Search results for: near misses

Authors: Nick Woodier, Paul Sampson, Iain Moppett

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Background: For years, healthcare across the world has recognised that patients are coming to harm from the very processes meant to help them. In response, healthcare tells itself that it needs to ‘be more like aviation.’ Aviation safety is highly regarded by those in healthcare and is seen as an exemplar. Specifically, healthcare is keen to learn from how aviation uses near misses to make their industry safer. Healthcare is rife with near misses; however, there has been little progress addressing them, with most research having focused on reporting. Addressing the factors that contribute to near misses will potentially help reduce the number of significant, harm patientsafety incidents. While the healthcare literature states the need to learn from aviation’s use of near misses, there is nothing that describes how best to do this. The authors, as part of a larger study of near-miss management in healthcare, sought to learn from aviation to develop principles for how healthcare can identify, report, and learn from near misses to improve patient safety. Methods: A Grounded Theory (GT) methodology, augmented by a scoping review, was used. Data collection included interviews, field notes, and the literature. The review protocol is accessible online. The GT aimed to develop theories about how aviation, amongst other safety-critical industries, manages near misses. Results: Twelve aviation interviews contributed to the GT across passenger airlines, air traffic control, and bodies involved in policy, regulation, and investigation. The scoping review identified 83 articles across a range of safety-critical industries, but only seven focused on aviation. The GT identified that aviation interprets the term ‘near miss’ in different ways, commonly using it to specifically refer to near-miss air collisions, also known as Airproxes. Other types of near misses exist, such as health and safety, but the reporting of these and the safety climate associated with them is not as mature. Safety culture in aviation was regularly discussed, with evidence that culture varies depending on which part of the industry is being considered (e.g., civil vs. business aviation). Near misses are seen as just one part of an extensive safety management system, but processes to support their reporting and their analysis are not consistent. Their value alone is also questionable, with the challenge to long-held beliefs originating from the ‘common cause hypothesis.’ Conclusions: There is learning that healthcare can take from how parts of aviation manage and learn from near misses. For example, healthcare would benefit from a formal safety management system that currently does not exist. However, it may not be as simple as ‘healthcare should learn from aviation’ due to variation in safety maturity across the industry. Healthcare needs to clarify how to incorporate near misses into learning and whether allocating resources to them is of value; it was heard that catastrophes have led to greater improvements in safety in aviation.

Keywords: aviation safety, patient safety, near miss, safety management systems

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Authors: Nick Woodier, Iain Moppett

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Background: It is estimated that one in ten patients admitted to hospital will suffer an adverse event in their care. While the majority of these will result in low harm, patients are being significantly harmed by the processes meant to help them. Healthcare, therefore, seeks to make improvements in patient safety by taking learning from other industries that are perceived to be more mature in their management of safety events. Of particular interest to healthcare are ‘near misses,’ those events that almost happened but for an intervention. Healthcare does not have any guidance as to how best to manage and learn from near misses to reduce the chances of harm to patients. The authors, as part of a larger study of near-miss management in healthcare, sought to learn from the UK nuclear sector to develop principles for how healthcare can identify, report, and learn from near misses to improve patient safety. The nuclear sector was chosen as an exemplar due to its status as an ultra-safe industry. Methods: A Grounded Theory (GT) methodology, augmented by a scoping review, was used. Data collection included interviews, scenario discussion, field notes, and the literature. The review protocol is accessible online. The GT aimed to develop theories about how nuclear manages near misses with a focus on defining them and clarifying how best to support reporting and analysis to extract learning. Near misses related to radiation release or exposure were focused on. Results: Eightnuclear interviews contributed to the GT across nuclear power, decommissioning, weapons, and propulsion. The scoping review identified 83 articles across a range of safety-critical industries, with only six focused on nuclear. The GT identified that nuclear has a particular focus on precursors and low-level events, with regulation supporting their management. Exploration of definitions led to the recognition of the importance of several interventions in a sequence of events, but that do not solely rely on humans as these cannot be assumed to be robust barriers. Regarding reporting and analysis, no consistent methods were identified, but for learning, the role of operating experience learning groups was identified as an exemplar. The safety culture across nuclear, however, was heard to vary, which undermined reporting of near misses and other safety events. Some parts of the industry described that their focus on near misses is new and that despite potential risks existing, progress to mitigate hazards is slow. Conclusions: Healthcare often sees ‘nuclear,’ as well as other ultra-safe industries such as ‘aviation,’ as homogenous. However, the findings here suggest significant differences in safety culture and maturity across various parts of the nuclear sector. Healthcare can take learning from some aspects of management of near misses in nuclear, such as how they are defined and how learning is shared through operating experience networks. However, healthcare also needs to recognise that variability exists across industries, and comparably, it may be more mature in some areas of safety.

