ml or μg/L) that was over twice that of the natural group (11.8 ng/ml). Our analysis suggests a relationship between total patch dosage and mean postmortem fentanyl concentration up to the 100-μg/h dose. The very wide and overlapping ranges of postmortem fentanyl concentrations effectively nullify the utility of correlating the dose and expected postmortem concentration for any particular death. Based on the variable relationship between dose and blood concentration, the antemortem dose cannot be reliably predicted based on the postmortem concentration. This does not, however, render the medical examiner/coroner unable to determine the cause and manner of death because the toxicology results are only one datum point among several that are considered. Although there was a weakly positive relationship between body mass index and fentanyl concentration, further research is needed to determine whether adipose tissue represents a significant depot for postmortem release of fentanyl.
Kõlves, Kairi; Milner, Allison; Värnik, Peeter
2013-07-01
After the collapse of the Soviet Union the various Eastern European (EE) countries adapted in different ways to the social, political and economic changes. The present study aims to analyse whether the factors related to social integration and regulation are able to explain the changes in the suicide rate in EE. A separate analysis of suicide rates, together with the undetermined intent mortality (UD), was performed. A cross-sectional time-series design and applied a panel data fixed-effects regression technique was used in analyses. The sample included 13 countries from the former Soviet bloc between 1990 and 2008. Dependent variables were gender-specific age-adjusted suicide rates and suicide plus UD rates. Independent variables included unemployment, GDP, divorce rate, birth rate, the Gini index, female labour force participation, alcohol consumption and general practitioners per 100,000 people. Male suicide and suicide or UD rates had similar predictors, which suggest that changes in suicide were related to socioeconomic disruptions experienced during the transition period. However, male suicide rates in EE were not associated with alcohol consumption during the study period. Even so, there might be underestimation of alcohol consumption due to illegal alcohol and differences between methodologies of calculating alcohol consumption. However, predictors of female suicide were related to economic integration and suicide or UD rates with domestic integration. © 2013 The Authors. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.
Characteristics of Violent Deaths Among Homeless People in Maryland, 2003-2011.
Stanley, Jennifer L; Jansson, Alexandra V; Akinyemi, Adebola A; Mitchell, Clifford S
2016-11-01
People experiencing homelessness are susceptible to many adverse health events, including violence. The purpose of this study was to provide a descriptive analysis of homeless individuals who suffered a violent death in Maryland. Characterizing these deaths will provide a basis for additional analyses that can inform violence prevention activities. This study used data from the Maryland Violent Death Reporting System to examine violent deaths of homeless people occurring from 2003 through 2011. This surveillance system collects information on all violent deaths occurring in Maryland. Victim demographics, injury and death information, precipitating circumstances contributing to deaths, and toxicology information were examined. All analyses were conducted in 2014 and 2015. Among all violent death victims from 2003 through 2011 (N=14,327), a total of 279 (2.0%) were identified as homeless victims. More than half (65.2%) of deaths were of undetermined intent, 21.2% were homicides, and 13.6% were suicides. The most common method of injury was poisoning (59.0%). Substance abuse and having a current mental health problem were among the most commonly reported circumstances relating to death. This study found substance abuse and mental health problems to be major circumstances precipitating violent death among people experiencing homelessness. This study will serve as a starting point for more in-depth analyses on experiences of violent death among homeless people that can inform violence prevention policy and programming. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Availability and quality of cause-of-death data for estimating the global burden of injuries
Harrison, James E; Shahraz, Saeid; Fingerhut, Lois A
2010-01-01
Abstract Objective To assess the availability and quality of global death registration data used for estimating injury mortality. Methods The completeness and coverage of recent national death registration data from the World Health Organization mortality database were assessed. The quality of data on a specific cause of injury death was judged high if fewer than 20% of deaths were attributed to any of several partially specified causes of injury, such as “unspecified unintentional injury”. Findings Recent death registration data were available for 83 countries, comprising 28% of the global population. They included most high-income countries, most countries in Latin America and several in central Asia and the Caribbean. Categories commonly used for partially specified external causes of injury resulting in death included “undetermined intent,” “unspecified mechanism of unintentional injury,” “unspecified road injury” and “unspecified mechanism of homicide”. Only 20 countries had high-quality data. Nevertheless, because the partially specified categories do contain some information about injury mechanisms, reliable estimates of deaths due to specific external causes of injury, such as road injury, suicide and homicide, could be derived for many more countries. Conclusion Only 20 countries had high-quality death registration data that could be used for estimating injury mortality because injury deaths were frequently classified using imprecise partially specified categories. Analytical methods that can derive national estimates of injury mortality from alternative data sources are needed for countries without reliable death registration systems. PMID:21076564
ERIC Educational Resources Information Center
Gardner, John
1987-01-01
The relationship between leaders and followers is crucial and often misunderstood. Ninety percent of leadership can be taught, and the remainder consists of energy, stamina, and ingredients of undetermined origin. Those who study leadership come from many disciplines, but what is learned should be shared. (MSE)
Comparison of Transmissible Mink Encephalopathy Isolates in Raccoons
USDA-ARS?s Scientific Manuscript database
Owing to its susceptibility to various transmissible spongiform encephalopathies (TSE) and relatively short incubation times, the raccoon (Procyon lotor) has been suggested as a model for TSE strain differentiation. Transmissible mink encephalopathy (TME) is a prion disease of undetermined origin in...
Caenorhabditis elegans chemical biology: lessons from small molecules
USDA-ARS?s Scientific Manuscript database
How can we complement Caenorhabditis elegans genomics and proteomics with a comprehensive structural and functional annotation of its metabolome? Several lines of evidence indicate that small molecules of largely undetermined structure play important roles in C. elegans biology, including key pathw...
Zieliński, Marek; Kamińska, Joanna; Czerska, Marta; Ligocka, Danuta; Urbaniak, Magdalena
2014-12-01
Polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs) are unwanted by-products in a variety of industrial and thermal processes. They have been present on Earth long before the human era, since they may be also formed as a result of forest fires or volcanic explosions. Polychlorinated biphenyls (PCBs) in turn, have been intentionally produced by humans. Poland was a minor producer of PCB mixtures (Chlorofen and Tarnol), which were a source of direct and indirect environmental diffusion with PCB and less with PCDDs/PCDFs. Industrial accidents with PCDDs/PCDFs were absent in Poland. Their stability and resistance to thermal breakdown made them very dangerous for environment and, in consequence, due to their environmental persistence, bioaccumulation and biomagnification in the terrestrial and aquatic food chains, to humans. Humans may become affected by PCDDs/PCDFs and PCBs through environmental (soil and water contamination, fish and food), occupational (incinerators; pulp, paper and metallurgy industry; copper production), or accidental (Seveso accident) exposure. The aim of this review was to evaluate environmental hazard caused by PCDDs, PCDFs and dioxin-like-PCBs in the central region of Poland based on the accessible data on diffusion of those compounds in sediments and riverine, reservoir and storm water from our previous studies and discussed in the context of other achievements in Poland and elsewhere.
Space operations and the human factor
NASA Astrophysics Data System (ADS)
Brody, Adam R.
1993-10-01
Although space flight does not put the public at high risk, billions of dollars in hardware are destroyed and the space program halted when an accident occurs. Researchers are therefore applying human-factors techniques similar to those used in the aircraft industry, albeit at a greatly reduced level, to the spacecraft environment. The intent is to reduce the likelihood of catastrophic failure. To increase safety and efficiency, space human factors researchers have simulated spacecraft docking and extravehicular activity rescue. Engineers have also studied EVA suit mobility and aids. Other basic human-factors issues that have been applied to the space environment include antropometry, biomechanics, and ergonomics. Workstation design, workload, and task analysis currently receive much attention, as do habitability and other aspects of confined environments. Much work also focuses on individual payloads, as each presents its own complexities.
Two fatal tiger attacks in zoos.
Tantius, Britta; Wittschieber, Daniel; Schmidt, Sven; Rothschild, Markus A; Banaschak, Sibylle
2016-01-01
Two captive tiger attacks are presented that took place in Cologne and Münster zoos. Both attacks occurred when the handlers, intent on cleaning the enclosures, entered whilst the tigers accidently retained access to the location, and thus defended their territory against the perceived intruders. Both victims suffered fatal neck injuries from the bites. At Münster, colleagues managed to lure the tiger away from its victim to enable treatment, whilst the Cologne zoo tiger had to be shot in order to allow access to be gained. Whilst it was judged that human error led to the deaths of the experienced zookeepers, the investigation in Münster was closed as no third party was found to be at fault, whereas the Cologne zoo director was initially charged with being negligent. These charges were subsequently dismissed as safety regulations were found to be up to date.
Central auditory processing in patients with spinocerebellar ataxia.
Zeigelboim, Bianca Simone; de Carvalho, Hugo Amilton Santos; Teive, Hélio Afonso Ghizoni; Liberalesso, Paulo Breno Noronha; Jurkiewicz, Ari Leon; da Silva Abdulmassih, Edna Márcia; Marques, Jair Mendes; Cordeiro, Mara Lúcia
2015-09-01
Autosomal dominant spinocerebellar ataxias (SCAs) are a group of rare and heterogeneous neurodegenerative diseases characterized by the presence of progressive cerebellar ataxia. Although the symptomatology of SCAs is well known, information regarding central auditory functioning in these patients is lacking. Therefore, we assessed the central auditory processing disorders (CAPD) in patients with different subtypes of SCA. In a retrospective cross-sectional study, we subjected 43 patients with SCAs to otorhinolaryngological, audiological, Brainstem Auditory Evoked Potential (BAEP) and acoustic immittance evaluations as well as CAPD tests, namely the Standard Spondaic Word (SSW) and the Random Gap Detection Test (RGDT). Most patients (83.7%) reported an imbalance when walking; many reported difficulty speaking (48.8%), dizziness (41.8%), and dysphagia (39.5%). In the audiometric test, 14/43 patients (32.5%) presented alterations, including 4/12 patients with SCA3 (33.3%), 1/8 patients with SCA2 (12.5%), 1/1 patient with SCA4 (100%), 1/1 patient with SCA6 (100%), 1/1 patient with SCA7 (100%), 3/6 patients with SCA10 (50%), and 3/14 patients with an undetermined type of SCA (21.4%). In the BAEP test, 20/43 patients (46.5%) presented alterations (11.6% na orelha esquerda e 34.9% bilateralmente), including 7/12 patients with SCA3 (58.3%), 5/8 patients with SCA2 (62.5%), 1/1 patient with SCA4 (100%), 1/1 patient with SCA6 (100%), 1/1 patient with SCA7 (100%), 4/6 patients with SCA10 (66.7%), and 2/14 patients with an undetermined type of SCA (14.2%). In the SSW, 22/40 patients (55%) presented alterations (2.5% in the right ear, 15% in the left ear, and 37.5% bilaterally), including 6/10 patients (60%) with SCA3, 3/8 (37.5%) with SCA2, 1/1 (100%) with SCA4, 1/1 (100%) with SCA6, 1/1 (100%) with SCA7, 4/5 (80%) with SCA10, and 8/14 (57.1%) with an undetermined type SCA. For the RGDT, 30/40 patients (75%) presented alterations, including 8/10 (80%) with SCA3, 6/8 (75%) with SCA2, 1/1 (100%) with SCA4, 1/1 (100%) with SCA6, 1/1 (100%) with SCA7, 4/5 (80%) with SCA10, and 9/14 (64.3%) with an undetermined type of SCA. In immittance testing, 19/43 patients (44.1%) presented alterations, including 6/12 (50%) with SCA3, 4/8 (50%) with SCA2, 1/1 (100%) with SCA4, 1/1 (100%) with SCA6, 1/1 (100%) with SCA7, 2/6 (33.3%) with SCA10, and 4/14 (28.6%) with an undetermined type of SCA. A majority of patients exhibited SSW test deficits, with a predominance of bilateralism, and three-fourths had impaired RGDT performance, pointing to difficulties with binaural integration and temporal resolution. Assessment of CAPD is important for therapeutic follow ups in patients with SCA. Copyright © 2015 Elsevier B.V. All rights reserved.
Forced Transitions: The Impact of Natural Disasters and Other Events on College Students
ERIC Educational Resources Information Center
Schuh, John H.; Laanan, Frankie Santos
2006-01-01
This chapter presents a hypothetical situation related to students who are displaced by Hurricane Katrina. It focuses on transition issues for the students as they are relocated to a new college for an undetermined length of time.
USING SUSTAINABILITY CRITERIA TO GUIDE LAND-USE DECISIONS
Human society and our economic systems are limited by the capacities of natural systems, and the sustainability of natural systems will be dependent upon the attainment of undetermined but minimum conditions of social and economic systems. These minimum conditions of intact econo...
Experimental transmission of Corynebacterium pseudotuberculosis biovar equi in horses by house flies
USDA-ARS?s Scientific Manuscript database
The route of Corynebacterium pseudotuberculosis infection in horses remains undetermined, but transmission by insects is suspected. Scientists from CMAVE and Auburn University investigated house flies (Musca domestica L.) as possible vectors. Three ponies were directly inoculated with C. pseudotuber...
SURVIVAL OF HELICOBACTER PYLORI IN A NATURAL FRESHWATER ENVIRONMENT
The mode by which Helicobacter pylori, the causative agent of most gastric ulcers, is transmitted remains undetermined. Epidemiological evidence suggests these organisms are waterborne; however, H. pylori has rarely been grown from potential water sources. This may be due to th...
Vernick, J; O'Brien, M; Hepburn, L; Johnson, S; Webster, D; Hargarten, S
2003-01-01
Objective: To determine the proportion of unintentional and undetermined firearm related deaths preventable by three safety devices: personalization devices, loaded chamber indicators (LCIs), and magazine safeties. A personalized gun will operate only for an authorized user, a LCI indicates when the gun contains ammunition, and a magazine safety prevents the gun from firing when the ammunition magazine is removed. Design: Information about all unintentional and undetermined firearm deaths from 1991–98 was obtained from the Office of the Chief Medical Examiner for Maryland, and from the Wisconsin Firearm Injury Reporting System for Milwaukee. Data regarding the victim, shooter, weapon, and circumstances were abstracted. Coding rules to classify each death as preventable, possibly preventable, or not preventable by each of the three safety devices were also applied. Results: There were a total of 117 firearm related deaths in our sample, 95 (81%) involving handguns. Forty three deaths (37%) were classified as preventable by a personalized gun, 23 (20%) by a LCI, and five (4%) by a magazine safety. Overall, 52 deaths (44%) were preventable by at least one safety device. Deaths involving children 0–17 (relative risk (RR) 3.3, 95% confidence interval (CI) 2.1 to 5.1) and handguns (RR 8.1, 95% CI 1.2 to 53.5) were more likely to be preventable. Projecting the findings to the entire United States, an estimated 442 deaths might have been prevented in 2000 had all guns been equipped with these safety devices. Conclusion: Incorporating safety devices into firearms is an important injury intervention, with the potential to save hundreds of lives each year. PMID:14693889
Relationship Between Visceral Infarction and Ischemic Stroke Subtype.
Finn, Caitlin; Hung, Peter; Patel, Praneil; Gupta, Ajay; Kamel, Hooman
2018-03-01
Most cryptogenic strokes are thought to have an embolic source. We sought to determine whether cryptogenic strokes are associated with visceral infarcts, which are usually embolic. Among patients prospectively enrolled in CAESAR (Cornell Acute Stroke Academic Registry), we selected those with a contrast-enhanced abdominal computed tomographic scan within 1 year of admission. Our exposure variable was adjudicated stroke subtype per the Trial of ORG 10172 in Acute Stroke Treatment classification. Our outcome was renal or splenic infarction as assessed by a single radiologist blinded to stroke subtype. We used Fisher exact test and multiple logistic regression to compare the prevalence of visceral infarcts among cardioembolic strokes, strokes of undetermined etiology, and noncardioembolic strokes (large- or small-vessel strokes). Among 227 patients with ischemic stroke and a contrast-enhanced abdominal computed tomographic scan, 59 had a visceral infarct (35 renal and 27 splenic). The prevalence of visceral infarction was significantly different among cardioembolic strokes (34.2%; 95% confidence interval [CI], 23.7%-44.6%), strokes of undetermined etiology (23.9%; 95% CI, 15.0%-32.8%), and strokes from large-artery atherosclerosis or small-vessel occlusion (12.5%; 95% CI, 1.8%-23.2%; P =0.03). In multiple logistic regression models adjusted for demographics and vascular comorbidities, we found significant associations with visceral infarction for both cardioembolic stroke (odds ratio, 3.5; 95% CI, 1.2-9.9) and stroke of undetermined source (odds ratio, 3.3; 95% CI, 1.1-10.5) as compared with noncardioembolic stroke. The prevalence of visceral infarction differed significantly across ischemic stroke subtypes. Cardioembolic and cryptogenic strokes were associated with a higher prevalence of visceral infarcts than noncardioembolic strokes. © 2018 American Heart Association, Inc.
SMASH-U: a proposal for etiologic classification of intracerebral hemorrhage.
Meretoja, Atte; Strbian, Daniel; Putaala, Jukka; Curtze, Sami; Haapaniemi, Elena; Mustanoja, Satu; Sairanen, Tiina; Satopää, Jarno; Silvennoinen, Heli; Niemelä, Mika; Kaste, Markku; Tatlisumak, Turgut
2012-10-01
The purpose of this study was to provide a simple and practical clinical classification for the etiology of intracerebral hemorrhage (ICH). We performed a retrospective chart review of consecutive patients with ICH treated at the Helsinki University Central Hospital, January 2005 to March 2010 (n=1013). We classified ICH etiology by predefined criteria as structural vascular lesions (S), medication (M), amyloid angiopathy (A), systemic disease (S), hypertension (H), or undetermined (U). Clinical and radiological features and mortality by SMASH-U (Structural lesion, Medication, Amyloid angiopathy, Systemic/other disease, Hypertension, Undetermined) etiology were analyzed. Structural lesions, namely cavernomas and arteriovenous malformations, caused 5% of the ICH, anticoagulation 14%, and systemic disease 5% (23 liver cirrhosis, 8 thrombocytopenia, and 17 various rare conditions). Amyloid angiopathy (20%) and hypertensive angiopathy (35%) were common, but etiology remained undetermined in 21%. Interrater agreement in classifying cases was high (κ, 0.89; 95% CI, 0.82-0.96). Patients with structural lesions had the smallest hemorrhages (median volume, 2.8 mL) and best prognosis (3-month mortality 4%), whereas anticoagulation-related ICHs were largest (13.4 mL) and most often fatal (54%). Overall, median ICH survival was 5½ years, varying strongly by etiology (P<0.001). After adjustment for baseline characteristics, patients with structural lesions had the lowest 3-month mortality rates (OR, 0.06; 95% CI, 0.01-0.37) and those with anticoagulation (OR, 1.9; 1.0-3.6) or other systemic cause (OR, 4.0; 1.6-10.1) the highest. In our patients, performing the SMASH-U classification was feasible and interrater agreement excellent. A plausible etiology was determined in most patients but remained elusive in one in 5. In this series, SMASH-U based etiology was strongly associated with survival.
Nassar, Aziza; Reynolds, Jordan P; Kerr, Sarah E; Jenkins, Sarah M; Lackore, Kandace A; Bernet, Victor
2015-01-01
The cytologic diagnosis of atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS) is controversial because of variation in how it is applied in practice, as well as uncertainty about patient management. We aimed to assess the percentage of thyroid fine-needle aspiration biopsies (FNABs) with AUS/FLUS diagnoses in different North American and European practice settings (e.g. community, academic, etc.), assess whether patients were managed according to current guidelines, and determine patient outcomes. A detailed questionnaire survey was posted in secure websites used separately by cytopathologists and cytotechnologists. The questionnaire was posted from August 1 through December 31, 2013. Endocrinologists and cytopathologists performed 51.7% and 37.1% of thyroid FNABs, respectively. The Bethesda reporting system for thyroid FNAB was used in 90% of practices. The rate of AUS/FLUS varied widely among institutions, with 46.1% of represented institutions reporting AUS/FLUS rates of 3-10%. The median follow-up rate of patients with an initial AUS/FLUS diagnosis was 70% (range, 10-100%). For the majority of represented institutions (86.4%), patients with initial AUS/FLUS diagnosis had follow-up with endocrinologists. Of repeat AUS/FLUS thyroid FNABs, a median of 52% was considered benign, and 18% were suspicious of or positive for malignancy (median, 10% and 7.5%, respectively). Reporting of the AUS/FLUS category varied widely among different institutions. The median follow-up rate was lower than published guidelines. The most common follow-up diagnosis was benign thyroid nodule. Improved standardization of cytologic criteria should be adopted to reduce such variation.
Nassar, Aziza; Reynolds, Jordan P.; Kerr, Sarah E.; Jenkins, Sarah M.; Lackore, Kandace A.; Bernet, Victor
2015-01-01
Background: The cytologic diagnosis of atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS) is controversial because of variation in how it is applied in practice, as well as uncertainty about patient management. We aimed to assess the percentage of thyroid fine-needle aspiration biopsies (FNABs) with AUS/FLUS diagnoses in different North American and European practice settings (e.g. community, academic, etc.), assess whether patients were managed according to current guidelines, and determine patient outcomes. Materials and Methods: A detailed questionnaire survey was posted in secure websites used separately by cytopathologists and cytotechnologists. The questionnaire was posted from August 1 through December 31, 2013. Results: Endocrinologists and cytopathologists performed 51.7% and 37.1% of thyroid FNABs, respectively. The Bethesda reporting system for thyroid FNAB was used in 90% of practices. The rate of AUS/FLUS varied widely among institutions, with 46.1% of represented institutions reporting AUS/FLUS rates of 3–10%. The median follow-up rate of patients with an initial AUS/FLUS diagnosis was 70% (range, 10–100%). For the majority of represented institutions (86.4%), patients with initial AUS/FLUS diagnosis had follow-up with endocrinologists. Of repeat AUS/FLUS thyroid FNABs, a median of 52% was considered benign, and 18% were suspicious of or positive for malignancy (median, 10% and 7.5%, respectively). Conclusions: Reporting of the AUS/FLUS category varied widely among different institutions. The median follow-up rate was lower than published guidelines. The most common follow-up diagnosis was benign thyroid nodule. Improved standardization of cytologic criteria should be adopted to reduce such variation. PMID:26195986
Mukai, Shigeto; Shigemura, Katsumi; Yamamichi, Fukashi; Kitagawa, Koichi; Takami, Nozomi; Nomi, Masashi; Arakawa, Soichi; Fujisawa, Masato
2017-01-01
There are several methods used to screen for latent tuberculosis (TB) infection (LTBI) including the QuantiFERON-TB Gold-in-Tube (QFT-GIT) and T-SPOT-TB (T-SPOT) tests. Many studies have reported the equivalence of these two methods, but it is unclear which of them is more cost effective. We investigated the age and cost issues of these tests in screening for LTBI among health-care workers. One hundred and forty new employees during 2008-2011 in our hospital were screened using the QFT-GIT test, and 140 new employees during 2011-2014 were screened with the T-SPOT test for LTBI. The results of both tests were classified as positive, undetermined (retesting required), or negative. There were six positive results (4.29%), eight undetermined results (5.71%), and 126 negative results (90.0%) with the QFT-GIT test. As for the T-SPOT test, there were eight positive results (5.71%), three undetermined results (2.14%), and 129 negative results (92.1%). Fourteen LTBI employees (6 in QFT-GIT and 8 in T-SPOT) were detected statistically equally using the two methods (P = 0.79). The total costs, including those incurred for retesting, were $7,711.86 (US dollar) and $6,525.42 for the QFT-GIT and T-SPOT tests (cost of one test is $55.08 for QFT-GIT and $46.61 for T-SPOT), respectively. T-SPOT is one of the options for screening for LTBI partly owing to the viewpoint of cost-effectiveness. Further prospective studies need to be considered for a definitive conclusion.
Pero Vaz de Caminha: an-interchange program for quality control between Brazil and Portugal.
Utagawa, Maria Lúcia; di Loreto, Celso; de Freitas, Cristina; Milanezi, Fernanda; Longatto Filho, Adhemar; Pereira, Sónia Maria Miranda; Maeda, Marina Yoshiê Sakamoto; Schmitt, Fernando C
2006-01-01
To start an interexchange program for quality control in cervical cytology and discuss conceptual criteria for diagnosis. Slides were selected in the archives of the 2 institutes and included cases with unsatisfactory, negative and positive results. Sets of slides were changed between the partners every 3 months. At the end of each year a senior cytopathologist was invited to discuss the major discrepancies found in the study. A total of 1,041 cases were analyzed. Full concordance was obtained in 74.4% (774) of cases and discrepancies in 25.6% (267 cases). Full agreement was achieved in 276 (39%) of 707 cases categorized as negative. In 421 negative cases from laboratory A, this concordance represents 65.5% and 96.5% for laboratory B, which submitted 286 negative cases. The main discordance was the high number of atypical squamous cells of undetermined significance cases: 3.1% for A and 128 (33.2%) for B. Samples with discrepancies related to the quality of the material was another controversial issue: of 16 cases from laboratory A, 6 (37.5%) unsatisfactory cases were the same and 10 (62.5%) different. Laboratory B presented 20 unsatisfactory cases, and 14 (70.0%) had other diagnoses. Low grade squamous intraepithelial lesion and high grade squamous intraepithelial lesion concordance ranged from 75% to 80%, and invasive carcinoma has 4 discordances (28.5%), 3 previously screened as high grade squamous intraepithelial lesion and 1 as atypical squamous cells of undetermined significance. The kappa value obtained was 0.65, indicating substantial agreement. Our results indicated that atypical squamous cells of undetermined significance diagnoses are the crucial point of controversies and concern the quality of routine diagnosis in cytopathology.
Cryptogenic Stroke and Nonstenosing Intracranial Calcified Atherosclerosis.
Kamel, Hooman; Gialdini, Gino; Baradaran, Hediyeh; Giambrone, Ashley E; Navi, Babak B; Lerario, Michael P; Min, James K; Iadecola, Costantino; Gupta, Ajay
2017-04-01
Because some cryptogenic strokes may result from large-artery atherosclerosis that goes unrecognized as it causes <50% luminal stenosis, we compared the prevalence of nonstenosing intracranial atherosclerotic plaques ipsilateral to cryptogenic cerebral infarcts versus the unaffected side using imaging biomarkers of calcium burden. In a prospective stroke registry, we identified patients with cerebral infarction limited to the territory of one internal carotid artery (ICA). We included patients with stroke of undetermined etiology and, as controls, patients with cardioembolic stroke. We used noncontrast computed tomography to measure calcification in both intracranial ICAs, including qualitative calcium scoring and quantitative scoring utilizing the Agatston-Janowitz (AJ) calcium scoring. Within subjects, the Wilcoxon signed-rank sum test for nonparametric paired data was used to compare the calcium burden in the ICA upstream of the infarction versus the ICA on the unaffected side. We obtained 440 calcium measures from 110 ICAs in 55 patients. Among 34 patients with stroke of undetermined etiology, we found greater calcium in the ICA ipsilateral to the infarction (mean Modified Woodcock Visual Scale score, 6.7 ± 4.6) compared with the contralateral side (5.4 ± 4.1) (P = .005). Among 21 patients with cardioembolic stroke, we found no difference in calcium burden ipsilateral to the infarction (6.7 ± 5.9) versus the contralateral side (7.3 ± 6.3) (P = .13). The results were similar using quantitative calcium measurements, including the AJ calcium scores. In patients with strokes of undetermined etiology, the burden of calcified intracranial large-artery plaque was associated with downstream cerebral infarction. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
The Phase Rule in a System Subject to a Pressure Gradient
NASA Astrophysics Data System (ADS)
Podladchikov, Yuri; Connolly, James; Powell, Roger; Aardvark, Alberto
2015-04-01
It can be shown by diligent application of Lagrange's method of undetermined multipliers that the phase rule in a system subject to a pressure gradient is: � + 赑 ≥ ρ. We explore the consequence of this important relationship for natural systems.
OUTBREAKS ASSOCIATED WITH RECREATIONAL WATER IN THE UNITED STATES
In this article, we review the causes of outbreaks associated with recreational water during 1971-2000. A bacterial or protozoan etiology was identified in three-quarters of the outbreaks; 23% of the outbreaks were of undetermined etiology. The most frequently identified agents w...
Raab, Stephen S; Andrew-Jaja, Carey; Condel, Jennifer L; Dabbs, David J
2006-01-01
The objective of the study was to determine whether the Toyota production system process improves Papanicolaou test quality and patient safety. An 8-month nonconcurrent cohort study that included 464 case and 639 control women who had a Papanicolaou test was performed. Office workflow was redesigned using Toyota production system methods by introducing a 1-by-1 continuous flow process. We measured the frequency of Papanicolaou tests without a transformation zone component, follow-up and Bethesda System diagnostic frequency of atypical squamous cells of undetermined significance, and diagnostic error frequency. After the intervention, the percentage of Papanicolaou tests lacking a transformation zone component decreased from 9.9% to 4.7% (P = .001). The percentage of Papanicolaou tests with a diagnosis of atypical squamous cells of undetermined significance decreased from 7.8% to 3.9% (P = .007). The frequency of error per correlating cytologic-histologic specimen pair decreased from 9.52% to 7.84%. The introduction of the Toyota production system process resulted in improved Papanicolaou test quality.
Khudair, I F; Jassim, Z; Hanssens, Y; Alsaad, W A
2013-09-01
Data about etiologic and demographic characteristics of acute poisoning in adults in Qatar are lacking. This prospective observational study was undertaken to analyze characteristics and possible determinants of acute poisoning in adults in Qatar. During 2010, 18,073 patients attended the emergency department of Hamad General Hospital, a teaching hospital in Qatar. Out of them, 599 (3.3%) patients were diagnosed as "poisoning case" with either chemical or pharmaceutical substances. The prevalence rate of poisoning incidence was 35.3/100,000 population. Seven patients died, corresponding with a case-fatality rate of 0.39/1000. The majority were male (65%) and the mean age was 34 years. The poisons involved were mainly chemicals (61.6%) and pharmaceuticals (38.4%). Female, mainly single, suffered more intentional poisoning compared to male. Of the patients aged 60 years and above (7.2%), the majority (95.3%) suffered unintentional poisoning with pharmaceuticals; 56% with warfarin, 12% with digoxin and 7% with insulin. Multivariate analysis shows that female gender, single status, younger than 35 years of age, being poisoned by pharmaceutical products, and the need for hospitalization are significant determinants for acute intentional poisoning after adjusting all other possible covariates. The findings of this study can be used to establish awareness and prophylactic campaigns in Qatar.
Hospital bioterrorism planning and burn surge.
Kearns, Randy D; Myers, Brent; Cairns, Charles B; Rich, Preston B; Hultman, C Scott; Charles, Anthony G; Jones, Samuel W; Schmits, Grace L; Skarote, Mary Beth; Holmes, James H; Cairns, Bruce A
2014-01-01
On the morning of June 9, 2009, an explosion occurred at a manufacturing plant in Garner, North Carolina. By the end of the day, 68 injured patients had been evaluated at the 3 Level I trauma centers and 3 community hospitals in the Raleigh/Durham metro area (3 people who were buried in the structural collapse died at the scene). Approximately 300 employees were present at the time of the explosion, when natural gas being vented during the repair of a hot water heater ignited. The concussion from the explosion led to structural failure in multiple locations and breached additional natural gas, electrical, and ammonia lines that ran overhead in the 1-story concrete industrial plant. Intent is the major difference between this type of accident and a terrorist using an incendiary device to terrorize a targeted population. But while this disaster lacked intent, the response, rescue, and outcomes were improved as a result of bioterrorism preparedness. This article discusses how bioterrorism hospital preparedness planning, with an all-hazards approach, became the basis for coordinated burn surge disaster preparedness. This real-world disaster challenged a variety of systems, hospitals, and healthcare providers to work efficiently and effectively to manage multiple survivors. Burn-injured patients served as a focus for this work. We describe the response, rescue, and resuscitation provided by first responders and first receivers as well as efforts made to develop burn care capabilities and surge capacity.
