Search results for: mass casualty incidents

Authors: Hendri Purwadi, Christine McCloud

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Triage is a complex decision-making process that aims to categorize a victim’s level of acuity and the need for medical assistance. Two common triage systems have been widely used in Mass Casualty Incidents (MCIs) and disaster situation are START (Simple triage algorithm and rapid treatment) and SALT (sort, asses, lifesaving, intervention, and treatment/transport). There is currently controversy regarding the effectiveness of SALT over START triage system. This systematic review aims to investigate and compare the effectiveness between SALT and START triage system in disaster and MCIs setting. Literatures were searched via systematic search strategy from 2009 until 2019 in PubMed, Cochrane Library, CINAHL, Scopus, Science direct, Medlib, ProQuest. This review included simulated-based and medical record -based studies investigating the accuracy and applicability of SALT and START triage systems of adult and children population during MCIs and disaster. All type of studies were included. Joana Briggs institute critical appraisal tools were used to assess the quality of reviewed studies. As a result, 1450 articles identified in the search, 10 articles were included. Four themes were identified by review, they were accuracy, under-triage, over-triage and time to triage per individual victim. The START triage system has a wide range and inconsistent level of accuracy compared to SALT triage system (44% to 94. 2% of START compared to 70% to 83% of SALT). The under-triage error of START triage system ranged from 2.73% to 20%, slightly lower than SALT triage system (7.6 to 23.3%). The over-triage error of START triage system was slightly greater than SALT triage system (START ranged from 2% to 53% compared to 2% to 22% of SALT). The time for applying START triage system was faster than SALT triage system (START was 70-72.18 seconds compared to 78 second of SALT). Consequently; The START triage system has lower level of under-triage error and faster than SALT triage system in classifying victims of MCIs and disaster whereas SALT triage system is known slightly more accurate and lower level of over-triage. However, the magnitude of these differences is relatively small, and therefore the effect on the patient outcomes is not significance. Hence, regardless of the triage error, either START or SALT triage system is equally effective to triage victims of disaster and MCIs.

Keywords: disaster, effectiveness, mass casualty incidents, START triage system, SALT triage system

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Authors: Catherine Bernard, Paul Ransom

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Recent events have prompted emergency planners to re-evaluate their emergency response to major incidents and mass casualties. At the Royal Sussex County Hospital, we have adopted a tiered system comprised of three levels, anticipating an increasing P1, P2 or P3 load. This will aid planning in the golden period between Major Incident ‘Standby,’ and ‘Declared’. Each tier offers step-by-step instructions on appropriate patient movement within and out of the department, as well as suggestions for overflow areas and additional staffing levels. This system can be adapted to individual hospitals and provides concise instructions to be followed in a potentially overwhelming situation.

Keywords: disaster planning, emergency preparedness, major incident planning, mass casualty event

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Authors: U. K. Tamuli

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Introduction: North East India is graced with natural beauty and hazards. This area is prone to major earthquakes, floods, landslides, accidents, terrorist activities etc. Academy of Trauma (AOT), an NGO of Doctors, conducts training programs, mock drills, field trials amongst the doctors and paramedics in North East India. The present study is to evaluate the efficacy of such training in terms of sensitivity, awareness, and delivery systems of the products. Here the health care delivery system for disaster management is inadequate. Clear guideline of mass casualty management is unavailable. AOT has initiated steps to increase the awareness and handling of mass casualty management to improve the emergency health care delivery system. Method: AOT has conducted training programmes on emergency health management, mass casualty management and hospital preparedness amongst 800 doctors and 1200 paramedics in twenty-two districts of Assam in Northeast India. The training module consists of lectures, hands-on workshop using manikins, mock drills, distribution of manuals, emergency management exercises, periodic exchange of experience and debriefings. AOT evaluates the impact of these trainings by conducting pre and post tests of delegates, trainer’s evaluation, delegate’s satisfaction and confidence level and their suggestions. Results: The module, training, hands-on workshops, mock drills were highly appreciated. There is significant improvement in scores on the post-training tests. The confidence level of the participants has risen to deal with emergency medical situation Conclusion: These kinds of trainings increase the awareness of the medical members to handle mass casualties in different situations. One such training actually sensitises the delegates. Repetition of such training, TOT (Training-of-Trainers) programs, and individual efforts of delegates are extremely important for sustenance and success of health care delivery service during disasters in the developing countries. Further collaboration, assistance, networking, suggestions from established global agencies in this field will be highly appreciated.

Keywords: capacity building, North East India, non-governmental organization, trauma

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Authors: Nurten Akgun, Dilum Dissanayake, Neil Thorpe, Margaret C. Bell

