Search results for: patient safety incidents

Authors: Rizka Aisha Rahmi Hariadi, Chao Ou-Yang, Han-Cheng Wang, Rajesri Govindaraju

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As the increasing of medical check-up popularity, there are a huge number of medical check-up data stored in database and have not been useful. These data actually can be very useful for future strategic planning if we mine it correctly. In other side, a lot of patients come with unpredictable coming and also limited available facilities make medical check-up service offered by hospital not maximal. To solve that problem, this study used those medical check-up data to predict patient re-coming. Sequential pattern mining (SPM) and association rules method were chosen because these methods are suitable for predicting patient re-coming using sequential data. First, based on patient personal information the data was grouped into … groups then discriminant analysis was done to check significant of the grouping. Second, for each group some frequent patterns were generated using SPM method. Third, based on frequent patterns of each group, pairs of variable can be extracted using association rules to get general pattern of re-coming patient. Last, discussion and conclusion was done to give some implications of the results.

Keywords: patient re-coming, medical check-up, health examination, data mining, sequential pattern mining, association rules, discriminant analysis

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Authors: M. C. Pardo-Ferreira, J. C. Rubio-Romero, M. Martínez-Rojas

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Resilience Engineering is a new paradigm of safety management that proposes to change the way of managing the safety to focus on the things that go well instead of the things that go wrong. Many complex and high-risk sectors such as air traffic control, health care, nuclear power plants, railways or emergencies, have applied this new vision of safety and have obtained very positive results. In the construction sector, safety management continues to be a problem as indicated by the statistics of occupational injuries worldwide. Therefore, it is important to improve safety management in this sector. For this reason, it is proposed to apply Resilience Engineering to the construction sector. The Construction Phase Health and Safety Plan emerges as a key element for the planning of safety management. One of the key tools of Resilience Engineering is the Resilience Assessment Grid that allows measuring the four essential abilities (respond, monitor, learn and anticipate) for resilient performance. The purpose of this paper is to develop a questionnaire based on the Resilience Assessment Grid, specifically on the ability to learn, to assess whether a Construction Phase Health and Safety Plans helps companies in a construction site to implement this ability. The research process was divided into four stages: (i) initial design of a questionnaire, (ii) validation of the content of the questionnaire, (iii) redesign of the questionnaire and (iii) application of the Delphi method. The questionnaire obtained could be used as a tool to help construction companies to evolve from Safety-I to Safety-II. In this way, companies could begin to develop the ability to learn, which will serve as a basis for the development of the other abilities necessary for resilient performance. The following steps in this research are intended to develop other questions that allow evaluating the rest of abilities for resilient performance such as monitoring, learning and anticipating.

Keywords: resilience engineering, construction sector, resilience assessment grid, construction phase health and safety plan

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Authors: Michael Scott, Phil Jarrell

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Digitalization seems to be everywhere these days. So if one was to digitalize Functional Safety, what would that require: • Ability to directly use data from intelligent P&IDs / process design in a PHA / LOPA • Ability to directly use data from intelligent P&IDs in the SIS Design to support SIL Verification Calculations, SRS, C&Es, Functional Test Plans • Ability to create Unit Operation / SIF Libraries to radically reduce engineering manhours while ensuring consistency and improving quality of SIS designs • Ability to link data directly from a PHA / LOPA to SIS Designs • Ability to leverage reliability models and SRS details from SIS Designs to automatically program the Safety PLC • Ability to leverage SIS Test Plans to automatically create Safety PLC application logic Test Plans for a virtual FAT • Ability to tie real-time data from Process Historians / CMMS to assumptions in the PHA / LOPA and SIS Designs to generate leading indicators on protection layer health • Ability to flag SIS bad actors for proactive corrective actions prior to a near miss or loss of containment event What if I told you all of this was available today? This paper will highlight how the digital revolution has revolutionized the way Safety Instrumented Systems are designed, configured, operated and maintained.

