Search results for: surgical safety checklist

Authors: Stephanie Cheng, Benjamin Poh, Vivyan Tay, Sachin Mathur

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Aim: Diabetes mellitus (DM) is a worldwide pandemic affecting 500 million people. It is known to be associated with increased susceptibility to soft tissue infections (STI). Despite being a major public health burden, the literature relating the effects of DM and the presentation, severity and healing of STIs in general surgical patients remain limited. Methods: We conducted a retrospective review of all patients admitted with STI in a tertiary teaching hospital over a 12-month period. Patient demographics and surgical outcomes were collected and analyzed. Results: During the study period, 1059 patients were admitted for STIs, of which 936 (88%) required surgical intervention. Diabetic patients were presented with a higher body-mass index (BMI) (28 vs 26), larger abscess size (24 vs 14 cm²) and a longer length of stay (LOS)(4.4 days vs 2.9 days). They also underwent a higher proportion of wide debridement as well as application of negative pressure wound therapy (NPWT) (42% vs 35%). More diabetic patients underwent subsequent re-operation within the same sitting (8 vs 4). There were no differences in re-admission rates within 30 days nor subsequent abscess formation in those followed for 6 months. Conclusion: The incidence of STIs among DM patients represents a significant disease burden; surgeons should consider intensive patient counseling and partnering with primary care providers in order to help reduce the incidence of future STI admissions based on lifestyle modification and glucose control.

Keywords: general surgery, emergency general surgery, acute care surgery, soft tissue infections, diabetes mellitus

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Authors: Marcelo R. G. Duarte, Marcilio Alves

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Pedestrians are the fourth group among road traffic users that most suffer accidents. Their death rate is even higher than the motorcyclists group. This gives motivation for the development of an urban vehicle capable of complying with the United Nations Economic Commission for Europe pedestrian regulations. The conceptual vehicle is capable of transporting two passengers and small parcels for 100 km at a maximum speed of 90 km/h. This paper presents the design of this vehicle using the finite element method specially in connection with frontal crash test and car to pedestrian collision. The simulation is based in a human body FE.

Keywords: electric urban vehicle, finite element method, global human body model, pedestrian safety, road safety

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Authors: Jongtae Rhee, Sangkwon Han, Seungbin Ji, Junhyeong Park, Byeonghun Kim, Taekyung Kim, Byeonghyeon Jeon, Jiwoo Yang

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The shared kitchen is a concept that transfers the value of the sharing economy to the kitchen. It is a type of kitchen equipped with cooking facilities that allows multiple companies or chefs to share time and space and use it jointly. These shared kitchens provide economic benefits and convenience, such as reduced investment costs and rent, but also increase the risk of safety management, such as cross-contamination of food ingredients. Therefore, to manage the safety of food ingredients and finished products in a shared kitchen where several entities jointly use the kitchen and handle various types of food ingredients, it is critical to manage followings: the freshness of food ingredients, user hygiene and safety and cross-contamination of cooking equipment and facilities. In this study, it propose a machine learning-based system for hygiene safety and cross-contamination management, which are highly difficult to manage. User clothing management and user access management, which are most relevant to the hygiene and safety of shared kitchens, are solved through machine learning-based methodology, and cutting board usage management, which is most relevant to cross-contamination management, is implemented as an integrated safety management system based on artificial intelligence. First, to prevent cross-contamination of food ingredients, we use images collected through a real-time camera to determine whether the food ingredients match a given cutting board based on a real-time object detection model, YOLO v7. To manage the hygiene of user clothing, we use a camera-based facial recognition model to recognize the user, and real-time object detection model to determine whether a sanitary hat and mask are worn. In addition, to manage access for users qualified to enter the shared kitchen, we utilize machine learning based signature recognition module. By comparing the pairwise distance between the contract signature and the signature at the time of entrance to the shared kitchen, access permission is determined through a pre-trained signature verification model. These machine learning-based safety management tasks are integrated into a single information system, and each result is managed in an integrated database. Through this, users are warned of safety dangers through the tablet PC installed in the shared kitchen, and managers can track the cause of the sanitary and safety accidents. As a result of system integration analysis, real-time safety management services can be continuously provided by artificial intelligence, and machine learning-based methodologies are used for integrated safety management of shared kitchens that allows dynamic contracts among various users. By solving this problem, we were able to secure the feasibility and safety of the shared kitchen business.

Keywords: artificial intelligence, food safety, information system, safety management, shared kitchen

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Authors: Yi Xiong, Tao Kong

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Traditional safety, risk and reliability analysis approaches are problem-oriented, which make it great workload when analyzing complicated and huge system, besides, too much repetitive work would to do if the analyzed system composed by many similar components. It is pressing need an object and function oriented approach to maintain high consistency with problem domain. A new approach is proposed to overcome these shortcomings of traditional approaches, the concepts: class, abstract, inheritance, polymorphism and encapsulation are introduced into FTA and establish the professional class library that the abstractions of physical objects in real word, four areas relevant information also be proposed as the establish help guide. The interaction between classes is completed by the inside or external methods that mapping the attributes to base events through fully search the knowledge base, which forms good encapsulation. The object oriented fault tree analysis system that analyze and evaluate the system safety and reliability according to the original appearance of the problem is set up, where could mapped directly from the class and object to the problem domain of the fault tree analysis. All the system failure situations can be analyzed through this bottom-up fault tree construction approach. Under this approach architecture, FTA approach is developed, which avoids the human influence of the analyst on analysis results. It reveals the inherent safety problems of analyzed system itself and provides a new way of thinking and development for safety analysis. So that object oriented technology in the field of safety applications and development, safety theory is conducive to innovation.