Keywords: culture, definitions, near miss, nuclear safety, patient safety

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Authors: Khyamling Parane, B. M. Prabhu Prasad, Basavaraj Talawar

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Fast simulations are critical in reducing time to market in CMPs and SoCs. Several simulators have been used to evaluate the performance and power consumed by Network-on-Chips. Researchers and designers rely upon these simulators for design space exploration of NoC architectures. Our experiments show that simulating large NoC topologies take hours to several days for completion. To speed up the simulations, it is necessary to investigate and optimize the hotspots in simulator source code. Among several simulators available, we choose Booksim2.0, as it is being extensively used in the NoC community. In this paper, we analyze the cache and memory system behaviour of Booksim2.0 to accurately monitor input dependent performance bottlenecks. Our measurements show that cache and memory usage patterns vary widely based on the input parameters given to Booksim2.0. Based on these measurements, the cache configuration having least misses has been identified. To further reduce the cache misses, we use software optimization techniques such as removal of unused functions, loop interchanging and replacing post-increment operator with pre-increment operator for non-primitive data types. The cache misses were reduced by 18.52%, 5.34% and 3.91% by employing above technology respectively. We also employ thread parallelization and vectorization to improve the overall performance of Booksim2.0. The OpenMP programming model and SIMD are used for parallelizing and vectorizing the more time-consuming portions of Booksim2.0. Speedups of 2.93x and 3.97x were observed for the Mesh topology with 30 × 30 network size by employing thread parallelization and vectorization respectively.

Keywords: cache behaviour, network-on-chip, performance profiling, vectorization

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Authors: Sharifah Liew, Azlihanis Abdul Hadi, Nurul Shahida Mohd Saffe, Azhar Hamzah, Maslina Musa

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Fatigue is a common health problem among healthcare workers, ranging from ambulance drivers to specialist doctors. In Malaysia, majority of healthcare workers prefer to commute to work by their own vehicle compared to public transport. Thus, exposed to risk on the road while commuting to work. The aim of the study is to find out the effects of fatigue on road crashes among healthcare workers while they commute to work. The research conducted using the semi-quantitative approach based on self- reported questionnaires. In total, five hundred and fifty-one healthcare workers from selected five hospitals were involved in this study. Results showed significant differences between crash involvement, travelling distance and time to and from work among healthcare workers. Most of the participants (37%) reported that causes of road crashes were due to fatigue, sleepiness and microsleep while driving to and back from work. In addition, there were significant differences between fatigue and road crashes and near misses. This research suggests that the hospitals’ management may need to review their staffs’ job scopes and workloads to overcome the fatigue problems and, consider their feedback when designing work schedules and investigate staff commuting distance from home to workplace and vice-versa.

Keywords: fatigue, healthcare, road crashes, near misses, Malaysia

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Authors: Camilla Elphick, Graham Hole, Samuel Hutton, Graham Pike

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Pupil size has been found to change irrespective of luminosity, suggesting that it can be used to make inferences about cognitive processes, such as cognitive load. To see whether identifying a target requires a different cognitive load to rejecting distractors, the effect of viewing a target (compared with viewing distractors) on pupil size was investigated using a sequential video lineup procedure with two lineup sessions. Forty one participants were chosen randomly via the university. Pupil sizes were recorded when viewing pre target distractors and post target distractors and compared to pupil size when viewing the target. Overall, pupil size was significantly larger when viewing the target compared with viewing distractors. In the first session, pupil size changes were significantly different between participants who identified the target (Hits) and those who did not. Specifically, the pupil size of Hits reduced significantly after viewing the target (by 26%), suggesting that cognitive load reduced following identification. The pupil sizes of Misses (who made no identification) and False Alarms (who misidentified a distractor) did not reduce, suggesting that the cognitive load remained high in participants who failed to make the correct identification. In the second session, pupil sizes were smaller overall, suggesting that cognitive load was smaller in this session, and there was no significant difference between Hits, Misses and False Alarms. Furthermore, while the frequency of Hits increased, so did False Alarms. These two findings suggest that the benefits of including a second session remain uncertain, as the second session neither provided greater accuracy nor a reliable way to measure it. It is concluded that pupil size is a measure of face recognition strength in the first session of a target present lineup procedure. However, it is still not known whether cognitive load is an adequate explanation for this, or whether cognitive engagement might describe the effect more appropriately. If cognitive load and cognitive engagement can be teased apart with further investigation, this would have positive implications for understanding eyewitness identification. Nevertheless, this research has the potential to provide a tool for improving the reliability of lineup procedures.

Keywords: cognitive load, eyewitness identification, face recognition, pupillometry

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Authors: Gupta Rajesh, Paudel Sagar, Sharma Utkarsh, Singh Amit Kumar

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Thermal stratification has drawn much attention because of the malfunctions at various nuclear plants in U.S.A that raised significant safety concerns. The concerns due to this phenomenon relate to thermal stresses in branch pipes connected to the reactor coolant system piping. This stress limits the lifetime of the piping system, and even leading to penetrating cracks. To assess origin of valve damage in the pipeline, it is essential to determine the effect of turbulence penetration on valve leakage; since stratified flow is generally generated by turbulent penetration or valve leakage. As a result, we concluded with the help of coupled fluent-structural analysis that the pipe with less turbulence has less chance of failure there by requiring less maintenance.