Keywords: IEC 61511, safety instrumented systems, functional safety, digitalization, IIoT

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Authors: Szu-Yi Chang, Jiin-Ru Rong

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This paper discussed a case involving a young female patient with schizophrenia. The patient's condition was deteriorating, and she was becoming increasingly reliant on her family to take care of her, and as her father did not understand the illness well and was afraid that others will learn about the presence of a mentally ill individual in their family, he and the patient's mother were thus unable to cope with the patient's deteriorating condition, which in turn caused her to suffer from a lack of self-confidence and low self-esteem. The patient received nursing care from July 26th to October 25th, 2017, during which counseling, family visits, and phone interviews were carried out, and her condition was monitored. By referring to the practical ability indicators for community psychiatric mental health nursing that were developed by the psychiatric mental health nurses' association of the Republic of China, defining categories such as 'self-construction,' 'self-management,' 'disease management,' and 'family nursing,' and incorporating indicators for empowerment and various skills into the steps and strategies used for nursing care, we will able to help the patient to construct her own identity, raise her self-esteem, improve her ability to independently perform activities of daily living, strengthen her disease management ability, and gradually build up her life management skills. The patient's family was also encouraged to communicate more among themselves, so as to align them with the nursing care objectives of improving the patient's ability to adapt to community life and her disease. The results indicated that the patient was able to maintain her mental stability within her community. By implementing effective self-management and maintaining a routine life, the patient was able to continue her active participation in community work and rehabilitation activities. Improvements were also achieved with respect to family role issues by establishing mutual understanding among the patient's family members and gaining their support. It is recommended that mental health nurses can leverage their community mental health nursing skills and the related strategies to promote adaptation to community life among mental life patients.

Keywords: community psychiatric mental health nursing, family nursing, schizophrenia, self-management

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Authors: Sibongiseni Thabethe, Ian Korir

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The effective management of spent fuel pool (SFP) safety has been raised as one of the emerging issues to further enhance nuclear installation safety after the Fukushima accident on March 11, 2011. Before then, SFP safety-related issues have been mainly focused on (a) controlling the configuration of the fuel assemblies in the pool with no loss of pool coolants and (b) ensuring adequate pool storage space to prevent fuel criticality owing to chain reactions of the fission products and the ability for neutron absorption to keep the fuel cool. A probabilistic safety (PSA) assessment was performed using the systems analysis program for hands-on integrated reliability evaluations (SAPHIRE) computer code. Event and fault tree analysis was done to develop a PSA model for the Koeberg SFP. We present preliminary PSA results of events that lead to boiling and cause fuel uncovering, resulting in possible fuel damage in the Koeberg SFP.

Keywords: computer code, fuel assemblies, probabilistic risk assessment, spent fuel pool

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Authors: Praveenkumar Natarajan

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A 59-year-old male with no known co-morbidities was admitted to a private hospital for complaints of fever and cough and was diagnosed to haveCOVID-19. CT of the thorax revealed the involvement of 50% of the lungs. Screening ECG and ECHO were normal. The patient was treated with oxygen therapy and drugs and was discharged after 12 days of admission. Post-discharge, the patient remained symptom-free and continued his work. After one month, the patient developed a fever for three days, for which he took antipyretics. Subsequently, the patient developed sudden onset breathlessness, which rapidly progressed to grade 4 NYHA, and developed a cough as well. Suspecting COVID-19 reinfection, the patient visited a nearby hospital, where COVID–19 rt-PCR swabs turned out to be positive, and was referred to our hospital. On receiving, the patient had diffuse lung crepitations and a diastolic murmur in the neo-aortic area. CT thorax revealed pulmonary edema with areas of consolidation. ECHO revealed vegetation on the aortic valve with severe aortic regurgitation. Blood cultures were taken, which revealed the growth of Enterococcus faecalis. The diagnosis of infective endocarditis was made, and the patient was started on appropriate treatment. COVID–19 has effects on various systems, including the cardiovascular system. Even though infective endocarditis is common in the elderly with valvular heart disease, this patient had developed infective endocarditis in an apparently normal aortic valve. Infective endocarditis and COVID–19 can have similar presentations leading to diagnostic difficulties. COVID–19, affecting the heart valves causing valvulitis and predisposing them to the development of infective endocarditis, is also an area to be explored.