Keywords: FTA, knowledge base, object-oriented technology, reliability analysis

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Authors: Deepak Ganjiwale, Karthik Vishwanathan

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Objective: Splinting is a great domain of occupational therapy profession.Making a splint for the patient would depend upon the need or requirement of the problems and deformities. Swan neck deformity is not very common in finger it may occur after any disease. Conservative treatment of the swan neck deformity is available by using different static splints only. There are very few reports of surgical correction of swan-neck deformity in benign hypermobility syndrome. Method: This case report describes the result of surgical intervention and hand splint in a twenty year old lady with past history of cardiovascular stroke with no residual neurological deficit. She presented with correctable swan neck deformity and failed to improve with static ring splints to correct the deformity. She was noted to have hyperlaxity (EhlerDanlos type) as per modified Beighton’s score of 5/9. She underwent volar plate plication of the proximal interphalangeal joint of the left ring finger along with hemitenodesis of ulnar slip of flexor digitorum superficialis (FDS) tendon whereby, the ulnar slip of FDS was passed through a small surgically created rent in A2 pulley and sutured back to itself. Result: Postoperatively, the patient was referred to occupational therapy for splinting with the instruction that the splint would work some time for as static and some time as dynamic for positional and correction of the finger. Conclusion: After occupational therapy intervention and splinting, the patient had a full correction of the swan-neck deformity with near full flexion of the operated finger and is able to work independently.

Keywords: swan neck, finger, deformity, splint, hypermobility

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Authors: Ahmed O. Babaleye, Rafet E. Kurt

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The global oil and gas industry is beginning to witness an increase in the number of installations moving towards decommissioning. Decommissioning of offshore installations is a complex, costly and hazardous activity, making safety one of the major concerns. Among existing removal options, complete and partial removal options pose the highest risks. Therefore, a dynamic risk model of the accidents from the two options is important to assess the risks on an overall basis. In this study, a risk-based safety model is developed to conduct quantitative risk analysis (QRA) for jacket structure systems failure. Firstly, bow-tie (BT) technique is utilised to model the causal relationship between the system failure and potential accident scenarios. Subsequently, to relax the shortcomings of BT, Bayesian Belief Networks (BBNs) were established to dynamically assess associated uncertainties and conditional dependencies. The BBN is developed through a similitude mapping of the developed bow-tie. The BBN is used to update the failure probabilities of the contributing elements through diagnostic analysis, thus, providing a case-specific and realistic safety analysis method when compared to a bow-tie. This paper presents the application of dynamic safety analysis to guide the allocation of risk control measures and consequently, drive down the avoidable cost of remediation.

Keywords: Bayesian belief network, offshore decommissioning, dynamic safety model, quantitative risk analysis

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Authors: J. R. Wang, H. T. Lin, Y. Chiang, H. C. Chen, C. Shih

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Kuosheng Nuclear Power Plant (NPP) is located on the northern coast of Taiwan. Its nuclear steam supply system is a type of BWR/6 designed and built by General Electric on a twin unit concept. First, the methodology of Kuosheng NPP SPU (Stretch Power Uprate) safety analysis TRACE/SNAP model was developed in this research. Then, in order to estimate the safety of Kuosheng NPP under the more severe condition, the SBO (Station Blackout) + LOCA (Loss-of-Coolant Accident) transient analysis of Kuosheng NPP SPU TRACE/SNAP model was performed. Besides, the animation model of Kuosheng NPP was presented using the animation function of SNAP with TRACE/SNAP analysis results.

Keywords: TRACE, safety analysis, BWR/6, severe accident

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Authors: Arvind Aggarwal

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We have developed a comprehensive global healthcare delivery System based on information technology. It has medical consultation system where a virtual consultant can give medical consultation to the patients and Doctors at the digital medical centre after reviewing the patient’s EMR file consisting of patient’s history, investigations in the voice, images and data format. The system has the surgical operation system too, where a remote robotic consultant can conduct surgery at the robotic surgical centre. The instant speech and text translation is incorporated in the software where the patient’s speech and text (language) can be translated into the consultant’s language and vice versa. A consultant of any specialty (surgeon or Physician) based in any country can provide instant health care consultation, to any patient in any country without loss of time. Robotic surgeons based in any country in a tertiary care hospital can perform remote robotic surgery, through patient friendly telemedicine and tele-surgical centres. The patient EMR, financial data and data of all the consultants and robotic surgeons shall be stored in cloud. It is a complete comprehensive business model with healthcare medical and surgical delivery system. The whole system is self-financing and can be implemented in any country. The entire system uses paperless, filmless techniques. This eliminates the use of all consumables thereby reduces substantial cost which is incurred by consumables. The consultants receive virtual patients, in the form of EMR, thus the consultant saves time and expense to travel to the hospital to see the patients. The consultant gets electronic file ready for reporting & diagnosis. Hence time spent on the physical examination of the patient is saved, the consultant can, therefore, spend quality time in studying the EMR/virtual patient and give his instant advice. The time consumed per patient is reduced and therefore can see more number of patients, the cost of the consultation per patients is therefore reduced. The additional productivity of the consultants can be channelized to serve rural patients devoid of doctors.