Keywords: nuclear reactor coolant system, thermal stratification, turbulent penetration, coupled fluent-structural analysis, Von-Misses stress

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Authors: Ernesto Pineda Leon, Dante Tolentino Lopez, Janis Zapata Lopez

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The current paper shows the application of the boundary element method for the analysis of plates under shear stress causing plasticity. In this case, the shear deformation of a plate is considered by means of the Reissner’s theory. The probability of failure of a Reissner’s plate due to a proposed index plastic behavior is calculated taken into account the uncertainty in mechanical and geometrical properties. The problem is developed in two dimensions. The classic plasticity’s theory is applied and a formulation for initial stresses that lead to the boundary integral equations due to plasticity is also used. For the plasticity calculation, the Von Misses criteria is used. To solve the non-linear equations an incremental method is employed. The results show a relatively small failure probability for the ranges of loads between 0.6 and 1.0. However, for values between 1.0 and 2.5, the probability of failure increases significantly. Consequently, for load bigger than 2.5 the plate failure is a safe event. The results are compared to those that were found in the literature and the agreement is good.

Keywords: boundary element method, failure, plasticity, probability

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Authors: Vitor S. Mendonca, Maria Luisa S. Schmidt

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The Brazilian medical profession is viewed as being error-free, so healthcare professionals who commit an error are condemned there. Medical errors occur frequently in the Brazilian healthcare system, so identifying better options for handling this issue has become of interest primarily for physicians. The purpose of this study is to better understand the tensions involved in the fear of making an error due to the harm and risk this would represent for those involved. A qualitative study was performed by means of the narratives of the lived experiences of ten acting physicians in the State of Sao Paulo. The concept and characterization of errors were discussed, together with the fear of making an error, the near misses or error in itself, how to deal with errors and what to do to avoid them. The analysis indicates an excessive pressure in the medical profession for error-free practices, with a well-established physician-patient relationship to facilitate the management of medical errors. The error occurs, but a lack of information and discussion often leads to its concealment due to fear or possible judgment by society or peers. The establishment of programs that encourage appropriate medical conduct in the event of an error requires coherent answers for humanization in Brazilian medical science. It is necessary to improve the discussion about medical errors and disseminate models of communication and notification of errors in Brazil.

Keywords: medical error, narrative, physician-patient relationship, qualitative research

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Authors: Aileen F. Wang

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Mammography has been one of the most reliable methods for early detection and diagnosis of breast cancer. However, mammography misses about 17% and up to 30% of breast cancers due to the subtle and unstable appearances of breast cancer in their early stages. Recent computer-aided diagnosis (CADx) technology using Zernike moments has improved detection accuracy. However, it has several drawbacks: it uses manual segmentation, Zernike moments are not robust, and it still has a relatively high false negative rate (FNR)–17.6%. This project will focus on the development of a novel breast cancer detection algorithm to automatically segment the breast mass and further reduce FNR. The algorithm consists of automatic segmentation of a single breast mass using Point Region Growing Segmentation, reconstruction of the segmented breast mass using Pseudo-Zernike moments, and classification of the breast mass using the root mean square (RMS). A comparative study among the various algorithms on the segmentation and reconstruction of breast masses was performed on randomly selected mammographic images. The results demonstrated that the newly developed algorithm is the best in terms of accuracy and cost effectiveness. More importantly, the new classifier RMS has the lowest FNR–6%.

Keywords: computer aided diagnosis, mammography, point region growing segmentation, pseudo-zernike moments, root mean square

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Authors: Chaithanya Pothuganti

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Open and semi-open spaces in educational buildings like corridors, mid landings, seating spaces, lobby, courtyards are traditionally have been the places of social communion and interaction which helps in promoting the knowledge, performance, activeness, and motivation in students. Factors like availability of land, commercialization, of educational facilities, especially in e-techno and smart schools, led to closed classrooms to accommodate students thereby lack quality open and semi-open spaces. This insufficient attention towards open space design which is a means of informal learning misses an opportunity to encourage the student’s skill development, behavior and learning skills. The core objective of this paper is to find the level of impact on student learning behavior and to identify the suitable proportions and configuration of spaces that shape the schools. In order to achieve this, different types of open spaces in schools and their impact on student’s performance in various existing models are analysed using case studies to draw some design principles. The study is limited to indoor open spaces like corridors, break out spaces and courtyards. The expected outcome of the paper is to suggest better design considerations for the development of semi-open and open spaces which functions as an element for informal learnings. Its focus is to provide further thinking on designing and development of open spaces in educational buildings.

Keywords: configuration of spaces and proportions, informal learning, open spaces, schools, student’s behavior

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Authors: Gayan Mapitiya

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Maintaining good occupational health and safety (OHS) performance is significant at the coalface, especially in industries such as mining, power, and construction. Coalface workers are vulnerable to high OHS risks such as working at heights, working with mobile plants and vehicles, working with underground and above ground services, chemical emissions, radiation hazards and explosions at everyday work. To improve OHS performance of workers, OHS key performance indicators (KPIs) (for example, lost time injuries (LTI), serious injury frequency rate (SIFR), total reportable injury frequency rate (TRIFR) and number of near misses) are widely used by managers in making OHS business decisions such as investing in safety equipment and training programs. However, in many organizations, workers at the coalface hardly see any relevance or value addition of OHS KPIs to their everyday work. Therefore, the aim of the study was to understand why coalface workers perceive that OHS KPIs are not practically relevant to their jobs. Accordingly, this study was conducted as a qualitative case study focusing on a large electricity and gas firm in Australia. Semi-structured face to face interviews were conducted with selected coalface workers to gather data on their attitude towards OHS KPIs. The findings of the study revealed that workers at the coalface generally have no understanding of the purpose of KPIs, the meaning of each KPI, origin of KPIs, and how KPIs are correlated to organizational performance. Indeed, KPIs are perceived as ‘meaningless obstacles’ imposed on workers by managers without a rationale. It is recommended to engage coalface workers (a fair number of representatives) in both KPIs setting and revising processes while maintaining a continuous dialogue between workers and managers in regards OHS KPIs.