Keywords: aortic regurgitation, COVID-19, infective endocarditis, valvulitis

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Authors: Khair Jadaan, Qasem Alqasem

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School children are vulnerable road user groups and are particularly at high risk calling for the need to improve their safety. Safe Routes to Schools (SRTS) concept is considered as one safety improvement approach that would effectively help improve school children’s safety. This paper aims to determine the best practice SRTS for Jordan based on the international experience attained through extensive and selected literature review falling under the 5 E’s and additionally on information/data collected through a survey performed using an online predesigned questionnaire to investigate the reactions and attitudes of students and their parents towards the proposed SRTS program. Data are analyzed using SPSS and MS software, especially Excel, in addition to some literature reviews inserted in this study. The results represent some recommendations that are strongly believed to help decision makers to develop the current safety conditions of the school routes. The challenges that the implementation of this program would face including COVID-19 protection for teachers and students are addressed.

Keywords: children, COVID-19, Jordan, safety, school, SRTS, 5 E’s

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Authors: Rebecca Oakes

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In the New Zealand public health system, work has been taking place to use electronic systems to convey data from the ‘floor to the board’ that makes patient needs, and therefore nursing work, visible. For nurses, these developments in health information technology puts us in a very new and exciting position of being able to articulate the work of nursing through a language understood at all levels of an organisation, the language of acuity. Nurses increasingly have a considerable stake-hold in patient acuity data. Patient acuity systems, when used well, can assist greatly in demonstrating how much work is required, the type of work, and when it will be required. The New Zealand Safe Staffing Unit is supporting New Zealand nurses to create a culture of shared governance, where nursing data is informing policies, staffing methodologies and forecasting within their organisations. Assisting organisations to understand their acuity data, strengthening user confidence in using electronic patient acuity systems, and ensuring nursing and midwifery workload is accurately reflected is critical to the success of the safe staffing programme. Nurses and midwives have the capacity via an acuity tool to become key informers of organisational planning. Quality patient care, best use of health resources and a quality work environment are essential components of a safe, resilient and well resourced organisation. Nurses are the key informers of this information. In New Zealand a national level approach is paving the way for significant changes to the understanding and use of patient acuity and nursing workload information.

Keywords: nursing workload, patient acuity, safe staffing, New Zealand

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Authors: Jae-Woo Kim, Kyung-Jung Lee, Hyun-Sik Ahn

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This paper presents a design methodology for the motor driven automotive subsystems with the consideration of the functional safety. There are many such modules in vehicles which use DC/AC motors for an electronic throttle control system, a motor driven power steering, a motor driven seat belt systems and for HVAC systems. The functional safety for the automotive electrical and electronic parts are standardized as ISO 26262, but the development procedure is very complex to be followed. We focus on the functional safe motor controller design process and show the designed motor controller hardware satisfies the required safety integrity level by using metric calculations with the safety mechanism.

Keywords: AUTOSAR, MDPS, Simulink, software component

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Authors: Achim Washington, Reece Clothier, Jose Silva

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System Safety Regulations (SSR) are a central component to the airworthiness certification of Unmanned Aircraft Systems (UAS). There is significant debate on the setting of appropriate SSR for UAS. Putting this debate aside, the challenge lies in how to apply the system safety process to UAS, which lacks the data and operational heritage of conventionally piloted aircraft. The limited knowledge and lack of operational data result in uncertainty in the system safety assessment of UAS. This uncertainty can lead to incorrect compliance findings and the potential certification and operation of UAS that do not meet minimum safety performance requirements. The existing system safety assessment and compliance processes, as used for conventional piloted aviation, do not adequately account for the uncertainty, limiting the suitability of its application to UAS. This paper discusses the challenges of undertaking system safety assessments for UAS and presents current and envisaged research towards addressing these challenges. It aims to highlight the main advantages associated with adopting a risk based framework to the System Safety Performance Requirement (SSPR) compliance process that is capable of taking the uncertainty associated with each of the outputs of the system safety assessment process into consideration. Based on this study, it is made clear that developing a framework tailored to UAS, would allow for a more rational, transparent and systematic approach to decision making. This would reduce the need for conservative assumptions and take the risk posed by each UAS into consideration while determining its state of compliance to the SSR.