Hospital Bioterrorism Planning and Burn Surge
Myers, Brent; Cairns, Charles B.; Rich, Preston B.; Hultman, C. Scott; Charles, Anthony G.; Jones, Samuel W.; Schmits, Grace L.; Skarote, Mary Beth; Holmes, James H.; Cairns, Bruce A.
2014-01-01
On the morning of June 9, 2009, an explosion occurred at a manufacturing plant in Garner, North Carolina. By the end of the day, 68 injured patients had been evaluated at the 3 Level I trauma centers and 3 community hospitals in the Raleigh/Durham metro area (3 people who were buried in the structural collapse died at the scene). Approximately 300 employees were present at the time of the explosion, when natural gas being vented during the repair of a hot water heater ignited. The concussion from the explosion led to structural failure in multiple locations and breached additional natural gas, electrical, and ammonia lines that ran overhead in the 1-story concrete industrial plant. Intent is the major difference between this type of accident and a terrorist using an incendiary device to terrorize a targeted population. But while this disaster lacked intent, the response, rescue, and outcomes were improved as a result of bioterrorism preparedness. This article discusses how bioterrorism hospital preparedness planning, with an all-hazards approach, became the basis for coordinated burn surge disaster preparedness. This real-world disaster challenged a variety of systems, hospitals, and healthcare providers to work efficiently and effectively to manage multiple survivors. Burn-injured patients served as a focus for this work. We describe the response, rescue, and resuscitation provided by first responders and first receivers as well as efforts made to develop burn care capabilities and surge capacity. PMID:24527874
Daruwalla, Nayreen; Belur, Jyoti; Kumar, Meena; Tiwari, Vinay; Sarabahi, Sujata; Tilley, Nick; Osrin, David
2014-11-30
Most burns happen in low- and middle-income countries. In India, deaths related to burns are more common in women than in men and occur against a complex background in which the cause - accidental or non-accidental, suicidal or homicidal - is often unclear. Our study aimed to understand the antecedents to burns and the problem of ascribing cause, the sequence of medicolegal events after a woman was admitted to hospital, and potential opportunities for improvement. We conducted semi-structured interviews with 33 women admitted to two major burns units, their families, and 26 key informant doctors, nurses, and police officers. We used framework analysis to examine the context in which burns occurred and the sequence of medicolegal action after admission to hospital. Interviewees described accidents, attempted suicide, and attempted homicide. Distinguishing between these was difficult because the underlying combination of poverty and cultural precedent was common to all and action was contingent on potentially conflicting narratives. Space constraint, problems with cooking equipment, and inflammable clothing increased the risk of accidental burns, but coexisted with household conflict, gender-based violence, and alcohol use. Most burns were initially ascribed to accidents. Clinicians adhered to medicolegal procedures, the police carried out their investigative requirements relatively rapidly, but both groups felt vulnerable in the face of the legal process. Women's understandable reticence to describe burns as non-accidental, the contested nature of statements, their perceived history of changeability, the limited quality and validity of forensic evidence, and the requirement for resilience on the part of clients underlay a general pessimism. The similarities between accident and intention cluster so tightly as to make them challenging to distinguish, especially given women's understandable reticence to describe burns as non-accidental. The contested status of forensic evidence and a reliance on testimony means that only a minority of cases lead to conviction. The emphasis should be on improving documentation, communication between service providers, and public understanding of the risks of burns.
Partial Fractions via Calculus
ERIC Educational Resources Information Center
Bauldry, William C.
2018-01-01
The standard technique taught in calculus courses for partial fraction expansions uses undetermined coefficients to generate a system of linear equations; we present a derivative-based technique that calculus and differential equations instructors can use to reinforce connections to calculus. Simple algebra shows that we can use the derivative to…
Experimental transmission of Corynebacterium pseudotuberculosis in horses by house flies
USDA-ARS?s Scientific Manuscript database
The route of infection of pigeon fever remains undetermined. The purpose of this study was to investigate house flies (Musca domestica L.) as vectors of Corynebacterium pseudotuberculosis in horses. Eight ponies were used in a randomized, controlled, blinded experimental study. Ten wounds were creat...
Marihuana in Man: Three Years Later
ERIC Educational Resources Information Center
Hollister, Leo E.
1971-01-01
Reviews three years of research on the effects of marihuana in man. Previously known clinical mental and physical effects have been confirmed. Causes and mechanisms of these effects generally remain undetermined in man and animals. Social implications and long term effects require additional study, although usage appears detrimental. (JM)
USDA-ARS?s Scientific Manuscript database
Rhagoletis jamaicensis Foote, 1981 and an undetermined species of the psalida group, are recorded for the first time in Colombia. The morphological variation of the Colombian specimens of these species and of other species closely related are discussed....
[Danger from exploding fireworks and blank firearms].
Just, T; Pau, H W; Kaduk, W; Hingst, V
2000-12-01
Explosive amusement and deterrent articles such as New Year's Eve cannons and rockets, toy pistols, and blank guns are not at all harmless items. Their potential dangerousness is often extremely underestimated. Two damaging mechanisms are important: during explosions, high pressures and temperatures develop and a considerable sound pressure level can be measured. If the explosion happens near the human body (intentionally or inadvertently), not only superficial lesions can occur, but also (mainly due to contact shots) serious, deep-seated tissue damage, especially in the head and neck region with its endangered sense organs such as eye and ear, the vessels and nerves supplying the brain, the speech- and voice-forming apparatus, and in particular the face, can be the consequence. Their mutilation can lead to serious and extensive interpersonalchanges. Accidents are published in the relevant otological and forensic medical papers, but nevertheless it seems important to us to point out the dangerousness of these readily available items.
Nakajima, Satomi; Masaya, Ito; Akemi, Shirai; Takako, Konishi
2012-01-01
Violent death, such as homicide, accident, and suicide, is sudden, unexpected, and caused by intentional power, The prevalence of complicated grief among those bereaved by violent death is 12,5% to 78,0%. The factors affecting this prevalence rate are considered to be comorbid mental disorders, lack of readiness for the death, difficulty in making sense of the death, high level of negative appraisal about the self and others, and various social stressors. Post-traumatic stress disorder is, in particular, considered to contribute to the development of complicated grief by suppressing function of the medial prefrontal cortex and the anterior cingulate cortex, which works at facilitating the normal mourning process. An understanding of the mechanism and biological basis of complicated grief by violent death will be helpful in developing effective preventive intervention and treatment. PMID:22754294
Meyer, N; McMenamin, J; Robertson, C; Donaghy, M; Allardice, G; Cooper, D
2008-07-01
In 18 weeks, Health Protection Scotland (HPS) deployed a syndromic surveillance system to early-detect natural or intentional disease outbreaks during the G8 Summit 2005 at Gleneagles, Scotland. The system integrated clinical and non-clinical datasets. Clinical datasets included Accident & Emergency (A&E) syndromes, and General Practice (GPs) codes grouped into syndromes. Non-clinical data included telephone calls to a nurse helpline, laboratory test orders, and hotel staff absenteeism. A cumulative sum-based detection algorithm and a log-linear regression model identified signals in the data. The system had a fax-based track for real-time identification of unusual presentations. Ninety-five signals were triggered by the detection algorithms and four forms were faxed to HPS. Thirteen signals were investigated. The system successfully complemented a traditional surveillance system in identifying a small cluster of gastroenteritis among the police force and triggered interventions to prevent further cases.
Lewandowsky, Stephan; Stritzke, Werner G K; Freund, Alexandra M; Oberauer, Klaus; Krueger, Joachim I
2013-10-01
The dissemination and control of information are indispensable ingredients of violent conflict, with all parties involved in a conflict or at war seeking to frame the discussion on their own terms. Those attempts at information control often involve the dissemination of misinformation or disinformation (i.e., information that is incorrect by accident or intent, respectively). We review the way in which misinformation can facilitate violent conflicts and, conversely, how the successful refutation of misinformation can contribute to peace. We illustrate the relevant cognitive principles by examining two case studies. The first, a retrospective case, involves the Iraq War of 2003 and the "War on Terror." The second, a prospective case, points to likely future sources of conflict arising from climate change and its likely consequences. PsycINFO Database Record (c) 2013 APA, all rights reserved
Cutting the Nation's Health Care Costs
Davis, Emsley A.
1987-01-01
In 1984 health care expenditures totaled $387.4 billion, and may reach $757.9 billion by 1990. The following factors and their annual cost overrun price tags are the prime forces behind this rapidly growing expense: professional liability insurance, litigations, and defensive medicine, $30 billion; hospital administrative management and employee excess, $6.3 billion; community hospital profits, $8.3 billion; oversupply and duplication of drugs and drug sundries, $22.5 billion; the oversupply of physician specialists, at least $10 to $15 billion; unsolicited physician interpretation of routine, unsophisticated tests, $13.2 billion; and, finally, an American lifestyle adversely affected by illicit drugs ($60 billion), alcohol ($117 billion), and automobile accidents ($43.3 billion), for a total cost of $220 billion yearly. The intent of this article is to educate the public in an open and responsible fashion, and to demonstrate that the health care industry in the United States can save approximately $334.0 billion yearly. PMID:3118051
Burn Control Mechanisms in Tokamaks
NASA Astrophysics Data System (ADS)
Hill, M. A.; Stacey, W. M.
2015-11-01
Burn control and passive safety in accident scenarios will be an important design consideration in future tokamak reactors, in particular fusion-fission hybrid reactors, e.g. the Subcritical Advanced Burner Reactor. We are developing a burning plasma dynamics code to explore various aspects of burn control, with the intent to identify feedback mechanisms that would prevent power excursions. This code solves the coupled set of global density and temperature equations, using scaling relations from experimental fits. Predictions of densities and temperatures have been benchmarked against DIII-D data. We are examining several potential feedback mechanisms to limit power excursions: i) ion-orbit loss, ii) thermal instability density limits, iii) MHD instability limits, iv) the degradation of alpha-particle confinement, v) modifications to the radial current profile, vi) ``divertor choking'' and vii) Type 1 ELMs. Work supported by the US DOE under DE-FG02-00ER54538, DE-FC02-04ER54698.
'Getting the biosecurity architecture right' in the Asia-Pacific region.
Minehata, Masamichi
2012-01-01
This paper offers insights to enhance biosecurity in the Asia-Pacific by asking three questions. What risks/threats are significant in the region? Which security measures should be prioritized? What kind of regional--institutionalized and ad-hoc--arrangements should be implemented? By doing so the paper specifically focuses on two important aspects of biosecurity. Firstly, the issue of immediate capacity-building in the context of disaster relief, public health preparedness and biodefence. Secondly, the long-term preventive aspect, namely education and awareness-raising activities to more broadly promote responsible conduct in life science research in terms of laboratory accidents as well as the intentional use of biological agents for hostile purposes. In order to promote both aspects of biosecurity within the policy process, the paper analyses the strategic value of the US-Japan partnership in its efforts to build a biosecurity architecture in the Asia-Pacific region.
Martínez-Alava, Javier O; Serna, Francisco; Norrbom, Allen L
2017-06-07
Rhagoletis jamaicensis Foote, 1981 and an undetermined species of the psalida group, are recorded for the first time in Colombia. The morphological variations of the Colombian specimens of these species and of other species closely related are discussed.
Visibility of Displayed Information
1978-07-01
assume that the reader is familiar with the concept of the modulation transfer function and has a basic knowledge of Fourier analysis. For exposi ...initial condition m1 (v) = ab + c - mT(G) + k(v)m2(v). Substituting this form into Eq. (E-3) allows the identification of the undetermined constants. 2
Code of Federal Regulations, 2010 CFR
2010-10-01
... distribute these funds after he or she has made a thorough evaluation of the scientific information submitted, and has determined that a commercial fishery failure of a fishery resource arising from natural or undetermined causes has occurred. Funds may only be used to restore the resource affected by the disaster, and...
USDA-ARS?s Scientific Manuscript database
Energy deficit and dietary macronutrient intake are thought to independently modulate cognition, mood and sleep. To what extent manipulating the dietary ratio of protein-to-carbohydrate affects mood, cognition and sleep during short-term energy deficit is undetermined. Using a randomized, block desi...
75 FR 69619 - East Reservoir Project; Kootenai National Forest, Lincoln County, MT
Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-15
... harvest. Vegetation treatments total approximately 13,000 acres of treated area. (2) Road management includes new road construction, road storage and adding existing, undetermined roads to the National Forest Service road system. Approximately 2.04 miles of new road construction is proposed. Approximately 40 miles...
In search of planets and life around other stars.
Lunine, J I
1999-05-11
The discovery of over a dozen low-mass companions to nearby stars has intensified scientific and public interest in a longer term search for habitable planets like our own. However, the nature of the detected companions, and in particular whether they resemble Jupiter in properties and origin, remains undetermined.
2017-08-25
Monoclonal Gammopathy of Undetermined Significance (MGUS); Chronic Lymphocytic Leukemia (CLL); Myelodysplastic-Myeloproliferative Diseases; Hematological Malignancies; B-cell Malignancy, Low-grade; Myelodysplastic Syndrome With Low-grade Lesions; IgG Monoclonal Gammopathy of Uncertain Significance; Smoldering Multiple Myeloma; Waldenstrom Macroglobulinemia
Webb, Roger T; Pickles, Andrew R; Appleby, Louis; Mortensen, Preben B; Abel, Kathryn M
2007-03-01
Offspring of psychiatric inpatients are at higher risk of death from all causes, but their cause-specific risks have not been quantified. To investigate cause-specific deaths at 1 to 25 years in offspring of parents previously admitted as psychiatric inpatients. Population-based cohort study. The entire Danish population. All singleton births (N = 1.38 million) from January 1, 1973, to December 31, 1997, with follow-up to January 1, 1999. Linkage to the national psychiatric register identified all previous parental admissions. Deaths from all natural causes and all unnatural causes, specifically, accidents, homicides, suicides, and undetermined causes. The highest observed relative risk (RR) was for homicide in young and older children with affected mothers or fathers. Homicides were between 5 and 10 times more likely to occur in this group, according to child's age and whether the mother or father had been admitted. There was previous parental admission in approximately one third of all child homicides. We found no evidence of increased risk of homicide in exposed young adults, but this group had a 2-fold to 3-fold higher risk of suicide. In almost one fourth of the suicides, there was a history of parental admission. Young adults with 2 previously admitted parents were 6 times more likely to kill themselves than were their peers in the general population. Relative risk of suicide or open-verdict deaths by poisoning were higher than for such deaths occurring by other means. Almost 99% of children studied survived to their mid-20s. However, they were more vulnerable to death from unnatural causes, notably, homicide during childhood and suicide in early adulthood. Further research is needed to establish how parental psychopathology contributes to increased risk of premature death in these offspring.
NASA Astrophysics Data System (ADS)
Barberie, S. R.
2015-12-01
Since data science does not exist as a stand-alone discipline within major universities, learning data science, or even learning that data science exists is, for an aspiring researcher at the graduate or undergraduate level, something that only happens by accident. Here I present my own series of accidents that transformed me from a somewhat aimless graduate student into an aspiring data scientist and the challenges that that aspiration has created in fitting into traditional academic programs and finding a coherent path forward. I also present my current conundrum: with the clear intention of pursuing data science but an academic background in other subjects, where do I go from here? Do I start my education over, pursue professional certification courses and bootcamp programs, or engage in not-very-marketable self study? This career chasm creates a strange environment for aspiring data scientists where we have a destination, but not a clear road to get there. I also discuss how joining a data focused interest group called The Federation of Earth Science Information Partners (ESIP) bridged some of the gap left by Academia in allowing me to network and collaborate with real data scientists from a variety of backgrounds. Organizations like this may someday play an important role in helping aspiring data scientists find their place, although for the moment many gaps and obstacles still remain, and the path forward is far from clear.
Burden of Violent Death on Years of Life Lost in Rhode Island, 2006-2013.
Jiang, Yongwen; Ranney, Megan L; Perez, Beatriz; Viner-Brown, Samara
2016-11-01
Mortality from injuries, particularly violent injuries, is more common among the young. Although traditional epidemiologic measures describe burden of death using rate-related mortalities, this method may not accurately represent burden of premature death. Years of life lost (YLLs) incorporate time discounting and age weighting to more accurately estimate the burden of death. To the authors' knowledge, there has been no examination of YLLs using the Rhode Island Violent Death Reporting System data. This study's objective was to assess the burden of violent death in Rhode Island in terms of YLLs. This study used 2006-2013 Rhode Island Violent Death Reporting System data. YLLs as a result of premature violent deaths were assessed overall and by age, sex, race/ethnicity, and manner of death. Data were analyzed in 2015. Suicide made the largest contribution to the overall YLLs (61.3%), followed by homicide (24.0%), whereas undetermined intent deaths captured by the system accounted for 14.8% of YLLs. In Rhode Island, people aged 25-44 years had the highest YLLs due to suicide, and Hispanics had the highest YLLs due to homicide/legal intervention. By comparison, using crude mortality rate calculations, people aged 45-64 years had the highest suicide mortality rate and non-Hispanic blacks had the highest homicide mortality rate. YLL calculations provide a different picture than crude mortality-based assessments of the population at highest risk for violent death. This study demonstrates the strengths of using YLL to assess the burden of violent death at the state level. Published by Elsevier Inc.
O'Farrell, I B; Corcoran, P; Perry, I J
2016-06-01
Numerous studies have examined the ecological relationship between suicide and area level determinants such as deprivation and social fragmentation. In Ireland, there is considerable geographic variation in the rates of suicide. However, there is a dearth of Irish studies investigating the geographic variability of suicide. The Irish Central Statistics Office (CSO) provided data relating to all deaths by suicide and deaths of undetermined intent that occurred from 2009 to 2011. Negative binomial regression was used to examine the relationship between area level suicide rates and measures of deprivation, social fragmentation and population density that were taken from the 2011 National Census. Overall deprivation had the strongest independent effect on small-area rates of suicide, with the most deprived areas showing the greatest risk of suicide (risk ratio = 2.1; 95 % CI 1.70-2.52). Low population density (rurality) was associated with an increased risk suicide in males across both age groups and among females in the older 40-64-year age group. Conversely, a weak association between high population density (urbanicity) and increased suicide risk was found among females in the 15-39-year age group. Associations with social fragmentation only became apparent in the sub group analysis. Social fragmentation was associated with an elevated risk of suicide in the older 40-64 age group, with this effect being most pronounced among females. The findings of this study demonstrate marked geographical inequalities in the distribution of suicide in Ireland and highlight the importance of targeting suicide prevention resources in the most deprived areas.
Who is Overdosing? An Updated Picture of Overdose Deaths From 2008 to 2015.
Eigner, Gregory; Henriksen, Brian; Huynh, Philip; Murphy, David; Brubaker, Christopher; Sanders, Jana; McMahan, Deborah
2017-01-01
To determine the role of opioids in drug overdose deaths in Allen County, Indiana between January 1, 2008, and December 31, 2015. File review of 418 overdose deaths was performed using Indiana State Department of Health death certificates available through the Allen County Coroner's Office. Data from autopsy and toxicology reports and coroner-requested prescribing data from Indiana's Prescription Monitoring Program were reviewed. Cause of death and available data were analyzed to identify patterns and trends related to overdose deaths. Four hundred eighteen drug overdose deaths were identified (336 accidental, 66 intentional, and 16 undetermined). Mean age was 42.5 years, 88.5% were Caucasian, and 68.7% were employed. The majority of deaths occurred at a place of residence (71.4%) and with other people present (57.5% of the time). Depression was the most common comorbidity identified. The most common drug classes identified by toxicology were opioids, followed by benzodiazepines. Significant increases in both heroin (35% of deaths in 2015 versus 8.2% in 2013) and fentanyl (30% of deaths in 2015 versus 2.2% in 2011) were observed. Drug overdose continues to be a significant cause of death in Allen County. The majority of deaths were accidental and in relatively young, employed individuals. Prevention and awareness strategies should be encouraged, given that the majority of overdose deaths occurred at a place of residence with other people frequently present. Additional concerns about patterns of drug use were confirmed with marked increases in both heroin and fentanyl contributing to overdose deaths in the latter part of the study.
AHTR Mechanical, Structural, and Neutronic Preconceptual Design
DOE Office of Scientific and Technical Information (OSTI.GOV)
Varma, V.K.; Holcomb, D.E.; Peretz, F.J.
2012-09-15
This report provides an overview of the mechanical, structural, and neutronic aspects of the Advanced High Temperature Reactor (AHTR) design concept. The AHTR is a design concept for a large output Fluoride salt cooled High-temperature Reactor (FHR) that is being developed to enable evaluation of the technology hurdles remaining to be overcome prior to FHRs becoming an option for commercial reactor deployment. This report documents the incremental AHTR design maturation performed over the past year and is focused on advancing the design concept to a level of a functional, self-consistent system. The reactor concept development remains at a preconceptual levelmore » of maturity. While the overall appearance of an AHTR design is anticipated to be similar to the current concept, optimized dimensions will differ from those presented here. The AHTR employs plate type coated particle fuel assemblies with rapid, off-line refueling. Neutronic analysis of the core has confirmed the viability of a 6-month two-batch cycle with 9 wt. % enriched uranium fuel. Refueling is intended to be performed automatically under visual guidance using dedicated robotic manipulators. The report includes a preconceptual design of the manipulators, the fuel transfer system, and the used fuel storage system. The present design intent is for used fuel to be stored inside of containment for at least six months and then transferred to local dry wells for intermediate term, on-site storage. The mechanical and structural concept development effort has included an emphasis on transportation and constructability to minimize construction costs and schedule. The design intent is that all components be factory fabricated into rail transportable modules that are assembled into subsystems at an on-site workshop prior to being lifted into position using a heavy-lift crane in an open-top style construction. While detailed accident identification and response sequence analysis has yet to be performed, the design concept incorporates fully passive responses to all identified design basis or non-very-low frequency beyond design basis accidents as well as multiple levels of radioactive material containment. Key building design elements include (1) below grade siting to minimize vulnerability to aircraft impact, (2) multiple natural circulation decay heat rejection chimneys, (3) seismic base isolation, and (4) decay heat powered back-up electricity generation.« less
AHTR Mechanical, Structural, And Neutronic Preconceptual Design
DOE Office of Scientific and Technical Information (OSTI.GOV)
Varma, Venugopal Koikal; Holcomb, David Eugene; Peretz, Fred J
2012-10-01
This report provides an overview of the mechanical, structural, and neutronic aspects of the Advanced High Temperature Reactor (AHTR) design concept. The AHTR is a design concept for a large output Fluoride salt cooled High-temperature Reactor (FHR) that is being developed to enable evaluation of the technology hurdles remaining to be overcome prior to FHRs becoming a commercial reactor class. This report documents the incremental AHTR design maturation performed over the past year and is focused on advancing the design concept to a level of a functional, self-consistent system. The AHTR employs plate type coated particle fuel assemblies with rapid,more » off-line refueling. Neutronic analysis of the core has confirmed the viability of a 6-month 2-batch cycle with 9 weight-percent enriched uranium fuel. Refueling is intended to be performed automatically under visual guidance using dedicated robotic manipulators. The present design intent is for used fuel to be stored inside of containment for at least 6 months and then transferred to local dry wells for intermediate term, on-site storage. The mechanical and structural concept development effort has included an emphasis on transportation and constructability to minimize construction costs and schedule. The design intent is that all components be factory fabricated into rail transportable modules that are assembled into subsystems at an on-site workshop prior to being lifted into position using a heavy-lift crane in an open-top style construction. While detailed accident identification and response sequence analysis has yet to be performed, the design concept incorporates multiple levels of radioactive material containment including fully passive responses to all identified design basis or non-very-low frequency beyond design basis accidents. Key building design elements include: 1) below grade siting to minimize vulnerability to aircraft impact, 2) multiple natural circulation decay heat rejection chimneys, 3) seismic base isolation, and 4) decay heat powered back-up electricity generation. The report provides a preconceptual design of the manipulators, the fuel transfer system, and the salt transfer loops. The mechanical handling of the fuel and how it is accomplished without instrumentation inside the salt is described within the report. All drives for the manipulators reside outside the reactor top flange. The design has also taken into account the transportability of major components and how they will be assembled on site« less
Tavafian, Sedigheh Sadat; Aghamolaei, Teamur; Gregory, David; Madani, Abdoulhossain
2011-02-01
Seat belt use plays an important role in traffic safety by reducing the severity of injuries and fatality rates during vehicle accidents. The aim of this study was to investigate predictors of self-reported seat belt use in a sample of automobile drivers in Bandar Abbas, Iran. The theory of planed behavior and the health belief model served as the conceptual framework for the study. The convenience sample consisted of 284 eligible automobile drivers who frequented 8 petrol stations in different geographical areas of the city. Of the drivers approached to participate in the study, 21 declined to take part in the study and 12 other questionnaires were incomplete. Thus, a total of 251 questionnaires were analyzed (response rate=88.4%). A self-administered questionnaire including demographic characteristics and items arising from the theory of planed behavior and health belief model constructs were used to collect data. Data were analyzed using SPSS 16 (version 16, Chicago, IL, USA). The subjects' mean age was 31.6 years (SD=8.7), mostly male (72.9%), and 53.4 percent of them reported that they used their seat belt "often." Multiple regression analyses revealed that from the theory of planed behavior, attitude, subjective norms, and perceived behavioral control significantly predicted intention to use a seat belt (R2=0.38, F=51.1, p<.001); and subjective norms, perceived behavioral control, and behavioral intention significantly predicted seat belt use (R2=0.43, F=45.7, p<.001). Arising from the health belief model, perceived benefits and perceived barriers significantly predicted seat belt use (R2=0.39, F=26.2, p<.001). This study revealed that automobile drivers who perceived more subjective norms, more behavioral control, greater intention to use seat belts as well as more benefits and fewer barriers were more likely to use their seat belts.
USDA-ARS?s Scientific Manuscript database
Infection with Sarcocystis spp. often resolves in a progressive decline in muscle integrity. The underlying cause for this has remained undetermined. Previously, we described the presence of proinflammatory muscle protein nitration (PMPN) in calves (ScI) chronically infected with Sarcocystis cruzi. ...
CPA Perceptions of Human Skills for Professional Competency Development Needs
ERIC Educational Resources Information Center
Day, Kari C.
2017-01-01
This study addressed CPA perceptions about the need for human skill competencies as professional development. The problem was identified as the undetermined assessment of state level CPA perceptions about human skill competencies as developmental needs. CPAs and education providers may be impacted by this problem. The purpose of this study was to…
77 FR 9660 - Proposed Data Collections Submitted for Public Comment and Recommendations
Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-17
... target age range with a normal Pap test and a negative HPV DNA test. Primary goals of the study are to... Description The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) is the only organized... secondary screening tool for ASCUS (Atypical Squamous Cells of Undetermined Significance), and as a primary...
ERIC Educational Resources Information Center
Lastica, Joelle R.
2009-01-01
In her book Borderlands/La frontera: The New Mestiza, Gloria Anzaldua writes of a "Borderlands," which she describes as "a vague and undetermined place created by the emotional residue of an unnatural boundary....a constant state of transition" (1999, p. 25). In this paper, I explore my own borderlands, between the spaces of my classroom as a…
ERIC Educational Resources Information Center
Weitlauf, Amy S.; Gotham, Katherine O.; Vehorn, Alison C.; Warren, Zachary E.
2014-01-01
Proposed DSM-5 revisions to the diagnosis of autism spectrum disorder (ASD) include a "severity" marker based on degree of impairment. Although qualitative differences between support levels are described, quantitative methods or practice recommendations for differentiating between levels remain undetermined. This leaves the field…
The "Eye Avoidance" Hypothesis of Autism Face Processing
ERIC Educational Resources Information Center
Tanaka, James W.; Sung, Andrew
2016-01-01
Although a growing body of research indicates that children with autism spectrum disorder (ASD) exhibit selective deficits in their ability to recognize facial identities and expressions, the source of their face impairment is, as yet, undetermined. In this paper, we consider three possible accounts of the autism face deficit: (1) the holistic…
The Occurrence and Prevalence of Giraffe Skin Disease in Protected Areas of Northern Tanzania.
Lee, Derek E; Bond, Monica L
2016-07-01
Giraffe skin disease (GSD) is a disorder of undetermined etiology that causes lesions on the forelimbs of Masai giraffe ( Giraffa camelopardalis tippelskirchi). We estimated occurrence and prevalence of GSD in six wildlife conservation areas of Tanzania. The disjunct spatial pattern of occurrence implies that environmental factors may influence GSD.
In search of planets and life around other stars
Lunine, Jonathan I.
1999-01-01
The discovery of over a dozen low-mass companions to nearby stars has intensified scientific and public interest in a longer term search for habitable planets like our own. However, the nature of the detected companions, and in particular whether they resemble Jupiter in properties and origin, remains undetermined. PMID:10318886
The Role of Attention in the Academic Attainment of Children with Autism Spectrum Disorder
ERIC Educational Resources Information Center
May, Tamara; Rinehart, Nicole; Wilding, John; Cornish, Kim
2013-01-01
Academic attainment in children with Autism Spectrum Disorder (ASD) is under-studied, with associated factors largely undetermined. Parent-reported attention symptoms, attentional-switching and sustained-attention tasks were examined to determine relationships with mathematics and reading attainment in 124 children aged 7-12 years; sixty-four with…
Local Educators Prepare to Use One-Time Funds
ERIC Educational Resources Information Center
Hoff, David J.
2009-01-01
The Los Angeles Unified School District stands to receive an estimated $566 million in extra Title I and special education money--plus an undetermined amount of state stabilization money--from the federal stimulus package. This article reports that officials in hard-hit states like California are breathing a little easier now that they can use…
History, Philosophy, and Science in a Social Perspective: A Pedagogical Project
ERIC Educational Resources Information Center
Guerra, Andreia; Braga, Marco; Reis, Jose Claudio
2013-01-01
Various studies have promoted instruction in the history and philosophy of science (HPS) in science classes, but the best way of putting this perspective into practice remains undetermined. To contribute to this issue, we developed a pedagogical project in some high schools in Brazil that aimed to present science content using an…
16 CFR 303.13 - Sale of remnants and products made of remnants.
Code of Federal Regulations, 2010 CFR
2010-01-01
... ACTS OF CONGRESS RULES AND REGULATIONS UNDER THE TEXTILE FIBER PRODUCTS IDENTIFICATION ACT § 303.13... information as “remnants of undetermined fiber content.” (2) Where such remnants of fabrics are displayed for... conjunction with such display, stating with respect to required fiber content disclosure that the goods are...
ICUS/CCUS/CHIP: basics & beyond.
Jain, Mili; Tripathi, Anil
2017-10-01
Patients presenting with idiopathic cytopenia with non-diagnostic marrow morphology and a normal karyotype pose a diagnostic and therapeutic challenge. Additional diagnostic information from mutation analysis could provide important clinical insights. However, one has to be cautious during such diagnostic interpretations in view of the recent documentation of clonal somatic mutations in healthy elder individuals. Whether to regard clonality synonymous with malignant proliferation or a manifestation of ageing process is to be judged carefully. Areas covered: The review covers defining criteria and diagnostic work up for Idiopathic cytopenia of undetermined significance (ICUS), Clonal cytopenia of undetermined significance (CCUS), Clonal hematopoiesis of indeterminate potential (CHIP). It also presents the results from previous reports on this subject. In addition the evolution and potential impact of these entities is discussed. Expert commentary: Current evidence does not support the use of somatic mutations as presumptive evidence of myelodysplastic syndrome (MDS). Including CCUS under the category of MDS requires further insight on natural disease course. Longitudinal follow up study on ICUS, CCUS, CHIP may eventually identify the pathological significance of the clonal mutations. An absence of mutation however may still be useful as good predictor of not having MDS.