Keywords: KPIs, coalface, OHS risks, case-study

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Authors: Seyyed Abbas Mojtabavi, Mojtaba Fatzaneh Moghadam, Masoud Mahdavi

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Steel Metal Shear Wall is one of the most common and widely used energy dissipation systems in structures, which is used today as a damping system due to the increase in the construction of metal structures. In the present study, the shear wall of the steel plate with dimensions of 5×3 m and thickness of 0.024 m was modeled with 2 floors of total height from the base level with finite element method in Abaqus software. The loading is done as a concentrated load at the upper point of the shear wall on the second floor based on step type buckle. The mesh in the model is applied in two directions of length and width of the shear wall, equal to 0.02 and 0.033, respectively, and the mesh in the models is of sweep type. Finally, it was found that the steel plate shear wall with cavity (CSPSW) compared to the SPSW model, S (Mises), Smax (In-Plane Principal), Smax (In-Plane Principal-ABS), Smax (Min Principal) increased by 53%, 70%, 68% and 43%, respectively. The presence of cavities has led to an increase in the estimated stresses, but their presence has caused critical stresses and critical deformations created to be removed from the inner surface of the shear wall and transferred to the desired sections (regular cavities) which can be suggested as a solution in seismic design and improvement of the structure to transfer possible damage during the earthquake and storm to the desired and pre-designed location in the structure.

Keywords: steel plate shear wall, abacus software, finite element method, , boundary element, seismic structural improvement, von misses stress

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Authors: Ramiz Kuliev, Fuad Kuliev-Smirnov

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The 'Shadow Sparring' training exercise is widely used in the training of boxers and martial artists. The main disadvantage of the usual shadow sparring is that the trainer cannot fully control such training and evaluate its results. During the competition, the athlete, preparing for the upcoming fight, imagines the Shadow (upcoming opponent) in accordance with his own imagination. A ‘Smart-Shadow Sparring’ (SSS) is an innovative version of the ‘Shadow Sparring’. During SSS, the fighter will see the Shadow (virtual opponent that moves, defends, and punches) and understand when he misses the punches from the Shadow. The task of a real athlete is to spar with a virtual one, move around, punch in the direction of unprotected areas of the Shadow and dodge his punches. Moves and punches of Shadow are set up before each training. The system will give the coach full information about virtual sparring: (i) how many and what type of punches has the fighter landed, (ii) accuracy of these punches, (iii) how many and what type of virtual punches (punches of Smart-Shadow) has the fighter missed, etc. SSS will be recorded as animated fighting of two fighters and will help the coach to analyze past training. SSS can be configured to fit the physical and technical characteristics of the next real opponent (size, techniques, speed, missed and landed punches, etc.). This will allow to simulate and rehearse the upcoming fight and improve readiness for the next opponent. For amateur fighters, SSS will be reconfigured several times during a tournament, when the real opponent becomes known. SSS can be used in three versions: (1) Digital Shadow: the athlete will see a Shadow on a monitor (2) VR-Shadow: the athlete will see a Shadow in a VR-glasses (3) Smart Shadow: a Shadow will be controlled by artificial intelligence. These technologies are based on the ‘semi-real simulation’ method. The technology allows coaches to train athletes remotely. Simulation of different opponents will help the athletes better prepare for competition. Repeat rehearsals of the upcoming fight will help improve results. SSS can improve results in Boxing, Taekwondo, Karate, and Fencing. 41 sets of medals will be awarded in these sports at the 2020 Olympic Games.

Keywords: boxing, combat sports, fight simulation, shadow sparring

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Authors: Vinay Suhalka

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In India, the official nomenclature used by the State for persons with disability is divyang (literally, the one with a divine limb), a word coming from the Sanskrit language. Disability thus gets portrayed as divine, at least in the welfare sector from where it flows down even to the popular imagination where it gets equated to divinity. This paper looks at reference to persons with disabilities as divyangs and goes on to discusses what such usage for an already marginalized group achieves and misses out. The issue of nomenclature and language has always been a contested one when it comes to disability. At the same time, there is also an issue of who determines these labels for the persons with disability. Nomenclature and language used for disability can have real consequences for the population of persons with disability as it may empower or disempower them. Thus, this paper looks at the issue of what it means for persons with disabilities as ‘exceptionally gifted’ and hence divyang. Language can be a powerful tool to communicate meanings and messages associated with a term. When the persons with disabilities as a group are described as ‘exceptionally gifted, talented and the source of inspiration’, it essentially stereotypes and marginalizes them by putting a burden of performance that all of them ought to be achievers, and it is only then that they would be assimilated in the larger society. This paper also argues that such a situation creates a ‘double bind’ where the person is always trying to match up to the labels (the disabled as ‘achiever, overcomer, inspirational’) created by somebody else and looks at self through the eyes of others. This conceptual paper also presents an overview of disability labels while simultaneously looking at projecting disability as divinity which has the potential to wrongly portray the lives of persons with disability in India due to the official usage of the term. It also explores the question of visibility of disability since the idea of divyang implicitly assumes that all disabilities are visible. In reality, however, it may not be the case simply because all forms of disabilities are not visible, people may choose not to visibilize their disabilities if they can and pass as able-bodied, fearing the stigma that surrounds disability. Finally, it argues for an increased focus on understanding the everyday lived realities of those with disability in order to regard it as an important form of difference which could be a potential resource for the society.