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Cycling has gained a great attention with comparable speeds, low cost, health benefits and reducing the impact on the environment. The main challenge associated with cycling is the provision of safety for the people choosing to cycle as their main means of transport. From the road safety point of view, cyclists are considered as vulnerable road users because they are at higher risk of serious casualty in the urban network but more specifically at roundabouts. This research addresses the development of an enhanced mathematical model by including a broad spectrum of casualty related variables. These variables were geometric design measures (approach number of lanes and entry path radius), speed limit, meteorological condition variables (light, weather, road surface) and socio-demographic characteristics (age and gender), as well as contributory factors. Contributory factors included driver’s behavior related variables such as failed to look properly, sudden braking, a vehicle passing too close to a cyclist, junction overshot, failed to judge other person’s path, restart moving off at the junction, poor turn or manoeuvre and disobeyed give-way. Tyne and Wear in the UK were selected as a case study area. The cyclist casualty data was obtained from UK STATS19 National dataset. The reference categories for the regression model were set to slight and serious cyclist casualties. Therefore, binary logistic regression was applied. Binary logistic regression analysis showed that approach number of lanes was statistically significant at the 95% level of confidence. A higher number of approach lanes increased the probability of severity of cyclist casualty occurrence. In addition, sudden braking statistically significantly increased the cyclist casualty severity at the 95% level of confidence. The result concluded that cyclist casualty severity was highly related to approach a number of lanes and sudden braking. Further research should be carried out an in-depth analysis to explore connectivity of sudden braking and approach number of lanes in order to investigate the driver’s behavior at approach locations. The output of this research will inform investment in measure to improve the safety of cyclists at roundabouts.

Keywords: binary logistic regression, casualty severity, cyclist safety, roundabout

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Authors: Jacob J. Shila, Xiaoyu O. Wu

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As the applications of unmanned aerial vehicles (UAV) continue to increase across the world, it is critical to understand the factors that contribute to incidents and accidents associated with these systems. Given the variety of daily applications that could utilize the operations of the UAV (e.g., medical, security operations, construction activities, landscape activities), the main discussion has been how to safely incorporate the UAV into the national airspace system. The types of UAV incidents being reported range from near sightings by other pilots to actual collisions with aircraft or UAV. These incidents have the potential to impact the rest of aviation operations in a variety of ways, including human lives, liability costs, and delay costs. One of the largest causes of these incidents cited is the human factor; other causes cited include maintenance, aircraft, and others. This work investigates the key human factors associated with UAV incidents. To that end, the data related to UAV incidents that have occurred in the United States is both reviewed and analyzed to identify key human factors related to UAV incidents. The data utilized in this work is gathered from the Federal Aviation Administration (FAA) drone database. This study adopts the human factor analysis and classification system (HFACS) to identify key human factors that have contributed to some of the UAV failures to date. The uniqueness of this work is the incorporation of UAV incident data from a variety of applications and not just military data. In addition, identifying the specific human factors is crucial towards developing safety operational models and human factor guidelines for the UAV. The findings of these common human factors are also compared to similar studies in other countries to determine whether these factors are common internationally.

Keywords: human factors, incidents and accidents, safety, UAS, UAV

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Authors: Victor Toom

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Albeit it is never possible to anticipate the full range of difficulties after a catastrophe, efforts to identify victims of mass casualty events have become institutionalized and standardized with the aim of effectively and efficiently addressing the many challenges and contingencies. Such ‘disaster victim identification’ (DVI) practices are dependent on the forensic sciences, are subject of national legislation, and are reliant on technical and organizational protocols to mitigate the many complexities in the wake of catastrophe. Apart from such technological, legal and bureaucratic elements constituting a DVI operation, victims’ families and their emotions are also part and parcel of any effort to identify casualties of mass human fatality incidents. Take for example the fact that forensic experts require (antemortem) information from the group of relatives to make identification possible. An identified body or body part is also repatriated to kin. Relatives are thus main stakeholders in DVI operations. Much has been achieved in years past regarding facilitating victims’ families’ issues and their emotions. Yet, how families are dealt with by experts and authorities is still considered a difficult topic. Due to sensitivities and required emphatic interaction with families on the one hand, and the rationalized DVI efforts, on the other hand, there is still scope for improving communication, providing information and meaningful inclusion of relatives in the DVI effort. This paper aims to bridge the standardized world of DVI efforts and families’ experienced realities and makes suggestions to further improve DVI efforts through inclusion of victims’ families. Based on qualitative interviews, the paper narrates involvement and experiences of inter alia DVI practitioners, victims’ families, advocates and clergy in the wake of the 1995 Srebrenica genocide which killed approximately 8,000 men, and the 9/11 in New York City with 2,750 victims. The paper shows that there are several models of including victims’ families into a DVI operation, and it argues for a model of where victims’ families become a partner in DVI operations.

Keywords: disaster victim identification (DVI), victims’ families, social science (qualitative), 9/11 attacks, Srebrenica genocide

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Authors: Lancer Scott

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Purpose: High quality clinical disaster medicine requires providers working collaboratively to care for multiple patients in chaotic environments; however, many providers lack adequate training. To address this deficit, we created a competency-based, 5-hour Emergency Preparedness Training (EPT) curriculum using didactics, small-group discussion, and kinetic learning. The goal was to evaluate the effect of a short course on improving provider knowledge, confidence and skills in disaster scenarios. Methods: Diverse groups of medical university students, health care professionals, and community members were enrolled between 2011 and 2014. The course consisted of didactic lectures, small group exercises, and two live, multi-patient mass casualty incident (MCI) scenarios. The outcome measures were based on core competencies and performance objectives developed by a curriculum task force and assessed via trained facilitator observation, pre- and post-testing, and a course evaluation. Results: 708 participants completed were trained between November 2011 and August 2014, including 49.9% physicians, 31.9% medical students, 7.2% nurses, and 11% various other healthcare professions. 100% of participants completed the pre-test and 71.9% completed the post-test, with average correct answers increasing from 39% to 60%. Following didactics, trainees met 73% and 96% of performance objectives for the two small group exercises and 68.5% and 61.1% of performance objectives for the two MCI scenarios. Average trainee self-assessment of both overall knowledge and skill with clinical disasters improved from 33/100 to 74/100 (overall knowledge) and 33/100 to 77/100 (overall skill). The course assessment was completed by 34.3% participants, of whom 91.5% highly recommended the course. Conclusion: A relatively short, intensive EPT course can improve the ability of a diverse group of disaster care providers to respond effectively to mass casualty scenarios.