Keywords: e-health, telemedicine, telecare, IT-based healthcare

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Authors: Thozama Kwinana-Mandindi

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The contribution made by wild edible plants to the livelihoods, food baskets and diets of the indigenous people, particularly among the rural dwellers is invaluable. These wild vegetables are among the non-conventional crops which are widely distributed throughout the wild regions in South Africa, indigenous communities have always exploited for micro-nutrient supply. They also supply significant complex, recently discovered compounds, naturally occurring phytonutrients. In order to protect and promote sustainable use of these plants for household food security, there is a need to better understand them through studies and innovations. Assessment of the wild edible plants’ safety is very key to the promotion as an agricultural product which can be utilised during dry seasons and periods of food scarcity to alleviate nutrient insecurity. Through the use of Scanning Electron Microscope (SEM) and energy dispersive X-ray spectroscopy (EDXS), the study is seen as the vital step in taking a holistic view of the value of the four most consumed wild vegetables in the Eastern Cape Province of South Africa as they were analysed for safety and appraised for components that can influence utilisation. Results indicate that they can be relied upon and cultivation be promoted.

Keywords: nature’s resource, wild vegetables, appraisal for safety, SEM

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Authors: Naci Büyükkaraciğan, Yildirim Akyol

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Large plants that covering the back and accumulate water of a river valley for energy production, drinking, irrigation water supply, economic benefits that serve many purposes, such as regulation of flood protection, are called dams. Place, in which unites in order to achieve an optimum balance between manpower for Lowest cost and economic as belonging to that structure to create machines, materials and construction of the project, is called as the site. Dam construction sites are combined sites in together in many businesses. Therefore, there can be found in the many workers and machines are many accidents in this type of construction sites. The necessity of systematic and scientific studies due to various reasons arises in order to be protected from conditions that could damage the health, During the execution of the work on construction sites. Occupational health and safety of the study, called the case, also in the European Union has begun to be addressed by weight since the 1980s. In particular, issued in 1989 89/391/EEC on occupational health and safety directive, occupational health and adopted the Directive within the framework of the security field, and then exposed to a large number of individual directive within this framework on the basis of the directive. Turkey's Law No. 6331 entered into force in June 2012 on the subject. In this study, measures related to the construction site of the dam should be taken with occupational safety and health have been examined and tried to put forward recommendations on the subject.

Keywords: civil engineering, dam, occupational safety and health, site organizations

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Authors: Muksalmina

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Transportation plays an important role in people's daily activities but is often marred by traffic accidents. In Indonesia, traffic accidents are the third leading cause of death after coronary heart disease and tuberculosis, according to the World Health Organization (2013). Several roads in East Aceh District are strategic access points for economic growth in the Aceh region. There were 446 traffic accidents in 2023, which is the highest case in the last five years. This study aims to analyze black spot locations on national roads in East Aceh District and evaluate road safety deficiencies in the area. The research methodology began by selecting the locations with the highest accident rates based on data from East Aceh Police from 2019-2023. Next, Average Daily Traffic (ADT) was measured by projecting population growth data. The analysis of road safety deficiencies included measurements of road geometrics, traffic signs and markings, and traffic volumes at black spot locations. The study results showed deficiencies in lane width, shoulder width, and inadequate road safety facilities at several locations. Recommendations for improvements include increasing lane and shoulder widths and adding signs and markings to improve safety. This study is expected to serve as a reference for the government and relevant stakeholders in improving traffic safety in East Aceh District.

Keywords: black spot, traffic accident, severity index, road safety

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Authors: Mohammad Javad Mollakazemi, Farhad Asadi

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In this paper a real-time obstacle avoidance approach for both autonomous and non-autonomous dynamical systems (DS) is presented. In this approach the original dynamics of the controller which allow us to determine safety margin can be modulated. Different common types of DS increase the robot’s reactiveness in the face of uncertainty in the localization of the obstacle especially when robot moves very fast in changeable complex environments. The method is validated by simulation and influence of different autonomous and non-autonomous DS such as important characteristics of limit cycles and unstable DS. Furthermore, the position of different obstacles in complex environment is explained. Finally, the verification of avoidance trajectories is described through different parameters such as safety factor.