Gómez Alcaraz, Jorge; Bustamante, José; Corral, Ervigio; Casado Florez, Maria Isabel; Vivas, David; Cañadas-Godoy, Victoria; González Del Castillo, Juan; González Armengol, Juan Jorge; López-Farré, Antonio; Martín Sánchez, Francisco Javier
2018-04-25
To study the frequency of genetic mutations related to genetic heart disease among young patients admitted for syncope during sport practice. A case series study that included patients≤45 years admitted for syncope during sport practice during 2010-2011. We collected demographic and clinical variables, genetic tests mutations and final clinical diagnosis. A genetic test was performed in 46 (76.7%) of 60 patients evaluated. The genetic test was positive in 12 (26%; 95% CI 15.6-40.3) patients; 10 (21.7%) had PKP2 mutation related to arrhythmogenic right ventricular dysplasia mutation, one (2.2%) KCNQ1 mutation and one (2.2%) SCN5A mutation related to channelopathies. The genetic test was positive in 11 (35.5%) cases of undetermined syncope and one (50%) case of cardiac syncope, being negative in all cases with neuromediated syncopes (P=.037). Gene mutations are common in young patients suffering from syncope during sports, especially in those with cardiac or undetermined aetiology. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.
Density profiles of supernova matter and determination of neutrino parameters
NASA Astrophysics Data System (ADS)
Chiu, Shao-Hsuan
2007-08-01
The flavor conversion of supernova neutrinos can lead to observable signatures related to the unknown neutrino parameters. As one of the determinants in dictating the efficiency of resonant flavor conversion, the local density profile near the Mikheyev-Smirnov-Wolfenstein (MSW) resonance in a supernova environment is, however, not so well understood. In this analysis, variable power-law functions are adopted to represent the independent local density profiles near the locations of resonance. It is shown that the uncertain matter density profile in a supernova, the possible neutrino mass hierarchies, and the undetermined 1-3 mixing angle would result in six distinct scenarios in terms of the survival probabilities of νe and ν¯e. The feasibility of probing the undetermined neutrino mass hierarchy and the 1-3 mixing angle with the supernova neutrinos is then examined using several proposed experimental observables. Given the incomplete knowledge of the supernova matter profile, the analysis is further expanded to incorporate the Earth matter effect. The possible impact due to the choice of models, which differ in the average energy and in the luminosity of neutrinos, is also addressed in the analysis.
Gökçal, Elif; Niftaliyev, Elvin; Asil, Talip
2017-09-01
Analysis of stroke subtypes is important for making treatment decisions and prognostic evaluations. The TOAST classification system is most commonly used, but the CCS and ASCO classification systems might be more useful to identify stroke etiologies in young patients whose strokes have a wide range of different causes. In this manuscript, we aim to compare the differences in subtype classification between TOAST, CCS, and ASCO in young stroke patients. The TOAST, CCS, and ASCO classification schemes were applied to 151 patients with ischemic stroke aged 18-49 years old and the proportion of subtypes classified by each scheme was compared. For comparison, determined etiologies were defined as cases with evident and probable subtypes when using the CCS scheme and cases with grade 1 and 2 subtypes but no other grade 1 subtype when using the ASCO scheme. The McNemar test with Bonferroni correction was used to assess significance. By TOAST, 41.1% of patients' stroke etiology was classified as undetermined etiology, 19.2% as cardioembolic, 13.2% as large artery atherosclerosis, 11.3% as small vessel occlusion, and 15.2% as other causes. Compared with TOAST, both CCS and ASCO assigned fewer patients to the undetermined etiology group (30.5% p < 0.001 and 26.5% p < 0.001, respectively) and assigned more patients to the small vessel occlusion category (19.9%, p < 0.001, and 21.9%, p < 0.001, respectively). Additionally, both schemes assigned more patients to the large artery atherosclerosis group (15.9 and 16.6%, respectively). The proportion of patients assigned to either the cardioembolic or the other causes etiology did not differ significantly between the three schemes. Application of the CCS and ASCO classification schemes in young stroke patients seems feasible, and using both schemes may result in fewer patients being classified as undetermined etiology. New studies with more patients and a prospective design are needed to explore this topic further.
Brandler, Tamar C; Aziz, Mohamed S; Coutsouvelis, Constantinos; Rosen, Lisa; Rafael, Oana C; Souza, Fabiola; Jelloul, Fatima-Zahra; Klein, Melissa A
2016-01-01
The Bethesda system (TBS) for the reporting of thyroid cytopathology established the category of atypia of undetermined significance (AUS) with a 7% target rate and a 5% to 15% implied malignancy risk. Recent literature has reported a broad range of AUS rates, subsequent malignancy rates, and discrepant results from repeat fine-needle aspiration (FNA) versus surgical follow-up. Therefore, this study examined AUS data from the Hofstra North Shore-LIJ School of Medicine to determine the best clinical follow-up. Thyroid aspirates interpreted as AUS in 2012-2014 at the Hofstra North Shore-LIJ School of Medicine were collected. Repeat FNA and surgical follow-up data were tabulated to establish AUS, secondary AUS (diagnosed upon repeat FNA follow-up of a primary FNA AUS diagnosis), atypia of undetermined significance/malignancy (AUS:M) ratios (according to the TBS categories), and malignancy rates for AUS. The AUS rate was 8.5% (976/11,481), and there was follow-up data for 545 cases. The AUS:M ratio was 2.0. Repeat FNA was performed for 281 cases; 57 proceeded to surgical intervention. Repeat FNA reclassified 71.17% of the cases. The malignancy rates for AUS cases proceeding directly to surgery and for those receiving a surgical intervention after a repeat AUS diagnosis were 33.33% and 43.75%, respectively. Repeat FNA resulted in definitive diagnostic reclassification for 67.61% of primary AUS cases and reduced the number of patients triaged to surgery, with 56.58% of the cases recategorized as benign. Cases undergoing surgery after repeat AUS had a higher malignancy rate than those going straight to surgery, and this emphasizes the value of repeat FNA in selecting surgical candidates. In addition, this study highlights the utility of AUS rate monitoring as a quality measure that has contributed to the ability of the Hofstra North Shore-LIJ School of Medicine to adhere closely to TBS recommendations. © 2016 American Cancer Society.
Haeusler, Karl Georg; Wollboldt, Christian; Bentheim, Laura Zu; Herm, Juliane; Jäger, Sebastian; Kunze, Claudia; Eberle, Holger-Carsten; Deluigi, Claudia Christina; Bruder, Oliver; Malsch, Carolin; Heuschmann, Peter U; Endres, Matthias; Audebert, Heinrich J; Morguet, Andreas J; Jensen, Christoph; Fiebach, Jochen B
2017-05-01
Etiology of acute ischemic stroke remains undetermined (cryptogenic) in about 25% of patients after state-of-the-art diagnostic work-up. One-hundred and three patients with magnetic resonance imaging (MRI)-proven acute ischemic stroke of undetermined origin were prospectively enrolled and underwent 3-T cardiac MRI and magnetic resonance angiography of the aortic arch in addition to state-of-the-art diagnostic work-up, including transesophageal echocardiography (TEE). We analyzed the feasibility, diagnostic accuracy, and added value of cardiovascular MRI (cvMRI) compared with TEE for detecting sources of stroke. Overall, 102 (99.0%) ischemic stroke patients (median 63 years [interquartile range, 53-72], 24% female, median NIHSS (National Institutes of Health Stroke Scale) score on admission 2 [interquartile range, 1-4]) underwent cvMRI and TEE in hospital; 89 (86.4%) patients completed the cvMRI examination. In 93 cryptogenic stroke patients, a high-risk embolic source was found in 9 (8.7%) patients by cvMRI and in 11 (11.8%) patients by echocardiography, respectively. cvMRI and echocardiography findings were consistent in 80 (86.0%) patients, resulting in a degree of agreement of κ=0.24. In 82 patients with cryptogenic stroke according to routine work-up, including TEE, cvMRI identified stroke etiology in additional 5 (6.1%) patients. Late gadolinium enhancement consistent with previous myocardial infarction was found in 13 (14.6%) out of 89 stroke patients completing cvMRI. Only 2 of these 13 patients had known coronary artery disease. Our study demonstrated that cvMRI was feasible in the vast majority of included patients with acute ischemic stroke. The diagnostic information of cvMRI seems to be complementary to TEE but is not replacing echocardiography after acute ischemic stroke. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01917955. © 2017 American Heart Association, Inc.
Boyd, Theonia K.; Wright, Colleen A.; Odendaal, Hein J.; Elliott, Amy J.; Sens, Mary Ann; Folkerth, Rebecca D.; Roberts, Drucilla J.; Kinney, Hannah C.
2017-01-01
OBJECTIVE Describe the classification system for the assignment of the cause of death for stillbirth in the Safe Passage Study, an international, multi-institutional, prospective analysis conducted by the NIAAA/NICHD funded PASS Network (The Prenatal Alcohol in SIDS and Stillbirth (PASS) Research Network). The study mission is to determine the role of prenatal alcohol and/or cigarette smoke exposure in adverse pregnancy outcomes, including stillbirth, in a high-risk cohort of 12,000 maternal/fetal dyads. METHODS The PASS Network classification system is based upon 5 ‘sites of origin’ for cause of stillbirth (Fetal, Placental, Maternal, External/Environmental, or Undetermined), further subdivided into mechanism subcategories (e.g., Placental Perfusion Failure). Both site of origin and mechanism stratification are employed to assign an ultimate cause of death. Each PASS stillbirth (n=19) in the feasibility study was assigned a cause of death, and status of sporadic versus recurrent. Adjudication involved review of the maternal and obstetrical records, and fetal autopsy and placental findings, with complete consensus in each case. Two published classification systems, i.e., INCODE and ReCoDe, were used for comparison. RESULTS Causes of stillbirth classified were: fetal (n=5, 26%), placental (n=10, 53%), external (n=1, 5%), and undetermined (n=3, 16%). Nine cases (47%) had placental causes of death due to maternal disorders that carry recurrence risks. There was complete agreement for the cause of death across the three classification systems in 26% of cases, and a combination of partial or complete agreement in 68% of cases. Complete vs. partial agreements were predicated upon the classification schemes used for comparison. CONCLUSIONS The proposed PASS system is a user-friendly classification system that provides comparable information to previously published systems. Advantages include its simplicity, mechanistic formulations, tight clinicopathologic integration, provision for an undetermined category, and its wide applicability for use by perinatal mortality review boards with access to information routinely collected during clinicopathologic evaluations. PMID:27116324
Falconi, Caterina; López-Olvera, Jorge Ramón; Boadella, Mariana; Camarena, Javier; Rosell, Rosa; Alcaide, Vicente; Vicente, Joaquín; Sánchez-Vizcaíno, José Manuel; Pujols, Joan; Gortázar, Christian
2012-09-14
Bluetongue (BT) is an infectious disease of wild and domestic ruminants caused by bluetongue virus (BTV). BTV-4 spread through southern Spain from 2004 to 2006, whereas a BTV-1 outbreak that started in southern Spain in 2007 is still ongoing. Vaccination and movement restriction regulations are applied to domestic ruminants to control BT, but the potential reservoir role of wild European ungulates has not been clarified so far. The aim of this study was to describe the epidemiology of BTV in the wild free-ranging red deer (Cervus elaphus) population of Cabañeros National Park (CNP) in central Spain during the BTV-4 and BTV-1 epizootics, assessing the potential role of this deer population as a BTV reservoir. Blood samples from 2885 (2542 adults, 208 calves and 135 undetermined) wild red deer were collected from 2005 to 2010 in CNP and surrounding hunting estates. All sera were tested for antibodies against the BTV VP7 protein by ELISA. Ninety-four of the ELISA-positive samples were analysed by serum neutralization to detect BTV-4 and BTV-1 specific antibodies, and 142 blood samples were analysed by RT-PCR for BTV RNA. A total of 371 (12.9%) out of the 2,885 deer (35/208 calves, 307/2,542 adults, and 29/135 undetermined) were positive for antibodies against BTV. Prevalence increased in adult deer from 2005-2006 to 2008-2009, declining thereafter. No positive samples for BTV-1 were found by serum neutralization, whereas 43 deer (38 adults, four calves and one undetermined) were positive for BTV-4 specific antibodies. No BTV RNA positive deer were found by RT-PCR. Antibody detection throughout the study period suggests a maintained circulation of BTV in red deer. However, the lack of BTV RNA detection suggests a minor transmission risk to livestock. Copyright © 2012 Elsevier B.V. All rights reserved.
Geometric and Road Environmental Effects against Total Number of Traffic Accidents in Kendari
NASA Astrophysics Data System (ADS)
Kurdin, M. Akbar; Welendo, La; Annisa, Nur
2017-05-01
From the large number of traffic accidents that occurred, the carrying of Kendari as the biggest contributor to accidents in the Southeast. The number of accidents in Kendari row since 2011 was recorded at 18 accidents due to the influence of geometric road, in 2012 registered at 13 accident and in 2013 amounted to 6 accidents, with accident data because of the influence Geometric recorded for 3 consecutive years the biggest contributor to accidents because of the influence of geometric is Abeli districts. This study aimed to determine the road which common point of accident-prone (Black spot) in Kecamatan Abeli as accident-prone areas in Kendari, analyze the influence of geometric and road environment against accidents on roads in Kecamatan Abeli, provide alternative treatment based on the causes of accidents on the location of the accident-prone points (blackspot) to reduce the rate of traffic accidents. From the results of a study of 6 curve the accident-prone locations, that the curve I, II, and VI is the “Black Spot” influenced by the amount and condition of traffic accidents, while at the curve II, a traffic accident that occurred also be caused by unsafe geometric where the type of geometric should be changed from Spiral-Spiral type to Spiral-Circle-Spiral type. This indicates geometric effect on the number of accidents.
USDA-ARS?s Scientific Manuscript database
Species of Colletotrichum interact with a vast but as yet undetermined number of plant species as pathogens and as asymptomatic endophytes. It is not known, however, whether these contrasting ecological modes are optional strategies exercised by individual species or whether species ecology is more ...
Rate of Financial Return to University Schooling among Lecturers in Two Public Universities in Kenya
ERIC Educational Resources Information Center
Rugar, T. O.; Ayodo, T. M. O.; Agak, J. O.
2010-01-01
Influence of education on earnings among workers is well documented. However, the level of relationship that exists between earnings and schooling among lecturers in public universities in Kenya remain undetermined. The purpose of this study was to establish the financial profitability of university schooling in Kenya. The study was based on the…
Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ®)—Patient Version
Plasma cell neoplasms occur when abnormal plasma cells or myeloma cells form tumors in the bones or soft tissues of the body. Multiple myeloma, plasmacytoma, lymphoplasmacytic lymphoma, and monoclonal gammopathy of undetermined significance (MGUS) are different types of plasma cell neoplasms. Find out about risk factors, symptoms, diagnostic tests, prognosis, and treatment for these diseases.
ERIC Educational Resources Information Center
Bell, Emily; Wallace, Tessa; Chouinard, Isabelle; Shevell, Michael; Racine, Eric
2011-01-01
Faced with the limitations of currently available mainstream medical treatments and interventions, parents of children with neurodevelopmental disorders often seek information about unproven interventions. These interventions frequently have undetermined efficacy and uncertain safety profiles. In this article, we present a general background and…
NASA Technical Reports Server (NTRS)
Mendis, A.; Alfven, H.
1976-01-01
Physico-chemical processes leading to the dynamic formation and physical evolution of comets are reviewed in relationship to the various theories that propose solar origins, protoplanetary origins, planetary origins and interstellar origins. Evidence points to the origins of comets by the growth and agglomeration of small particles from gas and dust at very low temperatures at undetermined regions in space.
Laboratory hydraulic calibration of the Helley-Smith bedload sediment sampler
Druffel, Leroy; Emmett, W.W.; Schneider, V.R.; Skinner, J.V.
1976-01-01
Filling the sample bag to 40 percent capacity with a sediment larger in diameter than the mesh size of the bag had no effect on the hydraulic efficiency. Particles close to the 0.2 mm mesh size of the sample bag plugged the openings and caused the efficiency to decrease in an undetermined manner.
Long daily movements of wolves (Canis lupus) during pup raising
Mech, L. David; Cluff, H. Dean
2009-01-01
Wolves, Canis lupus, on Ellesmere Island traveled a daily round-trip distance of 40.2 km from their den to a landfill during July 2008, plus an undetermined distance hunting after leaving the landfill. Although long travels by Wolves are well known, this appears to be the first documentation of long daily movements by Wolves rearing pups.
Parental Support for Basic Psychological Needs and Happiness: The Importance of Sense of Uniqueness
ERIC Educational Resources Information Center
Simsek, Omer Faruk; Demir, Meliksah
2013-01-01
Past empirical research relying on self-determination theory (SDT) has consistently shown that parental support of basic psychological needs (BPN) is associated with adolescent happiness. Yet, the specific mechanisms accounting for this link are still undetermined. The present study aimed to address this gap in the literature by testing a…
The ToxCast program has generated a wealth of in vitro high throughput screening data, and best approaches for the interpretation and use of these data remain undetermined. We present case studies comparing the ToxCast and in vivo toxicity data for two food contact substances us...
USDA-ARS?s Scientific Manuscript database
Helminths induce potent Th2-type immune responses that can lead to worm expulsion, but it remains undetermined whether components of this response can enhance the wound healing responses elicited as these large multi-cellular parasites traffic thru vital tissues. We used a model of helminth infecti...
McAuliffe, Carmel; Corcoran, Paul; Hickey, Portia; McLeavey, Breda C
2008-03-01
To investigate the association between optional thinking (the ability to generate alternative solutions to interpersonal problems) in deliberate self-harm (DSH) patients and repeated self-harm. A prospective study of the association between optional thinking in interpersonal problem solving and repeated DSH within 12 months. A non-consecutive sample (N=152) of DSH patients presenting to the Accident and Emergency department of an acute hospital in Cork city, Ireland, was assessed using a structured interview schedule including the Suicide Intent Scale, the Hopelessness Scale, and the Optional Thinking Test. Repetition within 1 year was established by checking Accident and Emergency records at all three city hospitals. Participants were categorized as repeaters if they engaged in at least one further hospital-treated DSH episode, or non-repeaters. Approximately two-thirds (63.1%) of the sample had engaged in at least one act of DSH prior to their index episode. During follow-up 31 individuals (20.4%) repeated. History of self-harm was significantly associated with prospective repetition when considered alongside all the other predictor variables. Among first evers, low scores on the optional thinking test were significantly associated with the increased risk of repetition within 12 months. Among those with previous DSH, there was no evidence of an association between optional thinking and repetition within 12 months. Poor optional thinking is associated with increased risk of repeated deliberate self-harm in those who present with a first self-harm episode. Interventions to improve optional thinking skills, delivered soon after a first DSH presentation, may be useful in preventing repetition.
Murder and robbery by vehicular impact: true vehicular homicide.
Nadesan, K
2000-06-01
True vehicular homicides are defined as those occurrences in which a motor vehicle is intentionally used as a weapon in taking of a life. A case is presented in which the deceased was traveling in the front passenger seat of a motor car that was deliberately rammed by a heavy jeep that came in the opposite direction, resulting in a serious frontal collision. Immediately after the impact, while the occupants of the car were lying in a dazed condition, the two persons riding in the jeep escaped with a bag containing money that was in the car, leaving the jeep behind. The impact mainly involved the driver's sides of both vehicles. The driver of the car sustained serious injuries but was found to be alive, whereas the front-seat passenger, who did not show any serious external injuries, was found to be in a collapsed state and was pronounced dead on admission to the hospital within 30 minutes of the accident. The autopsy revealed that death was caused by closed hemopericardium from a ruptured right atrium. The evaluation of the external and internal injuries confirmed that the fatal injury and a few serious internal injuries were caused by the seat belt (tertiary-impact injuries). The ruptured right atrium was attributed to blunt abdominal trauma by impacting against the lap belt. The case was a true vehicular homicide in which a motor vehicle had been used as a weapon to kill a person. Various aspects pertaining to road accidents, the safety of the occupants, and the advantage and disadvantage of the safety devices are discussed.
Deaths: Leading Causes for 2012.
Heron, Melonie
2015-08-31
This report presents final 2012 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2012," the National Center for Health Statistics' annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2012. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2012, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer's disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). These causes accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2012 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods.
Deaths: leading causes for 2009.
Heron, Melonie
2012-10-26
This report presents final 2009 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the Division of Vital Statistics' annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2009. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2009, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer's disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). These causes accounted for approximately 75% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2009 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods.
Deaths: leading causes for 2008.
Heron, Melonie
2012-06-06
This report presents final 2008 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the Division of Vital Statistics' annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2008. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. in 2008, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer's disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for approximately 76 percent of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2008 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods.
NASA Astrophysics Data System (ADS)
Heo, S.; Lee, W. K.; Jong-Ryeul, S.; Kim, M. I.
2016-12-01
The use of chemical compounds are keep increasing because of their use in manufacturing industry. Chemical accident is growing as the consequence of the chemical use increment. Devastating damages from chemical accidents are far enough to aware people's cautious about the risk of the chemical accident. In South Korea, Gumi Hydrofluoric acid leaking accident triggered the importance of risk management and emphasized the preventing the accident over the damage reducing process after the accident occurs. Gumi accident encouraged the government data base construction relate to the chemical accident. As the result of this effort Chemical Safety-Clearing-house (CSC) have started to record the chemical accident information and damages according to the Harmful Chemical Substance Control Act (HCSC). CSC provide details information about the chemical accidents from 2002 to present. The detail informations are including title of company, address, business type, accident dates, accident types, accident chemical compounds, human damages inside of the chemical industry facilities, human damage outside of the chemical industry facilities, financial damages inside of the chemical industry facilities, and financial damages outside of the chemical industry facilities, environmental damages and response to the chemical accident. Collected the chemical accident history of South Korea from 2002 to 2015 and provide the spatial information to the each accident records based on their address. With the spatial information, compute the data on ArcGIS for the spatial-temporal analysis. The spatial-temporal information of chemical accident is organized by the chemical accident types, damages, and damages on environment and conduct the spatial proximity with local community and environmental receptors. Find the chemical accident vulnerable area of South Korea from 2002 to 2015 and add the vulnerable area of total period to examine the historically vulnerable area from the chemical accident in South Korea.
Khakzad, Nima; Khan, Faisal; Amyotte, Paul
2015-07-01
Compared to the remarkable progress in risk analysis of normal accidents, the risk analysis of major accidents has not been so well-established, partly due to the complexity of such accidents and partly due to low probabilities involved. The issue of low probabilities normally arises from the scarcity of major accidents' relevant data since such accidents are few and far between. In this work, knowing that major accidents are frequently preceded by accident precursors, a novel precursor-based methodology has been developed for likelihood modeling of major accidents in critical infrastructures based on a unique combination of accident precursor data, information theory, and approximate reasoning. For this purpose, we have introduced an innovative application of information analysis to identify the most informative near accident of a major accident. The observed data of the near accident were then used to establish predictive scenarios to foresee the occurrence of the major accident. We verified the methodology using offshore blowouts in the Gulf of Mexico, and then demonstrated its application to dam breaches in the United Sates. © 2015 Society for Risk Analysis.
Firearm related deaths: the impact of regulatory reform.
Ozanne-Smith, J; Ashby, K; Newstead, S; Stathakis, V Z; Clapperton, A
2004-10-01
To examine trends in rates of firearm related deaths in Victoria, Australia, over 22 years in the context of legislative reform and describe and investigate impact measures to explain trends. Mortality data were extracted from vital statistics for 1979-2000. Data on firearm related deaths that were unintentional deaths, assaults, suicides, and of undetermined intent were analyzed. Rates were calculated with population data derived from estimates by the Australian Bureau of Statistics. A quasi-experimental design that used a Poisson regression model was adopted to compare relative rates of firearm related deaths for Victoria and the rest of Australia over three critical periods of legislative reform. The Wilcoxon signed ranks test was used to assess changes in the types of firearm related deaths before and after 1998. In Victoria, two periods of legislative reform related to firearms followed mass shooting events in 1988 and 1996. A national firearm amnesty and buyback scheme followed the latter. Victorian and Australian rates of firearm related deaths before reforms (1979-86) were steady. After initial Victorian reforms, a significant downward trend was seen for numbers of all firearm related deaths between 1988 and 1995 (17.3% in Victoria compared with the rest of Australia, p<0.0001). A further significant decline between 1997 and 2000 followed the later reforms. After the later all state legislation, similar strong declines occurred in the rest of Australia from 1997 (14.0% reduction compared with Victoria, p = 0.0372). Victorian reductions were observed in frequencies of firearm related suicides, assaults, and unintentional deaths before and after the 1988 reforms, but statistical significance was reached only for suicide. Dramatic reductions in overall firearm related deaths and particularly suicides by firearms were achieved in the context of the implementation of strong regulatory reform.
Who is Overdosing? An Updated Picture of Overdose Deaths From 2008 to 2015
Eigner, Gregory; Huynh, Philip; Murphy, David; Brubaker, Christopher; Sanders, Jana; McMahan, Deborah
2017-01-01
Purpose: To determine the role of opioids in drug overdose deaths in Allen County, Indiana between January 1, 2008, and December 31, 2015. Methods: File review of 418 overdose deaths was performed using Indiana State Department of Health death certificates available through the Allen County Coroner’s Office. Data from autopsy and toxicology reports and coroner-requested prescribing data from Indiana’s Prescription Monitoring Program were reviewed. Cause of death and available data were analyzed to identify patterns and trends related to overdose deaths. Results: Four hundred eighteen drug overdose deaths were identified (336 accidental, 66 intentional, and 16 undetermined). Mean age was 42.5 years, 88.5% were Caucasian, and 68.7% were employed. The majority of deaths occurred at a place of residence (71.4%) and with other people present (57.5% of the time). Depression was the most common comorbidity identified. The most common drug classes identified by toxicology were opioids, followed by benzodiazepines. Significant increases in both heroin (35% of deaths in 2015 versus 8.2% in 2013) and fentanyl (30% of deaths in 2015 versus 2.2% in 2011) were observed. Conclusions: Drug overdose continues to be a significant cause of death in Allen County. The majority of deaths were accidental and in relatively young, employed individuals. Prevention and awareness strategies should be encouraged, given that the majority of overdose deaths occurred at a place of residence with other people frequently present. Additional concerns about patterns of drug use were confirmed with marked increases in both heroin and fentanyl contributing to overdose deaths in the latter part of the study. PMID:28959707
Firearm related deaths: the impact of regulatory reform
Ozanne-Smith, J; Ashby, K; Newstead, S; Stathakis, V; Clapperton, A
2004-01-01
Objectives: To examine trends in rates of firearm related deaths in Victoria, Australia, over 22 years in the context of legislative reform and describe and investigate impact measures to explain trends. Design: Mortality data were extracted from vital statistics for 1979–2000. Data on firearm related deaths that were unintentional deaths, assaults, suicides, and of undetermined intent were analyzed. Rates were calculated with population data derived from estimates by the Australian Bureau of Statistics. A quasi-experimental design that used a Poisson regression model was adopted to compare relative rates of firearm related deaths for Victoria and the rest of Australia over three critical periods of legislative reform. The Wilcoxon signed ranks test was used to assess changes in the types of firearm related deaths before and after 1998. Results: In Victoria, two periods of legislative reform related to firearms followed mass shooting events in 1988 and 1996. A national firearm amnesty and buyback scheme followed the latter. Victorian and Australian rates of firearm related deaths before reforms (1979–86) were steady. After initial Victorian reforms, a significant downward trend was seen for numbers of all firearm related deaths between 1988 and 1995 (17.3% in Victoria compared with the rest of Australia, p<0.0001). A further significant decline between 1997 and 2000 followed the later reforms. After the later all state legislation, similar strong declines occurred in the rest of Australia from 1997 (14.0% reduction compared with Victoria, p = 0.0372). Victorian reductions were observed in frequencies of firearm related suicides, assaults, and unintentional deaths before and after the 1988 reforms, but statistical significance was reached only for suicide. Conclusion: Dramatic reductions in overall firearm related deaths and particularly suicides by firearms were achieved in the context of the implementation of strong regulatory reform. PMID:15470007
Code of Federal Regulations, 2014 CFR
2014-10-01
... public accident investigation dockets, and accident database data. 837.3 Section 837.3 Transportation... investigation dockets, and accident database data. (a) Demands for material contained in the NTSB's official public docket files of its accident investigations, or its computerized accident database(s) shall be...
Code of Federal Regulations, 2012 CFR
2012-10-01
... public accident investigation dockets, and accident database data. 837.3 Section 837.3 Transportation... investigation dockets, and accident database data. (a) Demands for material contained in the NTSB's official public docket files of its accident investigations, or its computerized accident database(s) shall be...
Code of Federal Regulations, 2010 CFR
2010-10-01
... public accident investigation dockets, and accident database data. 837.3 Section 837.3 Transportation... investigation dockets, and accident database data. (a) Demands for material contained in the NTSB's official public docket files of its accident investigations, or its computerized accident database(s) shall be...
Code of Federal Regulations, 2013 CFR
2013-10-01
... public accident investigation dockets, and accident database data. 837.3 Section 837.3 Transportation... investigation dockets, and accident database data. (a) Demands for material contained in the NTSB's official public docket files of its accident investigations, or its computerized accident database(s) shall be...
Code of Federal Regulations, 2011 CFR
2011-10-01
... public accident investigation dockets, and accident database data. 837.3 Section 837.3 Transportation... investigation dockets, and accident database data. (a) Demands for material contained in the NTSB's official public docket files of its accident investigations, or its computerized accident database(s) shall be...
[Occupational accidents in an oil refinery in Brazil].
Souza, Carlos Augusto Vaz de; Freitas, Carlos Machado de
2002-10-01
Work in oil refineries involves the risk of minor to major accidents. National data show the impact of accidents on this industry. A study was carried out to describe accident profile and evaluate the adequacy of accident reporting system. Data on all accidents reported in an oil refinery in the state of Rio de Janeiro for the year 1997 were organized and analyzed. The study population consisted of 153 injury cases, 83 hired and 69 contracted workers. The variables were: type of accident, operation mode and position of the worker injured. Among hired workers, minor accidents predominated (54.2%) and they occurred during regular operation activities (62.9%). Among contracted workers, there also predominated minor accidents (75.5%) in a higher percentage, but they occurred mainly during maintenance activities (96.8%). The study results showed that there is a predominance of accidents in lower hierarchy workers, and these accidents occur mainly during maintenance activities. There is a need to improve the company's accident reporting system and accident investigation procedures.
Melo, Cristiane Magalhães de; Bevilacqua, Paula Dias; Barletto, Marisa; França, Elisabeth Barboza
2014-09-01
This study aimed to assess the quality of data on deaths from external causes in Viçosa, Minas Gerais State, Brazil, from 2000 to 2009, and the completeness of the Mortality Information System (SIM). The data were obtained from the SIM of the Municipal Health Department, municipal police enquiries, and local newspaper articles, resulting in a databank with 495 deaths from external causes. The results showed a high proportion of deaths with indeterminate intent (21%) in the SIM, suggesting problems with quality of information. Comparison of data from the SIM and police department detected problems with coverage in the SIM (21%) and thus in the official statistics on mortality from accidents and violence. The results emphasize the importance of searches in other data sources to upgrade the SIM and expand its coverage, and especially the need for studies to identify and analyze problems faced by small and medium-sized cities in the production of mortality data.