Keywords: Part 1309 regulations, risk models, uncertainty, unmanned aircraft systems

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Authors: Mehravar Javid, Rohma Hassan

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Understanding a patient’s hallucinations requires a degree of cultural humility when these experiences are consistent with beliefs that are normative to the patient’s respective culture and religion, and in this exploratory case study, the treatment history of a 32-year-old female Iranian patient who sought psychoanalytic treatment in Iran is explored, who stated that she had been witnessing jinn since she was fifteen-years-old. She experienced considerable disempowerment and lack of support in her upbringing and curiously believes that the jinn provide her with comfort and power, yet simultaneously create a sense of fear and horror. When her analyst wonders about a possible link between the jinn and the patient’s self-object needs and what was denied for her in her youth, the patient becomes resistant to treatment, especially when the possibility of the jinn existing as hallucinations is raised. Throughout the course of therapy, the patient discusses her tumultuous marriage, her strained relationship with her family, and inner conflicts. She also begins to find solace in her relationship with her therapist, satisfying her self-object needs and enabling her to widen her self-awareness and wish for deeper connections with others. In understanding her needs and fears, the role of the jinn in her psychological landscape aims to be understood, with a larger discussion of how to work with patients experiencing supernatural phenomena and how the phenomena serve as an object, whether real or imaginary. The overall aim is to shed light on the intricate interplay between cultural and religious beliefs and psychological manifestations.

Keywords: cultural considerations, jinn, projective identification, self-object needs, transference

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Authors: Pinar Ercan, Bulut Mert

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The baking industry is prone to occupational health challenges like other industries. Workers in bakeries face many hazards in their work environment; hazards have the potential for causing injury, illness or work accidents. Most of these hazards are preventable and arise from the neglect of occupational safety measures. Some bakeries in Izmır Turkey was evaluated according to occupational health and safety. First of all, the production process was evaluated. The survey was administered to a total of 50 employees. The survey consisted of two sections. The first one comprised only demographic questions and items related to job characteristics. The remaining section was assessing the satisfaction and confidence about occupational health and safety in terms of employees consist of a 10-item questionnaire by using HSE (2010) survey with some modifications. Also, hazards, risks and control measures in the bakeries were determined. Risk assessment has been done by the use of '5x5 Risk Assessment Table' for this purpose.

Keywords: bakeries, occupational health and safety, hazards, risks, risk assessment

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Authors: Junjira Mahaboon, Anongnard Boonpak, Nattakarn Worrasan, Busma Kama, Mujalin Saikliang, Siripor Dankachatarn

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Rubber wood processing is one of the most important industries in southern Thailand. The process has several safety hazards for example unsafe wood cutting machine guarding, wood dust, noise, and heavy lifting. However, workers’ occupational health and safety measures to promote their behaviors are still limited. This quasi-experimental research was to determine factors affecting workers’ safety behaviors using theory of planned behavior after implementing job safety intervention program. The purposes were to (1) determine factors affecting workers’ behaviors and (2) to evaluate effectiveness of the intervention program. The sample of study was 66 workers from a rubber wood processing factory. Factors in the Theory of Planned Behavior model (TPB) were measured before and after the intervention. The factors of TPB included attitude towards behavior, subjective norm, perceived behavioral control, intention, and behavior. Firstly, Job Safety Analysis (JSA) was conducted and Safety Standard Operation Procedures (SSOP) were established. The questionnaire was also used to collect workers’ characteristics and TPB factors. Then, job safety intervention program to promote workers’ behavior according to SSOP were implemented for a four month period. The program included SSOP training, personal protective equipment use, and safety promotional campaign. After that, the TPB factors were again collected. Paired sample t-test and independent t-test were used to analyze the data. The result revealed that attitude towards behavior and intention increased significantly after the intervention at p<0.05. These factors also significantly determined the workers’ safety behavior according to SSOP at p<0.05. However, subjective norm, and perceived behavioral control were not significantly changed nor related to safety behaviors. In conclusion, attitude towards behavior and workers’ intention should be promoted to encourage workers’ safety behaviors. SSOP intervention program e.g. short meeting, safety training, and promotional campaign should be continuously implemented in a routine basis to improve workers’ behavior.