Keywords: persons with disability, labels, language use, divinity

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Authors: Samuel Kaspi, Sitalakshmi Venkatraman

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In-memory database systems are becoming popular due to the availability and affordability of sufficiently large RAM and processors in modern high-end servers with the capacity to manage large in-memory database transactions. While fast and reliable in-memory systems are still being developed to overcome cache misses, CPU/IO bottlenecks and distributed transaction costs, disk-based data stores still serve as the primary persistence. In addition, with the recent growth in multi-tenancy cloud applications and associated security concerns, many organisations consider the trade-offs and continue to require fast and reliable transaction processing of disk-based database systems as an available choice. For these organizations, the only way of increasing throughput is by improving the performance of disk-based concurrency control. This warrants a hybrid database system with the ability to selectively apply an enhanced disk-based data management within the context of in-memory systems that would help improve overall throughput. The general view is that in-memory systems substantially outperform disk-based systems. We question this assumption and examine how a modified variation of access invariance that we call enhanced memory access, (EMA) can be used to allow very high levels of concurrency in the pre-fetching of data in disk-based systems. We demonstrate how this prefetching in disk-based systems can yield close to in-memory performance, which paves the way for improved hybrid database systems. This paper proposes a novel EMA technique and presents a comparative study between disk-based EMA systems and in-memory systems running on hardware configurations of equivalent power in terms of the number of processors and their speeds. The results of the experiments conducted clearly substantiate that when used in conjunction with all concurrency control mechanisms, EMA can increase the throughput of disk-based systems to levels quite close to those achieved by in-memory system. The promising results of this work show that enhanced disk-based systems facilitate in improving hybrid data management within the broader context of in-memory systems.

Keywords: in-memory database, disk-based system, hybrid database, concurrency control

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Authors: Tanu Khanuja, Harikrishnan N. Unni

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Head is the most vulnerable part of human body and may cause severe life threatening injuries. As the in vivo brain response cannot be recorded during injury, computational investigation of the head model could be really helpful to understand the injury mechanism. Majority of the physical damage to living tissues are caused by relative motion within the tissue due to tensile and shearing structural failures. The present Finite Element study focuses on investigating intracranial pressure and stress/strain distributions resulting from impact loads on various sites of human head. This is performed by the development of the 3D model of a human head with major segments like cerebrum, cerebellum, brain stem, CSF (cerebrospinal fluid), and skull from patient specific MRI (magnetic resonance imaging). The semi-automatic segmentation of head is performed using AMIRA software to extract finer grooves of the brain. To maintain the accuracy high number of mesh elements are required followed by high computational time. Therefore, the mesh optimization has also been performed using tetrahedral elements. In addition, model validation with experimental literature is performed as well. Hard tissues like skull is modeled as elastic whereas soft tissues like brain is modeled with viscoelastic prony series material model. This paper intends to obtain insights into the severity of brain injury by analyzing impacts on frontal, top, back, and temporal sites of the head. Yield stress (based on von Mises stress criterion for tissues) and intracranial pressure distribution due to impact on different sites (frontal, parietal, etc.) are compared and the extent of damage to cerebral tissues is discussed in detail. This paper finds that how the back impact is more injurious to overall head than the other. The present work would be helpful to understand the injury mechanism of traumatic brain injury more effectively.

Keywords: dynamic impact analysis, finite element analysis, intracranial pressure, MRI, traumatic brain injury, von Misses stress

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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: Laura Pytel, Georg Baumann, Gregor Gstrein, Corina Klug

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Premium cars often coat the instrument panels with a bilaminate consisting of a soft foam and a plastic skin. The coating is torn open during the passenger airbag deployment under high strain rates. Characterizing and simulating the top coat layer is crucial for predicting the attenuation that delays the airbag deployment, effecting the design of the restrain system and to reduce the demand of simulation adjustments through expensive physical component testing.Up to now, bilaminates used within cars either have been modelled by using a two-dimensional shell formulation for the whole coating system as one which misses out the interaction of the two layers or by combining a three-dimensional formulation foam layer with a two-dimensional skin layer but omitting the foam in the significant parts like the expected tear line area and the hinge where high compression is expected. In both cases, the properties of the coating causing the attenuation are not considered. Further, at present, the availability of material information, as there are failure dependencies of the two layers, as well as the strain rate of up to 200 1/s, are insufficient. The velocity of the passenger airbag flap during an airbag shot has been measured with about 11.5 m/s during first ripping; the digital image correlation evaluation showed resulting strain rates of above 1500 1/s. This paper provides a high strain rate material characterization of a bilaminate consisting of a thin polypropylene foam and a thermoplasctic olefins (TPO) skin and the creation of validated material models. With the help of a Split Hopkinson tension bar, strain rates of 1500 1/s were within reach. The experimental data was used to calibrate and validate a more physical modelling approach of the forced ripping of the bilaminate. In the presented model, the three-dimensional foam layer is continuously tied to the two-dimensional skin layer, allowing failure in both layers at any possible position. The simulation results show a higher agreement in terms of the trajectory of the flaps and its velocity during ripping. The resulting attenuation of the airbag deployment measured by the contact force between airbag and flaps increases and serves usable data for dimensioning modules of an airbag system.