Detailed Studies on the Structure and Dynamics of Reacting Dusty Flows at Normal and Microgravity
NASA Technical Reports Server (NTRS)
Egolfopoulos, Fokion N.; Campbell, Charles S.
1997-01-01
Two-phase reacting flows are substantially less understood compared to gas phase flows. While extensive work has been done on sprays, less attention has been given to the details of dusty reacting flows. Dusty flows are of particular interest for a wide range of applications. Particles can be present in a gas intentionally or unintentionally, and they can be inert or reacting. Inert particles can be also present in an otherwise reacting gas flow, and that can lead to flame cooling and modification of the extinction limits of a combustible mixture. Reacting solid particles can release substantial amounts of heat upon oxidation, and can be used either for propulsion (e.g. Al, B, Mg) or power generation (coal). Furthermore, accidents can occur when a reacting dust accumulates in air and which, in the presence of an ignition source, can cause explosion. Such explosions can occur during lumber milling, in grain elevators, and in mine galleries.
Literature Survey of Crude Oil Properties Relevant to Handling and Fire Safety in Transport.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lord, David; Luketa, Anay; Wocken, Chad
2015-03-01
Several fiery rail accidents in 2013-2015 in the U.S. and Canada carrying crude oil produced from the Bakken region of North Dakota have raised questions at many levels on the safety of transporting this, and other types of crude oil, by rail. Sandia National Laboratories was commissioned by the U.S. Department of Energy to investigate the material properties of crude oils, and in particular the so-called "tight oils" like Bakken that comprise the majority of crude oil rail shipments in the U.S. at the current time. The current report is a literature survey of public sources of information on crudemore » oil properties that have some bearing on the likelihood or severity of combustion events that may occur around spills associated with rail transport. The report also contains background information including a review of the notional "tight oil" field operating environment, as well a basic description of crude oils and potential combustion events in rail transport. This page intentionally blank« less
CSHM: Web-based safety and health monitoring system for construction management.
Cheung, Sai On; Cheung, Kevin K W; Suen, Henry C H
2004-01-01
This paper describes a web-based system for monitoring and assessing construction safety and health performance, entitled the Construction Safety and Health Monitoring (CSHM) system. The design and development of CSHM is an integration of internet and database systems, with the intent to create a total automated safety and health management tool. A list of safety and health performance parameters was devised for the management of safety and health in construction. A conceptual framework of the four key components of CSHM is presented: (a) Web-based Interface (templates); (b) Knowledge Base; (c) Output Data; and (d) Benchmark Group. The combined effect of these components results in a system that enables speedy performance assessment of safety and health activities on construction sites. With the CSHM's built-in functions, important management decisions can theoretically be made and corrective actions can be taken before potential hazards turn into fatal or injurious occupational accidents. As such, the CSHM system will accelerate the monitoring and assessing of performance safety and health management tasks.
Differences among Job Positions Related to Communication Errors at Construction Sites
NASA Astrophysics Data System (ADS)
Takahashi, Akiko; Ishida, Toshiro
In a previous study, we classified the communicatio n errors at construction sites as faulty intention and message pattern, inadequate channel pattern, and faulty comprehension pattern. This study seeks to evaluate the degree of risk of communication errors and to investigate differences among people in various job positions in perception of communication error risk . Questionnaires based on the previous study were a dministered to construction workers (n=811; 149 adminis trators, 208 foremen and 454 workers). Administrators evaluated all patterns of communication error risk equally. However, foremen and workers evaluated communication error risk differently in each pattern. The common contributing factors to all patterns wer e inadequate arrangements before work and inadequate confirmation. Some factors were common among patterns but other factors were particular to a specific pattern. To help prevent future accidents at construction sites, administrators should understand how people in various job positions perceive communication errors and propose human factors measures to prevent such errors.
Inherited and predisposing factors in the development of gastric dilatation volvulus in dogs.
Bell, Jerold S
2014-09-01
This review article summarizes what is known as well as what is undetermined concerning the inherited and environmental pathogenesis of gastric dilatation volvulus in dogs. The disorder primarily affects large and giant, deep-chested breeds. A concise description of a typical dog affected with gastric dilatation volvulus is presented. Copyright © 2014 Elsevier Inc. All rights reserved.
11. An abandoned electrical system was found under the pressedsteel ...
11. An abandoned electrical system was found under the pressed-steel ceiling. For some undetermined reason the pattern of the ceiling panels has 'photographed' onto the cardboard substrate. Two different panel designs were utilized in a checkerboard pattern. One panel of each design remains in place. Credit GADA/MRM. - Stroud Building, 31-33 North Central Avenue, Phoenix, Maricopa County, AZ
ERIC Educational Resources Information Center
Schieve, Laura A.; Fountain, Christine; Boulet, Sheree L.; Yeargin-Allsopp, Marshalyn; Kissin, Dmitry M.; Jamieson, Denise J.; Rice, Catherine; Bearman, Peter
2015-01-01
Previous studies report associations between conception with assisted reproductive technology (ART) and autism. Whether these associations reflect an ascertainment or biologic effect is undetermined. We assessed diagnosis age and initial autism symptom severity among >30,000 children with autism from a linkage study of California Department of…
Prescribed burning effects on the hydrologic behavior of gullies in the South Carolina Piedmont
M.A. Galang; L.A. Morris; D. Markewitz; C.R. Jackson; E.A Carter
2010-01-01
Gullies found in the Piedmont of South Carolina are legacies of past land use and erosion. Although the majority of these gullies are now under forest vegetation and perceived as geomorphologically stable, the question of gully contribution to nonpoint source pollution remains undetermined, especially when these gullies are subjected to prescribed burning or other...
Code of Federal Regulations, 2014 CFR
2014-01-01
... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Blood meal, tankage, meat meal, and... controlled risk or undetermined risk for BSE of processed animal protein derived from animals other than... protein derived from animals other than ruminants is prohibited importation into the United States unless...
Paschke, Ralf; Cantara, Silvia; Crescenzi, Anna; Jarzab, Barbara; Musholt, Thomas J; Sobrinho Simoes, Manuel
2017-07-01
Molecular fine-needle aspiration (FNA) cytology diagnostics has the potential to address the inherent limitation of FNA cytology which is an indeterminate (atypia of undetermined significance/follicular lesion of undetermined significance follicular neoplasm) cytology. Because of the emerging role of molecular FNA cytology diagnostics, the European Thyroid Association convened a panel of international experts to review methodological aspects, indications, results, and limitations of molecular FNA cytology diagnostics. The panel reviewed the evidence for the diagnostic value of mutation panel assessment (including at least BRAF , NRAS , HRAS , KRAS , PAX8/PPARG , RET/PTC ) of targeted next generation sequencing and of a microarray gene expression classifier (GEC) test in the diagnostic assessment of an indeterminate cytology thyroid nodule. Moreover, possible surgical consequences of molecular FNA diagnostic results of thyroid nodules and the evidence that analysis of a molecular FNA diagnostic panel of somatic mutations or a microarray GEC test can alter the follow-up were reviewed. Molecular tests may help clinicians to drive patient care and the surgical decision if the analysis is performed in specialized laboratories. These molecular tests require standardization of performance characteristics and appropriate calibration as well as analytic validation before clinical interpretation.
Paschke, Ralf; Cantara, Silvia; Crescenzi, Anna; Jarzab, Barbara; Musholt, Thomas J.; Sobrinho Simoes, Manuel
2017-01-01
Molecular fine-needle aspiration (FNA) cytology diagnostics has the potential to address the inherent limitation of FNA cytology which is an indeterminate (atypia of undetermined significance/follicular lesion of undetermined significance follicular neoplasm) cytology. Because of the emerging role of molecular FNA cytology diagnostics, the European Thyroid Association convened a panel of international experts to review methodological aspects, indications, results, and limitations of molecular FNA cytology diagnostics. The panel reviewed the evidence for the diagnostic value of mutation panel assessment (including at least BRAF, NRAS, HRAS, KRAS, PAX8/PPARG, RET/PTC) of targeted next generation sequencing and of a microarray gene expression classifier (GEC) test in the diagnostic assessment of an indeterminate cytology thyroid nodule. Moreover, possible surgical consequences of molecular FNA diagnostic results of thyroid nodules and the evidence that analysis of a molecular FNA diagnostic panel of somatic mutations or a microarray GEC test can alter the follow-up were reviewed. Molecular tests may help clinicians to drive patient care and the surgical decision if the analysis is performed in specialized laboratories. These molecular tests require standardization of performance characteristics and appropriate calibration as well as analytic validation before clinical interpretation. PMID:28785538
Heng, Suttichai; Sirichaisutdhikorn, Daranee
2016-01-01
To determine the incidence of high-grade cervical intraepithelial neoplasia (CIN2-3) among patients with atypical squamous cells of undetermined significance (ASC-US) Papanicolaou (Pap) smears. One-hundred and eighty-seven patients with ASC-US Pap smears who underwent colposcopy with histological study were enrolled between September 2007 and August 2015. Patient factors (including age, parity, current pills used, HIV status, age at first sexual intercourse and number of sexual partners) were obtained. Logistic regression analysis was used to evaluate clinical factors associated with CIN2-3. CIN was diagnosed in 92 of 187 women (49.2%). Sixty-one of these (32.6%) had CIN1 and 31 (16.6%) had CIN2-3. There was no woman who had invasive cancer. There was no correlation of high-grade CIN with factors in this study including age, parity, current pills used, HIV status, age at first sexual intercourse and number of sexual partners. Data from this study showed no invasive cervical cancer was found in patients with ASC-US. There was no patient factor associated with high grade intraepithelial neoplasia in patients with ASC-US Pap smears.
Lousuebsakul, V; Knutsen, S M; Gram, I T; Akin, M R
2000-01-01
To assess the percentage of squamous intraepithelial lesions (SILs) in the atypical squamous cells of undetermined significance (ASCUS) cytologic diagnosis. From January 1994 to December 1995, 421 cervical Pap smears with a diagnosis of ASCUS were followed with cervical biopsies within three months. The ASCUS cytologic diagnosis was correlated with the histologic findings and stratified according to age group, previous abnormal history and cell type of ASCUS (squamoid vs. metaplastic). Histologic diagnosis showed that of ASCUS diagnoses, 13% were normal, 34% were reactive, 4.8% were atypical, 43% were low grade SIL, 4% were high grade SIL, 1% were carcinoma in situ, and none were invasive lesions. The patients in the youngest group, up to 25 years, demonstrated the highest percentage of SIL. Patients with a previous abnormal gynecologic history showed a higher percentage of SIL than those without an abnormal history. SILs were observed in 51.5% of squamoid ASCUS and 36.5% of metaplastic ASCUS. Forty-eight percent of females having an ASCUS diagnosis on Pap smears had SIL and thus a preneoplastic lesion. The highest percentage of SIL was found in females 25 years and younger. Our findings suggest that an ASCUS diagnosis warrants ongoing follow-up.
Analysis of National Major Work Safety Accidents in China, 2003–2012
YE, Yunfeng; ZHANG, Siheng; RAO, Jiaming; WANG, Haiqing; LI, Yang; WANG, Shengyong; DONG, Xiaomei
2016-01-01
Background: This study provides a national profile of major work safety accidents in China, which cause more than 10 fatalities per accident, intended to provide scientific basis for prevention measures and strategies to reduce major work safety accidents and deaths. Methods: Data from 2003–2012 Census of major work safety accidents were collected from State Administration of Work Safety System (SAWS). Published literature and statistical yearbook were also included to implement information. We analyzed the frequency of accidents and deaths, trend, geographic distribution and injury types. Additionally, we discussed the severity and urgency of emergency rescue by types of accidents. Results: A total of 877 major work safety accidents were reported, resulting in 16,795 deaths and 9,183 injuries. The numbers of accidents and deaths, mortality rate and incidence of major accidents have declined in recent years. The mortality rate and incidence was 0.71 and 1.20 per 106 populations in 2012, respectively. Transportation and mining contributed to the highest number of major accidents and deaths. Major aviation and railway accidents caused more casualties per incident, while collapse, machinery, electrical shock accidents and tailing dam accidents were the most severe situation that resulted in bigger proportion of death. Conclusion: Ten years’ major work safety accident data indicate that the frequency of accidents and number of eaths was declined and several safety concerns persist in some segments. PMID:27057515
Accident history, risk perception and traffic safe behaviour.
Ngueutsa, Robert; Kouabenan, Dongo Rémi
2017-09-01
This study clarifies the associations between accident history, perception of the riskiness of road travel and traffic safety behaviours by taking into account the number and severity of accidents experienced. A sample of 525 road users in Cameroon answered a questionnaire comprising items on perception of risk, safe behaviour and personal accident history. Participants who reported involvement in more than three accidents or involvement in a severe accident perceived road travel as less risky and also reported behaving less safely compared with those involved in fewer, or less severe accidents. The results have practical implications for the prevention of traffic accidents. Practitioner Summary: The associations between accident history, perceived risk of road travel and safe behaviour were investigated using self-report questionnaire data. Participants involved in more than three accidents, or in severe accidents, perceived road travel as less risky and also reported more unsafe behaviour compared with those involved in fewer, or less severe accidents. Campaigns targeting people with a less serious, less extensive accident history should aim to increase awareness of hazards and the potential severity of their consequences, as well as emphasising how easy it is to take the recommended preventive actions. Campaigns targeting those involved in more frequent accidents, and survivors of serious accidents, should address feelings of invulnerability and helplessness.
Estimation of fatality and injury risk by means of in-depth fatal accident investigation data.
Yannis, George; Papadimitriou, Eleonora; Dupont, Emmanuelle; Martensen, Heike
2010-10-01
In this article the factors affecting fatality and injury risk of road users involved in fatal accidents are analyzed by means of in-depth accident investigation data, with emphasis on parameters not extensively explored in previous research. A fatal accident investigation (FAI) database is used, which includes intermediate-level in-depth data for a harmonized representative sample of 1300 fatal accidents in 7 European countries. The FAI database offers improved potential for analysis, because it includes information on a number of variables that are seldom available, complete, or accurately recorded in road accident databases. However, the fact that only fatal accidents are examined requires for methodological adjustments, namely, the correction for two types of effects on a road user's baseline risk: "accident size" effects, and "relative vulnerability" effects. Fatality and injury risk can be then modeled through multilevel logistic regression models, which account for the hierarchical dependences of the road accident process. The results show that the baseline fatality risk of road users involved in fatal accidents decreases with accident size and increases with the vulnerability of the road user. On the contrary, accident size increases nonfatal injury risk of road users involved in fatal accidents. Other significant effects on fatality and injury risk in fatal accidents include road user age, vehicle type, speed limit, the chain of accident events, vehicle maneuver, and safety equipment. In particular, the presence and use of safety equipment such as seat belt, antilock braking system (ABS), and electronic stability program (ESP) are protection factors for car occupants, especially for those seated at the front seats. Although ABS and ESP systems are typically associated with positive effects on accident occurrence, the results of this research revealed significant related effects on accident severity as well. Moreover, accident consequences are more severe when the most harmful event of the accident occurs later within the accident chain.
Developing techniques for cause-responsibility analysis of occupational accidents.
Jabbari, Mousa; Ghorbani, Roghayeh
2016-11-01
The aim of this study was to specify the causes of occupational accidents, determine social responsibility and the role of groups involved in work-related accidents. This study develops occupational accidents causes tree, occupational accidents responsibility tree, and occupational accidents component-responsibility analysis worksheet; based on these methods, it develops cause-responsibility analysis (CRA) techniques, and for testing them, analyzes 100 fatal/disabling occupational accidents in the construction setting that were randomly selected from all the work-related accidents in Tehran, Iran, over a 5-year period (2010-2014). The main result of this study involves two techniques for CRA: occupational accidents tree analysis (OATA) and occupational accidents components analysis (OACA), used in parallel for determination of responsible groups and responsibilities rate. From the results, we find that the management group of construction projects has 74.65% responsibility of work-related accidents. The developed techniques are purposeful for occupational accidents investigation/analysis, especially for the determination of detailed list of tasks, responsibilities, and their rates. Therefore, it is useful for preventing work-related accidents by focusing on the responsible group's duties. Copyright © 2016 Elsevier Ltd. All rights reserved.
Workplace accidents in materials transfer in Finland.
Perttula, Pia; Salminen, Simo
2012-01-01
The aim of this study was to show the proportion of workplace accidents related to materials transfer and to decide whether they were more serious than other kinds of workplace accidents. The research material for this study were statistics and data, available in Finland, regarding workplace accidents and fatal accidents. Twenty-five percent of studied fatal accidents were related to materials transfer; 26.9-27.7% of all workplace accidents in Finland in 2003-2007 were workplace accidents related to materials transfer. Over half (54.7%) of workplace accidents related to materials transfer caused disabilities lasting over 3 days. Most accidents related to materials transfer occurred to men aged 20-49 years. The most common types of injuries were dislocations, sprains and strains.
NASA Astrophysics Data System (ADS)
Mitsui, Masami; Takeuchi, Nobuo; Kawada, Yasuhiro; Kobayashi, Royoji; Nogami, Manami; Miki, Masami
2013-09-01
When records of success are accumulating, we should be most alert to maintain the safety culture we labored to establish and nurture.Space Shuttle Columbia Accident in 2002 and Fukushima Nuclear Power Station Accident in 2011 are seemingly unrelated. But, by studying the accident reports issued after these accidents, the authors found that the organizational causes that led to the accidents were surprisingly similar. The causes of these accidents were rooted in the history and culture of the respective organizations.In this paper, the authors will discuss differences and similarities in these two accidents based on the reports submitted by the accident investigation boards of these two accidents. This will be followed by the lessons learned the authors derived.
Sleepy driver near-misses may predict accident risks.
Powell, Nelson B; Schechtman, Kenneth B; Riley, Robert W; Guilleminault, Christian; Chiang, Rayleigh Ping-ying; Weaver, Edward M
2007-03-01
To quantify the prevalence of self-reported near-miss sleepy driving accidents and their association with self-reported actual driving accidents. A prospective cross-sectional internet-linked survey on driving behaviors. Dateline NBC News website. Results are given on 35,217 (88% of sample) individuals with a mean age of 37.2 +/- 13 years, 54.8% women, and 87% white. The risk of at least one accident increased monotonically from 23.2% if there were no near-miss sleepy accidents to 44.5% if there were > or = 4 near-miss sleepy accidents (P < 0.0001). After covariate adjustments, subjects who reported at least one near-miss sleepy accident were 1.13 (95% CI, 1.10 to 1.16) times as likely to have reported at least one actual accident as subjects reporting no near-miss sleepy accidents (P < 0.0001). The odds of reporting at least one actual accident in those reporting > or = 4 near-miss sleepy accidents as compared to those reporting no near-miss sleepy accidents was 1.87 (95% CI, 1.64 to 2.14). Furthermore, after adjustments, the summary Epworth Sleepiness Scale (ESS) score had an independent association with having a near-miss or actual accident. An increase of 1 unit of ESS was associated with a covariate adjusted 4.4% increase of having at least one accident (P < 0.0001). A statistically significant dose-response was seen between the numbers of self-reported sleepy near-miss accidents and an actual accident. These findings suggest that sleepy near-misses may be dangerous precursors to an actual accident.
Modeling secondary accidents identified by traffic shock waves.
Junhua, Wang; Boya, Liu; Lanfang, Zhang; Ragland, David R
2016-02-01
The high potential for occurrence and the negative consequences of secondary accidents make them an issue of great concern affecting freeway safety. Using accident records from a three-year period together with California interstate freeway loop data, a dynamic method for more accurate classification based on the traffic shock wave detecting method was used to identify secondary accidents. Spatio-temporal gaps between the primary and secondary accident were proven be fit via a mixture of Weibull and normal distribution. A logistic regression model was developed to investigate major factors contributing to secondary accident occurrence. Traffic shock wave speed and volume at the occurrence of a primary accident were explicitly considered in the model, as a secondary accident is defined as an accident that occurs within the spatio-temporal impact scope of the primary accident. Results show that the shock waves originating in the wake of a primary accident have a more significant impact on the likelihood of a secondary accident occurrence than the effects of traffic volume. Primary accidents with long durations can significantly increase the possibility of secondary accidents. Unsafe speed and weather are other factors contributing to secondary crash occurrence. It is strongly suggested that when police or rescue personnel arrive at the scene of an accident, they should not suddenly block, decrease, or unblock the traffic flow, but instead endeavor to control traffic in a smooth and controlled manner. Also it is important to reduce accident processing time to reduce the risk of secondary accident. Copyright © 2015 Elsevier Ltd. All rights reserved.
Comparisons of Traffic Collisions between Expressways and Rural Roads in Truck Drivers.
Lee, Sangbok; Jeong, Byung Yong
2016-03-01
Truck driving is known as one of the occupations with the highest accident rate. This study investigates the characteristics of traffic collisions according to road types (expressway and rural road). Classifying 267 accidents into expressway and rural road, we analyzed them based on driver characteristics (age, working experience, size of employment), time characteristics (day of accident, time, weather), and accident characteristics (accident causes, accident locations, accident types, driving conditions). When we compared the accidents by road conditions, no differences were found between the driver characteristics. However, from the accident characteristics, the injured person distributions were different by the road conditions. In particular, driving while drowsy is shown to be highly related with the accident characteristics. This study can be used as a guideline and a base line to develop a plan of action to prevent traffic accidents. It can also help to prepare formal regulations about a truck driver's vehicle maintenance and driving attitude for a precaution on road accidents.
Accidents in Germany: evaluation of the german telephone health survey 2004.
Saß, Anke-Christine
2008-09-01
In the year 2006 there were over 19 000 fatal accidents in Germany and estimates put the number of accidental injuries at more than 8 million. Detailed information on the pattern of accidents is indispensable for the definition of priorities in accident prevention. The German Telephone Health Survey 2004 provides representative cross-sectional data on the health of German residents from 18 years of age (n = 7341). Questions on the prevalence of accidents (13 items) were selected for analysis. Every tenth interviewee reported being injured in an accident in the previous 12 months. Men, particularly young men, are at greater risk of accidents than women. Almost one third of all accidents occurred at home. Social status had no influence on the probability of having an accident, but did affect where the accident happened. The survey yields information on the overall pattern of non-fatal accidents in Germany. The data point to target groups for accident prevention measures.
Occurrence and countermeasures of urban power grid accident
NASA Astrophysics Data System (ADS)
Wei, Wang; Tao, Zhang
2018-03-01
With the advance of technology, the development of network communication and the extensive use of power grids, people can get to know power grid accidents around the world through the network timely. Power grid accidents occur frequently. Large-scale power system blackout and casualty accidents caused by electric shock are also fairly commonplace. All of those accidents have seriously endangered the property and personal safety of the country and people, and the development of society and economy is severely affected by power grid accidents. Through the researches on several typical cases of power grid accidents at home and abroad in recent years and taking these accident cases as the research object, this paper will analyze the three major factors that cause power grid accidents at present. At the same time, combining with various factors and impacts caused by power grid accidents, the paper will put forward corresponding solutions and suggestions to prevent the occurrence of the accident and lower the impact of the accident.
Comparisons of Traffic Collisions between Expressways and Rural Roads in Truck Drivers
Lee, Sangbok; Jeong, Byung Yong
2015-01-01
Background Truck driving is known as one of the occupations with the highest accident rate. This study investigates the characteristics of traffic collisions according to road types (expressway and rural road). Methods Classifying 267 accidents into expressway and rural road, we analyzed them based on driver characteristics (age, working experience, size of employment), time characteristics (day of accident, time, weather), and accident characteristics (accident causes, accident locations, accident types, driving conditions). Results When we compared the accidents by road conditions, no differences were found between the driver characteristics. However, from the accident characteristics, the injured person distributions were different by the road conditions. In particular, driving while drowsy is shown to be highly related with the accident characteristics. Conclusion This study can be used as a guideline and a base line to develop a plan of action to prevent traffic accidents. It can also help to prepare formal regulations about a truck driver's vehicle maintenance and driving attitude for a precaution on road accidents. PMID:27014489
[Alcohol and driving: attitudes and habits of students after an intervention].
Ponce-Blandón, Jose Antonio; Romero-Martín, Macarena; Romero-Brioso, Concepción; Paredes-Jiménez, Antonio de Padua
2016-01-01
Knowing and contrasting attitudes and habits toward alcohol when it comes to driving among nursing students and to analyze the effectiveness of an educational intervention with testimonies in order to modify them. Analytical and quasiexperimental design with pre-test and post-test. The study population consists of students of nursing degree of the Red Cross from Sevilla. The intervention is based on attending an educational activity from people directly and personally experienced on car accidents, narrating their own lived facts. A specific questionnaire was used to measure attitudes and trends of behaviors towards alcohol drinking and driving. The mean of the responses related to the false beliefs of students in first course is 2.73 (standard deviation [SD]=0.14) versus 2.29 (SD=0.27) in fourth. For questions regarding the intentions of risky behavior, first course have a mean of 2.01 (SD=0.51) versus 1.76 (SD=1.76) in fourth. These differences were not found to be significant. No differences were found before and after the intervention on the two global dimensions studied. The disaggregated results per item show that the intervention significantly reduced the belief that alcohol does not affect safety (p=.001) and intention not to drink to accompany friends with your car (p=.026), among others. The analyzed intervention has a positive but limited influence. It is recommended to repeat it several times to improve a healthy lifestyle and also to improve the health habits of the general population in the future. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.
Children with burn injuries-assessment of trauma, neglect, violence and abuse
Toon, Michael H.; Maybauer, Dirk M.; Arceneaux, Lisa L.; Fraser, John F.; Meyer, Walter; Runge, Antoinette; Maybauer, Marc O.
2011-01-01
Abstract: Burns are an important cause of injury to young children, being the third most frequent cause of injury resulting in death behind motor vehicle accidents and drowning. Burn injuries account for the greatest length of stay of all hospital admissions for injuries and costs associated with care are substantial. The majority of burn injuries in children are scald injuries resulting from hot liquids, occurring most commonly in children aged 0-4 years. Other types of burns include electrical, chemical and intentional injury. Mechanisms of injury are often unique to children and involve exploratory behavior without the requisite comprehension of the dangers in their environment. Assessment of the burnt child includes airway, breathing and circulation stabilization, followed by assessment of the extent of the burn and head to toe examination. The standard rule of 9s for estimating total body surface area (TBSA) of the burn is inaccurate for the pediatric population and modifications include utilizing the Lund and Browder chart, or the child's palm to represent 1% TBSA. Further monitoring may include cardiac assessment, indwelling catheter insertion and evaluation of inhalation injury with or without intubation depending on the context of the injury. Risk factors and features of intentional injury should be known and sought and vital clues can be found in the history, physical examination and common patterns of presentation. Contemporary burn management is underscored by several decades of advancing medical and surgical care however, common to all injuries, it is in the area of prevention that the greatest potential to reduce the burden of these devastating occurrences exists. PMID:21498973
49 CFR 655.44 - Post-accident testing.
Code of Federal Regulations, 2011 CFR
2011-10-01
... the employer is unable to perform a post-accident test within the required period noted in paragraphs... 49 Transportation 7 2011-10-01 2011-10-01 false Post-accident testing. 655.44 Section 655.44... of Testing § 655.44 Post-accident testing. (a) Accidents. (1) Fatal accidents. (i) As soon as...
41 CFR 101-39.407 - Accident records.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Accident records. 101-39...-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.4-Accidents and Claims § 101-39.407 Accident records. If GSA's records of vehicle accidents indicate that a particular activity has had an unusually high accident frequency...
Desai, Vinit M; Roberts, Karlene H; Ciavarelli, Anthony P
2006-01-01
The association between accidents and subsequent work unit safety perceptions was assessed to address cognitive and behavioral changes following accidents. Many studies attempt to predict accident rates using measures of work unit safety, but effects vary considerably. Conversely, this study examined whether recent accidents may be positively associated with work unit safety perceptions, as suggested by behavioral learning mechanisms (increases in safety investments following accidents) or cognitive mechanisms (defensive attributions regarding accident causality). Lagged squadron-level accident experience was correlated with work unit safety perceptions obtained through a 61-question safety climate survey administered to 6,361 individuals in U.S. Navy flight squadrons. Positive associations between minor or intermediately severe accidents and future safety climate scores were found, although no effect was found for major accidents. We suggest that accident history should be considered when examining work unit safety perceptions because recent accidents may be associated with higher safety climate scores. We did not find that this varies systematically with accident severity, and longitudinal research on additional samples is needed to further test this possibility. This research may be used to refine measurement of work unit safety and to examine impacts of accidents or safety violations on workers' cognitive processes and group behavioral changes.
[Analysis of work accidents during the years 1999-2006 in a hospital company in Lombardia].
Melloni, P; Antoniazzi, E; Somenzi, V; Galli, L; Fazioli, R; Mottinelli, A; Franzosi, C; Cirla, A M; Gobba, E
2007-01-01
This study describe accidents occurred in the period between 1999 and 2006 in the Hospital of Cremona, in which about 2400 subjects operate. The analysis of Accident Register showed a reduction of about 30% of the total number of accidents during the examined period and a non homogeneous distribution of the various types of accidents. The most frequent accidents were prick (25.8%), trauma (22.9%) and "in itinere" accidents (7.8%). One type of accident has been little considered up to now: the aggressions. Professional nurses were the most frequently involved and the most affected units were those that belong to the Internal Medicine Department. "In itinere" accidents had the longest average prognosis (11.6 days). The repetition of accidents occurred to the same operator hasn't been analysed before now: a professional nurse had nine accidents (of various type) in the seven years considered. Probably the reduction of accident must be attributed to the effectiveness of the prevention activities undertaken during the reviewed period. Biological accidents, for which it was possible to implement prevention programs, have been markedly reduced; it was not the same for "In Itinere" accidents, that depend significantly on external factors that are not easily dismissed.
Secondary school accident reporting in one education authority.
Williams, W R; Latif, A H A; Sibert, J
2002-01-01
Secondary schools appear to have very different accident rates when they are compared on the basis of accident report returns. The variation may be as a result of real differences in accident rates or different reporting procedures. This study investigates accident reporting from secondary schools and, in particular, the role of the school nurse. Accident form returns covering a 2-year period were collected for statistical analysis from 13 comprehensive schools in one local education authority in Wales. School sites were visited in the following school year to obtain information about accident records held on site and accident reporting procedures. The main factors determining the number of school accident reports submitted to the education authority relate to differences in recording and reporting procedures, such as the employment of a nurse and the policy of the head teacher/safety officer on submitting accident returns. Accident and emergency department referrals from similar schools may show significant differences in specific injuries and their causes. The level of school accident activity cannot be gauged from reports submitted to the education authority. Lack of incentives for collecting good accident data, in conjunction with the degree of complacency in the current system, suggest that future accident rates and reporting activity are unlikely to change.
Occupational accidents aboard merchant ships
Hansen, H; Nielsen, D; Frydenberg, M
2002-01-01
Objectives: To investigate the frequency, circumstances, and causes of occupational accidents aboard merchant ships in international trade, and to identify risk factors for the occurrence of occupational accidents as well as dangerous working situations where possible preventive measures may be initiated. Methods: The study is a historical follow up on occupational accidents among crew aboard Danish merchant ships in the period 1993–7. Data were extracted from the Danish Maritime Authority and insurance data. Exact data on time at risk were available. Results: A total of 1993 accidents were identified during a total of 31 140 years at sea. Among these, 209 accidents resulted in permanent disability of 5% or more, and 27 were fatal. The mean risk of having an occupational accident was 6.4/100 years at sea and the risk of an accident causing a permanent disability of 5% or more was 0.67/100 years aboard. Relative risks for notified accidents and accidents causing permanent disability of 5% or more were calculated in a multivariate analysis including ship type, occupation, age, time on board, change of ship since last employment period, and nationality. Foreigners had a considerably lower recorded rate of accidents than Danish citizens. Age was a major risk factor for accidents causing permanent disability. Change of ship and the first period aboard a particular ship were identified as risk factors. Walking from one place to another aboard the ship caused serious accidents. The most serious accidents happened on deck. Conclusions: It was possible to clearly identify work situations and specific risk factors for accidents aboard merchant ships. Most accidents happened while performing daily routine duties. Preventive measures should focus on workplace instructions for all important functions aboard and also on the prevention of accidents caused by walking around aboard the ship. PMID:11850550
Incidents/accidents classification and reporting in Statoil.