Keywords: job safety analysis, rubber wood processing workers, safety standard operation procedure, theory of planned behavior

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Authors: Anders Thorsén, Behrooz Sangchoolie, Peter Folkesson, Ted Strandberg

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As more parts of the power grid become connected to the internet, the risk of cyberattacks increases. To identify the cybersecurity threats and subsequently reduce vulnerabilities, the common practice is to carry out a cybersecurity risk assessment. For safety classified systems and products, there is also a need for safety risk assessments in addition to the cybersecurity risk assessment in order to identify and reduce safety risks. These two risk assessments are usually done separately, but since cybersecurity and functional safety are often related, a more comprehensive method covering both aspects is needed. Some work addressing this has been done for specific domains like the automotive domain, but more general methods suitable for, e.g., intelligent distributed grids, are still missing. One such method from the automotive domain is the Security-Aware Hazard Analysis and Risk Assessment (SAHARA) method that combines safety and cybersecurity risk assessments. This paper presents an approach where the SAHARA method has been modified in order to be more suitable for larger distributed systems. The adapted SAHARA method has a more general risk assessment approach than the original SAHARA. The proposed method has been successfully applied on two use cases of an intelligent distributed grid.

Keywords: intelligent distribution grids, threat analysis, risk assessment, safety, cybersecurity

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Authors: Andrew Read, Alice Parry, Kate Woods

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Since the advent of the SARS-CoV-2 pandemic, the search for medications that can reduce mortality and morbidity has been a global research priority. Several multi-center trials have recently demonstrated improved mortality associated with the use of Tocilizumab, an interleukin-6 receptor antagonist, in patients with severe SARS-CoV-2 pneumonia. Initial data supported the administration in patients requiring respiratory support (non-invasive or invasive ventilation), but more recent data has shown benefit in all hypoxic patients. At the height of the second wave of COVID-19 infections in London, our hospital introduced the use of Tocilizumab for patients with severe COVID-19. Tocilizumab is licensed for use in chronic inflammatory conditions and has been associated with an increased risk of severe bacterial and fungal infections, as well as reactivation of chronic viral infections (e.g., hepatitis B). It is a specialist drug that suppresses the formation of C-reactive protein (CRP) for 6 – 12 weeks. It is not widely used by the general medical community. We aimed to assess Tocilizumab use in our hospital and to implement changes to the protocol as required to ensure administration was safe and appropriate. A retrospective study design was used to assess prescriptions over an initial 3-week period in both intensive care and on the medical wards. This amounted to a total of 13 patients. The initial data collection identified four key areas of concern: adherence to national and local inclusion & exclusion criteria; a collection of appropriate screening blood prior to administration; documentation of informed consent or best interest decision and documentation of Tocilizumab administration on patient discharge information, to alert future healthcare providers that typical measures of inflammation and infection, such as CRP, are unreliable for up to 3-months. Data were collected from electronic notes, blood results and observation charts, and cross referenced with pharmacy data. Initial results showed that all four key areas were completed in approximately 50% of cases. Of particular concern was adherence to exclusion criteria, such as current evidence of bacterial infection, and ensuring the correct screening blood was sent to exclude infections such as hepatitis. To remedy this and improve patient safety, the initial data was presented to relevant healthcare professionals. Subsequently, three interventions were introduced and education on each provided to hospital staff. An electronic ‘order set’ collating the appropriate screening blood was created simplifying the screening process. Pre-formed electronic documentation which can be inserted into the notes was created to provide a framework for consent discussions and reduce the time needed for junior doctors to complete this task. Additionally, a ‘Tocilizumab’ administration card was created and administered via pharmacy. This was distributed to each patient on discharge to ensure future healthcare professionals were aware of the potential effects of Tocilizumab administration, including suppression of CRP. Following these changes, repeat data collection over two months illustrated that each of the 4 safety aspects was met with a 100% success rate in every patient. Although this demonstrates good progress and effective interventions the challenge will be to maintain this progress. The audit data collection is ongoing