Keywords: limit cycles, nonlinear dynamical system, real time obstacle avoidance, safety margin

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Authors: Carolyn Whyte, Tina Halai, Sonita Koshal

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Aim: There are many methods available to assess the potential difficulty of third molar surgery. This study investigated various factors to assess whether they had a bearing on the difficulties encountered. Study design: A retrospective study was completed of 62 single mandibular third molar teeth removed under day case general anaesthesia between May 2016 and August 2016 by 3 consultant oral surgeons. Method: Data collection was by examining the OPG radiographs of each tooth and recording the necessary data. This was depth of impaction, angulation, bony impaction, point of application in relation to second molar, root morphology, Pell and Gregory classification and Winters Lines. This was completed by one assessor and verified by another. Information on medical history, anxiety, ethnicity and age were recorded. Case notes and surgical entries were examined for any difficulties encountered. Results: There were 5 cases which encountered surgical difficulties which included fracture of root apices (3) which were left in situ, prolonged bleeding (1) and post-operative numbness >6 months(1). Four of the 5 cases had Pell and Gregory classification as (B) where the occlusal plane of the impacted tooth is between the occlusal plane and the cervical line of the adjacent tooth. 80% of cases had the point of application as either coronal or apical one third (1/3) in relation to the second molar. However, there was variability in all other aspects of assessment in predicting difficulty of removal. Conclusions: Of the cases which encountered difficulties they all had at least one predictor of potential complexity but these varied case by case.

Keywords: impaction, mandibular third molar, radiographic assessment, surgical removal

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Authors: Thomas Nally, Jane Ireland, Roxanne Khan, Philip Birch

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Intimate Partner Violence (IPV), a significant societal problem, affects individuals worldwide. However, the strategies victims use to keep safe are under-researched. IPV is significantly under-reported, and services often are not able to be accessed by all victims. Thus they are likely to use their own strategies to manage their victimization before being able to seek support. Two studies were completed to understand these strategies. A systematic review of the literature and study completed with professionals who work with victims was undertaken to understand this area. In study one, a systematic review of the literature (n=61 papers), were analyzed using Thematic Analysis. The results indicated that victims use a large array of behaviors to increase their sense of safety and coping with emotions but also experience significant barriers to help-seeking. In study 2, sixty-nine professionals completed a measure exploring the likelihood and effectiveness of various victim strategies regarding increasing their sense of safety. Strategies included in the measure were obtained from those identified in study 1. Findings indicated that professionals perceived victims of IPV to be more likely to employ safety strategies and coping behaviors that may be ineffective but not help-seeking behaviors. Further, the responses were analyzed using Cluster Analysis. Safety strategies resulted in five clusters; perpetrator-directed strategies, prevention strategies, cognitive reappraisal, safety planning and avoidance strategies. Help-Seeking resulted in six clusters; information or practical support, abuse-related support, emotional support, secondary support and informal support. Finally, coping resulted in four clusters; emotional coping, self-directed coping, thought recording/change and cognitive coping. Both studies indicate that victims may use a variety of strategies to manage their safety besides seeking help. Professionals working with victims, using a strength-based approach, should understand what is used and is effective for victims who are unable to leave the relationships or access external support.

Keywords: intimate partner violence, help-seeking, professional support, victims, victim coping, victim safety

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Authors: Adriana C. Panayi, Riaz A. Agha, Brady A. Sieber, Dennis P. Orgill

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Background: Increased rates of both breast cancer and obesity have resulted in more women seeking breast reconstruction. These women may be at increased risk for perioperative complications. A systematic review was conducted to assess the outcomes in obese women who have undergone breast reconstruction following mastectomy. Methods: Cochrane, PUBMED and EMBASE electronic databases were screened and data was extracted from included studies. The clinical outcomes assessed were surgical complications, medical complications, length of postoperative hospital stay, reoperation rate and patient satisfaction. Results: 33 studies met the inclusion criteria for the review and 29 provided enough data to be included in the meta-analysis (71368 patients, 20061 of which were obese). Obese women were 2.3 times more likely to experience surgical complications (95 percent CI 2.19 to 2.39; P < 0.00001), 2.8 times more likely to have medical complications (95 percent CI 2.41 to 3.26; P < 0.00001) and had a 1.9 times higher risk of reoperation (95 percent CI 1.75 to 2.07; P < 0.00001). The most common complication, wound dehiscence, was 2.5 times more likely in obese women (95 percent CI 1.80 to 3.52; P < 0.00001). Sensitivity analysis confirmed that obese women were more likely to experience surgical complications (RR 2.36, 95% CI 2.22–2.52; P < 0.00001). Conclusions: This study provides evidence that obesity increases the risk of complications in both implant and autologous reconstruction. Additional prospective and observational studies are needed to determine if weight reduction prior to reconstruction reduces the perioperative risks associated with obesity.

Keywords: autologous reconstruction, breast cancer, breast reconstruction, literature review, obesity, oncology, prosthetic reconstruction

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Authors: Rukhsana Kausar, Khadija Rasheed

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This research explored general concerns, attitudes and perceptions of Pakistani mothers about their children’s vulnerability for sexual abuse and it also examined the effect of education and work status of mothers on their concerns and attitudes about the safety of their children. The sample consisted of 166 mothers comprising of 4 groups i.e. educated-working mothers, uneducated working mothers, educated non-working mothers and uneducated non-working mothers. This research comprised of two studies. Study 1 was carried out to construct two separate scales namely Maternal Concerns and Attitudes Scale for safety of Daughters (MCA-SD) and Maternal Concerns and Attitudes Scale for safety of Sons (MCA-SS) for assessing maternal concerns and attitudes about safety and protection of daughters and sons. These scales were used in study 2 with the objective to explore mothers’ general concerns, attitudes and perceptions of about child vulnerability for sexual abuse. Data were analyzed using two-way analysis of variance and independent-samples t-test. Educated mothers had more sense of responsibility, ensured more safety and provide more information about self-protection to their children as compared to uneducated mothers. Similarly non-working mothers showed more sense of responsibility and provided more information on self-protection to their children as compared to working mothers. Moreover, mothers living in nuclear family system trusted more on their relatives and other people for the protection of their children and ensured more safety of children than those living in joint family system. Findings have very important implications for protecting children from likely sexual abuse.