Berentsen, Rune; Holmboe, Rolf H
2004-07-26
Based on requirements in the new petroleum regulations from Norwegian Petroleum Directorate (NPD) and the realisation of a need to improve and rationalise the routines for reporting and follow up of incidents, Statoil Exploration & Production Norway (Statoil E&P Norway) has formulated a new strategy and process for handling of incidents/accidents. The following past experiences serve as basis for the changes made to incident reporting in Statoil E&P Norway; too much resources were spent on a comprehensive handling and analysis of a vast amount of incidents with less importance for the safety level, taking the focus away from the more severe and important issues at hand, the assessment of "Risk Factor", i.e. the combination of recurrence frequency and consequence, was difficult to use. The high degree of subjectivity involved in the determination of the "Risk Factor" (in particular the estimation of the recurrence frequency) resulted in poor data quality and lack of consistency in the data material. The new system for categorisation and handling of undesirable incidents was established in January 2002. The intention was to get a higher degree of focus on serious incidents (injuries, damages, loss and near misses), with a thorough handling and follow-up. This is reflected throughout the handling of the serious incidents, all the way from immediate notification of the incident, through investigation and follow-up of corrective and preventive actions. Simultaneously, it was also an objective to rationalise/simplify the handling of less serious incidents. These incidents are, however, subjected to analyses twice a year in order to utilize the learning opportunity that they also provide. A year after the introduction of this new system for categorisation and follow-up of undesirable incidents, Statoil's experiences are predominantly good; the intention to get a higher degree of focus on serious incidents (injuries, damages, loss and near misses), has been met, the data quality for the more serious incidents (5% of the total number of incidents registered) has improved, the improved handling of incidents has contributed to more reliable and accurate HSE indicators at a corporate level, more user friendly codes in place for incident registration (based on MTO methodology), the revised matrix gives distinct criteria with respect to which investigation level to be initiated for a specific incident. All activities related to handling of undesirable incidents have been summarised and illustrated on a two-sided plastic form, incorporating both the categorisation matrix and the activity flowchart (see Figs. 1 and 4).
Teymuri, Ghulam Heidar; Sadeghian, Marzieh; Kangavari, Mehdi; Asghari, Mehdi; Madrese, Elham; Abbasinia, Marzieh; Ahmadnezhad, Iman; Gholizadeh, Yavar
2013-01-01
Background: One of the significant dangers that threaten people’s lives is the increased risk of accidents. Annually, more than 1.3 million people die around the world as a result of accidents, and it has been estimated that approximately 300 deaths occur daily due to traffic accidents in the world with more than 50% of that number being people who were not even passengers in the cars. The aim of this study was to examine traffic accidents in Tehran and forecast the number of future accidents using a time-series model. Methods: The study was a cross-sectional study that was conducted in 2011. The sample population was all traffic accidents that caused death and physical injuries in Tehran in 2010 and 2011, as registered in the Tehran Emergency ward. The present study used Minitab 15 software to provide a description of accidents in Tehran for the specified time period as well as those that occurred during April 2012. Results: The results indicated that the average number of daily traffic accidents in Tehran in 2010 was 187 with a standard deviation of 83.6. In 2011, there was an average of 180 daily traffic accidents with a standard deviation of 39.5. One-way analysis of variance indicated that the average number of accidents in the city was different for different months of the year (P < 0.05). Most of the accidents occurred in March, July, August, and September. Thus, more accidents occurred in the summer than in the other seasons. The number of accidents was predicted based on an auto-regressive, moving average (ARMA) for April 2012. The number of accidents displayed a seasonal trend. The prediction of the number of accidents in the city during April of 2012 indicated that a total of 4,459 accidents would occur with mean of 149 accidents per day during these three months. Conclusion: The number of accidents in Tehran displayed a seasonal trend, and the number of accidents was different for different seasons of the year. PMID:26120405
49 CFR 655.44 - Post-accident testing.
Code of Federal Regulations, 2013 CFR
2013-10-01
... results may be used only when the employer is unable to perform a post-accident test within the required... 49 Transportation 7 2013-10-01 2013-10-01 false Post-accident testing. 655.44 Section 655.44... of Testing § 655.44 Post-accident testing. (a) Accidents. (1) Fatal accidents. (i) As soon as...
22 CFR 102.17 - Reports on accident.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Reports on accident. 102.17 Section 102.17... Accidents Abroad Foreign Aircraft Accidents Involving United States Persons Or Property § 102.17 Reports on accident. When an accident occurs to a foreign aircraft in the district of a Foreign Service post and...
22 CFR 102.17 - Reports on accident.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Reports on accident. 102.17 Section 102.17... Accidents Abroad Foreign Aircraft Accidents Involving United States Persons Or Property § 102.17 Reports on accident. When an accident occurs to a foreign aircraft in the district of a Foreign Service post and...
Rough set approach for accident chains exploration.
Wong, Jinn-Tsai; Chung, Yi-Shih
2007-05-01
This paper presents a novel non-parametric methodology--rough set theory--for accident occurrence exploration. The rough set theory allows researchers to analyze accidents in multiple dimensions and to model accident occurrence as factor chains. Factor chains are composed of driver characteristics, trip characteristics, driver behavior and environment factors that imply typical accident occurrence. A real-world database (2003 Taiwan single auto-vehicle accidents) is used as an example to demonstrate the proposed approach. The results show that although most accident patterns are unique, some accident patterns are significant and worth noting. Student drivers who are young and less experienced exhibit a relatively high possibility of being involved in off-road accidents on roads with a speed limit between 51 and 79 km/h under normal driving circumstances. Notably, for bump-into-facility accidents, wet surface is a distinctive environmental factor.
Road Traffic Accident Analysis of Ajmer City Using Remote Sensing and GIS Technology
NASA Astrophysics Data System (ADS)
Bhalla, P.; Tripathi, S.; Palria, S.
2014-12-01
With advancement in technology, new and sophisticated models of vehicle are available and their numbers are increasing day by day. A traffic accident has multi-facet characteristics associated with it. In India 93% of crashes occur due to Human induced factor (wholly or partly). For proper traffic accident analysis use of GIS technology has become an inevitable tool. The traditional accident database is a summary spreadsheet format using codes and mileposts to denote location, type and severity of accidents. Geo-referenced accident database is location-referenced. It incorporates a GIS graphical interface with the accident information to allow for query searches on various accident attributes. Ajmer city, headquarter of Ajmer district, Rajasthan has been selected as the study area. According to Police records, 1531 accidents occur during 2009-2013. Maximum accident occurs in 2009 and the maximum death in 2013. Cars, jeeps, auto, pickup and tempo are mostly responsible for accidents and that the occurrence of accidents is mostly concentrated between 4PM to 10PM. GIS has proved to be a good tool for analyzing multifaceted nature of accidents. While road safety is a critical issue, yet it is handled in an adhoc manner. This Study is a demonstration of application of GIS for developing an efficient database on road accidents taking Ajmer City as a study. If such type of database is developed for other cities, a proper analysis of accidents can be undertaken and suitable management strategies for traffic regulation can be successfully proposed.
[Sports accidents: 1963-1973 statistics].
Fasler, S
1976-01-01
Every year, the Swiss Accident Insurance Administration is paying a considerable amount of money for sports accidents. From 1963 to 1973 the number of these accidents has increased more markedly than other types of accidents. Different tendencies can be observed in the different types of sports: skiing accidents have, after a long period of retrogression until 1973, shown a noticeable augmentation again. Football accidents and accidents in other types of sports have on the other hand increased year by year. Mountaineering and aquatic sports often result in fatal accidents. The numerous preventive measures in skiing accidents have obviously been successful. Not only the fractures have decreased, but also the average number of days where sickness benefit was paid. Next to the traffic accidents, the skiing accidents are the most expensive ones. The nature of the healing cost in sports accidents has changed during the period from 1967 to 1972, depending on the different types of sports. In particular, hospital costs have changed considerably. The number of medical consultations per accident has decreased. Payment of sickness benefit has followed the development of the salaries on the one hand and the modifications of the number of lost days on the other. Finally, the costs of the annuities show more or less the same tendency as the ones for sickness benefit. A very gross estimation on the economical losses through sports accidents in Switzerland makes us believe that the direct and indirect costs actually amount to more than one thousand millions of Swiss Francs per year.
[Minor and major work accidents in a Puglia business in the food sector: a 10-year study].
Di Lorenzo, L; Zocchetti, C; Platania, A; De Francesco, G; De Metrio, R; Pirris, A; Gigante, M R
1998-01-01
At present no official data are available for those occupational accidents which, according to current law, are not subject to notification to the Italian National Institute for Insurance of Occupational Accidents (INAIL) and which are conventionally called "minor" accidents. They can be divided into accidents with prognosis from 1 to 3 days (franchises) and accidents which do not cause absence from work (medications). The already mentioned lack of data, which is not confined to Italy, is reflected in the small number of articles published in Italian and international journals. Also information regarding the possible relationships between "minor" accidents and the life habits of injured workers, are rare. The aim of this study was to provide detailed data on the characteristics of the different kinds of occupational accidents occurring in a food factory in Apulia, southern Italy, from 1985 to 1994, as well as to verify whether any relationship existed between the different types of occupational accidents and the consumption of cigarettes and alcohol by injured workers. The company's accident register yielded data on injuries which caused absence from work; the nursing service register provided information about accidents which did not determine absence from work; personal health documents gave details of worker life habits; and the company pay roll showed the amount of "worked hours". "Minor" accidents represented 70% of all accidents occurring during the ten year period studied. "Blue collars" had more frequent and serious occupational injuries, in comparison with "technical employees". "Minor" accidents, and especially "medications", occurred more frequently during one-shift work than during three-shift work. As work seniority increased, the number of "major" accidents decreased and number of accidents without absence from work rose. Contusions were the most frequent lesions and were responsible for the majority of the 3 kinds of accidents. "Medications" together with injuries notified to INAIL ("major" accidents), mostly involved upper limbs; "franchises" were mostly head interested. About 50% of all causes of occupational accidents were mainly associated with unsafe environmental and working situations, whereas the remaining 50% were mainly associated with unsafe behaviour by workers. Heavy smokers showed a higher frequency of "major" accidents. As alcohol consumption rose, she did number of accidents with absence from work. "Minor" accidents, particularly the "medicated" ones, represented the greatest part of occupational injuries. All the considered causes and circumstances contributed to determine the different kinds of accidents. Thereby, it appears necessary for prevention purposes to obtain information about any kind of injury in the different manufacturing sectors. Finally, it seems dutiful to inform workers about the relationships between life habits and occupational accidents.
29. May 1985. DETAIL OF INSCRIPTION IN WINDOW PANE IN ...
29. May 1985. DETAIL OF INSCRIPTION IN WINDOW PANE IN SITTING ROOM (window is immediately south of front, or east, doors; inscription reads: 'Another May new buds new flowers Ah why has happiness no second spring' (author and date undetermined) - Borough House, West Side State Route 261, about .1 mile south side of junction with old Garners Ferry Road, Stateburg, Sumter County, SC
ERIC Educational Resources Information Center
Fujisawa, Keiko K.; Ozaki, Koken; Suzuki, Kunitake; Yamagata, Shinji; Kawahashi, Ikko; Ando, Juko
2012-01-01
Although growth in head circumference (HC) during infancy is known to predict later childhood outcomes, the mechanisms underlying this association with later sociocognitive abilities remain undetermined. Thus, using a sample of 241 pairs of normally developing Japanese twins, this study investigated the underpinnings of the association between HC…
ERIC Educational Resources Information Center
Roman, Elliott M.
In 1993-94 the Career Awareness Program for Bilingual Haitian and Hispanic Students (Project CAP) was in its fifth and final year as an Elementary and Secondary Education Act Title VII project. Project CAP operated at two high schools in Brooklyn (New York), serving 136 Haitians at one and an undetermined number of Spanish-speaking and Haitian…
Interagency Assessment of Iraq Police Training
2005-07-15
performance of the police during the January elections, o the increased visibility of police on the streets, and o polls indicating a growing public...reality—was that training could be molded within a rapidly stabilizing political and security environment. The unexpected virulence and scope of... growing IPS force is the considerable, though undetermined, number of ‘ghost’ employees on the ministry’s roster. Although not productively engaged in
NASA Astrophysics Data System (ADS)
Khuluqi, M. H.; Prapdito, R. R.; Sambodo, F. P.
2018-04-01
In Indonesia, mining is categorized as a hazardous industry. In recent years, a dramatic increase of mining equipment and technological complexities had resulted in higher maintenance expectations that accompanied by the changes in the working conditions, especially on safety. Ensuring safety during the process of conducting maintenance works in underground mine is important as an integral part of accident prevention programs. Accident triangle has provided a support to safety practitioner to draw a road map in preventing accidents. Poisson distribution is appropriate for the analysis of accidents at a specific site in a given time period. Based on the analysis of accident statistics in the underground mine maintenance of PT. Freeport Indonesia from 2011 through 2016, it is found that 12 minor accidents for 1 major accident and 66 equipment damages for 1 major accident as a new value of accident triangle. The result can be used for the future need for improving the accident prevention programs.
[Accidents in travellers - the hidden epidemic].
Walz, Alexander; Hatz, Christoph
2013-06-01
The risk of malaria and other communicable diseases is well addressed in pre-travel advice. Accidents are usually less discussed. Thus, we aimed at assessing accident figures for the Swiss population, based on data of the register from 2004 to 2008 of the largest Swiss accident insurance organization (SUVA). More than 139'000 accidents over 5 years showed that 65 % of the accidents overseas are injuries, and 24 % are caused by poisoning or harm by cold, heat or air pressure. Most accidents happened during leisure activities or sports. More than one third of the non-lethal and more than 50 % of the fatal accidents happened in Asia. More than three-quarters of non-lethal accidents take place in people between 25 and 54 years. One out of 74 insured persons has an accident abroad per year. Despite of many analysis short-comings of the data set with regard to overseas travel, the figures document the underestimated burden of disease caused by accidents abroad and should affect the given pre-health advice.
Kim, Tae-gu; Kang, Young-sig; Lee, Hyung-won
2011-01-01
To begin a zero accident campaign for industry, the first thing is to estimate the industrial accident rate and the zero accident time systematically. This paper considers the social and technical change of the business environment after beginning the zero accident campaign through quantitative time series analysis methods. These methods include sum of squared errors (SSE), regression analysis method (RAM), exponential smoothing method (ESM), double exponential smoothing method (DESM), auto-regressive integrated moving average (ARIMA) model, and the proposed analytic function method (AFM). The program is developed to estimate the accident rate, zero accident time and achievement probability of an efficient industrial environment. In this paper, MFC (Microsoft Foundation Class) software of Visual Studio 2008 was used to develop a zero accident program. The results of this paper will provide major information for industrial accident prevention and be an important part of stimulating the zero accident campaign within all industrial environments.
Rivaroxaban for Stroke Prevention after Embolic Stroke of Undetermined Source.
Hart, Robert G; Sharma, Mukul; Mundl, Hardi; Kasner, Scott E; Bangdiwala, Shrikant I; Berkowitz, Scott D; Swaminathan, Balakumar; Lavados, Pablo; Wang, Yongjun; Wang, Yilong; Davalos, Antonio; Shamalov, Nikolay; Mikulik, Robert; Cunha, Luis; Lindgren, Arne; Arauz, Antonio; Lang, Wilfried; Czlonkowska, Anna; Eckstein, Jens; Gagliardi, Rubens J; Amarenco, Pierre; Ameriso, Sebastian F; Tatlisumak, Turgut; Veltkamp, Roland; Hankey, Graeme J; Toni, Danilo; Bereczki, Daniel; Uchiyama, Shinichiro; Ntaios, George; Yoon, Byung-Woo; Brouns, Raf; Endres, Matthias; Muir, Keith W; Bornstein, Natan; Ozturk, Serefnur; O'Donnell, Martin J; De Vries Basson, Matthys M; Pare, Guillaume; Pater, Calin; Kirsch, Bodo; Sheridan, Patrick; Peters, Gary; Weitz, Jeffrey I; Peacock, W Frank; Shoamanesh, Ashkan; Benavente, Oscar R; Joyner, Campbell; Themeles, Ellison; Connolly, Stuart J
2018-06-07
Embolic strokes of undetermined source represent 20% of ischemic strokes and are associated with a high rate of recurrence. Anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, may result in a lower risk of recurrent stroke than aspirin. We compared the efficacy and safety of rivaroxaban (at a daily dose of 15 mg) with aspirin (at a daily dose of 100 mg) for the prevention of recurrent stroke in patients with recent ischemic stroke that was presumed to be from cerebral embolism but without arterial stenosis, lacune, or an identified cardioembolic source. The primary efficacy outcome was the first recurrence of ischemic or hemorrhagic stroke or systemic embolism in a time-to-event analysis; the primary safety outcome was the rate of major bleeding. A total of 7213 participants were enrolled at 459 sites; 3609 patients were randomly assigned to receive rivaroxaban and 3604 to receive aspirin. Patients had been followed for a median of 11 months when the trial was terminated early because of a lack of benefit with regard to stroke risk and because of bleeding associated with rivaroxaban. The primary efficacy outcome occurred in 172 patients in the rivaroxaban group (annualized rate, 5.1%) and in 160 in the aspirin group (annualized rate, 4.8%) (hazard ratio, 1.07; 95% confidence interval [CI], 0.87 to 1.33; P=0.52). Recurrent ischemic stroke occurred in 158 patients in the rivaroxaban group (annualized rate, 4.7%) and in 156 in the aspirin group (annualized rate, 4.7%). Major bleeding occurred in 62 patients in the rivaroxaban group (annualized rate, 1.8%) and in 23 in the aspirin group (annualized rate, 0.7%) (hazard ratio, 2.72; 95% CI, 1.68 to 4.39; P<0.001). Rivaroxaban was not superior to aspirin with regard to the prevention of recurrent stroke after an initial embolic stroke of undetermined source and was associated with a higher risk of bleeding. (Funded by Bayer and Janssen Research and Development; NAVIGATE ESUS ClinicalTrials.gov number, NCT02313909 .).
Ng, Siew C; Tang, Whitney; Ching, Jessica Y; Wong, May; Chow, Chung Mo; Hui, A J; Wong, T C; Leung, Vincent K; Tsang, Steve W; Yu, Hon Ho; Li, Mo Fong; Ng, Ka Kei; Kamm, Michael A; Studd, Corrie; Bell, Sally; Leong, Rupert; de Silva, H Janaka; Kasturiratne, Anuradhani; Mufeena, M N F; Ling, Khoon Lin; Ooi, Choon Jin; Tan, Poh Seng; Ong, David; Goh, Khean L; Hilmi, Ida; Pisespongsa, Pises; Manatsathit, Sathaporn; Rerknimitr, Rungsun; Aniwan, Satimai; Wang, Yu Fang; Ouyang, Qin; Zeng, Zhirong; Zhu, Zhenhua; Chen, Min Hu; Hu, Pin Jin; Wu, Kaichun; Wang, Xin; Simadibrata, Marcellus; Abdullah, Murdani; Wu, Justin Cy; Sung, Joseph J Y; Chan, Francis K L
2013-07-01
Inflammatory bowel diseases (IBD) are becoming more common in Asia, but epidemiologic data are lacking. The Asia-Pacific Crohn's and Colitis Epidemiology Study aimed to determine the incidence and phenotype of IBD in 8 countries across Asia and in Australia. We performed a prospective, population-based study of IBD incidence in predefined catchment areas, collecting data for 1 year, starting on April 1, 2011. New cases were ascertained from multiple overlapping sources and entered into a Web-based database. Cases were confirmed using standard criteria. Local endoscopy, pathology, and pharmacy records were searched to ensure completeness of case capture. We identified 419 new cases of IBD (232 of ulcerative colitis [UC], 166 of Crohn's disease [CD], and 21 IBD-undetermined). The crude annual overall incidence values per 100,000 individuals were 1.37 for IBD in Asia (95% confidence interval: 1.25-1.51; 0.76 for UC, 0.54 for CD, and 0.07 for IBD-undetermined) and 23.67 in Australia (95% confidence interval: 18.46-29.85; 7.33 for UC, 14.00 for CD, and 2.33 for IBD-undetermined). China had the highest incidence of IBD in Asia (3.44 per 100,000 individuals). The ratios of UC to CD were 2.0 in Asia and 0.5 in Australia. Median time from symptom onset to diagnosis was 5.5 months (interquartile range, 1.4-15 months). Complicated CD (stricturing, penetrating, or perianal disease) was more common in Asia than Australia (52% vs 24%; P = .001), and a family history of IBD was less common in Asia (3% vs 17%; P < .001). We performed a large-scale population-based study and found that although the incidence of IBD varies throughout Asia, it is still lower than in the West. IBD can be as severe or more severe in Asia than in the West. The emergence of IBD in Asia will result in the need for specific health care resources, and offers a unique opportunity to study etiologic factors in developing nations. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.
Emotional stress and traffic accidents: the impact of separation and divorce.
Lagarde, Emmanuel; Chastang, Jean-François; Gueguen, Alice; Coeuret-Pellicer, Mireille; Chiron, Mireille; Lafont, Sylviane
2004-11-01
Personal responses to stressful life events are suspected of increasing the risk of serious traffic accidents. We analyzed data from a French cohort study (the GAZEL cohort), including a retrospective driving behavior questionnaire, from 13,915 participants (10,542 men age 52-62 years and 3373 women age 47-62 years in 2001). Follow-up data covered 1993-2000. Hazard ratios for serious accidents (n = 713) were computed by Cox's proportional hazard regression with time-dependent covariates. Separate analyses were also performed to consider only at-fault accidents. Marital separation or divorce was associated with an increased risk of a serious accident (all serious accidents: hazard ratio 2.9, 95% confidence interval = 1.7-5.0; at-fault accidents: 4.4, 2.3-8.3). The impact of separation and divorce did not differ according to alcohol consumption levels. Other life events associated with increased risk of serious accident were a child leaving home (all accidents: 1.2, 0.97-1.6; at-fault accidents: 1.5, 1.1-2.1), an important purchase (all accidents: 1.4, 1.1-1.7; at-fault accidents: 1.6, 1.2-2.1), and hospitalization of the partner (all accidents: 1.4, 1.1-2.0). This study suggests that recent separation and divorce are associated with an increase in serious traffic accidents.
Characteristics of worker accidents on NYSDOT construction projects.
Mohan, Satish; Zech, Wesley C
2005-01-01
This paper aims at providing cost-effective safety measures to protect construction workers in highway work zones, based on real data. Two types of accidents that occur in work zones were: (a) construction work area accidents, and (b) traffic accidents involving construction worker(s). A detailed analysis of work zone accidents involving 36 fatalities and 3,055 severe injuries to construction workers on New York State Department of Transportation (NYSDOT) construction projects from 1990 to 2001 established that five accident types: (a) Struck/Pinned by Large Equipment, (b) Trip or Fall (elevated), (c) Contact w/Electrical or Gas Utility, (d) Struck-by Moving/Falling Load, and (e) Crane/Lift Device Failure accounted for nearly 96% of the fatal accidents, nearly 63% of the hospital-level injury accidents, and nearly 91% of the total costs. These construction work area accidents had a total cost of $133.8 million. Traffic accidents that involve contractors' employees were also examined. Statistical analyses of the traffic accidents established that five traffic accident types: (a) Work Space Intrusion, (b) Worker Struck-by Vehicle Inside Work Space, (c) Flagger Struck-by Vehicle, (d) Worker Struck-by Vehicle Entering/Exiting Work Space, and (e) Construction Equipment Struck-by Vehicle Inside Work Space accounted for nearly 86% of the fatal, nearly 70% of the hospital-level injury and minor injury traffic accidents, and $45.4 million (79.4%) of the total traffic accident costs. The results of this paper provide real statistics on construction worker related accidents reported on construction work zones. Potential preventions based on real statistics have also been suggested. The ranking of accident types, both within the work area as well as in traffic, will guide the heavy highway contractor and owner agencies in identifying the most cost effective safety preventions.
Léger, Damien; Bayon, Virginie; Ohayon, Maurice M; Philip, Pierre; Ement, Philippe; Metlaine, Arnaud; Chennaoui, Mounir; Faraut, Brice
2014-04-01
The link between sleepiness and the risk of motor vehicle accidents is well known, but little is understood regarding the risk of home, work and car accidents of subjects with insomnia. An international cross-sectional survey was conducted across 10 countries in a population of subjects with sleep disturbances. Primary care physicians administered a questionnaire that included assessment of sociodemographic characteristics, sleep disturbance and accidents (motor vehicle, work and home) related to sleep problems to each subject. Insomnia was defined using the International Classification of Sleep Disorders (ICSD-10) criteria. A total of 5293 subjects were included in the study, of whom 20.9% reported having had at least one home accident within the past 12 months, 10.1% at least one work accident, 9% reported having fallen asleep while driving at least once and 4.1% reported having had at least one car accident related to their sleepiness. All types of accident were reported more commonly by subjects living in urban compared to other residential areas. Car accidents were reported more commonly by employed subjects, whereas home injuries were reported more frequently by the unemployed. Car accidents were reported more frequently by males than by females, whereas home accidents were reported more commonly by females. Patients with insomnia have high rates of home accidents, car accidents and work accidents related to sleep disturbances independently of any adverse effects of hypnotic treatments. Reduced total sleep time may be one factor explaining the high risk of accidents in individuals who complain of insomnia. © 2013 European Sleep Research Society.
World commercial aircraft accidents: 1st edition, 1946--1991
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kimura, C.Y.
1992-02-01
This report is a compilation of all accidents world-wide involving aircraft in commercial service which resulted in the loss of the airframe or one or more fatality, or both. This information has been gathered in order to present a complete inventory of commercial aircraft accidents. Events involving military action, sabotage, terrorist bombings, hijackings, suicides, and industrial ground accidents are included within this list. This report is organized into six chapters. The first chapter is the introduction. The second chapter contains the compilation of accidents involving world commercial jet aircraft from 1952 to 1991. The third chapter presents a compilation ofmore » accidents involving world commercial turboprop aircraft from 1952 to 1991. The fourth chapter presents a compilation of accidents involving world commercial pistonprop aircraft with four or more engines from 1946 to 1991. Each accident compilation or database in chapters two, three and four is presented in chronological order. Each accident is presented with information the following categories: date of accident, airline or operator and its flight number (if known), type of flight, type of aircraft and model, aircraft registration number, construction number/manufacturers serial number, aircraft damage resulting from accident, accident flight phase, accident location, number of fatalities, number of occupants, references used to compile the information, and finally cause, remarks, or description (brief) of the accident. The fifth chapter presents a list of all commercial aircraft accidents for all aircraft types with 100 or more fatalities in order of decreasing number of fatalities. Chapter six presents the commercial aircraft accidents for all aircraft types by flight phase. Future editions of this report will have additional follow-on chapters which will present other studies still in preparation at the time this edition was being prepared.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Tusheva, P.; Schaefer, F.; Kliem, S.
2012-07-01
The reactor safety issues are of primary importance for preserving the health of the population and ensuring no release of radioactivity and fission products into the environment. A part of the nuclear research focuses on improvement of the safety of existing nuclear power plants. Studies, research and efforts are a continuing process at improving the safety and reliability of existing and newly developed nuclear power plants at prevention of a core melt accident. Station blackout (loss of AC power supply) is one of the dominant accidents taken into consideration at performing accident analysis. In case of multiple failures of safetymore » systems it leads to a severe accident. To prevent an accident to turn into a severe one or to mitigate the consequences, accident management measures must be performed. The present paper outlines possibilities for application and optimization of accident management measures following a station blackout accident. Assessed is the behaviour of the nuclear power plant during a station blackout accident without accident management measures and with application of primary/secondary side oriented accident management measures. Discussed are the possibilities for operators ' intervention and the influence of the performed accident management measures on the course of the accident. Special attention has been paid to the effectiveness of the passive feeding and physical phenomena having an influence on the system behaviour. The performed simulations show that the effectiveness of the secondary side feeding procedure can be limited due to an early evaporation or flashing effects in the feed water system. The analyzed cases show that the effectiveness of the accident management measures strongly depends on the initiation criteria applied for depressurization of the reactor coolant system. (authors)« less
Resolution of aviation forensic toxicology findings with the aid of DNA profiling.
Chaturvedi, Arvind K; Craft, Kristi J; Kupfer, Doris M; Burian, Dennis; Canfield, Dennis V
2011-03-20
Body components of aviation accident fatalities are often scattered, disintegrated, commingled, contaminated, and/or putrefied at accident scenes. These situations may impose difficulties in victim identification/tissue matching. The prevalence of misidentification in relation to aviation accident forensic toxicology has not been well established. Therefore, the Civil Aerospace Medical Institute (CAMI) toxicology database was searched for the 1998-2008 period for those cases wherein DNA profiling was performed to resolve identity issue of the samples submitted to CAMI for toxicological evaluation. During this period, biological samples from the casualties of a total of 3523 accidents were submitted to CAMI. The submitted samples were primarily from pilots. Out of the 3523 accidents, at least, one fatality had occurred in 3366 (≈ 96%) accidents; thus, these accidents were considered fatal accidents. Accordingly, biological samples from 3319 pilots (3319 of the 3366 accidents) were received at CAMI for toxicological testing. Of these 3319 pilots, 3275 (≈ 99%) were fatally injured. DNA profiling was performed in 15 (≈ 0.5%) of the 3319 accidents. The profiling was conducted upon the requests of families in two accidents, accident investigators in three, and pathologists in four. In six accidents, contradictory toxicological findings led CAMI to initiate DNA profiling. The requests made by families and investigators were primarily triggered by inconsistency between the toxicological results and the history of drug use of the victims, while by pathologists because of commingling of samples. In three (20%) of the 15 accidents, at least one submitted sample was misidentified or mislabeled. The present study demonstrated that the number of aviation accident cases requiring DNA profiling was small and this DNA approach was effectively applied in resolving aviation toxicology findings associated with those accidents. Published by Elsevier Ireland Ltd.
NASA Medical Response to Human Spacecraft Accidents
NASA Technical Reports Server (NTRS)
Patlach, Robert
2010-01-01
Manned space flight is risky business. Accidents have occurred and may occur in the future. NASA's manned space flight programs, with all their successes, have had three fatal accidents, one at the launch pad and two in flight. The Apollo fire and the Challenger and Columbia accidents resulted in a loss of seventeen crewmembers. Russia's manned space flight programs have had three fatal accidents, one ground-based and two in flight. These accidents resulted in the loss of five crewmembers. Additionally, manned spacecraft have encountered numerous close calls with potential for disaster. The NASA Johnson Space Center Flight Safety Office has documented more than 70 spacecraft incidents, many of which could have become serious accidents. At the Johnson Space Center (JSC), medical contingency personnel are assigned to a Mishap Investigation Team. The team deploys to the accident site to gather and preserve evidence for the Accident Investigation Board. The JSC Medical Operations Branch has developed a flight surgeon accident response training class to capture the lessons learned from the Columbia accident. This presentation will address the NASA Mishap Investigation Team's medical objectives, planned response, and potential issues that could arise subsequent to a manned spacecraft accident. Educational Objectives are to understand the medical objectives and issues confronting the Mishap Investigation Team medical personnel subsequent to a human space flight accident.