Keywords: clinical disaster medicine, training, hospital preparedness, surge capacity, education, curriculum, research, performance, training, student, physicians, nurses, health care providers, health care

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Authors: Lin Tang, Xiaoxia Guo, Lingling Zhang

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Recent vaccine scandals overshadowed China’s accomplishment of public health, triggering discussions on the causes of vaccine incidents. Through legal interpretation of selected vaccine incidents and analysis of systemic vulnerabilities in vaccine circulation and lot release, a panoramic review of legislative progresses in the vaccine administration sheds the light on this debate. In essence, it is the combination of the lagging legal system and the absence of information technology infrastructure in the process of vaccine administration reform that has led to the recurrence of vaccine incidents. These findings have significant implications for further improvement of vaccine administration and China’s participation in global healthcare.

Keywords: legislation, lot release, public health, reform, vaccine administration, vaccine circulation

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Authors: Mohammad H. Yarmohammadian, Mehdi Nasr Isfahani, Elham Anbari

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Introduction: The awareness of using chemical, biological, and nuclear agents in everyday industrial and non-industrial incidents has increased recently; release of these materials can be accidental or intentional. Since hospitals are the forefronts of confronting Chemical, Biological, Radiological and Nuclear( CBRN) incidents, the goal of the present research was to provide a generic protocol for CBRN incidents through a comparative review of CBRN protocols and guidelines of different countries and reviewing various books, handbooks and papers. Method: The integrative approach or research synthesis was adopted in this study. First a simple narrative review of programs, books, handbooks, and papers about response to CBRN incidents in different countries was carried out. Then the most important and functional information was discussed in the form of a generic protocol in focus group sessions and subsequently confirmed. Results: Findings indicated that most of the countries had various protocols, guidelines, and handbooks for hazardous materials or CBRN incidents. The final outcome of the research synthesis was a 50 page generic protocol whose main topics included introduction, definition and classification of CBRN agents, four major phases of incident and disaster management cycle, hospital response management plan, equipment, and recommended supplies and antidotes for decontamination (radiological/nuclear, chemical, biological); each of these also had subtopics. Conclusion: In the majority of international protocols, guidelines, handbooks and also international and Iranian books and papers, there is an emphasis on the importance of incident command system, determining the safety degree of decontamination zones, maps of decontamination zones, decontamination process, triage classifications, personal protective equipment, and supplies and antidotes for decontamination; these are the least requirements for such incidents and also consistent with the provided generic protocol.

Keywords: hospital, CBRN, decontamination, generic protocol, CBRN Incidents

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Authors: Surayyo Shaamirova, Anwar Hasan Abdullah Othman

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This study investigates the co-integration association between the top 10 cryptocurrencies, namely Bitcoin, Ethereum, Ripple, Bitcoin Cash, EOS, Cardano, Litecoin, Stellar, IOTA, and NEO. The study applies Johansen Juselius co-integration test to examine the long-run co-integration and utilize the Engle and Granger casualty test to examine the short-run relationship. The findings of the study show that there is a strong co-integration relationship among the cryptocurrencies; however, in the short run, there is no causal relationship among the crypto currencies. These results, therefore, suggest that there are portfolio diversification opportunities in the cryptocurrencies industry when it comes to long run investment decisions, on the other hand, the cryptocurrencies industry shows the characteristics of efficiency in the short-run. This is an indication of a non-speculation investment in the cryptocurrencies industry in the short term investment.

Keywords: cryptocurrencies, Johansen-Juselius co-integration test, Engle and Granger casualty test, portfolio diversification

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Authors: Jeff Colwell, Benjamin Knox

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While fire and explosion incidents are often observed by eyewitnesses, the weight that fire investigators should place on those observations in their investigations is a complex issue. There is no doubt that eyewitness statements can be an important component to an investigation, particularly when other evidence is sparse, as is often the case when damage to the scene is severe. However, it is well known that eyewitness statements can be incorrect for a variety of reasons, including deception. In this paper, we reviewed factors that can have an effect on the complex processes associated with the perception, retention, and retrieval of an event. We then review the accuracy of eyewitness statements from unique criminal and civil incidents, including fire and explosion incidents, in which the accuracy of the statements could be independently evaluated. Finally, the motives for deceptive eyewitness statements are described, along with techniques that fire and explosion investigators can employ, to increase the accuracy of the eyewitness statements that they solicit.

Keywords: fire, explosion, eyewitness, reliability

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Authors: Omid Kalatpour, Mohammadreza Ajdari

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This article studied the possible causes of human error-induced incidents in the petrochemical industry maintenance activities by using Human Factors Analysis and Classification System (HFACS). The purpose of the study was anticipating and identifying these causes and proposing corrective and preventive actions. Maintenance department in a petrochemical company was selected for research. A checklist of human error-induced incidents was developed based on four HFACS main levels and nineteen sub-groups. Hierarchical task analysis (HTA) technique was used to identify maintenance activities and tasks. The main causes of possible incidents were identified by checklist and recorded. Corrective and preventive actions were defined depending on priority. Analyzing the worksheets of 444 activities in four levels of HFACS showed 37.6% of the causes were at the level of unsafe actions, 27.5% at the level of unsafe supervision, 20.9% at the level of preconditions for unsafe acts and 14% of the causes were at the level of organizational effects. The HFACS sub-groups showed errors (24.36%) inadequate supervision (14.89%) and violations (13.26%) with the most frequency. According to findings of this study, increasing the training effectiveness of operators and supervision improvement respectively are the most important measures in decreasing the human error-induced incidents in petrochemical industry maintenance.