Keywords: bilaminate ripping behavior, High strain rate material characterization and modelling, induced material failure, TPO and foam

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Authors: Hamed Yaghoubi, Esmaeil Salahi, Fateme Taati

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The effective shear and bulk viscosity, as well as dynamic viscosity, describe the rheological properties of the ceramic body during the liquid phase sintering process. The rheological parameters depend on the physical and thermomechanical characteristics of the material such as relative density, temperature, grain size, and diffusion coefficient and activation energy. The main goal of this research is to acquire a comprehensive understanding of the response of an incompressible viscose ceramic material during liquid phase sintering process such as stress-strain relations, sintering and hydrostatic stress, the prediction of anisotropic shrinkage and heterogeneous densification as a function of sintering time by including the simultaneous influence of gravity field, and frictional force. After raw materials analysis, the standard hard porcelain mixture as a ceramic body was designed and prepared. Three different experimental configurations were designed including midpoint deflection, sinter bending, and free sintering samples. The numerical method for the ceramic specimens during the liquid phase sintering process are implemented in the CREEP user subroutine code in ABAQUS. The numerical-experimental procedure shows the anisotropic behavior, the complete difference in spatial displacement through three directions, the incompressibility for ceramic samples during the sintering process. The anisotropic shrinkage factor has been proposed to investigate the shrinkage anisotropy. It has been shown that the shrinkage along the normal axis of casting sample is about 1.5 times larger than that of casting direction, the gravitational force in pyroplastic deformation intensifies the shrinkage anisotropy more than the free sintering sample. The lowest and greatest equivalent creep strain occurs at the intermediate zone and around the central line of the midpoint distorted sample, respectively. In the sinter bending test sample, the equivalent creep strain approaches to the maximum near the contact area with refractory support. The inhomogeneity in Von-Misses, pressure, and principal stress intensifies the relative density non-uniformity in all samples, except in free sintering one. The symmetrical distribution of stress around the center of free sintering sample, cause to hinder the pyroplastic deformations. Densification results confirmed that the effective bulk viscosity was well-defined with relative density values. The stress analysis confirmed that the sintering stress is more than the hydrostatic stress from start to end of sintering time so, from both theoretically and experimentally point of view, the sintering process occurs completely.

Keywords: anisotropic shrinkage, ceramic material, liquid phase sintering process, rheological properties, numerical-experimental procedure

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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: Cameron Wilson, Megan Hanrahan, Katie Brittain, Riona McArdle, Alison Keogh, Lynn Rochester

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Background: The loss of mobility and functional dependence is a significant marker in the progression of neurodegenerative diseases such as Parkinson’s Disease (PD). Pharmacological, surgical, and therapeutic treatments are available that can help in the management and amelioration of PD symptoms; however, these only prolong more severe symptoms. Accordingly, ensuring people with PD can maintain independence and a healthy wellbeing are essential in establishing an effective treatment option for those afflicted. Existing literature reviews have examined experiences in engaging with PD treatment options and the impact of PD on independence and wellbeing. Although, the literature fails to explore the influence of treatment options on independence and wellbeing and therefore misses what people value in their treatment. This review is the first that synthesises the impact of mobility-related treatments on independence and wellbeing in people with PD and their carers, offering recommendations to clinical practice and provides a conceptual framework (in development) for future research and practice. Objectives: To explore the impact of mobility-related treatment (both pharmacological and non-pharmacological) on the independence and wellbeing of people with PD and their carers. To propose a conceptual framework to patients, carers and clinicians which captures the qualities people with PD value as part of their treatment. Methods: We performed a critical interpretive synthesis of qualitative evidence, searching six databases for reports that explored the impact of mobility-related treatments (both drug and non-pharmacological) on independence and wellbeing in Parkinson’s Disease. The types of treatments included medication (Levodopa and Amantadine), dance classes, Deep-Brain Stimulation, aquatic therapies, physical rehabilitation, balance training and foetal transplantation. Data was extracted, and quality was assessed using an adapted version of the NICE Quality Appraisal Tool Appendix H before being synthesised according to the critical interpretive synthesis framework and meta-ethnography process. Results: From 2301 records, 28 were eligible. Experiences and impact of treatment pathway on independence and wellbeing was similar across all types of treatments and are described by five inter-related themes: (i) desire to maintain independence, (ii) treatment as a social experience during and after, (iii) medication to strengthen emotional health, (iv) recognising physical capacity and (v) emphasising the personal journey of Parkinson’s treatments. Conclusion: There is a complex and inter-related experience and effect of PD treatments common across all types of treatment. The proposed conceptual framework (in development) provides patients, carers, and clinicians recommendations to personalise the delivery of PD treatment, thereby potentially improving adherence and effectiveness. This work is vital to disseminate as PD treatment transitions from subjective and clinically captured assessments to a more personalised process supplemented using wearable technology.