Keywords: mothers’ concerns, attitudes, perceptions, child vulnerability, child sexual abuse

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Authors: Emil Sakharov, Alex Zotov, Ilkin Osmanov, Oleg Shelest, Aleksander Troitskiy, Robert Khabazov

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Objective: Since 2015, our center has been actively implementing methods of surgical correction of atrial fibrillation, in particular, in patients with coronary heart disease. The study presents a comparative analysis of the late postoperative period in patients with coronary artery bypass grafting and atrial fibrillation. Methods: The study included 150 patients with ischemic heart disease and atrial fibrillation for the period from 2015 to 2021. Patients were divided into 2 groups. The first group is represented by patients with ischemic heart disease and atrial fibrillation who underwent coronary bypass surgery and surgical correction of atrial fibrillation (N=50). The second group is represented by patients with ischemic heart disease and atrial fibrillation who underwent only myocardial revascularization (N=100). Patients were comparable in age, gender, and initial severity of the condition. Among the patients in group 1 there were 82% were men, while in the second group, their number was 75%. Among the patients of the first group, there were 36% with persistent atrial fibrillation, 20% with long-term persistent atrial fibrillation. In the second group, 10% with persistent atrial fibrillation and 17% with long-term persistent atrial fibrillation. Results: Average follow-up for groups 1 and 2 amounted to 47 months. There were no complications in group 1, such as bleeding and stroke. There was only 1 patient in group 1, who had died from cardiovascular disease. Freedom of atrial fibrillation was in 82% without AADs therapy. In group 2 there were 8 patients who had died from cardiovascular diseases and total freedom of atrial fibrillation was in 35% of patients, among which 42.8% had additional AADs therapy. Follow-up data are presented in Table 2. Progression of heart failure was observed in 3% in group 1 and 7% in group 2. Combined endpoints (recurrence of AF, stroke, progression of heart failure, myocardial infarction) were achieved in 16% in group 1 and 34% in group 2, respectively. Freedom from atrial fibrillation without antiarrhythmic therapy was 82% for group 1 and 35% for group 2. In the first group, there is a more pronounced decrease in heart failure rates. Deaths from cardiovascular causes were recorded in 2% for group 1 and 7% for group 2. Conclusion: Surgical treatment of atrial fibrillation helps to reduce adverse complications in the late postoperative period and contributes to the regression of heart failure.

Keywords: atrial fibrillation, coronary artery bypass grafting, ischaemic heart disease, heart failure

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Authors: Shane R. Jackson

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Gluteal augmentation with fat grafting, commonly referred to as the Brazilian Butt Lift, is the fastest-growing cosmetic surgical procedure, despite the risks and controversy that surrounds it. While many commentators attribute this rise in popularity with current societal trends towards public sharing of private life, the fascination with buttock size is in fact a much older human trait. By searching beyond medical literature and delving into historical sources, from ancient civilisations, through the Renaissance and Victorian eras to the ‘Instagram generation’ of the present day, this paper examines the differences – and similarities – in society’s ideal buttock shape and size. Furthermore, the ways in which these various cultures have altered their appearance to achieve this ideal are also examined, looking at the influence of the broader historical context. A deeper understanding of the historical, cultural and psychosocial factors that influence a patient’s desire for buttock augmentation allows the clinician to formulate a well-rounded surgical plan.

Keywords: augmentation, Brazilian butt lift, buttock, fat graft, gluteal

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Authors: Diego Carrasco, Catarina Freitas, Hugo Rio Tinto, Ricardo Rio Tinto, Nuno Couto, Joaquim Gago, Carlos Carvalho

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Introduction: Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CD) to drain the gallbladder can be a palliative care procedure for non-surgical oncologic patients with cholelithiasis and cholangitis process. Case description: A 59-years old Caucasian male diagnosed with extrahepatic cholangiocarcinoma with multiple liver, lung and peritoneum metastasis, unresponsive to treatment with gemcitabine/cisplatin, presented in the institution with fever, hypotension, and severe upper right abdominal pain secondary to cholelithiasis and cholangitis process. The patient was admitted and started on large spectrum antibiotics plus fluid-challenge. Afterward, a percutaneous transhepatic biliary drainage (PTBD) was performed to drain the gallbladder. This procedure temporarily stabilized the patient. However, the definitive solution required gallbladder removal. Since the patient exhibited an advanced oncologic disease and poor response to the chemotherapy, he was not a candidate for surgical intervention. Diagnostic Pathways: A self-expanding metal stent was placed from the duodenum into the bile duct by endoscopic ultrasound-guided. The stent allowed efficient drainage of the contrast from the gallbladder at the end of the endoscopic procedure. Conclusion and Discussion: The stent allowed efficient drainage of the contrast from the gallbladder at the end of the endoscopic procedure and successfully reversed the cholangitis process. EUS-CD is an effective and safe technique and can be used as a palliative care procedure for non-surgical oncologic patients.