Keywords: human error, petrochemical industry, maintenance, HFACS

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Authors: David Yartel, Johnmark Ampomah Mensah Fobi, Ernest Yeboah Acheampong, Sintim Musah

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Football has gone through a series of technological reforms targeted at improving the game for its audience. Yet, promote sanity of the game led to the introduction of the video assistant referee (VAR) to ‘check’ or ‘review’ an incident to clarify incidents and communicate the outcome to the referee and the fans. This is to reduce controversies regarding incidents on the pitch of play. In this study, we seek to survey the views of football fans to understand their perception of the video assistant referee, whether it has brought sanity or reduce the uncertainty regarding the decisions after reviews. The exploratory study focuses on 420 fans arbitrarily sampled on the university campuses to answer questionnaires based on the introduction of the video assistant referee. Results show that the VAR has interrupted the flow of the game, dropping passion, increased controversies including decisions from the referees’ call room leading to ensuing fans conflict, especially when it is against their team and vice versa. The study concludes by addressing some of their concerns as the VAR has come to minimise perceptions of incidents and engender fairness for teams.

Keywords: football fans, football incidents, football match, video assistant referee, technology

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Authors: Michael Scott Evans, Andrew Smith

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The feeling of fatigue at work could potentially have devastating consequences. The aim of this study was to investigate whether the well-established objective indicator of fatigue – the Fatigue Risk Index (FRI) calculator used by the rail industry is an effective indicator to the number of safety incidents, in which fatigue could have been a contributing factor. The study received ethics approval from Cardiff University’s Ethics Committee (EC.16.06.14.4547). A total of 901 safety incidents were recorded from a single British rail franchise between 1st June 2010 – 31st December 2016, into the Safety Management Information System (SMIS). The safety incident types identified that fatigue could have been a contributing factor were: Signal Passed at Danger (SPAD), Train Protection & Warning System (TPWS) activation, Automatic Warning System (AWS) slow to cancel, failed to call, and station overrun. From the 901 recorded safety incidents, the scheduling system CrewPlan was used to extract the Fatigue Index (FI) score and Risk Index (RI) score of all train drivers on the day of the safety incident. Only the working rosters of 64.2% (N = 578) (550 men and 28 female) ranging in age from 24 – 65 years old (M = 47.13, SD = 7.30) were accessible for analyses. Analysis from all 578 train drivers who were involved in safety incidents revealed that 99.8% (N = 577) of Fatigue Index (FI) scores fell within or below the identified guideline threshold of 45 as well as 97.9% (N = 566) of Risk Index (RI) scores falling below the 1.6 threshold range. Their scores represent good practice within the rail industry. These findings seem to indicate that the current objective indicator, i.e. the FRI calculator used in this study by the British rail franchise was not an effective predictor of train driver’s FI scores and RI scores, as safety incidents in which fatigue could have been a contributing factor represented only 0.2% of FI scores and 2.1% of RI scores. Further research is needed to determine whether there are other contributing factors that could provide a better indication as to why there is such a significantly large proportion of train drivers who are involved in safety incidents, in which fatigue could have been a contributing factor have such low FI and RI scores.

Keywords: fatigue risk index calculator, objective indicator of fatigue, rail industry, safety incident

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Authors: Rajender Dahiya

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Investigation outcomes of major process incidents have been consistent for decades and validate that the causes and consequences are often identical. The debate remains as we continue to experience similar process incidents even with enormous development of new tools, technologies, industry standards, codes, regulations, and learning processes? The objective of this paper is to investigate the most common causes of major industrial incidents and reveal industry challenges and best practices to prevent such incidents. The author, in his current role, performs audits and inspections of a variety of high-hazard industries in North America, including petroleum refineries, chemicals, petrochemicals, manufacturing, etc. In this paper, he shares real life scenarios, examples, and case studies from high hazards operating facilities including key challenges and best practices. This case study will provide a clear understanding of the importance of near miss incident investigation. The incident was a Safe operating limit excursion. The case describes the deficiencies in management programs, the competency of employees, and the culture of the corporation that includes hazard identification and risk assessment, maintaining the integrity of safety-critical equipment, operating discipline, learning from process safety near misses, process safety competency, process safety culture, audits, and performance measurement. Failure to identify the hazards and manage the risks of highly hazardous materials and processes is one of the primary root-causes of an incident, and failure to learn from past incidents is the leading cause of the recurrence of incidents. Several investigations of major incidents discovered that each showed several warning signs before occurring, and most importantly, all were preventable. The author will discuss why preventable incidents were not prevented and review the mutual causes of learning failures from past major incidents. The leading causes of past incidents are summarized below. Management failure to identify the hazard and/or mitigate the risk of hazardous processes or materials. This process starts early in the project stage and continues throughout the life cycle of the facility. For example, a poorly done hazard study such as HAZID, PHA, or LOPA is one of the leading causes of the failure. If this step is performed correctly, then the next potential cause is. Management failure to maintain the integrity of safety critical systems and equipment. In most of the incidents, mechanical integrity of the critical equipment was not maintained, safety barriers were either bypassed, disabled, or not maintained. The third major cause is Management failure to learn and/or apply learning from the past incidents. There were several precursors before those incidents. These precursors were either ignored altogether or not taken seriously. This paper will conclude by sharing how a well-implemented operating management system, good process safety culture, and competent leaders and staff contributed to managing the risks to prevent major incidents.