Keywords: parkinson's disease, medication, treatment, dance, review, healthcare, delivery, levodopa, social, emotional, psychological, personalised healthcare

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Authors: Umbreen Salim, Anila Noor

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This paper analyses the influences and faces of colonialism in women’s participation in economic activity in postcolonial Pakistan, through postcolonial feminist economic lens. It is an attempt to probe the shifts in gender inequalities that have existed in three stages; pre-colonial, colonial, and postcolonial times in the Indo-Pak subcontinent. It delves into an inquiry of pre-colonial as it is imperative to understand the situation and context before colonisation in order to assess the deviations associated with its onset. Hence, in order to trace gender inequalities this paper analyses from Mughal Era (1526-1757) that existed before British colonisation, then, the gender inequalities that existed during British colonisation (1857- 1947) and the associated dynamics and changes in women’s vulnerabilities to participate in the economy are examined. Followed by, the postcolonial (1947 onwards) scenario of discriminations and oppressions faced by women. As part of the research methodology, primary and secondary data analysis was done. Analysis of secondary data including literary works and photographs was carried out, followed by primary data collection using ethnographic approaches and participatory tools to understand the presence of coloniality and gender inequalities embedded in the social structure through participant’s real-life stories. The data is analysed using feminist postcolonial analysis. Intersectionality has been a key tool of analysis as the paper delved into the gender inequalities through the class and caste lens briefly touching at religion. It is imperative to mention the significance of the study and very importantly the practical challenges as historical analysis of 18th and 19th century is involved. Most of the available work on history is produced by a) men and b) foreigners and mostly white authors. Since the historical analysis is mostly by men the gender analysis presented misses on many aspects of women’s issues and since the authors have been mostly white European gives it as Mohanty says, ‘under western eyes’ perspective. Whereas the edge of this paper is the authors’ deep attachment, belongingness as lived reality and work with women in Pakistan as postcolonial subjects, a better position to relate with the social reality and understand the phenomenon. The study brought some key results as gender inequalities existed before colonisation when women were hidden wheel of stable economy which was completely invisible. During the British colonisation, the vulnerabilities of women only increased and as compared to men their inferiority status further strengthened. Today, the postcolonial woman lives in deep-rooted effects of coloniality where she is divided in class and position within the class, and she has to face gender inequalities within household and in the market for economic participation. Gender inequalities have existed in pre-colonial, during colonisation and postcolonial times in Pakistan with varying dynamics, degrees and intensities for women whereby social class, caste and religion have been key factors defining the extent of discrimination and oppression. Colonialism may have physically ended but the coloniality remains and has its deep, broad and wide effects in increasing gender inequalities in women’s participation in the economy in Pakistan.

Keywords: colonialism, economic participation, gender inequalities, women

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Authors: Mayank Gupta, Siba Prasad Samal, Vasu Kakkirala

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The internet world and its priorities have changed considerably in the last decade. Browsing on smart phones has increased manifold and is set to explode much more. Users spent considerable time browsing different websites, that gives a great deal of insight into user’s preferences. Instead of plain information classifying different aspects of browsing like Bookmarks, History, and Download Manager into useful categories would improve and enhance the user’s experience. Most of the classification solutions are server side that involves maintaining server and other heavy resources. It has security constraints and maybe misses on contextual data during classification. On device, classification solves many such problems, but the challenge is to achieve accuracy on classification with resource constraints. This on device classification can be much more useful in personalization, reducing dependency on cloud connectivity and better privacy/security. This approach provides more relevant results as compared to current standalone solutions because it uses content rendered by browser which is customized by the content provider based on user’s profile. This paper proposes a Naive Bayes based lightweight classification engine targeted for a resource constraint devices. Our solution integrates with Web Browser that in turn triggers classification algorithm. Whenever a user browses a webpage, this solution extracts DOM Tree data from the browser’s rendering engine. This DOM data is a dynamic, contextual and secure data that can’t be replicated. This proposal extracts different features of the webpage that runs on an algorithm to classify into multiple categories. Naive Bayes based engine is chosen in this solution for its inherent advantages in using limited resources compared to other classification algorithms like Support Vector Machine, Neural Networks, etc. Naive Bayes classification requires small memory footprint and less computation suitable for smartphone environment. This solution has a feature to partition the model into multiple chunks that in turn will facilitate less usage of memory instead of loading a complete model. Classification of the webpages done through integrated engine is faster, more relevant and energy efficient than other standalone on device solution. This classification engine has been tested on Samsung Z3 Tizen hardware. The Engine is integrated into Tizen Browser that uses Chromium Rendering Engine. For this solution, extensive dataset is sourced from dmoztools.net and cleaned. This cleaned dataset has 227.5K webpages which are divided into 8 generic categories ('education', 'games', 'health', 'entertainment', 'news', 'shopping', 'sports', 'travel'). Our browser integrated solution has resulted in 15% less memory usage (due to partition method) and 24% less power consumption in comparison with standalone solution. This solution considered 70% of the dataset for training the data model and the rest 30% dataset for testing. An average accuracy of ~96.3% is achieved across the above mentioned 8 categories. This engine can be further extended for suggesting Dynamic tags and using the classification for differential uses cases to enhance browsing experience.