Garus-Pakowska, Anna; Szatko, Franciszek; Ulrichs, Magdalena
2017-08-10
(1) Background: An analysis of work-related accidents in paramedics in Poland by presenting the model and trend of accidents, accident rates and by identifying causes and results of accidents; (2) Methods: A retrospective analysis of medical documentation regarding work-related accidents in a multi-specialist hospital, located in central Poland, in the period 2005-2015. The study group included paramedics who had an accident while being on duty; (3) Results: According to hospital records, 88 paramedics were involved in 390 accidents and 265 injuries caused by sharp instruments. The annual accident rate was 5.34/100 employed paramedics. Most of the accidents occurred at night. The most common reason for the accident was careless behaviour of the paramedic, which resulted in joint sprains and dislocations. Injuries accounted for a huge portion of the total number of events. As many as 45% of injuries were not officially recorded; (4) Conclusion: High rates of work-related accidents and injuries caused by sharp instruments in paramedics are a serious public health problem. Further studies should be conducted in order to identify risk factors of accidents, particularly injuries, and to implement preventative programmes, aiming to minimise rates of occupational hazards for paramedics.
Alizadeh, Seyed Shamseddin; Mortazavi, Seyed Bagher; Sepehri, Mohammad Mehdi
2015-01-01
Background: Because of occupational accidents, permanent disabilities and deaths occur and economic and workday losses emerge. Objectives: The purpose of the present study was to investigate the factors responsible for occupational accidents occurred in Iran. Patients and Methods: The current study analyzed 1464 occupational accidents recorded by the Ministry of Labor and Social Affairs’ offices in Iran during 2008 - 2012. At first, general understanding of accidents was obtained using descriptive statistics. Afterwards, the chi-square test and Cramer’s V statistic (Vc) were used to determine the association between factors influencing the type of injury as occupational accident outcomes. Results: There was no significant association between marital status and time of day with the type of injury. However, activity sector, cause of accident, victim’s education, age of victim and victim’s experience were significantly associated with the type of injury. Conclusions: Successful accident prevention relies largely on knowledge about the causes of accidents. In any accident control activity, particularly in occupational accidents, correctly identifying high-risk groups and factors influencing accidents is the key to successful interventions. Results of this study can cause to increase accident awareness and enable workplace’s management to select and prioritize problem areas and safety system weakness in workplaces. PMID:26568848
Szatko, Franciszek; Ulrichs, Magdalena
2017-01-01
(1) Background: An analysis of work-related accidents in paramedics in Poland by presenting the model and trend of accidents, accident rates and by identifying causes and results of accidents; (2) Methods: A retrospective analysis of medical documentation regarding work-related accidents in a multi-specialist hospital, located in central Poland, in the period 2005–2015. The study group included paramedics who had an accident while being on duty; (3) Results: According to hospital records, 88 paramedics were involved in 390 accidents and 265 injuries caused by sharp instruments. The annual accident rate was 5.34/100 employed paramedics. Most of the accidents occurred at night. The most common reason for the accident was careless behaviour of the paramedic, which resulted in joint sprains and dislocations. Injuries accounted for a huge portion of the total number of events. As many as 45% of injuries were not officially recorded; (4) Conclusion: High rates of work-related accidents and injuries caused by sharp instruments in paramedics are a serious public health problem. Further studies should be conducted in order to identify risk factors of accidents, particularly injuries, and to implement preventative programmes, aiming to minimise rates of occupational hazards for paramedics. PMID:28796193
Who by accident? The social morphology of car accidents.
Factor, Roni; Yair, Gad; Mahalel, David
2010-09-01
Prior studies in the sociology of accidents have shown that different social groups have different rates of accident involvement. This study extends those studies by implementing Bourdieu's relational perspective of social space to systematically explore the homology between drivers' social characteristics and their involvement in specific types of motor vehicle accident. Using a large database that merges official Israeli road-accident records with socioeconomic data from two censuses, this research maps the social order of road accidents through multiple correspondence analysis. Extending prior studies, the results show that different social groups indeed tend to be involved in motor vehicle accidents of different types and severity. For example, we find that drivers from low socioeconomic backgrounds are overinvolved in severe accidents with fatal outcomes. The new findings reported here shed light on the social regularity of road accidents and expose new facets in the social organization of death. © 2010 Society for Risk Analysis.
Domino effect in chemical accidents: main features and accident sequences.
Darbra, R M; Palacios, Adriana; Casal, Joaquim
2010-11-15
The main features of domino accidents in process/storage plants and in the transportation of hazardous materials were studied through an analysis of 225 accidents involving this effect. Data on these accidents, which occurred after 1961, were taken from several sources. Aspects analyzed included the accident scenario, the type of accident, the materials involved, the causes and consequences and the most common accident sequences. The analysis showed that the most frequent causes are external events (31%) and mechanical failure (29%). Storage areas (35%) and process plants (28%) are by far the most common settings for domino accidents. Eighty-nine per cent of the accidents involved flammable materials, the most frequent of which was LPG. The domino effect sequences were analyzed using relative probability event trees. The most frequent sequences were explosion→fire (27.6%), fire→explosion (27.5%) and fire→fire (17.8%). Copyright © 2010 Elsevier B.V. All rights reserved.
The Fukushima radiation accident: consequences for radiation accident medical management.
Meineke, Viktor; Dörr, Harald
2012-08-01
The March 2011 radiation accident in Fukushima, Japan, is a textbook example of a radiation accident of global significance. In view of the global dimensions of the accident, it is important to consider the lessons learned. In this context, emphasis must be placed on consequences for planning appropriate medical management for radiation accidents including, for example, estimates of necessary human and material resources. The specific characteristics of the radiation accident in Fukushima are thematically divided into five groups: the exceptional environmental influences on the Fukushima radiation accident, particular circumstances of the accident, differences in risk perception, changed psychosocial factors in the age of the Internet and globalization, and the ignorance of the effects of ionizing radiation both among the general public and health care professionals. Conclusions like the need for reviewing international communication, interfacing, and interface definitions will be drawn from the Fukushima radiation accident.
Deaths: Leading Causes for 2015.
Heron, Melonie
2017-11-01
Objectives-This report presents final 2015 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2015," the National Center for Health Statistics' annual report of final mortality statistics. Methods-Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2015. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. Results-In 2015, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Accidents (unintentional injuries); Cerebrovascular diseases; Alzheimer's disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2015 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
Accident or homicide--virtual crime scene reconstruction using 3D methods.
Buck, Ursula; Naether, Silvio; Räss, Beat; Jackowski, Christian; Thali, Michael J
2013-02-10
The analysis and reconstruction of forensically relevant events, such as traffic accidents, criminal assaults and homicides are based on external and internal morphological findings of the injured or deceased person. For this approach high-tech methods are gaining increasing importance in forensic investigations. The non-contact optical 3D digitising system GOM ATOS is applied as a suitable tool for whole body surface and wound documentation and analysis in order to identify injury-causing instruments and to reconstruct the course of event. In addition to the surface documentation, cross-sectional imaging methods deliver medical internal findings of the body. These 3D data are fused into a whole body model of the deceased. Additional to the findings of the bodies, the injury inflicting instruments and incident scene is documented in 3D. The 3D data of the incident scene, generated by 3D laser scanning and photogrammetry, is also included into the reconstruction. Two cases illustrate the methods. In the fist case a man was shot in his bedroom and the main question was, if the offender shot the man intentionally or accidentally, as he declared. In the second case a woman was hit by a car, driving backwards into a garage. It was unclear if the driver drove backwards once or twice, which would indicate that he willingly injured and killed the woman. With this work, we demonstrate how 3D documentation, data merging and animation enable to answer reconstructive questions regarding the dynamic development of patterned injuries, and how this leads to a real data based reconstruction of the course of event. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Biodefense research: can secrecy and safety coexist?
Kahn, Laura H
2004-01-01
Over the next 10 years, the United States will spend 6 billion US dollars to develop countermeasures against biological and chemical weapons. Much of this research on highly virulent pathogens will be done in academic settings around the country. This article explores the challenges in ensuring secrecy to protect national security while accommodating the right of local communities to have access to safety information regarding select agents and laboratory-acquired infections. Secrecy has been defended as being vital for protecting national security. Problems with secrecy can include the misinterpretation of intentions, particularly in laboratories located in nuclear weapons design facilities, and the restricted access to information relevant to public health and safety. While federal select agent legislation requires laboratories to have emergency plans in place with first responders, these plans do not necessarily include public health professionals, who will be responsible for any future public health action, such as quarantine, surveillance, or mass vaccinations, in the unlikely event that a laboratory-acquired infection spreads into a community. Laboratory-acquired infections do occur, even with the best safety mechanisms in place; however, the epidemiology of the incidence and severity of these infections are not known since there is no national surveillance reporting system. Evidence suggests that many of these infections occur in the absence of an actual laboratory accident. The best emergency plans and surveillance systems are only as good as the participation and vigilance of the laboratory workers themselves. Thus, laboratory workers have a responsibility to themselves and others to report all laboratory accidents and spills, regardless how minor. In addition, they should have a lower threshold than normal in seeking medical attention when feeling ill, and their physicians should be aware of what pathogens they work with to reduce the risk of a delay in diagnosis.
Deaths: Leading Causes for 2013.
Heron, Melonie
2016-02-16
This report presents final 2013 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2013," the National Center for Health Statistics’ annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2013. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD–10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2013, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Accidents (unintentional injuries); Cerebrovascular diseases; Alzheimer’s disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2013 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Newborn affected by maternal complications of pregnancy; Sudden infant death syndrome; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
Deaths: leading causes for 2010.
Heron, Melonie
2013-12-20
This report presents final 2010 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the Division of Vital Statistics' annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2010. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2010, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer's disease; Diabetes mellitus; Nephritis, nephrotic syndrome and nephrosis; Influenza and pneumonia; and Intentional self-harm (suicide). These 10 causes accounted for 75% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2010 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Necrotizing enterocolitis of newborn. Important variations in the leading causes of infant death are noted for the neonatal and post-neonatal periods. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
Deaths: Leading Causes for 2011.
Heron, Melonie
2015-07-27
This report presents final 2011 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements ‘‘Deaths: Final Data for 2011,’’ the National Center for Health Statistics’ annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2011. Causes of death classified by the International Classification of Diseases, 10th Revision (ICD–10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2011, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer’s disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2011 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
Occupational accidents in the Finnish local government sector: utilisation of national statistics.
Nenonen, Noora
2011-12-01
Occupational accidents in the Finnish local government sector in 2004 are analysed by gender, age and occupation class in order to identify particular risk groups. The accident data are compared with data concerning the number of employees, using frequency distributions and accident incidence rates. The possibilities of providing occupation class-specific accident incidence rates are also discussed. According to the results, commuting accidents are more common and severe in the local government sector than in general in Finland. In the local public sector occupational accidents more often involved women than men. Compared to other age groups and occupational classes, occupational accidents are more common in the age band of 45-54 and in the occupational class of medical and nursing work. However, compared to the employees' data, men and younger employees had an increased workplace accident risk, while women and older employees had an increased risk of commuting accidents. The highest accident incidence rate was in farming and animal husbandry work. Currently, the calculation of occupation class-specific accident incidence rates is difficult. Improving the consistency of the occupation classifications used in the various data sources would facilitate more reliable calculation of rates.
Pattern extraction for high-risk accidents in the construction industry: a data-mining approach.
Amiri, Mehran; Ardeshir, Abdollah; Fazel Zarandi, Mohammad Hossein; Soltanaghaei, Elahe
2016-09-01
Accidents involving falls and falling objects (group I) are highly frequent accidents in the construction industry. While being hit by a vehicle, electric shock, collapse in the excavation and fire or explosion accidents (group II) are much less frequent, they make up a considerable proportion of severe accidents. In this study, multiple-correspondence analysis, decision tree, ensembles of decision tree and association rules methods are employed to analyse a database of construction accidents throughout Iran between 2007 and 2011. The findings indicate that in group I, there is a significant correspondence among these variables: time of accident, place of accident, body part affected, final consequence of accident and lost workdays. Moreover, the frequency of accidents in the night shift is less than others, and the frequency of injury to the head, back, spine and limbs are more. In group II, the variables time of accident and body part affected are mostly related and the frequency of accidents among married and older workers is more than single and young workers. There was a higher frequency in the evening, night shifts and weekends. The results of this study are totally in line with the previous research.
Analysis of accidents in nine Iranian gas refineries: 2007-2011.
Mehrdad, R; Bolouri, A; Shakibmanesh, A R
2013-10-01
Occupational accidents are one of the major health hazards in industries and associated with high mortality, morbidity, spiritual damage and economic losses in the world. To determine the incidence of occupational accidents in 9 Iranian gas refineries between March 2007 and February 2011. Data on all occupational accidents occurred between March 2007 and February 2011, as well as other possible associated variables including time of accident, whether the accident was due to a personal or systemic fault, type of accident and its outcomes, age and gender of the victim, the injured parts of the body, job experience, and type of employment, were extracted from HSE reports and notes of health care services. Based on these data, we calculated the incidence rate of accidents and assessed the associated factors. During the 5 studied years, 1129 accidents have been recorded. The incidence of fatal accidents was 1.64 per 100 000 and of nonfatal accidents was 1857 per 100 000 workers per year. 99.4% of injured workers were male. The mean±SD age of injured people was 29.6±7.3 years. Almost 70% of injured workers aged under 30 years. The mean±SD job experience was 5.3±5.3 years. Accidents occurred more commonly around 10:00. More than 60% of accidents happened between 8:00 and 15:00. July had the highest incidence rate. The most common type of accident was being struck by an object (48%). More than 94% of accidents are caused by personal rather than systemic faults. Hands and wrists were the most common injured parts and involved in more than one-third of accidents. 70% of injured workers needed medical treatment and returned to work after primary treatment. The pattern of occupational accidents in Iranian gas refineries is similar to other previous reports in many ways. The incidence did not change significantly over the study period. Establishment of an online network for precise registration, notification and meticulous data collection seems necessary.
32 CFR 634.28 - Traffic accident investigation.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 32 National Defense 4 2011-07-01 2011-07-01 false Traffic accident investigation. 634.28 Section... accident investigation. Installation law enforcement personnel must make detailed investigations of accidents described in this section: (a) Accidents involving Government vehicles or Government property on...
A study of carburetor/induction system icing in general aviation accidents
NASA Technical Reports Server (NTRS)
Obermayer, R. W.; Roe, W. T.
1975-01-01
An assessment of the frequency and severity of carburetor/induction icing in general-aviation accidents was performed. The available literature and accident data from the National Transportation Safety Board were collected. A computer analysis of the accident data was performed. Between 65 and 90 accidents each year involve carburetor/induction system icing as a probable cause/factor. Under conditions conducive to carburetor/induction icing, between 50 and 70 percent of engine malfunction/failure accidents (exclusive of those due to fuel exhaustion) are due to carburetor/induction system icing. Since the evidence of such icing may not remain long after an accident, it is probable that the frequency of occurrence of such accidents is underestimated; therefore, some extrapolation of the data was conducted. The problem of carburetor/induction system icing is particularly acute for pilots with less than 1000 hours of total flying time. The severity of such accidents is about the same as any accident resulting from a forced landing or precautionary landing. About 144 persons, on the average, are exposed to death and injury each year in accidents involving carburetor/induction icing as a probable cause/factor.
Major differences in rates of occupational accidents between different nationalities of seafarers.
Hansen, Henrik L; Laursen, Lise Hedgaard; Frydberg, Morten; Kristensen, Soeren
2008-01-01
Earlier studies and statistics have shown that merchant seafarers from the South East Asia had considerable lower accident rates when compared with seafarers from Western Europe. The purposes of the study were to investigate whether the earlier observations were sustained if further sources on occurrence of accidents were used and to identify specific causes of excess accident rates among certain nationalities. Occupational accidents aboard Danish merchant ships during one year were identified from four different sources. These included accidents reported to the maritime authorities, accidents reported to a mutual insurance company, files on medical costs reimbursed by the government and finally, accidents in which there has been contact to the radio medical service. Time at risk aboard was obtained from a register on all employment periods aboard merchant ships. A total of 943 accidents causing personal injury to a seafarer directly caused by work aboard were identified. Among these accidents, 499 had taken place aboard cargo ships in international trade. Only these were used in the detailed analysis. The accident rate for all identified accidents aboard cargo ships were 84 accidents per 1,000 years aboard. The crude incidence rate ratio (IRR) for East European seafarers was 0.88 and for South East Asians 0.38 using West European seafarers as reference. In a Poisson regression analysis, the IRR for South East Asians was 0.29 (0.22-0.38). In an analysis including only more serious accidents, IRR for South East Asians rose to 0.36 (0.26-0.48). This study indicates that seafarers from South East Asia, mainly the Philippines, may have a genuine lower risk of occupational accidents in comparison with seafarers from Western and Eastern Europe. Differences in approach to safety and risk taking between South East Asian and European seafarers should be identified and positives attitudes included in accident preventing programmes. Main messages Seafarers from South East Asia, mainly the Philippines, seem to have a genuine lower risk of occupational accidents in comparison with seafarers from Western and Eastern Europe. Differences in approach to safety and risk taking between South East Asian and European seafarers should be identified and positives attitudes included in accident preventing programmes.
Comparison of the Chernobyl and Fukushima nuclear accidents: a review of the environmental impacts.
Steinhauser, Georg; Brandl, Alexander; Johnson, Thomas E
2014-02-01
The environmental impacts of the nuclear accidents of Chernobyl and Fukushima are compared. In almost every respect, the consequences of the Chernobyl accident clearly exceeded those of the Fukushima accident. In both accidents, most of the radioactivity released was due to volatile radionuclides (noble gases, iodine, cesium, tellurium). However, the amount of refractory elements (including actinides) emitted in the course of the Chernobyl accident was approximately four orders of magnitude higher than during the Fukushima accident. For Chernobyl, a total release of 5,300 PBq (excluding noble gases) has been established as the most cited source term. For Fukushima, we estimated a total source term of 520 (340-800) PBq. In the course of the Fukushima accident, the majority of the radionuclides (more than 80%) was transported offshore and deposited in the Pacific Ocean. Monitoring campaigns after both accidents reveal that the environmental impact of the Chernobyl accident was much greater than of the Fukushima accident. Both the highly contaminated areas and the evacuated areas are smaller around Fukushima and the projected health effects in Japan are significantly lower than after the Chernobyl accident. This is mainly due to the fact that food safety campaigns and evacuations worked quickly and efficiently after the Fukushima accident. In contrast to Chernobyl, no fatalities due to acute radiation effects occurred in Fukushima. © 2013.
Accidents of Electrical and Mechanical Works for Public Sector Projects in Hong Kong.
Wong, Francis K W; Chan, Albert P C; Wong, Andy K D; Hon, Carol K H; Choi, Tracy N Y
2018-03-10
A study on electrical and mechanical (E&M) works-related accidents for public sector projects provided the opportunity to gain a better understanding of the causes of accidents by analyzing the circumstances of all E&M works accidents. The research aims to examine accidents of E&M works which happened in public sector projects. A total of 421 E&M works-related accidents in the "Public Works Programme Construction Site Safety and Environmental Statistics" (PCSES) system were extracted for analysis. Two-step cluster analysis was conducted to classify the E&M accidents into different groups. The results identified three E&M accidents groups: (1) electricians with over 15 years of experience were prone to 'fall of person from height'; (2) electricians with zero to five years of experience were prone to 'slip, trip or fall on same level'; (3) air-conditioning workers with zero to five years of experience were prone to multiple types of accidents. Practical measures were recommended for each specific cluster group to avoid recurrence of similar accidents. The accident analysis would be vital for industry practitioners to enhance the safety performance of public sector projects. This study contributes to filling the knowledge gap of how and why E&M accidents occur and promulgating preventive measures for E&M accidents which have been under researched.
Accidents of Electrical and Mechanical Works for Public Sector Projects in Hong Kong
Wong, Francis K. W.; Chan, Albert P. C.; Wong, Andy K. D.; Choi, Tracy N. Y.
2018-01-01
A study on electrical and mechanical (E&M) works-related accidents for public sector projects provided the opportunity to gain a better understanding of the causes of accidents by analyzing the circumstances of all E&M works accidents. The research aims to examine accidents of E&M works which happened in public sector projects. A total of 421 E&M works-related accidents in the “Public Works Programme Construction Site Safety and Environmental Statistics” (PCSES) system were extracted for analysis. Two-step cluster analysis was conducted to classify the E&M accidents into different groups. The results identified three E&M accidents groups: (1) electricians with over 15 years of experience were prone to ‘fall of person from height’; (2) electricians with zero to five years of experience were prone to ‘slip, trip or fall on same level’; (3) air-conditioning workers with zero to five years of experience were prone to multiple types of accidents. Practical measures were recommended for each specific cluster group to avoid recurrence of similar accidents. The accident analysis would be vital for industry practitioners to enhance the safety performance of public sector projects. This study contributes to filling the knowledge gap of how and why E&M accidents occur and promulgating preventive measures for E&M accidents which have been under researched. PMID:29534429
28 CFR 301.106 - Repetitious accidents.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Repetitious accidents. 301.106 Section 301.106 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE INMATE ACCIDENT COMPENSATION General § 301.106 Repetitious accidents. If an inmate worker is involved in successive accidents...
28 CFR 301.106 - Repetitious accidents.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Repetitious accidents. 301.106 Section 301.106 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE INMATE ACCIDENT COMPENSATION General § 301.106 Repetitious accidents. If an inmate worker is involved in successive accidents...
49 CFR 801.30 - Records from accident investigations.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 49 Transportation 7 2010-10-01 2010-10-01 false Records from accident investigations. 801.30... TRANSPORTATION SAFETY BOARD PUBLIC AVAILABILITY OF INFORMATION Accident Investigation Records § 801.30 Records from accident investigations. Upon completion of an accident investigation, each NTSB investigator (or...
49 CFR 801.30 - Records from accident investigations.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 49 Transportation 7 2011-10-01 2011-10-01 false Records from accident investigations. 801.30... TRANSPORTATION SAFETY BOARD PUBLIC AVAILABILITY OF INFORMATION Accident Investigation Records § 801.30 Records from accident investigations. Upon completion of an accident investigation, each NTSB investigator (or...
49 CFR 195.50 - Reporting accidents.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 49 Transportation 3 2011-10-01 2011-10-01 false Reporting accidents. 195.50 Section 195.50 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Annual, Accident, and Safety-Related Condition Reporting § 195.50 Reporting accidents. An accident...
49 CFR 195.50 - Reporting accidents.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 49 Transportation 3 2010-10-01 2010-10-01 false Reporting accidents. 195.50 Section 195.50 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Annual, Accident, and Safety-Related Condition Reporting § 195.50 Reporting accidents. An accident...
10 CFR 835.1304 - Nuclear accident dosimetry.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 10 Energy 4 2013-01-01 2013-01-01 false Nuclear accident dosimetry. 835.1304 Section 835.1304... Nuclear accident dosimetry. (a) Installations possessing sufficient quantities of fissile material to... nuclear accident is possible, shall provide nuclear accident dosimetry for those individuals. (b) Nuclear...
10 CFR 835.1304 - Nuclear accident dosimetry.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 10 Energy 4 2014-01-01 2014-01-01 false Nuclear accident dosimetry. 835.1304 Section 835.1304... Nuclear accident dosimetry. (a) Installations possessing sufficient quantities of fissile material to... nuclear accident is possible, shall provide nuclear accident dosimetry for those individuals. (b) Nuclear...
10 CFR 835.1304 - Nuclear accident dosimetry.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 10 Energy 4 2011-01-01 2011-01-01 false Nuclear accident dosimetry. 835.1304 Section 835.1304... Nuclear accident dosimetry. (a) Installations possessing sufficient quantities of fissile material to... nuclear accident is possible, shall provide nuclear accident dosimetry for those individuals. (b) Nuclear...
10 CFR 835.1304 - Nuclear accident dosimetry.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 10 Energy 4 2012-01-01 2012-01-01 false Nuclear accident dosimetry. 835.1304 Section 835.1304... Nuclear accident dosimetry. (a) Installations possessing sufficient quantities of fissile material to... nuclear accident is possible, shall provide nuclear accident dosimetry for those individuals. (b) Nuclear...
10 CFR 835.1304 - Nuclear accident dosimetry.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 10 Energy 4 2010-01-01 2010-01-01 false Nuclear accident dosimetry. 835.1304 Section 835.1304... Nuclear accident dosimetry. (a) Installations possessing sufficient quantities of fissile material to... nuclear accident is possible, shall provide nuclear accident dosimetry for those individuals. (b) Nuclear...
Use of artificial intelligence in severe accident diagnosis for PWRs
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wu, Zheng; Okrent, D.; Kastenberg, W.E.
1995-12-31
A combination approach of an expert system and neural networks is used to implement a prototype severe accident diagnostic system which would monitor the progression of the severe accident and provide necessary plant status information to assist the plant staff in accident management during the accident. The station blackout accident in a pressurized water reactor (PWR) is used as the study case. The current phase of research focus is on distinguishing different primary system failure modes and following the accident transient before and up to vessel breach.
Rolison, Jonathan J; Regev, Shirley; Moutari, Salissou; Feeney, Aidan
2018-06-01
What are the main contributing factors to road accidents? Factors such as inexperience, lack of skill, and risk-taking behaviors have been associated with the collisions of young drivers. In contrast, visual, cognitive, and mobility impairment have been associated with the collisions of older drivers. We investigated the main causes of road accidents by drawing on multiple sources: expert views of police officers, lay views of the driving public, and official road accident records. In Studies 1 and 2, police officers and the public were asked about the typical causes of road traffic collisions using hypothetical accident scenarios. In Study 3, we investigated whether the views of police officers and the public about accident causation influence their recall accuracy for factors reported to contribute to hypothetical road accidents. The results show that both expert views of police officers and lay views of the driving public closely approximated the typical factors associated with the collisions of young and older drivers, as determined from official accident records. The results also reveal potential underreporting of factors in existing accident records, identifying possible inadequacies in law enforcement practices for investigating driver distraction, drug and alcohol impairment, and uncorrected or defective eyesight. Our investigation also highlights a need for accident report forms to be continuously reviewed and updated to ensure that contributing factor lists reflect the full range of factors that contribute to road accidents. Finally, the views held by police officers and the public on accident causation influenced their memory recall of factors involved in hypothetical scenarios. These findings indicate that delay in completing accident report forms should be minimised, possibly by use of mobile reporting devices at the accident scene. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.
Professional experience and traffic accidents/near-miss accidents among truck drivers.
Girotto, Edmarlon; Andrade, Selma Maffei de; González, Alberto Durán; Mesas, Arthur Eumann
2016-10-01
To investigate the relationship between the time working as a truck driver and the report of involvement in traffic accidents or near-miss accidents. A cross-sectional study was performed with truck drivers transporting products from the Brazilian grain harvest to the Port of Paranaguá, Paraná, Brazil. The drivers were interviewed regarding sociodemographic characteristics, working conditions, behavior in traffic and involvement in accidents or near-miss accidents in the previous 12 months. Subsequently, the participants answered a self-applied questionnaire on substance use. The time of professional experience as drivers was categorized in tertiles. Statistical analyses were performed through the construction of models adjusted by multinomial regression to assess the relationship between the length of experience as a truck driver and the involvement in accidents or near-miss accidents. This study included 665 male drivers with an average age of 42.2 (±11.1) years. Among them, 7.2% and 41.7% of the drivers reported involvement in accidents and near-miss accidents, respectively. In fully adjusted analysis, the 3rd tertile of professional experience (>22years) was shown to be inversely associated with involvement in accidents (odds ratio [OR] 0.29; 95% confidence interval [CI] 0.16-0.52) and near-miss accidents (OR 0.17; 95% CI 0.05-0.53). The 2nd tertile of professional experience (11-22 years) was inversely associated with involvement in accidents (OR 0.63; 95% CI 0.40-0.98). An evident relationship was observed between longer professional experience and a reduction in reporting involvement in accidents and near-miss accidents, regardless of age, substance use, working conditions and behavior in traffic. Copyright © 2016 Elsevier Ltd. All rights reserved.
Statistical Analysis And Treatment Of Accident Black Spots: A Case Study Of Nandyal Mandal
NASA Astrophysics Data System (ADS)
Sudharshan Reddy, B.; Vishnu Vardhan Reddy, L.; Sreenivasa Reddy, G., Dr
2017-08-01
Background: Increased, economic activity raised the consumption levels of the people across the country. This created scope for increase in travel and transportation. The increase in the vehicles since last 10 years has put lot of pressure on the existing roads and ultimately resulting in road accidents. Nandyal Mandal is located in the Kurnool district of Andhra Pradesh and well developed in both agricultural and industrial sectors after Kurnool. 567 accidents occurred in the last seven years at 143 locations shows the severity of the accidents in the Nandyal Mandal. There is a need to carry out some work in the Nandyal Mandal to improve the accidents black spots for reducing the accidents. Methods: Last seven years (2010-2016) of accident data collected from Police Stations. Weighted Severity Index (WSI), a scientific method is used for identifying the accident black spots. Statistical analysis has carried out for the collected data using Chi-Square Test to determine the independence of accidents with other attributes. Chi-Square Goodness of fit test conducted for test whether the accidents are occurring by chance or following any pattern. Results: WSI values are determined for the 143 locations. The Locations with high WSI are treated as accident black spots. Five black spots are taken for field study. After field observations and interaction with the public, some improvements are suggested for improving the accident black spots. There is no relationship between the severity of accidents and the other attributes like month, season, day, hours in day and the age group except type of vehicle. Road accidents are distributed throughout the Year, Month and Season. Road accidents are not distributed throughout the day.
Accidents in the greenhouse-construction industry of SE Spain.
Pérez-Alonso, José; Carreño-Ortega, Angel; Vázquez-Cabrera, Fernando J; Callejón-Ferre, Angel Jesús
2012-01-01
This work analyses the labour accidents in the greenhouse-construction industry of SE Spain for the period 1999-2007 through a sample of 180 accident reports. The accidents were characterised by studying 5 variables in order to know the day of the week in which the accident occurred, the hour of the day of the accident, type of accident, the region of Spain in which the accident happened, and the resulting injury. The data characterising the accidents were submitted to a descriptive multiple-correspondence analysis. The incidence of accidents in the greenhouse-construction industry presented a high mean value of 15133.7 per 100,000 workers per year. The days with the greatest incidence of accidents were Thursday and Monday, while the period of greatest number of accidents occurred in the first 4h of the workday. No significant correspondence was found between the day of the week, the hour of the day, or any of the other 3 variables studied. The types of accidents with most frequency were: cuts, punctures, contact with hard or rough material, overexertion, and falls from one level to another. The most affected parts of the anatomy were the eyes, thorax, back, sides, lower legs, and feet. The most common types of injury were bone fractures, twists and sprains, distended muscles, contusions, and being crushed. The study calls attention to the high number of accidents at work, which needs to be corrected by fulfilment of safety regulations at work, on the part of the company. Finally, recommendations are made to correct this situation of high number of accidents at work. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.
Road profiling of traffic accidents in Jos, Nigeria, 1995-1999.
Bombom, Leonard S; Edino, Marcus O
2009-09-01
Road traffic accident data in Nigeria generally lack exact coordinate information. Accident analysis is, therefore, restricted to aggregate data on trends, magnitude and temporal dimensions. This article addresses the road accident problem in Jos between 1995 and 1999 through a road profiling approach. Results show that four gateway routes, seven multi-lane roadways (including two gateway routes) and seven road intersections accounted for 84% of all traffic accidents, 84% of injured casualties and 88% of fatalities. This approach allows for quantification of impacts of controlling for accidents by deliberate profiling of roads for close monitoring and policing. For example, reducing accident counts and fatalities by 50% each on gateway routes will amount to approximately 35 and 40% reduction in accident and fatality counts, respectively. Countermeasures must consider these roadways and intersections as important inputs in their accidents and casualty reduction targets.