Keywords: education, patient safety , SARS-CoV-2, Tocilizumab

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Authors: Hugo d’Albert, Udo Lindemann

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The number of automotive electronic systems that allow realizing new functions, like driver assistance systems, has been increasing extremely in the last decade. Although they bring several benefits, their malfunctions can lead to severe consequences, such as personal injury of road users. Functional safety is an approach to identify these critical malfunctions and arrange technical systems that include only tolerable risk. This approach is– in comparison with other technical areas– relatively new in the automotive sector. For a long time, the automotive systems have based on mechanical components and approved principles, like robust design. With a growing number of electric and electronic components in the modern cars and realizing by software of the system functions, the need for new standards and methods to assure the functional safety has arisen. This paper described the current state of engineering for safety in automotive sector and discusses new directions to meet the challenges of the future.

Keywords: automotive systems, functional safety, quality engineering, quality management

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Authors: Azka Naeem, Kimberly Mae Soultan, Shree Laya Vemula, Marlon Rivera Boadla, Shaurya Sharma, Ravikaran Singh Patti

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Context: This case report discusses a rare and serious complication of acupuncture induced pneumothorax. The patient presented with acute chest pain and shortness of breath following acupuncture treatment for chronic elbow pain. Despite the generally safe reputation of acupuncture, pneumothorax can occur as a result of the procedure. This case highlights the importance of recognizing pneumothorax in patients who have undergone acupuncture treatment without any significant pre-existing lung disorder. Research Aim: The aim of this study is to report a case of acupuncture-induced pneumothorax and emphasize the importance of early detection to prevent the development of tension pneumothorax. The study also aims to raise awareness about the potential safety concerns of acupuncture for individuals who are lean and/or have underlying lung disorders, particularly when treatment is administered in high-risk areas such as the interscapular region. Methodology: The research methodology used in this study involved a retrospective chart review. Following informed consent, the researchers obtained information from the patient's medical records to gather relevant details about the case, including the patient's symptoms, medical history, and the acupuncture procedure performed. Findings: The case report describes the symptoms and physical examination findings of the patient, which led to the diagnosis of pneumothorax. The patient experienced sudden onset chest pain and shortness of breath, which occurred one hour after receiving acupuncture treatment. Physical examination revealed a mild increase in the work of breathing, reduced right sided chest excursion, and decreased breath sounds in the right upper lobe. A chest X-ray was done, which confirmed the presence of a moderate-sized right apical pneumothorax. Prompt intervention with a right pigtail catheter prevented the development of tension pneumothorax, and the patient's lung expansion was restored. Theoretical Importance: This case report highlights the importance of considering acupuncture-induced pneumothorax as a potential complication, even in patients without identifiable risk factors. It emphasizes the significance of early detection and appropriate management to prevent potential life-threatening complications. The study also contributes to the existing literature by drawing attention to the safety concerns associated with acupuncture for thin, lean individuals, particularly those with underlying lung disorders. Data Collection and Analysis Procedures: The data for this study were collected through a retrospective chart review. Information was obtained from the patient's medical records, including symptoms, medical history, and diagnostic findings. The analysis involved examining the relationship between the acupuncture procedure and the development of pneumothorax, as well as the effectiveness of the intervention in preventing tension pneumothorax. Conclusion: In conclusion, this case report highlights a rare but serious complication of acupuncture - pneumothorax. It emphasizes the need for vigilance and clinical suspicion in patients who present with chest pain and dyspnea following acupuncture treatment. Early detection and appropriate intervention can prevent the progression of tension pneumothorax. Clinicians should exercise caution when performing acupuncture on individuals with underlying lung disorders, particularly in high-risk areas.