Keywords: palliative care, cholangiocarcinoma, choledochoduodenostomy, endoscopic ultrasound-guided

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Authors: Douglas J. Kube

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At the beginning of the COVID-19 pandemic, the Canadian Red Cross deployed workers into long-term care homes across Canada to support our most vulnerable citizens. It began by recruiting and training small teams of workers to provide non-clinical services for facilities in outbreak. Deployed workers were trained on an approach based on successful Red Cross deployments used with Ebola in which zones were established, levels of protection used, and strict protocols followed to prevent exposure. This paper addresses aspects of human performance through a safety culture lens. The Red Cross deployments highlight valuable insights and are an excellent case study in the principles of human performance and organizational culture. This paper looks at human performance principles, including human fallibility, predictability of error-likely situations, avoiding events by understanding reasons mistakes occur, and the influence on behaviour by organizational factors. This study demonstrates how the Red Cross’s organizational culture and work design positively influenced performance to protect workers and residents/clients. Lastly, this paper shares lessons that can be applied in many workplaces to improve worker health and safety and safety culture. This critical examination is based on the author’s experience as a Senior Occupational Health and Safety Advisor with the Red Cross during the pandemic as part of the team responsible for developing and implementing biological safety practices in long-term care deployments.

Keywords: COVID, human performance, organizational culture, work design

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Authors: Ali E. Abbas

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This paper highlights some of the normative issues that might result by setting independent thresholds in risk analyses and particularly with safety regions. A second objective is to explain how such regions can be specified appropriately in a meaningful way. We start with a review of the importance of setting deterministic trade-offs among target requirements. We then show how to determine safety regions for risk analysis appropriately using utility functions.

Keywords: decision analysis, thresholds, risk, reliability

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Authors: Olusola Joseph Adesina, Sunmaila Oyetunji Raimi, Olufemi Akinloye Bolaji, Abiodun Ezekiel Adesina

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The quality of education and the standard of a nation cannot rise above the quality of the teacher (NPE, 2004). Efforts at improving the falling standard of education in the country call for the need-based assessment of the primary tier of education in Nigeria. It was revealed that the teachers’ standard of performance and pupils’ achievement was below average. Teachers’ cluster meeting intervention was therefore recommended as a step towards enhancing the teachers’ professional competency, efficient and effective proactive and interactive lesson presentation. The study thus determined the impact of the intervention on teachers’ professional performance (lesson note preparation and teaching performance) in Oyo State, Nigeria. The main and interaction effects of the gender of the teachers as moderator variable were also determined. Three null hypotheses guided the study. Pre-test, posttest control group quazi experimental design was adopted for the study. Three hundred intact classes from three hundred different schools were randomly selected into treatment and control groups. Two response instruments-Classroom Lesson Note Preparation Checklist (CLNPC; r = 0.89) Cluster Lesson Observation Checklist (CLOC; r = 0.86) were used for data collection. Mean, Standard deviation and Analysis of Covariance (ANCOVA) were used to analyse the collected data. The results showed that the teachers’ cluster meeting have significant impact on teachers’ lesson note preparation (F(1,295) = 31.607; p < 0.05; η2 = .097) and teaching performance (F(1,295) = 20.849; p < 0.05; η2 = .066) in the core subjects of primary schools in Oyo State, Nigeria. The study therefore recommended among others that teachers’ cluster meeting should be sustained for teachers’ professional development in the State.

Keywords: teachers’ cluster meeting, teacher lesson note preparation, teaching performance, teachers’ gender, primary schools in Oyo state

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Authors: Ege Can Onal, Enver Ersen, Meltem Elitas

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Laparoscopy is a surgical operation, well known as keyhole surgery. The operation is performed through small holes, hence, scars of a patient become much smaller, patients can recover in a short time and the hospital stay becomes shorter in comparison to an open surgery. Several tools are used at laparoscopic operations; among them, the laparoscope has a crucial role. It provides the vision during the operation, which will be the main focus in here. Since the operation area is very small, motion of the surgical tools might be limited in laparoscopic operations compared to traditional surgeries. To overcome this limitation, most of the laparoscopic tools have become more precise, dexterous, multi-functional or automated. Here, we present a robotic-assisted laparoscope that is controlled with pedals directly by a surgeon. Thus, the movement of the laparoscope might be controlled better, so there will not be a need to calibrate the camera during the operation. The need for an assistant that controls the movement of the laparoscope will be eliminated. The duration of the laparoscopic operation might be shorter since the surgeon will directly operate the camera.