Keywords: incident investigation, risk management, loss prevention, process safety, accident prevention

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Authors: Mohammad Javad Behzadnia, Amir Bahador Boroumand

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Introduction: Limited facility situations require allocating the most available resources for most casualties. Accordingly, Traumatic Brain Injury (TBI) is the one that may need to transport the patient as soon as possible. In a mass casualty event, deciding when the facilities are restricted is hard. The Extended Glasgow Outcome Score (GOSE) has been introduced to assess the global outcome after brain injuries. Therefore, we aimed to evaluate the prognostic factors associated with GOSE. Materials and Methods: In a multicenter cross-sectional study conducted on 144 patients with TBI admitted to trauma emergency centers. All the patients with isolated TBI who were mentally and physically healthy before the trauma entered the study. The patient’s information was evaluated, including demographic characteristics, duration of hospital stays, mechanical ventilation on admission laboratory measurements, and on-admission vital signs. We recorded the patients’ TBI-related symptoms and brain computed tomography (CT) scan findings. Results: GOSE assessments showed an increasing trend by the comparison of on-discharge (7.47 ± 1.30), within a month (7.51 ± 1.30), and within three months (7.58 ± 1.21) evaluations (P < 0.001). On discharge, GOSE was positively correlated with Glasgow Coma Scale (GCS) (r = 0.729, P < 0.001) and motor GCS (r = 0.812, P < 0.001), and inversely with age (r = −0.261, P = 0.002), hospitalization period (r = −0.678, P < 0.001), pulse rate (r = −0.256, P = 0.002) and white blood cell (WBC). Among imaging signs and trauma-related symptoms in univariate analysis, intracranial hemorrhage (ICH), interventricular hemorrhage (IVH) (P = 0.006), subarachnoid hemorrhage (SAH) (P = 0.06; marginally at P < 0.1), subdural hemorrhage (SDH) (P = 0.032), and epidural hemorrhage (EDH) (P = 0.037) were significantly associated with GOSE at discharge in multivariable analysis. Conclusion: Our study showed some predictive factors that could help to decide which casualty should transport earlier to a trauma center. According to the current study findings, GCS, pulse rate, WBC, and among imaging signs and trauma-related symptoms, ICH, IVH, SAH, SDH, and EDH are significant independent predictors of GOSE at discharge in TBI patients.

Keywords: field, Glasgow outcome score, prediction, traumatic brain injury.

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Authors: Abdullah Beyazkurk, Onur Ozdemir

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The evolution of warfare has been affected from technological developments to a large extent. Another important factor that affected the evolution of warfare is the space. Technological developments became cornerstones for the organization of the forces on the field, while space of the battlefield gained importance with the introduction of urban areas as 'battlefields'. The use of urban areas as battlefields increased the casualty, while technological developments began to play a remedial role. Thus, the unmanned systems drew attention as the remedy. Today's widely used unmanned aerial vehicles have great effects on the operations. On the other hand, with the increasing urbanization, and the wide use of urban areas as battlefields make it a necessity to benefit from unmanned systems on the ground as well. This study focuses on the use of unmanned aerial systems as well as unmanned ground systems in urban warfare, with regards to their performance and cost affectivity. The study defends that the use of unmanned vehicles will be remedial for increasing casualty rates, while their precision and superhuman capacity will manifest the performance advantage. The findings of this study will help modern armies focus on unmanned systems, especially for the urban, anti-terror, or counter insurgency operations.

Keywords: technology, warfare, urban warfare, unmanned systems, unmanned ground vehicles, unmanned aerial vehicles

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Authors: M. H. Saeed, M. Rasool, M. A. Jawed

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Arc Flash Analysis has been a subject of great interest since the electrical fire incidents have been reduced to a great extent after the implementation of arc flash study at different sites. An Arc flash in substations is caused by short circuits over the air or other melted conductors and small shrapnel. Arc flash incidents result in the majority of deaths in substations worldwide. Engro Fertilizers Limited (EFERT) site having a mix of vintage non-internal arc rated and modern arc rated switchgears, carried out an arc flash study of the whole site in accordance with NFPA70E standard. The results not only included optimizing site protection coordination settings but also included marking of Shock and Arc flash protection boundaries in all switchgear rooms. Work permit procedures upgradation is also done in accordance with this study to ensure proper arc rated PPEs and arc flash boundaries protocols are fully observed and followed. With the new safety, protocols working on electrical equipment will be much safer than ever before.

Keywords: Arc flash, non-internal arc rated, protection coordination, shock boundary

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Authors: J. J. Peña, J. Morales, J. García-Ravelo, L. Arcos-Díaz

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The Point canonical transformation method is applied for solving the Schrödinger equation with position-dependent mass. This class of problem has been solved for continuous mass distributions. In this work, a staggered mass distribution for the case of a free particle in an infinite square well potential has been proposed. The continuity conditions as well as normalization for the wave function are also considered. The proposal can be used for dealing with other kind of staggered mass distributions in the Schrödinger equation with different quantum potentials.