Keywords: acupuncture, pneumothorax, pigtail catheterization, pleuritic chest pain

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Authors: Faizan Rathore, Naveed Sultan, Humphrey O. Connor

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This study was carried out from Jan '12-Dec'12 to assess current practice in Kerry General Hospital against the age-related indicators for colonoscopies. A total of 1474 colonoscopies were performed,1177(79.9%) were diagnostic and 297 (20.1%) were therapeutic, patients were divided into 4 age groups under 75, 75-80, 81-85, 86+. The trend analysis revealed an increase in diagnostic colonoscopies and decrease in therapeutic colonoscopies with age. 664(45.04%) of colonoscopies were reported normal which made up the majority of the total diagnoses, 1330 (90.2%) of colonoscopies occurred without any complications. Main complications were patient discomfort being the highest, present in 112(7.6%) of patients, and lowest being urticaria around the IV site present in 1 (0.1%) of the cases. Patient discomfort was higher in younger patients as evidenced by 98 cases aged <75 , followed by 11 cases aged 75-80, 2 cases aged 81-85 and 1 case aged >86. Highest percentage of poor tolerance was found in 14 (1.1%) of total patients <75, 1 (0.8%) of total patients aged 75-80, 1(1.7%) of total patients in age group 81-85 and none (0%) in age group >86. We have established the safety of colonoscopy, low rate of complications and a better tolerance in the elderly from this study, however, its utility, especially in the presence of other comorbidities in elderly is questionable.

Keywords: colonoscopy, elderly patients, utility, tolerance

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Authors: Seyed Abolhassan Naeini, Azam Kouhpeyma

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Reduction of water level at which a slope is submerged with it is called drawdown. Draw down can took place rapidly or slowly and in both situations, it can affect slope stability. Using coupled analysis (seepage and stability analysis) causes more accurate results. In this study, the stability of homogeneous embankment is investigated numerically. Slope safety factor changes due to changes in three factors of height, slope and drawdown rate have been investigated and compared. It was found that with increasing height and slope, the safety factor decreases, and with increasing the discharge rate, the safety factor increases.

Keywords: drawdown, slope stability, coupled seepage and stability analysis

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Authors: Oshienemen Albert

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Human’s activities could be pointed as the root cause of almost all environmental damages/ disasters as we contribute to the activities that are currently damaging the ozone layers (global warming), unusual environmental changes and extreme weather conditions (climate change) in recent times. Nigeria just as every other disaster-prone nation is faced with different types of disasters and environmental calamities, starting from terrorist displacement disasters, flood, drought and oil spill hazards. Oil spillage as an environmental disaster has great consequences not just on the environment but on human health, economy and the entire populace that might be involved, which deem necessary to look into the root causes of the incidents and how it can be curtailed. The different incidents of oil spillages and other oil production consequent on the environment is alarming in the Nigerian context and cannot be overemphasized without a critical investigation and synthesis. This paper investigates the root causes of environmental pollution induced by oil spill hazards from petroleum activities within Niger Delta communities of effects and detailed the potential solutions to reduce the causal factors and reoccurrence of the incidents. This study adopts a desk-based approach, interviews with key members of communities which consist of chiefs, youth leaders, and key women within the high environmental damaged communities. Also, Interviews were conducted with environmental expertise representatives from the oil and gas sectors and representatives from oil spill-related agency. Data were analyzed using thematic techniques. The study shows different influencing factors of sabotage and vandalism of oil facilities as such; marginalization, deprivation of resources utility and resource derivation principles were identified as major contributors to vandalism and sabotage act. The study proposed potential strategies to curtail the root causes of sabotage and vandalism as the major causes of environmental devastations in Nigeria.

Keywords: environment, oil spill hazards, Niger delta, Nigeria

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Authors: Kyung-Jung Lee, Hyun-Sik Ahn

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This paper suggests a design methodology for the hardware and software of the Electronic Control Unit (ECU) of safety-critical vehicle applications such as braking and steering. The architecture of the hardware is a high integrity system such that it incorporates a high performance 32-bit CPU and a separate Peripheral Control-Processor (PCP) together with an external watchdog CPU. Communication between the main CPU and the PCP is executed via a common area of RAM and events on either processor which are invoked by interrupts. Safety-related software is also implemented to provide a reliable, self-testing computing environment for safety critical and high integrity applications. The validity of the design approach is shown by using the Hardware-in-the-Loop Simulation (HILS) for Electric Power Steering (EPS) systems which consists of the EPS mechanism, the designed ECU, and monitoring tools.