Keywords: chromium, lightweight engine, mobile computing, Naive Bayes, Tizen, web browser, webpage classification

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Authors: Piotr Wadolowski, Grzegorz Krzesinski, Piotr Gutowski

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The aim of the presented investigation is to recognize the possible mechanical issues of mini-plate connection used to treat mandible fractures and to check the impact of different factors for the stresses and displacements within the bone-stabilizer system. The mini-plate osteosynthesis technique is a common type of internal fixation using metal plates connected to the fractured bone parts by a set of screws. The selected two types of plate application methodology used by maxillofacial surgeons were investigated in the work. Those patterns differ in location and number of plates. The bone geometry was modeled on the base of computed tomography scans of hospitalized patient done just after mini-plate application. The solid volume geometry consisting of cortical and cancellous bone was created based on gained cloud of points. Temporomandibular joint and muscle system were simulated to imitate the real masticatory system behavior. Finite elements mesh and analysis were performed by ANSYS software. To simulate realistic connection behavior nonlinear contact conditions were used between the connecting elements and bones. The influence of the initial compression of the connected bone parts or the gap between them was analyzed. Nonlinear material properties of the bone tissues and elastic-plastic model of titanium alloy were used. The three cases of loading assuming the force of magnitude of 100N acting on the left molars, the right molars and the incisors were investigated. Stress distribution within connecting plate shows that the compression of the bone parts in the connection results in high stress concentration in the plate and the screws, however the maximum stress levels do not exceed material (titanium) yield limit. There are no significant differences between negative offset (gap) and no-offset conditions. The location of the external force influences the magnitude of stresses around both the plate and bone parts. Two-plate system gives generally lower von Misses stress under the same loading than the one-plating approach. Von Mises stress distribution within the cortical bone shows reduction of high stress field for the cases without the compression (neutral initial contact). For the initial prestressing there is a visible significant stress increase around the fixing holes at the bottom mini-plate due to the assembly stress. The local stress concentration may be the reason of bone destruction in those regions. The performed calculations prove that the bone-mini-plate system is able to properly stabilize the fractured mandible bone. There is visible strong dependency between the mini-plate location and stress distribution within the stabilizer structure and the surrounding bone tissue. The results (stresses within the bone tissues and within the devices, relative displacements of the bone parts at the interface) corresponding to different models of the connection provide a basis for the mechanical optimization of the mini-plate connections. The results of the performed numerical simulations were compared to clinical observation. They provide information helpful for better understanding of the load transfer in the mandible with the stabilizer and for improving stabilization techniques.

Keywords: finite element modeling, mandible fracture, mini-plate connection, osteosynthesis

Procedia PDF Downloads 217

Authors: Jatziri Y. Moreno-Martínez, Arturo Galván, Israel Enrique Herrera Díaz, José Ramón Gasca Tirado

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In recent years, for the elevated viaducts in Mexico City, a construction system based on precast/pre-stressed concrete elements has been used, in which the bridge girders are divided in two parts by imposing a hinged support in sections where the bending moments that are originated by the gravity loads in a continuous beam are minimal. Precast concrete girders with dapped ends are a representative sample of a behavior that has complex configurations of stresses that make them more vulnerable to cracking due to flexure–shear interaction. The design procedures for ends of the dapped girders are well established and are based primarily on experimental tests performed for different configurations of reinforcement. The critical failure modes that can govern the design have been identified, and for each of them, the methods for computing the reinforcing steel that is needed to achieve adequate safety against failure have been proposed. Nevertheless, the design recommendations do not include procedures for controlling diagonal cracking at the entrant corner under service loading. These cracks could cause water penetration and degradation because of the corrosion of the steel reinforcement. The lack of visual access to the area makes it difficult to detect this damage and take timely corrective actions. Three-dimensional non-linear numerical models based on Finite Element Method to study the cracking at the entrant corner of dapped-end beams were performed using the software package ANSYS v. 11.0. The cracking was numerically simulated by using the smeared crack approach. The concrete structure was modeled using three-dimensional solid elements SOLID65 capable of cracking in tension and crushing in compression. Drucker-Prager yield surface was used to include the plastic deformations. The longitudinal post-tension was modeled using LINK8 elements with multilinear isotropic hardening behavior using von Misses plasticity. The reinforcement was introduced with smeared approach. The numerical models were calibrated using experimental tests carried out in “Instituto de Ingeniería, Universidad Nacional Autónoma de México”. In these numerical models the characteristics of the specimens were considered: typical solution based on vertical stirrups (hangers) and on vertical and horizontal hoops with a post-tensioned steel which contributed to a 74% of the flexural resistance. The post-tension is given by four steel wires with a 5/8’’ (16 mm) diameter. Each wire was tensioned to 147 kN and induced an average compressive stress of 4.90 MPa on the concrete section of the dapped end. The loading protocol consisted on applying symmetrical loading to reach the service load (180 kN). Due to the good correlation between experimental and numerical models some additional numerical models were proposed by considering different percentages of post-tension in order to find out how much it influences in the appearance of the cracking in the reentrant corner of the dapped-end beams. It was concluded that the increasing of percentage of post-tension decreases the displacements and the cracking in the reentrant corner takes longer to appear. The authors acknowledge at “Universidad de Guanajuato, Campus Celaya-Salvatierra” and the financial support of PRODEP-SEP (UGTO-PTC-460) of the Mexican government. The first author acknowledges at “Instituto de Ingeniería, Universidad Nacional Autónoma de México”.

Keywords: concrete dapped-end beams, cracking control, finite element analysis, postension

Procedia PDF Downloads 194