Keywords: free particle, point canonical transformation method, position-dependent mass, staggered mass distribution

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Authors: Samiah H. Ghounaim

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The topic of this paper is significant because of the increasing need for intercultural training for foreign language teachers due to the continuous challenges they face in their diverse classrooms. First, the structure of the intercultural training program designed will be briefly described, and the structure of a 3D vignette and its intended purposes will be elaborated on. This was the first stage where the program was designed and implemented on the period of three months with a group of local and expatriate foreign language teachers/practitioners at a university in the Middle East. After that, a set of primary data collected during the first stage of this research on the design and co-construction process of a 3D vignette will be reviewed and analysed in depth. Each practitioner designed a personal incident into a 3D vignette where each dimension of the vignette viewed the same incident from a totally different perspective. Finally, the results and the implications of having participant construct their personal incidents into a 3D vignette as a reflective practice will be discussed in detail as well as possible extensions for the research. This process proved itself to be an effective reflective practice where the participants were stimulated to view their incidents in a different light. Co-constructing one’s own critical incidents –be it a positive experience or not– into a structured 3D vignette encouraged participants to decentralise themselves from the incidents and, thus, creating a personal reflective space where they had the opportunity to see different potential outcomes for each incident, as well as prepare for the reflective discussion of their vignette with their peers. This provides implications for future developments in reflective writing practices and possibilities for educators’ continuous professional development (CPD).

Keywords: 3D vignettes, intercultural competence training, reflective practice, teacher training

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Authors: Mariam Shah

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‘Honour’ crime has commonly been perceived in the UK as being a ‘domestic violence’ related issue due to incidents perceived to take place within a domestic context, and commonly by familial perpetrators. The lack of differentiation between domestic violence and ‘honour’ related incidents has several negative implications. Firstly, the prevalence and extent of ‘honour’ related crime within the UK cannot be accurately quantified due to ‘honour’ incidents being classed statistically as domestic violence incidents. Secondly, lack of differentiation means that the negative stereotypical attitudes ascribed to domestic violence which has resulted in lower criminal conviction rates that are also impacting the conviction of perpetrators of ‘honour’ crime. Thirdly, ‘honour’ related crime is innately distinct from domestic violence due to the perpetrator’s resolute intent of cleansing perceived ‘shame’ in any way possible, often with the involvement and collusion of multiple perpetrators from within the family and/or community. Domestic violence is typically restricted to the ‘home’, but ‘honour’ crime can operate between national and international boundaries. This paper critically examines the current academic literature and concludes that the few similarities between domestic violence and ‘honour’ related crime are not sufficient to warrant identical treatment under UK criminal law. ‘Honour’ related crime is a distinct and stand-alone offence which should be recognised as such. The appropriate identification and treatment of ‘honour’ crime are crucial, particularly in light of the UK’s first ‘white’ honour killing which saw a young English woman murdered after being deemed to have brought ‘shame’ on her ex-boyfriend’s family. This incident highlights the possibility of ‘honour’ crime extending beyond its perceived ‘ethnic minority’ roots and becoming more of a ‘mainstream’ issue for the multi-cultural and multi-racial UK.

Keywords: differentiation, domestic violence, honour crime, United Kingdom

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Authors: Chijindu D. Mgbemere

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Mass killing also known as genocide is the systematic killing of people from national, ethnic, or religious group, or an attempt to do so. The act has been there before 1948, when it was officially recognized for what it is. From then, the world has continued to witness genocide in diverse forms- negating different measures by the United Nations and its agencies to curb it. So far, all the studies and documentations on this subject are biased in favor of radio and the print. This paper therefore extended the interrogation of genocide, drumming its devastating effects, using the film medium; and in doing so devised innovative and pragmatic approach to genocide scholarship. It further centered attention on the factors and impacts of genocide, with a view to determine how effective film can be in such a study. The study is anchored on Bateson’s Framing Theory. Four films- Hotel Rwanda, Half of a Yellow Sun, Attack on Darfur, and sarafina, were analyzed, based on background, factors/causes, impacts, and development of genocide, via Content Analysis. The study discovered that: as other continents strive towards peace, acts of genocide are on the increase in African. Bloodletting stereotypes give Africa negative image in the global society. Difficult political frameworks, the trauma of postcolonial state, aggravated by ethnic and religious intolerance, and limited access to resources are responsible for high cases of genocide in Africa. The media, international communities, and peace agencies often abet other than prevent genocide or mass killings in Africa. High human casualty and displacement, children soldering, looting, hunger, rape, sex-slavery and abuse, mental and psychosomatic stress disorders are some of the impacts of genocide. Genocidaires are either condemned or killed. Grievances can be vented using civil resistance, negotiation, adjudication, arbitration, and mediation. The cinema is an effective means of studying and documenting genocide. Africans must factor the image laundering of their continent into consideration. Punishment of genocidaires without an attempt to de-radicalize them is counterproductive.

Keywords: African film, genocide, framing theory, mass murder

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Authors: Nastaran Ahmadpour Samani, Shahram Talebi

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Added mass is an important quantity in analysis of the motion of a submerged object ,which can be calculated by solving the equation of potential flow around the object . Here, we consider systems in which a square object is submerged in a channel of fluid and moves parallel to the wall. The corresponding added mass at a given distance from the wall d and for the object size s (which is the side of square object) is calculated via lattice Blotzmann simulation . By changing d and s separately, their effect on the added mass is studied systematically. The simulation results reveal that for the systems in which d > 4s, the distance does not influence the added mass any more. The added mass increases when the object approaches the wall and reaches its maximum value as it moves on the wall (d -- > 0). In this case, the added mass is about 73% larger than which of the case d=4s. In addition, it is observed that the added mass increases by increasing of the object size s and vice versa.