Keywords: laparoscope, laparoscopy, low-cost, minimally invasive surgery, robotic-assisted surgery

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Authors: Muhammad Afiq Anaqi Bin Baharudin, Muhammad Izamuddin Bin Mohd Nasir, Syarifuddin Bin Sujuanda, Muhammad Syahmi Rusyaidi Bin Sham Suddin, Danish Hakimi Bin kamaruzaman, Muhammad Haqimi Nazim Bin Hasmanizam, Mohammad Akmal Zakwan Bin Amran, Muhammad Alparizi Bin Latif

Abstract:

In particular, for small and medium enterprises (SMBs) in Malaysia, process safety management (PSM) is a crucial component of industrial safety. Limited resources, a lack of technical know-how, and linguistic and cultural obstacles are just a few of the difficulties SMBs in Malaysia encounter while putting PSM programmes into practice. A number of studies have emphasised the significance of leadership commitment, hazard identification and assessment, and employee involvement in the execution of effective PSM programmes, which are crucial for preventing accidents and incidents. In the literature, there has been a lot of discussion on the creation of specialised PSM frameworks for SMBs in Malaysia. Several studies have proposed implementation frameworks for PSM programmes that are based on recognised worldwide standards. Despite the significance of PSM in ensuring industrial safety, there are still a number of gaps in the literature on PSM in Malaysian SMBs. These gaps include the need for additional research on the efficiency of PSM programmes in reducing accidents and incidents in SMBs as well as the development of more specialised approaches to implementing PSM programmes in SMBs with limited resources and technical expertise. The goal of this review is to give a thorough overview of the body of research on PSM in Malaysian SMBs while highlighting important findings, points of contention, and knowledge gaps that need to be filled in.

Keywords: process safety management, occupational safety and health (OSH), small businesses, medium businesses, malaysia

Procedia PDF Downloads 110

Authors: Suehyun Cho, Darrell Harrington, Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Alex Kiselyov, Michael Shpigelmacher

Abstract:

Bionaut Labs, LLC is developing a minimally invasive robotic microdevice designed to treat non-communicating hydrocephalus in both adult and pediatric patients. The device utilizes biocompatible microsurgical particles (Bionaut™) that are specifically designed to safely and reliably perform accurate fenestration(s) in the 3rd ventricle, aqueduct of Sylvius, and/or trapped intraventricular cysts of the brain in order to re-establish normal cerebrospinal fluid flow dynamics and thereby balance and/or normalize intra/intercompartmental pressure. The Bionaut™ is navigated to the target via CSF or brain tissue in a minimally invasive fashion with precise control using real-time imaging. Upon reaching the pre-defined anatomical target, the external driver allows for directing the specific microsurgical action defined to achieve the surgical goal. Notable features of the proposed protocol are i) Bionaut™ access to the intraventricular target follows a clinically validated endoscopy trajectory which may not be feasible via ‘traditional’ rigid endoscopy: ii) the treatment is microsurgical, there are no foreign materials left behind post-procedure; iii) Bionaut™ is an untethered device that is navigated through the subarachnoid and intraventricular compartments of the brain, following pre-designated non-linear trajectories as determined by the safest anatomical and physiological path; iv) Overall protocol involves minimally invasive delivery and post-operational retrieval of the surgical Bionaut™. The approach is expected to be suitable to treat pediatric patients 0-12 months old as well as adult patients with obstructive hydrocephalus who fail traditional shunts or are eligible for endoscopy. Current progress, including platform optimization, Bionaut™ control, and real-time imaging and in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of ovine models, will be discussed.

Keywords: Bionaut™, cerebrospinal fluid, CSF, fenestration, hydrocephalus, micro-robot, microsurgery

Procedia PDF Downloads 161

Authors: Francisco Toledo-Castillo, Pilar Peiró-Torres, María Josefa Sospedra-Baeza, Sergio Hidalgo-Fuentes

Abstract:

The communication presented is about tasks that are been developed in the research project “safeRoute”, “Information safety system for professional road driving” (IPT-2012-110-370000). This R&D project was proposed by the consortium formed by Fagor Electronica la SEU 3 and the University of Valencia to the Ministry of Economy and Competitiveness, which approved it inside the INNPACTO subprogramme grants. Through this type of calls, the Ministry promote the innovative capacity of the Spanish companies and turn on the mechanism for competing internationally. With this kind of calls, private investments for technological and industrial development join their R & D resources with public entities to implement innovative project that could have an international exposure. Thus INNPACTO subprogramme promotes the creation of research projects with public-private partnerships that create exploitable final products. The “safeRoute” Project pretends develop a tool to help to make more safety the travels of commercial transport vehicles of goods and passengers. To achieve its objectives, the project is focused in three main lines of research: vehicle safety, the safety of the roads that they are using, and the safety which drivers do their job, their behaviour while they are driving. To improve safety, the project gives information about these three factors to all people that are involved in the safety of the professional transport. These three factors have influence to the occurrence of traffic accidents, thanks to the information provided and treated about these factors, we can achieve a significant reduction in occupational accidents in the transport sector. SafeRoute provide information about routes, vehicles, and driver behaviours, and in this manner pretends provide to transport companies a tool which could result in a safer driving results and could reduce their costs related to traffic accidents of their vehicles, in that way, this tool could help them to be more competitive, and give a more reliable service. This paper will focus mainly on the information about routes that drivers use to travel in their professional work, and how the researchers of this project have catalogued and evaluated these routes, and finally how that information will be provided to users.