Alameddine, Mohamad; Mourad, Yara; Dimassi, Hani
2015-01-01
Healthcare institutions have commonly reported exposure of employees, particularly nurses, to high levels of occupational violence. Despite such evidence in the Middle East Region, there is a dearth of national studies that have systematically investigated this phenomenon. This study investigates the prevalence, characteristics, consequences and factors associated with nurses' exposure to occupational violence in Lebanon. A cross-sectional design was utilized to survey a nationally representative sample of 915 nurses registered with the Order of Nurses in Lebanon. Stratified random sampling by governorate was utilized. Individually-mailed questionnaires collected information on exposure to violence, degree of burnout and demographic/professional background. The main outcome variables were exposure to verbal abuse (never, 1-3, 4-9 and 10+ times) and physical violence (never, ever) over the past 12-months. Descriptive statistics were used to estimate prevalence of violence. Multivariable, binomial and multinomial regression models were carried out to investigate the correlates of exposure to verbal abuse and physical violence, respectively. Response rate was 64.8%. Over the last year, prevalence of nurses' exposure to verbal abuse was 62%, (CI: 58-65%) and physical violence was 10%, (CI: 8-13%). Among respondents, 31.7% of nurses indicated likelihood to quit their jobs and 22.3% were undetermined. Furthermore, 54.1% reported high levels of emotional exhaustion and 28.8% reported high levels of depersonalization. Compared to nurses with no exposure to verbal abuse, nurses reporting high exposure had high levels of emotional exhaustion (OR:6.4; CI:1.76-23.32), depersonalization (OR:6.8; CI: 3-15) and intention to quit job (OR:3.9; CI: 1.8-8.3). They further reported absence of anti-violence policies at their institutions (OR: 3; CI: 1.5-6.3). Nurses that were ever exposed to physical violence were more likely to be males (OR: 2.2; CI: 1.1-4.3), working day and night shifts (OR: 2.8; CI: 1.4-5.5) and subject to ten or more incidents of verbal abuse per year (OR: 46.7; CI: 10.1-214). An alarming two-thirds of respondents reported exposure to verbal abuse which was found to be a significant predictor of the three subscales of burnout, intention to quit and exposure to physical violence. The prevalence of exposure to physical violence is disconcerting due to its severe consequences. Policy and decision-makers are urged to use study findings for policy and practice interventions to create safe work environments conducive to nurses' productivity and retention.
Development of Database for Accident Analysis in Indian Mines
NASA Astrophysics Data System (ADS)
Tripathy, Debi Prasad; Guru Raghavendra Reddy, K.
2016-10-01
Mining is a hazardous industry and high accident rates associated with underground mining is a cause of deep concern. Technological developments notwithstanding, rate of fatal accidents and reportable incidents have not shown corresponding levels of decline. This paper argues that adoption of appropriate safety standards by both mine management and the government may result in appreciable reduction in accident frequency. This can be achieved by using the technology in improving the working conditions, sensitising workers and managers about causes and prevention of accidents. Inputs required for a detailed analysis of an accident include information on location, time, type, cost of accident, victim, nature of injury, personal and environmental factors etc. Such information can be generated from data available in the standard coded accident report form. This paper presents a web based application for accident analysis in Indian mines during 2001-2013. An accident database (SafeStat) prototype based on Intranet of the TCP/IP agreement, as developed by the authors, is also discussed.
Primary school accident reporting in one education authority
Latif, A; Williams, W; Sibert, J
2002-01-01
Background: Studies have shown a correlation between increased accident rates and levels of deprivation in the community. School accident reporting is one area where an association might be expected. Aims: To investigate differences in primary school accident rates in deprived and more affluent wards, in an area managed by one education authority. Methods: Statistical analysis of accident form returns for 100 primary schools in one education authority in Wales over a two year period, in conjunction with visits to over one third of school sites. Results: Accident report rates from schools in deprived wards were three times higher than those from schools in more affluent wards. School visits showed that this discrepancy was attributable primarily to differences in reporting procedures. One third of schools did not report accidents and approximately half did not keep records of minor accidents. Conclusions: The association between school accident report rates and deprivation in the community is complex. School accident data from local education authorities may be unreliable for most purposes of collection. PMID:11827900
Primary school accident reporting in one education authority.
Latif, A H A; Williams, W R; Sibert, J
2002-02-01
Studies have shown a correlation between increased accident rates and levels of deprivation in the community. School accident reporting is one area where an association might be expected. To investigate differences in primary school accident rates in deprived and more affluent wards, in an area managed by one education authority. Statistical analysis of accident form returns for 100 primary schools in one education authority in Wales over a two year period, in conjunction with visits to over one third of school sites. Accident report rates from schools in deprived wards were three times higher than those from schools in more affluent wards. School visits showed that this discrepancy was attributable primarily to differences in reporting procedures. One third of schools did not report accidents and approximately half did not keep records of minor accidents. The association between school accident report rates and deprivation in the community is complex. School accident data from local education authorities may be unreliable for most purposes of collection.
Epidemiology of occupational accidents in iran based on social security organization database.
Mehrdad, Ramin; Seifmanesh, Shahdokht; Chavoshi, Farzaneh; Aminian, Omid; Izadi, Nazanin
2014-01-01
Today, occupational accidents are one of the most important problems in industrial world. Due to lack of appropriate system for registration and reporting, there is no accurate statistics of occupational accidents all over the world especially in developing countries. The aim of this study is epidemiological assessment of occupational accidents in Iran. Information of available occupational accidents in Social Security Organization was extracted from accident reporting and registration forms. In this cross-sectional study, gender, age, economic activity, type of accident and injured body part in 22158 registered accidents during 2008 were described. The occupational accidents rate was 253 in 100,000 workers in 2008. 98.2% of injured workers were men. The mean age of injured workers was 32.07 ± 9.12 years. The highest percentage belonged to age group of 25-34 years old. In our study, most of the accidents occurred in basic metals industry, electrical and non-electrical machines and construction industry. Falling down from height and crush injury were the most prevalent accidents. Upper and lower extremities were the most common injured body parts. Due to the high rate of accidents in metal and construction industries, engineering controls, the use of appropriate protective equipment and safety worker training seems necessary.
Epidemiology of Occupational Accidents in Iran Based on Social Security Organization Database
Mehrdad, Ramin; Seifmanesh, Shahdokht; Chavoshi, Farzaneh; Aminian, Omid; Izadi, Nazanin
2014-01-01
Background: Background: Today, occupational accidents are one of the most important problems in industrial world. Due to lack of appropriate system for registration and reporting, there is no accurate statistics of occupational accidents all over the world especially in developing countries. Objectives: The aim of this study is epidemiological assessment of occupational accidents in Iran. Materials and Methods: Information of available occupational accidents in Social Security Organization was extracted from accident reporting and registration forms. In this cross-sectional study, gender, age, economic activity, type of accident and injured body part in 22158 registered accidents during 2008 were described. Results: The occupational accidents rate was 253 in 100,000 workers in 2008. 98.2% of injured workers were men. The mean age of injured workers was 32.07 ± 9.12 years. The highest percentage belonged to age group of 25-34 years old. In our study, most of the accidents occurred in basic metals industry, electrical and non-electrical machines and construction industry. Falling down from height and crush injury were the most prevalent accidents. Upper and lower extremities were the most common injured body parts. Conclusion: Due to the high rate of accidents in metal and construction industries, engineering controls, the use of appropriate protective equipment and safety worker training seems necessary. PMID:24719699
Civilian Helicopter Search and Rescue Accidents in the United States: 1980 Through 2013.
Worley, Gordon H
2015-12-01
Helicopters are commonly used in search and rescue operations, and accidents have occurred during helicopter search and rescue (HSAR) missions. The purposes of this study were to investigate whether the HSAR accident rate in the United States could be determined and whether any common contributing factors or trends could be identified. Searches were conducted of the National Transportation Safety Board aviation accident database, the records of the major search and rescue and air medical organizations, and the medical and professional literature for reports of HSAR accidents. A total of 47 civilian HSAR accidents were identified during the study. Of these, 43% involved fatal injuries, compared with a 19% fatality rate for US helicopter general aviation accidents during the same time period and a 40% rate for helicopter emergency medical services. The HSAR accidents carried a significantly higher risk of fatal outcomes when compared with helicopter general aviation accidents (2-tailed Fisher's exact test, P < .0005). Accidents that occurred at night and under instrument meteorological conditions did not have a statistically significant increase in percentage of fatal outcomes (P > .05). The number of HSAR missions conducted annually could not be established, so an overall accident rate could not be calculated. Although the overall number of HSAR accidents is small, the percentage of fatal outcomes from HSAR accidents is significantly higher than that from general helicopter aviation accidents and is comparable to that seen for helicopter emergency medical services operations. Further study could help to improve the safety of HSAR flights. Copyright © 2015 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.
Batty, G D; Deary, I J; Schoon, I; Gale, C R
2007-07-01
Few data link childhood mental ability (IQ) with risk of accidents, and most published studies have methodological limitations. To examine the relationship between scores from a battery of mental ability tests taken in childhood, and self-reported accidents between the ages of 16 and 30 years. In the British Cohort study, a sample of 8172 cohort members born in Great Britain in 1970 had complete data for IQ score assessed at 10 years of age and accident data self-reported at age 30 years. The relationship between childhood IQ score and later risk of accident was complex, differing according to sex and the type of accident under consideration. Women with higher childhood IQ were more likely than those with lower scores to report having had an accident(s) while at work, in a vehicle, engaging in sports, and in unspecified circumstances. Adjustment for markers of socioeconomic position weakened or eliminated some of these relations, but higher childhood IQ remained associated with increased risk of sporting and unspecified accidents. Men with higher childhood IQ scores were less likely than those with lower scores to report accidents at work, but more likely to report accidents at home, playing sports or in unspecified circumstances. After adjustment for socioeconomic circumstances, higher childhood IQ in men remained associated with an increased risk of accidents at home or in unspecified circumstances. The relationship between childhood mental ability and accidents in adulthood is complex. As in other studies, socioeconomic position has an inconsistent relationship with non-fatal accident type.
Tepeler, Abdulkadir; Sninsky, Brian C; Nakada, Stephen Y
2015-11-01
The objective of this study is to present the outcomes of flexible ureteroscopic laser lithotripsy (URS) for upper urinary tract stone disease in spinal cord injury (SCI) patients performed by a single surgeon. A retrospective analysis was performed for SCI patients treated with flexible URS for proximal ureter and kidney stone disease by a single surgeon between 2003 and 2013. Patient characteristics, operative outcomes, metabolic evaluation, and stone analyses were assessed in detail. A total of 27 URS procedures were performed for urolithiasis in 21 renal units of 19 patients. The mean age was 52.1 ± 15.6 years (16-72) and mean BMI was 29.2 ± 7.3 kg/m(2) (20-45.7). Etiology of SCI was trauma (n: 10), multiple sclerosis (n: 6), cerebrovascular accident (n: 1), or undetermined (n: 2). The mean stone size was 15.9 ± 8.6 (6-40) mm. In the 27 URS procedures, stones were located in the ureter (n: 5), the kidney (n: 14), and both areas (n: 8). Mean hospitalization time was 2.0 ± 2.4 (0-10) days. Postoperative complications were observed in 6 cases (22.2%). Three major complications included urosepsis (n: 1) and respiratory failure (n: 2), that were observed postoperatively and required admission to the intensive care unit. The 2 minor complications were hypotension, fever and UTI, and required medical treatment. Fourteen (66.6%) of the 21 renal units were stone free. Calcium phosphate carbonate (n: 9) and struvite (n: 5) were the primary stone compositions detected. Hypocitraturia (n: 6), hypercalciuria (n: 5), hypernaturia (n: 5), hyperoxaluria (n: 4), and hyperuricosuria (n: 1) were common abnormalities in 24-h urine analysis. Ureteroscopic laser lithotripsy can be an effective treatment modality for SCI patients with upper urinary tract calculi.
Inversion of Atmospheric Tracer Measurements, Localization of Sources
NASA Astrophysics Data System (ADS)
Issartel, J.-P.; Cabrit, B.; Hourdin, F.; Idelkadi, A.
When abnormal concentrations of a pollutant are observed in the atmosphere, the question of its origin arises immediately. The radioactivity from Tchernobyl was de- tected in Sweden before the accident was announced. This situation emphasizes the psychological, political and medical stakes of a rapid identification of sources. In tech- nical terms, most industrial sources can be modeled as a fixed point at ground level with undetermined duration. The classical method of identification involves the cal- culation of a backtrajectory departing from the detector with an upstream integration of the wind field. We were first involved in such questions as we evaluated the ef- ficiency of the international monitoring network planned in the frame of the Com- prehensive Test Ban Treaty. We propose a new approach of backtracking based upon the use of retroplumes associated to available measurements. Firstly the retroplume is related to inverse transport processes, describing quantitatively how the air in a sam- ple originates from regions that are all the more extended and diffuse as we go back far in the past. Secondly it clarifies the sensibility of the measurement with respect to all potential sources. It is therefore calculated by adjoint equations including of course diffusive processes. Thirdly, the statistical interpretation, valid as far as sin- gle particles are concerned, should not be used to investigate the position and date of a macroscopic source. In that case, the retroplume rather induces a straightforward constraint between the intensity of the source and its position. When more than one measurements are available, including zero valued measurements, the source satisfies the same number of linear relations tightly related to the retroplumes. This system of linear relations can be handled through the simplex algorithm in order to make the above intensity-position correlation more restrictive. This method enables to manage in a quantitative manner the unavoidable ambiguity of atmospheric phenomena. When several measurements are available the ambiguity about the identification of a source is reduced significantly.
Commuting by bike in Belgium, the costs of minor accidents.
Aertsens, Joris; de Geus, Bas; Vandenbulcke, Grégory; Degraeuwe, Bart; Broekx, Steven; De Nocker, Leo; Liekens, Inge; Mayeres, Inge; Meeusen, Romain; Thomas, Isabelle; Torfs, Rudi; Willems, Hanny; Int Panis, Luc
2010-11-01
Minor bicycle accidents are defined as "bicycle accidents not involving death or heavily injured persons, implying that possible hospital visits last less than 24 hours". Statistics about these accidents and related injuries are very poor, because they are mostly not reported to police, hospitals or insurance companies. Yet, they form a major share of all bicycle accidents. Official registrations underestimate the number of minor accidents and do not provide cost data, nor the distance cycled. Therefore related policies are hampered by a lack of accurate data. This paper provides more insight into the importance of minor bicycle accidents and reports the frequency, risk and resulting costs of minor bicycle accidents. Direct costs, including the damage to bike and clothes as well as medical costs and indirect costs such as productivity loss and leisure time lost are calculated. We also estimate intangible costs of pain and psychological suffering and costs for other parties involved in the accident. Data were collected during the SHAPES project using several electronic surveys. The weekly prospective registration that lasted a year, covered 1187 persons that cycled 1,474,978 km. 219 minor bicycle accidents were reported. Resulting in a frequency of 148 minor bicycle accidents per million kilometres. We analyzed the economic costs related to 118 minor bicycle accidents in detail. The average total cost of these accidents is estimated at 841 euro (95% CI: 579-1205) per accident or 0.125 euro per kilometre cycled. Overall, productivity loss is the most important component accounting for 48% of the total cost. Intangible costs, which in past research were mostly neglected, are an important burden related to minor bicycle accidents (27% of the total cost). Even among minor accidents there are important differences in the total cost depending on the severity of the injury. 2010 Elsevier Ltd. All rights reserved.
Network-level accident-mapping: Distance based pattern matching using artificial neural network.
Deka, Lipika; Quddus, Mohammed
2014-04-01
The objective of an accident-mapping algorithm is to snap traffic accidents onto the correct road segments. Assigning accidents onto the correct segments facilitate to robustly carry out some key analyses in accident research including the identification of accident hot-spots, network-level risk mapping and segment-level accident risk modelling. Existing risk mapping algorithms have some severe limitations: (i) they are not easily 'transferable' as the algorithms are specific to given accident datasets; (ii) they do not perform well in all road-network environments such as in areas of dense road network; and (iii) the methods used do not perform well in addressing inaccuracies inherent in and type of road environment. The purpose of this paper is to develop a new accident mapping algorithm based on the common variables observed in most accident databases (e.g. road name and type, direction of vehicle movement before the accident and recorded accident location). The challenges here are to: (i) develop a method that takes into account uncertainties inherent to the recorded traffic accident data and the underlying digital road network data, (ii) accurately determine the type and proportion of inaccuracies, and (iii) develop a robust algorithm that can be adapted for any accident set and road network of varying complexity. In order to overcome these challenges, a distance based pattern-matching approach is used to identify the correct road segment. This is based on vectors containing feature values that are common in the accident data and the network data. Since each feature does not contribute equally towards the identification of the correct road segments, an ANN approach using the single-layer perceptron is used to assist in "learning" the relative importance of each feature in the distance calculation and hence the correct link identification. The performance of the developed algorithm was evaluated based on a reference accident dataset from the UK confirming that the accuracy is much better than other methods. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.
32 CFR 644.532 - Reporting accidents.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 32 National Defense 4 2011-07-01 2011-07-01 false Reporting accidents. 644.532 Section 644.532... and Improvements § 644.532 Reporting accidents. Immediately upon receipt of information of an accident... that an accident has occurred, the former using command should be requested to send qualified explosive...
49 CFR 845.40 - Accident report.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 49 Transportation 7 2011-10-01 2011-10-01 false Accident report. 845.40 Section 845.40... RULES OF PRACTICE IN TRANSPORTATION; ACCIDENT/INCIDENT HEARINGS AND REPORTS Board Reports § 845.40 Accident report. (a) The Board will issue a detailed narrative accident report in connection with the...
48 CFR 852.236-87 - Accident prevention.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Accident prevention. 852... Accident prevention. As prescribed in 836.513, insert the following clause: Accident Prevention (SEP 1993....236-13, Accident Prevention. However, only the Contracting Officer may issue an order to stop all or...
48 CFR 852.236-87 - Accident prevention.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Accident prevention. 852... Accident prevention. As prescribed in 836.513, insert the following clause: Accident Prevention (SEP 1993....236-13, Accident Prevention. However, only the Contracting Officer may issue an order to stop all or...
Five Common Bus Accidents--And How to Prevent Them.
ERIC Educational Resources Information Center
Fuller, Ronald
1989-01-01
Analyses of school bus accidents point to five accident-producing categories: (1) rear-end collisions; (2) sideswipes; (3) backing; (4) right turns; and (5) loading/unloading students. Reviews an accident of each type and focuses on the corrective action needed to reduce these accidents. (MLF)
6. Credit WCT. Original 21" x 2Y" color negative is ...
6. Credit WCT. Original 2-1" x 2-Y" color negative is housed in the JPL Photography Laboratory, Pasadena, California. JPL staff members Harold Anderson and John Morrow weigh out small amounts of an undetermined substance according to a solid propellant formula (JPL negative no. JPL-10277AC, 27 January 1989). - Jet Propulsion Laboratory Edwards Facility, Weigh & Control Building, Edwards Air Force Base, Boron, Kern County, CA
Communications Patterns in a Symbolic Multiprocessor.
1987-06-01
instruction references that Multilisp programs make. The cache hit ratio is greatest when instruction references have a high degree of -- locality. Another...future touches hit an undetermined future. N, The only exception is Consim, in which one third of future touches hit unde- termined futures. Task...Cambridge, MA, June 1985. [52] S. Sugimoto, K. Agusa, K. Tabata , and Y. Ohno. A multi-microprocessor system for concurrent Lisp. In Proceedings of
From gunstore to smoking gun: tracking guns that kill children in North Carolina.
Campbell, Brendan T; Radisch, Deborah L; Phillips, J Duncan; von Allmen, Daniel
2004-12-01
This study reviews the epidemiology of pediatric firearm deaths in North Carolina and estimates the time from the retail sale of guns to their involvement in pediatric firearm deaths. The authors reviewed autopsy reports for all children 0 to 14 years of age that died of firearm-related injuries in North Carolina from January 1999 through December 2002. Data obtained included demographic information, firearm type, and manner of death. Data from the Bureau of Alcohol, Tobacco and Firearms, which traced guns involved in crimes and determined the time elapsed from purchase to their involvement in a crime (ie, time-to-crime were also reviewed). During the study period, 40 children died of firearm injuries. Mean age was 7.6 years. Handguns were responsible for the majority of deaths (59%) followed by shotguns (27%), rifles (10%), and undetermined cause (10%). Most deaths were homicides (67%) followed by unintentional death (18%), suicide (13%), and undetermined cause (2%). Most crime guns (76%) were purchased legally, and many (40%) had a time-to-crime of less than 3 years. Legally purchased firearms pose a significant threat to children in North Carolina. A more restrictive approach to the sale of handguns is a logical approach to reducing pediatric firearm-related deaths in the United States.
Spectrum of risk of malignancy in subcategories of 'atypia of undetermined significance'.
Olson, Matthew T; Clark, Douglas P; Erozan, Yener S; Ali, Syed Z
2011-01-01
To determine if focal 'nuclear atypia' or 'microfollicular architecture' portends a higher risk of malignancy than other subcategories of atypia of undetermined significance (AUS) in thyroid fine-needle aspirations (FNAs). The frequencies of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) categories were calculated from 3,956 thyroid FNAs interpreted over a 26-month period at The Johns Hopkins Hospital after adoption of TBSRTC. TBSRTC criteria were applied strictly. The risk of malignancy, specifically for AUS subcategories, was analyzed by cyto-histo correlation. Of the 133 cases diagnosed as AUS, 32% were found to have stageable carcinoma (not incidental microcarcinoma) on resection. When the subset of AUS with 'nuclear atypia' (AUS-N) was separated from other AUS cases, 48% (30/62) of them had stageable carcinoma on resection; of the AUS subset with 'microfollicular architecture' (AUS-F), 27% (8/30) were malignant on resection. The 'suspicious for papillary thyroid carcinoma' (SPTC) group maintained a higher risk of malignancy versus AUS-N (relative risk, RR 1.57; 95% CI 1.23-1.81). The subcategory of 'nuclear atypia' within AUS indicates a higher risk of malignancy than other subcategories of AUS but has a lower risk of malignancy than SPTC does. Thus, it is an important distinction with potential clinical implications. Copyright © 2011 S. Karger AG, Basel.
Progressive myoclonic epilepsies
Michelucci, Roberto; Canafoglia, Laura; Striano, Pasquale; Gambardella, Antonio; Magaudda, Adriana; Tinuper, Paolo; La Neve, Angela; Ferlazzo, Edoardo; Gobbi, Giuseppe; Giallonardo, Anna Teresa; Capovilla, Giuseppe; Visani, Elisa; Panzica, Ferruccio; Avanzini, Giuliano; Tassinari, Carlo Alberto; Bianchi, Amedeo; Zara, Federico
2014-01-01
Objective: To define the clinical spectrum and etiology of progressive myoclonic epilepsies (PMEs) in Italy using a database developed by the Genetics Commission of the Italian League against Epilepsy. Methods: We collected clinical and laboratory data from patients referred to 25 Italian epilepsy centers regardless of whether a positive causative factor was identified. PMEs of undetermined origins were grouped using 2-step cluster analysis. Results: We collected clinical data from 204 patients, including 77 with a diagnosis of Unverricht-Lundborg disease and 37 with a diagnosis of Lafora body disease; 31 patients had PMEs due to rarer genetic causes, mainly neuronal ceroid lipofuscinoses. Two more patients had celiac disease. Despite extensive investigation, we found no definitive etiology for 57 patients. Cluster analysis indicated that these patients could be grouped into 2 clusters defined by age at disease onset, age at myoclonus onset, previous psychomotor delay, seizure characteristics, photosensitivity, associated signs other than those included in the cardinal definition of PME, and pathologic MRI findings. Conclusions: Information concerning the distribution of different genetic causes of PMEs may provide a framework for an updated diagnostic workup. Phenotypes of the patients with PME of undetermined cause varied widely. The presence of separate clusters suggests that novel forms of PME are yet to be clinically and genetically characterized. PMID:24384641
Xiao, Ruobing; Cerny, Jan; Devitt, Katherine; Dresser, Karen; Nath, Rajneesh; Ramanathan, Muthalagu; Rodig, Scott J; Chen, Benjamin J; Woda, Bruce A; Yu, Hongbo
2014-06-01
It has been recognized that monoclonal gammopathy of undetermined significance (MGUS) precedes a diagnosis of plasma cell myeloma in most patients. Recent gene expression array analysis has revealed that an MYC activation signature is detected in plasma cell myeloma but not in MGUS. In this study, we performed immunohistochemical studies using membrane CD138 and nuclear MYC double staining on bone marrow biopsies from patients who met the diagnostic criteria of plasma cell myeloma or MGUS. Our study demonstrated nuclear MYC expression in CD138-positive plasma cells in 22 of 26 (84%) plasma cell myeloma samples and in none of the 29 bone marrow samples from patients with MGUS. In addition, our data on the follow-up biopsies from plasma cell myeloma patients with high MYC expression demonstrated that evaluation of MYC expression in plasma cells can be useful in detecting residual disease. We also demonstrated that plasma cells gained MYC expression in 5 of 8 patients (62.5%) when progressing from MGUS to plasma cell myeloma. Analysis of additional lymphomas with plasmacytic differentiation, including lymphoplasmacytic lymphoma, marginal zone lymphoma, and plasmablastic lymphoma, reveals that MYC detection can be a useful tool in the diagnosis of plasma cell myeloma.
Exopolysaccharides produced by clinical strains belonging to the Burkholderia cepacia complex.
Herasimenka, Yury; Cescutti, Paola; Impallomeni, Giuseppe; Campana, Silvia; Taccetti, Giovanni; Ravenni, Novella; Zanetti, Flavio; Rizzo, Roberto
2007-04-01
In the frame of a research line dedicated to better clarify the role of exopolysaccharides (EPS) in bacterial virulence, EPS produced by species of the Burkholderia cepacia complex (Bcc), namely Burkholderia multivorans, Burkholderia cenocepacia, and a Bcc member of undetermined genomovar, all isolated at the Cystic Fibrosis Regional Centre of Florence (Italy), were investigated for they structural properties. Three strains of B. multivorans, three of B. cenocepacia and one of a Bcc member of undetermined genomovar were isolated from CF patients. The reference strains C1576 and J2315, for genomovar II and III, respectively, were included in the study. The bacteria were grown on solid media, the exopolysaccharides produced were purified, and their structures were determined. In addition, sugar analysis of sputum samples was accomplished to search for EPS produced in vivo. Six strains out of seven produced the exopolysaccharide cepacian, while one strain of B. multivorans produced a completely different polymer, previously known in the literature as PS1. Two strains synthesised very small amounts of EPS. No definitive evidence for the presence of cepacian in sputum samples was found. Most strains examined produced abundant amounts of polysaccharides. Cepacian was the most common EPS isolated and its production was not associated to a particular genomovar.
Boulanger, Dany
2017-12-01
The Dialogic Self Theory (DST-Hermans et al. Integrative Psychology and Behavioral Sciences, 51(4), 1-31, 2017) is extended here in its dynamic aspects through focusing on the notions of indeterminacy, emptiness and movement. Linking with Husserl, I propose moving the dialogical self (DS) from a clear position in the "repertory of the Self" to an undetermined horizon. This makes it possible to introduce "holes" (emptiness) into the schematic representation of the "repertory of the Self". Yet Husserl's concept of horizon seems to focus too much on making the indeterminable determinate. To overcome this limit, I incorporate Bergson's concept of empty form into the DST. This enables conceptualising the extension and emergence of horizon. Extending Bergson's concept of organisation, it is possible to see how the expansion of the horizon in a movement of globalisation does not necessarily entail the disorganisation of the DS but rather to its further organisation. Extending the system of DS by Hermans et al. Integrative Psychology and Behavioral Sciences, 51(4), 1-31, (2017), I open by suggesting that movements are both horizontal (between people) and vertical (between the person, the institutions and the norms) connectors. My conceptual propositions are illustrated by parents' and educators' discourses in two Canadian socio-educational programs.
Chronic kidney disease among children in Guatemala.
Cerón, Alejandro; Fort, Meredith P; Morine, Chris M; Lou-Meda, Randall
2014-12-01
To describe the distribution of pediatric chronic kidney disease (CKD) in Guatemala, estimate incidence and prevalence of pediatric end-stage renal disease (ESRD), and estimate time to progress to ESRD. This study analyzed the registry of the only pediatric nephrology center in Guatemala, from 2004-2013. Incidence and prevalence were calculated for annual periods. Moran's index for spatial autocorrelation was used to determine significance of geographic distribution of incidence. Time to progress to ESRD and associated risk factors were calculated with multivariate Cox regression. Of 1 545 patients from birth to less than 20 years of age, 432 had chronic renal failure (CRF). Prevalence and incidence of ESRD were 4.9 and 4.6 per million age-related population, respectively. Incidence was higher for the Pacific coast and Guatemala City. The cause of CRF was undetermined in 43% of patients. Average time to progress to ESRD was 21.9 months; factors associated with progression were: older age, diagnosis of glomerulopathies, and advanced-stage CKD at consultation. Prevalence and incidence of ESRD in Guatemala are lower than in other countries. This may reflect poor access to diagnosis. Areas with higher incidence and large proportion of CKD of undetermined cause are compatible with other studies from the geographic subregion. Findings on progression to ESRD may reflect delayed referral.
Marcos Lopes, Ana Cristina; Campaner, Adriana Bittencourt; Henrique, Laílca Quirino
2016-01-01
To evaluate the prevalence of histological high-grade lesions and cervical cancer in patients with ASCUS cytology. This is a cross-sectional prospective study involving 703 women with a uterus and atypical squamous cells of undetermined significance (ASCUS). The patients were submitted to a colposcopy and underwent a guided biopsy when changes on the colposcopy were detected. The findings revealed 456 (64.9%) women with a normal colposcopy and 247 (35.1%) with colposcopic abnormalities. The biopsy results were: cervical intraepithelial neoplasia grade 1 (CIN 1) in 51 (20.6%) patients, CIN 2 in 11 (4.5%) patients, CIN 3 in 8 (3.2%) patients, and a negative result in 177 (71.7%) patients; no cases of cancer were detected. Tallying of 456 normal colposcopies and 177 negative biopsies yielded a total of 90.04% negative exams. Furthermore, around 7.2% (51/703) of the patients exhibited CIN 1, a lesion associated with a high potential for regression. The biopsy results were not associated with patient age or menopausal status. We conclude that cytological surveillance of patients with ASCUS is feasible and safe given the low risk of CIN 2/3 or cervical cancer. © 2016 S. Karger AG, Basel.
Fetal demise by umbilical cord around abdomen and stricture.
Tan, Shun-Jen; Chen, Chi-Huang; Wu, Gwo-Jang; Chen, Wei-Hwa; Chang, Cheng-Chang
2010-01-01
Umbilical cord abnormalities are accepted as conditions associated with intrauterine fetal demise (IUFD), and umbilical cord stricture is most frequently encountered. In addition, although cord entanglement with multiple loops rarely increases the perinatal mortality, it is associated with a significant increase in variable kind of morbidity such as growth restriction. We describe a 27-year-old woman, with a missed abortion history at about 10 weeks' gestation in her first pregnancy, who presented to our outpatient department at 34 4/7 weeks of gestation due to decreased fetal activity during the preceding week. No fetal heart activity and blood flow had been detected by ultrasonography and pulsed-wave Doppler. A demised fetus with umbilical cord stricture and three loops around abdomen was delivered and was weighted 1,830 g that was below the tenth percentile for the gestational age. Either umbilical cord stricture or entanglement around the body can affect the development of the fetus and even be lethal. The former might play a more important role in this case. Their etiology and the sequence of the events are still undetermined, and additional evaluation such as autopsy and further research may be needed. In addition, counsel and frequent fetal surveillance should be done in patients with previous IUFD attributed to cord stricture during next pregnancy because of undetermined risk of recurrence.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-17
... post-accident testing, FRA routinely conducts tests for alcohol, marijuana, cocaine, phencyclidine (PCP..., as part of its accident investigation program, FRA has conducted post-accident alcohol and drug tests... conduct post-accident tests for any substance (e.g., carbon [[Page 29308
Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-24
... Accidents or Incidents and Overdue Aircraft, and Preservation of Aircraft Wreckage, Mail, Cargo, and Records... its regulations on the notification and reporting of aircraft accidents or incidents by adding a definition of ``unmanned aircraft accident'' and requiring that operators notify the NTSB of accidents...