Keywords: Lattice Boltzmann simulation , added mass, square, variable size

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Authors: Thitima Plejai

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The practice in the operating room has been continually performed according to standards of services; however, undesirable incidents from surgical services are found such as surgical complications in the operating room. This participation action research aimed to develop practice guidelines for surgical safety management to reduce undesirable incidents from surgical services in the operating room of Songkhla Hospital. The target population was all 84 members of the multidisciplinary team who were involved in surgical services in the operating room consisting of 28 surgeons from five branches of surgery, 27 anesthetists and nurse anesthetists, and 29 surgical nurses. The data were collected through in-depth interviews, and non-participatory observations. The research instrument was tested by three experts, and the steps of the development consisted of four cycles, each consisting of assessment, planning, practice, practice reflection, and improvement until every step is practicable. The data were validated through triangulation research method, analyzed through content analysis and statistical analysis with number and percentage. The results of the development of practice guidelines surgical safety management to reduce undesirable incidents from surgical services could be concluded as follows. 1) The multidisciplinary team in surgery participated in the needs assessment for development of practice guidelines for surgical patient safety, and agreed on adapting the WHO Surgical Safety Checklists for use. 2) The WHO Surgical Safety Checklists was implemented, and meetings were held for the multidisciplinary team in surgery and the organizational risk committee to improve the practice guidelines to make them more practicable. 3) The multidisciplinary team consisting of surgeons from five branches of surgery, anesthetists, nurse anesthetists, surgical nurses, and the organizational risk committee announced policy on safety for surgical patients; the organizational risk committee designated the Surgical Safety Checklist as an instrument for surgical patient safety. The results of the safety management found that the surgical team members who could follow 100 percent of the guidelines were: professional nurses who checked patient identity and information before taking the patient to the operating room and kept complete records of data on the patients; surgical nurses who checked readiness of the patient before surgery; nurse anesthetists who assessed readiness before administering anesthetic drugs, and confirmed correctness of the patient; and circulating perioperative nurses who gave confirmation to the surgical team after completion of the surgery. The rates of undesirable incidents (surgical complications rates) before and after the implementation of the surgical safety management were 1.60 percent and 0.66 percent, respectively. The satisfaction of the surgery-related teams towards the use of the guidelines was 89 percent. The practice guidelines for surgical safety management to reduce undesirable incidents were taken as guidelines for surgical safety that the multidisciplinary team involved in the surgical process implemented correctly and in the same direction and clearly reduced undesirable incidents in surgical patients.

Keywords: practice guidelines, surgical safety management, reduce undesirable incidents, operating Room

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Authors: S. Kopylov, C. Z. Bo

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This study is aimed at exploring the possibility of energy recovery through the suppression of vibrations. The article describes design of electromagnetic dynamic damper. The magnetic part of the device performs the function of a tuned mass damper, thereby providing both energy regeneration and damping properties to the protected mass. According to the theory of tuned mass damper, equations of mathematical models were obtained. Then, under given properties of current system, amplitude frequency response was investigated. Therefore, main ideas and methods for further research were defined.

Keywords: electromagnetic damper, oscillations with two degrees of freedom, regeneration systems, tuned mass damper

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Authors: Carlos V. Gonzalez

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Background: Providers of in-home and community based services strive for the elimination of preventable harm to the people under their care as well as to the employees who support them. Traditional models of safety and protection from harm have assumed that the absence of incidents of harm is a good indicator of safe practices. However, this model creates an illusion of safety that is easily shaken by sudden and inadvertent harmful events. As an alternative, we have developed and implemented an evidence-based resilient model of safety known as C.O.P.E. (Caring, Observing, Predicting and Evaluating). Within this model, safety is not defined by the absence of harmful incidents, but by the presence of continuous monitoring, anticipation, learning, and rapid response to events that may lead to harm. Objective: The objective was to evaluate the effectiveness of the C.O.P.E. model for the reduction of harm to individuals with mental disabilities who receive home and community based services. Methods: Over the course of 2 years we counted the number of incidents of harm and near misses. We trained employees on strategies to eliminate incidents before they fully escalated. We trained employees to track different levels of patient status within a scale from 0 to 10. Additionally, we provided direct support professionals and supervisors with customized smart phone applications to track and notify the team of changes in that status every 30 minutes. Finally, the information that we collected was saved in a private computer network that analyzes and graphs the outcome of each incident. Result and conclusions: The use of the COPE model resulted in: A reduction in incidents of harm. A reduction the use of restraints and other physical interventions. An increase in Direct Support Professional’s ability to detect and respond to health problems. Improvement in employee alertness by decreasing sleeping on duty. Improvement in caring and positive interaction between Direct Support Professionals and the person who is supported. Developing a method to globally measure and assess the effectiveness of prevention from harm plans. Future applications of the COPE model for the reduction of harm to people who receive home and community based services are discussed.