Keywords: driver support systems, professional drivers, road safety, safeRoute

Procedia PDF Downloads 398

Authors: Z. Sakka, I. Assakkaf, T. Al-Yaqoub, J. Parol

Abstract:

A reliability-based methodology for the analysis assessment and evaluation of reinforced concrete structural elements of concrete structures is presented herein. The results of the reliability analysis and assessment for structural elements are verified by the results obtained from the deterministic methods. The analysis outcomes of reliability-based analysis are compared against the safety limits of the required reliability index β according to international standards and codes. The methodology is based on probabilistic analysis using reliability concepts and statistics of the main random variables that are relevant to the subject matter, and for which they are to be used in the performance-function equation(s) related to the structural elements under study. These methodology techniques can result in reliability index β, which is commonly known as the reliability index or reliability measure value that can be utilized to assess and evaluate the safety, human risk, and functionality of the structural component. Also, these methods can result in revised partial safety factor values for certain target reliability indices that can be used for the purpose of redesigning the reinforced concrete elements of the building and in which they could assist in considering some other remedial actions to improve the safety and functionality of the member.

Keywords: structural reliability, concrete structures, FORM, Monte Carlo simulation

Procedia PDF Downloads 508

Authors: Deborah Weidner, Melissa Morgera

Abstract:

The model of care delivery in the Behavioral Health Network (BHN) is integrated across all five regions of Hartford Healthcare and thus spans the entirety of the state of Connecticut, with care provided in seven inpatient settings and over 30 ambulatory outpatient locations. While safety has been a core priority of the BHN in alignment with High Reliability practices, safety initiatives have historically been facilitated locally in each region or within each entity, with interventions implemented locally as opposed to throughout the network. To address this, the BHN introduced a network wide Safety Huddle during 2022. Launched in January, the BHN Safety Huddle brought together internal stakeholders, including medical and administrative leaders, along with executive institute leadership, quality, and risk management. By bringing leaders together and introducing a network-wide safety huddle into the way we work, the benefit has been an increase in awareness of safety events occurring in behavioral health areas as well as increased systemization of countermeasures to prevent future events. One significant discussion topic presented in huddles has pertained to environmental design and patient access to potentially dangerous items, addressing some of the most relevant factors resulting in harm to patients in inpatient and emergency settings for behavioral health patients. The safety huddle has improved visibility of potential environmental safety risks through the generation of over 15 safety alerts cascaded throughout the BHN and also spurred a rapid improvement project focused on standardization of patient belonging searches to reduce patient access to potentially dangerous items on inpatient units. Safety events pertaining to potentially dangerous items decreased by 31% as a result of standardized interventions implemented across the network and as a result of increased awareness. A second positive outcome originating from the BHN Safety Huddle was implementation of a recommendation to increase the emergency Narcan®(naloxone) supply on hand in ambulatory settings of the BHN after incidents involving accidental overdose resulted in higher doses of naloxone administration. By increasing the emergency supply of naloxone on hand in all ambulatory and residential settings, colleagues are better prepared to respond in an emergency situation should a patient experience an overdose while on site. Lastly, discussions in safety huddle spurred a new initiative within the BHN to improve responsiveness to assaultive incidents through a consultation service. This consult service, aligned with one of the network’s improvement priorities to reduce harm events related to assaultive incidents, was borne out of discussion in huddle in which it was identified that additional interventions may be needed in providing clinical care to patients who are experiencing multiple and/ or frequent safety events.

Keywords: quality, safety, behavioral health, risk management

Procedia PDF Downloads 77

Authors: John Gaber, Youssef Ahmed, Hossam A. Gabbar, Jing Ren

Abstract:

Accidents at Nuclear Power Plants (NPPs) occur due to various factors, notable among them being poor safety management and poor safety culture. During abnormal situations, the likelihood of human error is many-fold higher due to the higher cognitive workload. The most common cause of human error and high cognitive workload is mental fatigue. Electroencephalography (EEG) is a method of gathering the electromagnetic waves emitted by a human brain. We propose a safety system by monitoring brainwaves for signs of mental fatigue using an EEG system. This requires an analysis of the mental model of the NPP operator, changes in brain wave power in response to certain stimuli, and the risk factors on mental fatigue and attention that NPP operators face when performing their tasks. We analyzed these factors and developed an EEG-based monitoring system, which aims to alert NPP operators when levels of mental fatigue and attention hinders their ability to maintain safety.

Keywords: brain imaging, EEG, power plant operator, psychology

Procedia PDF Downloads 94

Authors: Ali Akber Jaffri, Asad Naseem, Javeria Khan, Zubair Hamza, Ishtiaq

Abstract:

The purpose of this study is to determine safety stock, maximum inventory level, reordering point, and reordering quantity by rearranging lot sizes for supplier and customer in MRO (maintenance repair operations) warehouse of Engro Polymers & Chemicals. To achieve the aim, physical analysis method and excel commands were carried out to elicit the customer and supplier data provided by the company. Initially, we rearranged the current lot sizes and MOUs (measure of units) in SAP software. Due to change in lot sizes, we have to determine the new quantities for safety stock, maximum inventory, reordering point and reordering quantity as per company's demand. By proposed system, we saved extra cost in terms of reducing time of receiving from vendor and in issuance to customer, ease of material handling in MRO warehouse and also reduce human efforts.

Keywords: maintenance repair operation, maximum inventory, reorder quantity, safety stock

Procedia PDF Downloads 268