32 CFR 634.29 - Traffic accident investigation reports.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 32 National Defense 4 2011-07-01 2011-07-01 false Traffic accident investigation reports. 634.29... accident investigation reports. (a) Accidents requiring immediate reports. The driver or owner of any vehicle involved in an accident, as described in § 634.28, on the installation, must immediately notify...
14 CFR 415.41 - Accident investigation plan.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Accident investigation plan. 415.41 Section... Launch Range § 415.41 Accident investigation plan. An applicant must file an accident investigation plan... reporting and responding to launch accidents, launch incidents, or other mishaps, as defined by § 401.5 of...
14 CFR 415.41 - Accident investigation plan.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Accident investigation plan. 415.41 Section... Launch Range § 415.41 Accident investigation plan. An applicant must file an accident investigation plan... reporting and responding to launch accidents, launch incidents, or other mishaps, as defined by § 401.5 of...
32 CFR 636.13 - Traffic accident investigation reports.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 32 National Defense 4 2011-07-01 2011-07-01 false Traffic accident investigation reports. 636.13... Stewart, Georgia § 636.13 Traffic accident investigation reports. In addition to the requirements in § 634... record traffic accident investigations on DA Form 3946 (Military Police Traffic Accident Report) and DA...
49 CFR 195.54 - Accident reports.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 49 Transportation 3 2010-10-01 2010-10-01 false Accident reports. 195.54 Section 195.54... PIPELINE Annual, Accident, and Safety-Related Condition Reporting § 195.54 Accident reports. (a) Each operator that experiences an accident that is required to be reported under § 195.50 shall as soon as...
49 CFR 801.32 - Accident reports.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 49 Transportation 7 2011-10-01 2011-10-01 false Accident reports. 801.32 Section 801.32... PUBLIC AVAILABILITY OF INFORMATION Accident Investigation Records § 801.32 Accident reports. (a) The NTSB....S. civil transportation accidents, in accordance with 49 U.S.C. 1131(e). (b) These reports may be...
40 CFR 68.42 - Five-year accident history.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Five-year accident history. 68.42... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Hazard Assessment § 68.42 Five-year accident history. (a) The owner or operator shall include in the five-year accident history all accidental releases from...
40 CFR 68.42 - Five-year accident history.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 40 Protection of Environment 15 2011-07-01 2011-07-01 false Five-year accident history. 68.42... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Hazard Assessment § 68.42 Five-year accident history. (a) The owner or operator shall include in the five-year accident history all accidental releases from...
40 CFR 68.42 - Five-year accident history.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 40 Protection of Environment 16 2013-07-01 2013-07-01 false Five-year accident history. 68.42... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Hazard Assessment § 68.42 Five-year accident history. (a) The owner or operator shall include in the five-year accident history all accidental releases from...
40 CFR 68.42 - Five-year accident history.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 40 Protection of Environment 16 2012-07-01 2012-07-01 false Five-year accident history. 68.42... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Hazard Assessment § 68.42 Five-year accident history. (a) The owner or operator shall include in the five-year accident history all accidental releases from...
40 CFR 68.42 - Five-year accident history.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Five-year accident history. 68.42... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Hazard Assessment § 68.42 Five-year accident history. (a) The owner or operator shall include in the five-year accident history all accidental releases from...
[Traffic accidents associated with emotional stress after divorce].
Cui, Li-Juan; Yi, Xu-Fu; Chen, Xiao-Gang
2009-04-01
In recent years, the traffic accidents increased gradually, especially those caused by the drivers daily emotional abnormality and in which the drivers were liable. This article reviewed the traffic accidents caused by divorced driver's emotional abnormality, illustrated the features of those accidents from the gender, age, occupation and mileage of drivers. It was considered that the major cause of those accidents was excessive drinking due to drivers' emotional stress. Suggestions about preventing the traffic accidents caused by emotional abnormality were put forward so as to make the corresponding rules and finally decrease the emotional abnormality traffic accidents.
An Application of CICCT Accident Categories to Aviation Accidents in 1988-2004
NASA Technical Reports Server (NTRS)
Evans, Joni K.
2007-01-01
Interventions or technologies developed to improve aviation safety often focus on specific causes or accident categories. Evaluation of the potential effectiveness of those interventions is dependent upon mapping the historical aviation accidents into those same accident categories. To that end, the United States civil aviation accidents occurring between 1988 and 2004 (n=26,117) were assigned accident categories based upon the taxonomy developed by the CAST/ICAO Common Taxonomy Team (CICTT). Results are presented separately for four main categories of flight rules: Part 121 (large commercial air carriers), Scheduled Part 135 (commuter airlines), Non-Scheduled Part 135 (on-demand air taxi) and Part 91 (general aviation). Injuries and aircraft damage are summarized by year and by accident category.
Factors associated with automobile accidents and survival.
Kim, Hong Sok; Kim, Hyung Jin; Son, Bongsoo
2006-09-01
This paper develops an econometric model for vehicles' inherent mortality rate and estimates the probability of accidents and survival in the United States. Logistic regression model is used to estimate probability of survival, and censored regression model is used to estimate probability of accidents. The estimation results indicated that the probability of accident and survival are influenced by the physical characteristics of the vehicles involved in the accident, and by the characteristics of the driver and the occupants. Using restrain system and riding in heavy vehicle increased the survival rate. Middle-aged drivers are less susceptible to involve in an accident, and surprisingly, female drivers are more likely to have an accident than male drivers. Riding in powerful vehicles (high horsepower) and driving late night increase the probability of accident. Overall, the driving behavior and characteristics of vehicle does matter and affects the probabilities of having a fatal accident for different types of vehicles.
Basso, Antonella; Serra, Rosaria; Drago, Ignazio; Soleo, Leonardo; Lovreglio, Piero
2016-11-01
The phenomenon of accidents at work was investigated among the resident physicians of the School of Medicine, Bari University, by a self-administered anonymous questionnaire probing personal details and inquiring about any accidents at work experienced during the training period, and by a comparison with the accidents reported to the Hospital Accidents Registry. At least 1 biological accident was reported by 18.2% of the 450 participants, this percentage being significantly higher in the surgical area (33.3%), where biological accidents were much more rarely reported to either the Residency School Director or the Accidents Registry. In conclusion, despite an overall reduction compared with the past, the frequency both of biological accidents and of underreporting is still high among resident physicians, particularly in the surgical area. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Machine-related injuries in the US mining industry and priorities for safety research.
Ruff, Todd; Coleman, Patrick; Martini, Laura
2011-03-01
Researchers at the National Institute for Occupational Safety and Health studied mining accidents that involved a worker entangled in, struck by, or in contact with machinery or equipment in motion. The motivation for this study came from the large number of severe accidents, i.e. accidents resulting in a fatality or permanent disability, that are occurring despite available interventions. Accident descriptions were taken from an accident database maintained by the United States Department of Labor, Mine Safety and Health Administration, and 562 accidents that occurred during 2000-2007 fit the search criteria. Machine-related accidents accounted for 41% of all severe accidents in the mining industry during this period. Machinery most often involved in these accidents included conveyors, rock bolting machines, milling machines and haulage equipment such as trucks and loaders. The most common activities associated with these accidents were operation of the machine and maintenance and repair. The current methods to safeguard workers near machinery include mechanical guarding around moving components, lockout/tagout of machine power during maintenance and backup alarms for mobile equipment. To decrease accidents further, researchers recommend additional efforts in the development of new control technologies, training materials and dissemination of information on best practices.
Rodrigues, Cintia Leci; de Eston Armond, Jane; Gorios, Carlos; Souza, Patricia Colombo
2014-01-01
Objective To describe the characteristics of motorcycle and bicycle accident victims, according to notifications of suspected and confirmed accidents that have occurred in the municipality of São Paulo. Method This was a descriptive epidemiological study. It covered all accidents (12,924) that occurred involving motorcycles (11,366) and bicycles (1558) between January 2011 and October 2013. Data in the Health Department's information system for surveillance of violence and accidents (SIVVA) was surveyed. Results Motorcycle accidents accounted for 52.1% of the cases notified and bicycles, 7.1%. Males predominated in both types of accidents: 81.6% and 80.6%, respectively. In the motorcycle accidents, the predominant age group among the victims was from 20 to 24 years. Both types of accidents occurred during the daytime (7:00–18:00 h): 37.4% and 27.0% respectively. Among the motorcycle accidents, the driver had been using alcohol in 3% and it was not possible to identify whether this had occurred in 67%. Conclusions Public policies prioritizing financial and human resources applied toward reducing these types of accidents need to be brought in. PMID:26229868
Salguero-Caparros, Francisco; Suarez-Cebador, Manuel; Carrillo-Castrillo, Jesús A; Rubio-Romero, Juan Carlos
2018-01-01
A public accident investigation is carried out when the consequences of the incident are significant or the accident has occurred in unusual circumstances. We evaluated the quality of the official accident investigations being conducted by Safety Specialists of the Labour Authorities in Andalusia. To achieve this objective, we analysed 98 occupational accident investigations conducted by the Labour Authorities in Andalusia in the last quarter of 2014. Various phases in the accident investigation process were examined, such as the use of the Eurostat variables within European Statistics on Accidents at Work (ESAW), detection of causes, determination of preventive measures, cost analysis of the accidents, identification of noncompliance with legal requirements or the investigation method used. The results of this study show that 77% of the official occupational accident investigation reports analysed were conducted in accordance with all the quality criteria recommended in the literature. To enhance glogal learning, and optimize allocation of resources, we propose the development of a harmonized European model for the public investigation of occupational accidents. Further it would be advisable to create a common classification and coding system for the causes of accidents for all European Union Member States.
Cirrus Airframe Parachute System and Odds of a Fatal Accident in Cirrus Aircraft Crashes.
Alaziz, Mustafa; Stolfi, Adrienne; Olson, Dean M
2017-06-01
General aviation (GA) accidents have continued to demonstrate high fatality rates. Recently, ballistic parachute recovery systems (BPRS) have been introduced as a safety feature in some GA aircraft. This study evaluates the effectiveness and associated factors of the Cirrus Airframe Parachute System (CAPS) at reducing the odds of a fatal accident in Cirrus aircraft crashes. Publicly available Cirrus aircraft crash reports were obtained from the National Transportation Safety Board (NTSB) database for the period of January 1, 2001-December 31, 2016. Accident metrics were evaluated through univariate and multivariate analyses regarding odds of a fatal accident and use of the parachute system. Included in the study were 268 accidents. For CAPS nondeployed accidents, 82 of 211 (38.9%) were fatal as compared to 8 of 57 (14.0%) for CAPS deployed accidents. After controlling for all other factors, the adjusted odds ratio for a fatal accident when CAPS was not deployed was 13.1. The substantial increased odds of a fatal accident when CAPS was not deployed demonstrated the effectiveness of CAPS at providing protection of occupants during an accident. Injuries were shifted from fatal to serious or minor with the use of CAPS and postcrash fires were significantly reduced. These results suggest that BPRS could play a significant role in the next major advance in improving GA accident survival.Alaziz M, Stolfi A, Olson DM. Cirrus Airframe Parachute System and odds of a fatal accident in Cirrus aircraft crashes. Aerosp Med Hum Perform. 2017; 88(6):556-564.
World commercial aircraft accidents. Second edition, 1946--1992
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kimura, C.Y.
1993-01-01
This report is a compilation of all accidents world-wide involving aircraft in commercial service which resulted in the loss of the airframe or one or more fatality, or both. This information has been gathered in order to present a complete inventory of commercial aircraft accidents. Events involving military action, sabotage, terrorist bombings, hijackings, suicides, and industrial ground accidents are included within this list. Included are: accidents involving world commercial jet aircraft, world commercial turboprop aircraft, world commercial pistonprop aircraft with four or more engines and world commercial pistonprop aircraft with two or three engines from 1946 to 1992. Each accidentmore » is presented with information in the following categories: date of the accident, airline and its flight numbers, type of flight, type of aircraft, aircraft registration number, construction number/manufacturers serial number, aircraft damage, accident flight phase, accident location, number of fatalities, number of occupants, cause, remarks, or description (brief) of the accident, and finally references used. The sixth chapter presents a summary of the world commercial aircraft accidents by major aircraft class (e.g. jet, turboprop, and pistonprop) and by flight phase. The seventh chapter presents several special studies including a list of world commercial aircraft accidents for all aircraft types with 100 or more fatalities in order of decreasing number of fatalities, a list of collision accidents involving commercial aircrafts, and a list of world commercial aircraft accidents for all aircraft types involving military action, sabotage, terrorist bombings, and hijackings.« less
World commercial aircraft accidents
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kimura, C.Y.
1993-01-01
This report is a compilation of all accidents world-wide involving aircraft in commercial service which resulted in the loss of the airframe or one or more fatality, or both. This information has been gathered in order to present a complete inventory of commercial aircraft accidents. Events involving military action, sabotage, terrorist bombings, hijackings, suicides, and industrial ground accidents are included within this list. Included are: accidents involving world commercial jet aircraft, world commercial turboprop aircraft, world commercial pistonprop aircraft with four or more engines and world commercial pistonprop aircraft with two or three engines from 1946 to 1992. Each accidentmore » is presented with information in the following categories: date of the accident, airline and its flight numbers, type of flight, type of aircraft, aircraft registration number, construction number/manufacturers serial number, aircraft damage, accident flight phase, accident location, number of fatalities, number of occupants, cause, remarks, or description (brief) of the accident, and finally references used. The sixth chapter presents a summary of the world commercial aircraft accidents by major aircraft class (e.g. jet, turboprop, and pistonprop) and by flight phase. The seventh chapter presents several special studies including a list of world commercial aircraft accidents for all aircraft types with 100 or more fatalities in order of decreasing number of fatalities, a list of collision accidents involving commercial aircrafts, and a list of world commercial aircraft accidents for all aircraft types involving military action, sabotage, terrorist bombings, and hijackings.« less
Marziale, Maria Helena Palucci; Rocha, Fernanda Ludmilla Rossi; Robazzi, Maria Lúcia do Carmo Cruz; Cenzi, Camila Maria; dos Santos, Heloisa Ehmke Cardoso; Trovó, Marli Elisa Mendes
2013-01-01
to analyze work accidents involving exposure to biological materials which took place among personnel working in nursing and to evaluate the influence of the organizational culture on the occurrence of these accidents. a retrospective, analytical study, carried out in two stages in a hospital that was part of the Network for the Prevention of Work Accidents. The first stage involved the analysis of the characteristics of the work accidents involving exposure to biological materials as recorded over a seven-year period by the nursing staff in the hospital studied, and registered in the Network databank. The second stage involved the analysis of 122 nursing staff members' perception of the institutional culture, who were allocated to the control group (workers who had not had an accident) and the case group (workers who had had an accident). 386 accidents had been recorded: percutaneous lesions occurred in 79% of the cases, needles were the materials involved in 69.7% of the accidents, and in 81.9% of the accident there was contact with blood. Regarding the influence of the organizational culture on the occurrence of accidents, the results obtained through the analysis of the two groups did not demonstrate significant differences between the average scores attributed by the workers in each organizational value or practice category. It is concluded that accidents involving exposure to biological material need to be avoided, however, it was not possible to confirm the influence of organizational values or practices on workers' behavior concerning the occurrence of these accidents.
Sadeghain, Marzieh; Farid, Ramin Ataei; Dormohammadi, Ali; Aghaei, Habib Allah; Rahmani, Abdolrasoul; Farhadi, Rozita; Eskandari, Rasoul; Karchani, Mohsen
2013-01-01
Occupational accidents have been considered as one of the most important crippling factors contributing to disabilities and life-threatening situations in many countries. This study was conducted to survey the prevalence of occupational accidents and the factors of that lead to injuries in an Electricity Distribution Company during a five-year period. In this descriptive study, the accident report form included items asking about the season of the year when the accident occurred, the ages and the average age of those injured, the type of employment, work experience, nature of the injuries that occurred, parts of the body affected, treatments that were applied, average number of days lost per accident, the levels of education of those involved, and their marital status. Data was analyzed using SPSS. A total of 66 Electricity Distribution Company workers were determined to be suffering from injuries due to accidents. The accidents mostly occurred in the summer (33%). Most of the injured workers (16.7%) belonged to the age groups of 25 to 29 and 40 to 44; there were no accidents reported for workers who were less than 20. About 48% of the accident victims had to be hospitalized. Furthermore, 35% of the accident victims were treated in outpatient clinics, and 7.4% of the accident victims died. We demonstrated that there were significant relationships between: 1) marital status and accidental injuries (P<0.001); 2) the average age of those injured among both permanent and temporary workers (P<0.001), 3) the level of education and the consequences of the accidents (P<0.001), and 4) the average of days lost per accident in both the permanent and temporary workers (P<0.001). In this study, no significant relationships were found between the accident occurrence and age (P>0.05) or work experience and the distribution of the accidents (P>0.05). This study indicated that most of the injuries in these accidents were related to the nature of employment, marital status, and level of education. The results showed the necessity for providing appropriate safety training for the workers.
Sadeghain, Marzieh; Farid, Ramin Ataei; Dormohammadi, Ali; Aghaei, Habib Allah; Rahmani, Abdolrasoul; Farhadi, Rozita; Eskandari, Rasoul; Karchani, Mohsen
2013-01-01
Background: Occupational accidents have been considered as one of the most important crippling factors contributing to disabilities and life-threatening situations in many countries. This study was conducted to survey the prevalence of occupational accidents and the factors of that lead to injuries in an Electricity Distribution Company during a five-year period. Methods: In this descriptive study, the accident report form included items asking about the season of the year when the accident occurred, the ages and the average age of those injured, the type of employment, work experience, nature of the injuries that occurred, parts of the body affected, treatments that were applied, average number of days lost per accident, the levels of education of those involved, and their marital status. Data was analyzed using SPSS. Results: A total of 66 Electricity Distribution Company workers were determined to be suffering from injuries due to accidents. The accidents mostly occurred in the summer (33%). Most of the injured workers (16.7%) belonged to the age groups of 25 to 29 and 40 to 44; there were no accidents reported for workers who were less than 20. About 48% of the accident victims had to be hospitalized. Furthermore, 35% of the accident victims were treated in outpatient clinics, and 7.4% of the accident victims died. We demonstrated that there were significant relationships between: 1) marital status and accidental injuries (P<0.001); 2) the average age of those injured among both permanent and temporary workers (P<0.001), 3) the level of education and the consequences of the accidents (P<0.001), and 4) the average of days lost per accident in both the permanent and temporary workers (P<0.001). In this study, no significant relationships were found between the accident occurrence and age (P>0.05) or work experience and the distribution of the accidents (P>0.05). Conclusion: This study indicated that most of the injuries in these accidents were related to the nature of employment, marital status, and level of education. The results showed the necessity for providing appropriate safety training for the workers. PMID:26120397
Learning lessons from Natech accidents - the eNATECH accident database
NASA Astrophysics Data System (ADS)
Krausmann, Elisabeth; Girgin, Serkan
2016-04-01
When natural hazards impact industrial facilities that house or process hazardous materials, fires, explosions and toxic releases can occur. This type of accident is commonly referred to as Natech accident. In order to prevent the recurrence of accidents or to better mitigate their consequences, lessons-learned type studies using available accident data are usually carried out. Through post-accident analysis, conclusions can be drawn on the most common damage and failure modes and hazmat release paths, particularly vulnerable storage and process equipment, and the hazardous materials most commonly involved in these types of accidents. These analyses also lend themselves to identifying technical and organisational risk-reduction measures that require improvement or are missing. Industrial accident databases are commonly used for retrieving sets of Natech accident case histories for further analysis. These databases contain accident data from the open literature, government authorities or in-company sources. The quality of reported information is not uniform and exhibits different levels of detail and accuracy. This is due to the difficulty of finding qualified information sources, especially in situations where accident reporting by the industry or by authorities is not compulsory, e.g. when spill quantities are below the reporting threshold. Data collection has then to rely on voluntary record keeping often by non-experts. The level of detail is particularly non-uniform for Natech accident data depending on whether the consequences of the Natech event were major or minor, and whether comprehensive information was available for reporting. In addition to the reporting bias towards high-consequence events, industrial accident databases frequently lack information on the severity of the triggering natural hazard, as well as on failure modes that led to the hazmat release. This makes it difficult to reconstruct the dynamics of the accident and renders the development of equipment vulnerability models linking the natural-hazard severity to the observed damage almost impossible. As a consequence, the European Commission has set up the eNATECH database for the systematic collection of Natech accident data and near misses. The database exhibits the more sophisticated accident representation required to capture the characteristics of Natech events and is publicly accessible at http://enatech.jrc.ec.europa.eu. This presentation outlines the general lessons-learning process, introduces the eNATECH database and its specific structure, and discusses natural-hazard specific lessons learned and features common to Natech accidents triggered by different natural hazards.
Effects of personality on risky driving behavior and accident involvement for Chinese drivers.
Yang, Jiaoyan; Du, Feng; Qu, Weina; Gong, Zhun; Sun, Xianghong
2013-01-01
Motor vehicle accidents are the leading cause of injury-related fatalities in China and pose the most serious threat to driving safety. Driver personality is considered as an effective predictor for risky driving behavior and accident liability. Previous studies have focused on the relationship between personality and risky driving behavior, but only a few of them have explored the effects of personality variables on accident involvement. In addition, few studies have examined the effects of personality on Chinese drivers' risky driving and accident involvement. The present study aimed to examine the effects of personality variables on Chinese drivers' unsafe driving behaviors and accident involvement. Two hundred and twenty-four Chinese drivers aged 20 to 50 were required to complete questionnaires assessing their personality traits (anger, sensation-seeking, altruism, and normlessness), risky driving behaviors (aggressive violations, ordinary violations), and accident involvement (all accidents, serious accidents, at-fault accidents). Multivariate regression analyses, adjusting for gender, age, and overall mileage, were conducted to identify the personality traits related to risky driving behaviors and accident involvement. Participants' personality traits were found to be significantly correlated with both risky driving behavior and accident involvement. Specifically, the traits of anger and normlessness were effective predictors for aggressive violations. The traits of anger, sensation-seeking, normlessness, and altruism were effective predictors for ordinary violations. Moreover, altruism and normlessness were significant predictors for the total number of accidents participants had during the past 3 years. Consistent with previous studies, the present study revealed that personality traits play an important role in predicting Chinese drivers' risky driving behaviors. In addition, Chinese drivers' personality characteristics were also associated with accident involvement.
[Risk factors for accidental injuries in the construction industry].
Gravseth, Hans Magne; Lund, Johan; Wergeland, Ebba
2006-02-09
The construction industry is prone to accidents. In Norway there is little research-based knowledge on accident pattern and risk factors. The main objective of the study was to examine whether in-depth studies of accidents in this industry, leading to injuries registered by the health services, could identify preventable risk factors and preventive measures. 50 accidents in the construction industry were thoroughly investigated. All had led to serious personal injury. Patients were interviewed after treatment in emergency wards and hospitals in Oslo, and inspections of the accident sites were performed. An interdisciplinary expert group discussed the accidents in order to identify risk factors and suggest preventive measures. The accident reports in the study were compared to reports from the Labour Inspectorate on the same accidents. The investigation identified several risk factors, and a number of detailed preventive measures were proposed. We submitted these proposals to the authorities and organisations involved. Accidents because of time pressure and electricity were two main groups. More than one third of the respondents said that time pressure had contributed to the accident. Accident risk caused by time pressure can be reduced by avoiding piecework contracts, unrealistic time limits, and the use of day penalties for breach of contract. Possible preventive measures for electric injuries imply modification of the reporting system and of the work organisation so that workers can comply with the regulations more easily. The study reports generally contained more information of relevance for prevention than the routine reports from the Labour Inspectorate did. For accidents reported by the Inspectorate to the police, their reports were more informative than the study reports. By the method presented, we obtained detailed information about accidents and preventable risk factors, so that preventive measures could be proposed. The method can also be used for other types of accidents.
36 CFR 1004.4 - Report of motor vehicle accident.
Code of Federal Regulations, 2010 CFR
2010-07-01
... accident. 1004.4 Section 1004.4 Parks, Forests, and Public Property PRESIDIO TRUST VEHICLES AND TRAFFIC SAFETY § 1004.4 Report of motor vehicle accident. (a) The operator of a motor vehicle involved in an accident resulting in property damage, personal injury or death shall report the accident to the Executive...
32 CFR 634.30 - Use of traffic accident investigation report data.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 32 National Defense 4 2010-07-01 2010-07-01 true Use of traffic accident investigation report data... § 634.30 Use of traffic accident investigation report data. (a) Data derived from traffic accident... accidents (collision diagram) will be examined. (b) Law enforcement personnel and others who prepare traffic...
49 CFR 230.22 - Accident reports.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 49 Transportation 4 2011-10-01 2011-10-01 false Accident reports. 230.22 Section 230.22... Requirements § 230.22 Accident reports. In the case of an accident due to failure, from any cause, of a steam... persons, the railroad on whose line the accident occurred shall immediately make a telephone report of the...
33 CFR 401.81 - Reporting an accident.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Reporting an accident. 401.81... an accident. (a) Where a vessel on the Seaway is involved in an accident or a dangerous occurrence, the master of the vessel shall report the accident or occurrence, pursuant to the requirements of the...
49 CFR 382.209 - Use following an accident.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 49 Transportation 5 2010-10-01 2010-10-01 false Use following an accident. 382.209 Section 382.209... ALCOHOL USE AND TESTING Prohibitions § 382.209 Use following an accident. No driver required to take a post-accident alcohol test under § 382.303 shall use alcohol for eight hours following the accident, or...
50 CFR 25.72 - Reporting of accidents.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 50 Wildlife and Fisheries 8 2011-10-01 2011-10-01 false Reporting of accidents. 25.72 Section 25... Reporting of accidents. Accidents involving damage to property, injury to the public or injury to wildlife..., but in no event later than 24 hours after the accident, by the persons involved, to the refuge manager...
46 CFR 78.33-5 - Accidents to machinery.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 46 Shipping 3 2011-10-01 2011-10-01 false Accidents to machinery. 78.33-5 Section 78.33-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PASSENGER VESSELS OPERATIONS Reports of Accidents, Repairs, and Unsafe Equipment § 78.33-5 Accidents to machinery. (a) In the event of an accident...
41 CFR 101-39.401 - Reporting of accidents.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Reporting of accidents...-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.4-Accidents and Claims § 101-39.401 Reporting of accidents. (a) The..., by telephone, or by facsimile machine of any accident in which the vehicle may be involved: (1) The...
33 CFR 401.81 - Reporting an accident.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Reporting an accident. 401.81... an accident. (a) Where a vessel on the Seaway is involved in an accident or a dangerous occurrence, the master of the vessel shall report the accident or occurrence, pursuant to the requirements of the...
32 CFR 634.30 - Use of traffic accident investigation report data.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 32 National Defense 4 2011-07-01 2011-07-01 false Use of traffic accident investigation report... § 634.30 Use of traffic accident investigation report data. (a) Data derived from traffic accident investigation reports and from vehicle owner accident reports will be analyzed to determine probable causes of...
49 CFR 382.209 - Use following an accident.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 49 Transportation 5 2011-10-01 2011-10-01 false Use following an accident. 382.209 Section 382.209... ALCOHOL USE AND TESTING Prohibitions § 382.209 Use following an accident. No driver required to take a post-accident alcohol test under § 382.303 shall use alcohol for eight hours following the accident, or...
49 CFR 230.22 - Accident reports.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 49 Transportation 4 2010-10-01 2010-10-01 false Accident reports. 230.22 Section 230.22... Requirements § 230.22 Accident reports. In the case of an accident due to failure, from any cause, of a steam... persons, the railroad on whose line the accident occurred shall immediately make a telephone report of the...
46 CFR 78.33-5 - Accidents to machinery.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 46 Shipping 3 2010-10-01 2010-10-01 false Accidents to machinery. 78.33-5 Section 78.33-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PASSENGER VESSELS OPERATIONS Reports of Accidents, Repairs, and Unsafe Equipment § 78.33-5 Accidents to machinery. (a) In the event of an accident...
16 CFR 1015.20 - Public availability of accident or investigation reports.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Public availability of accident or... Commission Accident or Investigation Reports Under 15 U.S.C. 2074(c) § 1015.20 Public availability of accident or investigation reports. (a) Accident or investigation reports made by an officer, employee, or...
50 CFR 25.72 - Reporting of accidents.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Reporting of accidents. 25.72 Section 25... Reporting of accidents. Accidents involving damage to property, injury to the public or injury to wildlife..., but in no event later than 24 hours after the accident, by the persons involved, to the refuge manager...
36 CFR 1004.4 - Report of motor vehicle accident.
Code of Federal Regulations, 2011 CFR
2011-07-01
... accident. 1004.4 Section 1004.4 Parks, Forests, and Public Property PRESIDIO TRUST VEHICLES AND TRAFFIC SAFETY § 1004.4 Report of motor vehicle accident. (a) The operator of a motor vehicle involved in an accident resulting in property damage, personal injury or death shall report the accident to the Executive...
33 CFR 173.55 - Report of casualty or accident.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Report of casualty or accident... (CONTINUED) BOATING SAFETY VESSEL NUMBERING AND CASUALTY AND ACCIDENT REPORTING Casualty and Accident Reporting § 173.55 Report of casualty or accident. (a) The operator of a vessel shall submit the casualty or...
16 CFR 1015.20 - Public availability of accident or investigation reports.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Public availability of accident or... Commission Accident or Investigation Reports Under 15 U.S.C. 2074(c) § 1015.20 Public availability of accident or investigation reports. (a) Accident or investigation reports made by an officer, employee, or...
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-06
... of an accident or that supports mitigation of an accident previously evaluated. The proposed... probability or consequences of an accident previously evaluated; or (2) create the possibility of a new or different kind of accident from any accident previously evaluated; or (3) involve a significant reduction in...
Code of Federal Regulations, 2012 CFR
2012-10-01
... 49 Transportation 7 2012-10-01 2012-10-01 false Obtaining Board accident reports, factual accident reports, and supporting information. 835.11 Section 835.11 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL TRANSPORTATION SAFETY BOARD TESTIMONY OF BOARD EMPLOYEES § 835.11 Obtaining Board accident reports, factual...
Code of Federal Regulations, 2011 CFR
2011-10-01
... 49 Transportation 7 2011-10-01 2011-10-01 false Obtaining Board accident reports, factual accident reports, and supporting information. 835.11 Section 835.11 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL TRANSPORTATION SAFETY BOARD TESTIMONY OF BOARD EMPLOYEES § 835.11 Obtaining Board accident reports, factual...
Code of Federal Regulations, 2014 CFR
2014-10-01
... 49 Transportation 7 2014-10-01 2014-10-01 false Obtaining Board accident reports, factual accident reports, and supporting information. 835.11 Section 835.11 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL TRANSPORTATION SAFETY BOARD TESTIMONY OF BOARD EMPLOYEES § 835.11 Obtaining Board accident reports, factual...