Keywords: harm, patients, resilience, safety, mental illness, disability

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Authors: Setareh Shayanfar

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Given the increasing importance of peer relationships during adolescence, the present study aimed to examine peer interactions that facilitate or hinder adolescents’ regulation of negative emotions. Using the Enhanced Critical Incident Technique, 1-hour semi-structured interviews were conducted with 16 junior high school adolescents. Participants were asked to recall situations when they experienced strong negative emotions during the past school year, indicate the peer interactions that helped or hindered their emotion regulation, and identify prospective interactions with the potential to help regulate their emotions. Data analysis extracted 182 critical incidents, including 109 helping incidents, 45 hindering incidents, and 28 wish list items, which generated 10 categories nested within four overarching themes: Positive Personal Support included (a) supportive presence, (b) expressing concern, (c) empathizing, and (d) encouraging and cheering up; while Strategy Transmission included (e) sharing perspective, and (f) giving advice; Activated Support included (g) taking action, and (h) distracting; while Negative Personal Interactions included (i) withdrawing and (j) punishing. Implications for mental health and service providers, as well as recommendations for future research, are presented.

Keywords: adolescence, emotion regulation, enhanced critical incident technique, peers

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Authors: Hagar Elsayed

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This case study examines the framing of the diverse populations of Arab, Muslim and South Asian immigrants and their descendants in local communities by both federal and local law enforcement agencies. It explores how urban spaces and policing are constructed as necessary components of national security in the context of the war on terror by focusing on practices employed in local spaces such as Dearborn, Michigan and training methods adopted on a national level. The proliferation of American Arabs as ‘terrorist’ works to legitimize not only increasing state surveillance, but also military strategies which infringe on ‘inside’ spaces. Sustaining these progressively militarized civil policing operations, which demand intense mobilization of state power, requires that whole neighborhoods and districts are reimagined to portray these geographies in a certain light. This case study is central in understanding how Arab, South Asian, and Muslim civilians’ transformation into a “national security” issue have created militarized police enforcement agencies that employ military tactics to map the terrain of Otherness. This study looks at how race factors into key recent incidents, and asks whether this militarization builds from past forms of racist policing, and whether these specific incidents are reflective of larger patterns or whether they are just isolated incidents.

Keywords: American-Muslims, Arabs, militarization, policing

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Authors: V. V. Povoroznyuk, Lar. P. Martynyuk, N. I. Dzerovych, Lil. P. Martyntyuk

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Objective: Menopause-related changes in female body are associated with the greater risk of metabolic syndrome (MS), which includes obesity, dyslipidemia, impaired glucose tolerance, hypertension. The aim of our study was to reveal peculiarities of fat and lean mass distribution between postmenopausal women with abdominal obesity and with MS. Materials and Methods: The sample consisted of 43 postmenopausal 60 – 69 years old women (age: mean = 64,8; S.D. = 0,4); duration of menopause: mean = 14,5; S.D.= 0,9). The diagnosis of MS was considered according to IDF (2005 yr) criteria. Lean and fat mass distrubution were measured by dual-energy X-ray absortiometry, and were compared for the cohorts with and without MS. Data were analyzed using Statistical Package 6.0 (Statsoft). Results: Findings revealed that 24 (55,8 %) of postmenopausal women had MS. In patients with and without MS compared, fat mass was higher in the former group (41248,25±2263,89 and 29817,68±2397,78 respectively; F=11,9; p=0,001) and at different body regions also: gynoid fat (6563,72±348,19 and 5115,21±392,43 respectively; F=7,6; p=0,008), android fat (3815,45±200,8128 and 2798,15±282,79 respectively; F=9,06; p=0,004. Lean mass comparing didn’t show significant differences in female with and without MS (42548,0±1239,18 and 40667,53±1223,78 respectively; F=1,1; p=0,29) and at different body regions also. Conclusion: These findings suggest that in postmenopausal women with MS there is prevalence of fat mass without increasing of lean mass quantity in compare to female with abdominal obesity without MS.

Keywords: lean mass, fat mass, овesity, metabolic syndrome, women, postmenopausal period

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Authors: Jogi Prayogo, Dwi Qaqa Prasetyatama, Rahmad Dwi Afandi, Kunto Arief Prasetyo, Viorel Herniza Leksono

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PT. Pertamina Trans Kontinental managed a fleet of 364 ships in 2018 - 2020. In that period, there were 8 incidents of ship damage, causing breakdown maintenance on 6 ships belonging to PT Pertamina Trans Kontinental throughout Indonesia's operational areas due to ropes entangled in propellers. The company's losses that were caused by the fouled propellers amounted to 306.35 Million Rupiah. Of the 8 incidents, Mooring Boat PSC I was taken as a pilot project for further analysis considering the location of the ship which is in Surabaya and Mooring Boat PSC I has experienced 2 incidents of rope entanglement that caused the company's losses due to the largest Breakdown Maintenance amounted to 200.99 Million Rupiah. After analyzing the rope entanglement in the ship's propeller based on the data of Mooring Boat PSC I related to the location of propellers that are often fouled in the conventional propulsion system, it was found that there is a suitable location for the implementation of SI KUMAN tool that serves to cut ropes to prevent the occurrence of rope entangled in ship propellers. The determination of SI KUMAN tool is based on the strength of the ship's material to be installed and a suitable design to prevent the occurrence of ropes being entangled in propellers. After the installation of the "SI KUMAN" tool and monitoring carried out for 1 year period (August 2020 - August 2021), it was found that SI KUMAN tool can eliminate the risk of fouled propeller incidents which previously occurred twice in one year so that the company's loss amounted to 200.99 Million Rupiah can be eliminated and SI KUMAN tool can still operate optimally.

Keywords: breakdown maintenance, mooring boat, fleet, fouled propeller, rope entangled, cut

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