Keywords: electronic control unit, electric power steering, functional safety, hardware-in-the-loop simulation

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Authors: Wing Hang Shelley Leung

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With the rise of the recent social movement, namely #MeToo, it shows that a lot of women and children in fact suffered from sexual abuse and some even suffered from child abuse, including in Hong Kong. In view of the ongoing social movements, this paper argues that we have to look beyond their impacts and understand the roots of the problem: what if the underlying cause of the recent social movements was the inherited values that were rooted in us since we were young, or the public’s lack of confidence in the legal system when it comes to this type of personal matters? What if the movements reveal the problematic issue of the lack of protection plans, either in the private or public sphere? If the legal system is presumed to not be able to preemptively protect everyone or effectively punish all perpetrators, can other pillars provide supports to fill in the loopholes of the legal system? This paper takes a theoretical approach to look into current sexuality education, the legal system in Hong Kong and the adoption of Asian values in society to argue that difficulties that are being placed onto victims in disclosing sexual violence they had experienced. Reviews of the current system and recent sexual assaults court cases for case studies allow the research to address the issues of victims’ experience including (a) their reactions to incidents; (b) issues they have in trials; (c) psychological impacts of the incidents; and (d) their understandings of gender equality before and after incidents. The study is significant because it criticises the current legal system in Hong Kong and provides insights to the public by explaining the dynamics between the problem, the legal system and the society. Also, it contributes to the ongoing research about the psychological impacts to victims in Hong Kong, especially how they are placed in a disadvantaged position in the legal system and society and even for their recovery. It contributes to the findings of how family structures, parental responsibilities and gender studies influence a child’s perception of gender equality in Hong Kong and hence their immediate reactions to incidents. To fully address the needs of victims, especially our younger generation, as well as to prevent future harm and to raise awareness, an inclusive framework which recognizes the needs of protecting and safeguarding women and children in the private sphere and a proper education for gender equality are needed.

Keywords: child abuse, children's rights, domestic violence, gender equality, Hong Kong, Me too, sexual violence, women's rights

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Authors: Yeo Ryeong Jeon, Pyong Kon Cho, Eun Ok Han, Hyon Chul Jang, Yong Min Kim

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This study surveyed on recognition related to radiation safety for radiation safety managers and workers those who have been worked in Republic of Korea education and research institution. At present, South Korea has no guideline and manual of radiation safety for education and research institution. Therefore, we tried to find an educational basis for development of radiation safety guideline and manual. To check the level of knowledge, attitude, and behavior about radiation safety, we used the questionnaire that consisted of 29 questions against knowledge, attitude and behavior, 4 questions against self-efficacy and expectation based on four factors (radiation source, human, organizational and physical environment) of the Haddon's matrix. Responses were collected between May 4 and June 30, 2015. We analyzed questionnaire by means of IBM SPSS/WIN 15 which well known as statistical package for social science. The data were compared with mean, standard deviation, Pearson's correlation, ANOVA (analysis of variance) and regression analysis. 180 copies of the questionnaire were returned from 60 workplaces. The overall mean results for behavior level was relatively lower than knowledge and attitude level. In particular, organizational environment factor on the radiation safety management indicated the lowest behavior level. Most of the factors were correlated in Pearson’s correlation analysis, especially between knowledge of human factors and behavior of human factors (Pearson’s correlation coefficient 0.809, P<.01). When analysis performed in line with the main radiation source type, institutions where have been used only opened RI (radioisotope) behavior level was the lowest among all subjects. Finally, knowledge of radiation source factor (β=0.556, P<.001) and human factor(β=0.376, P<.001) had the greatest impact in terms of behavior practice. Radiation safety managers and workers think positively about radiation safety management, but are poorly informed organizational environment of their institution. Thus, each institution need to efforts to settlement of radiation safety culture. Also, pedagogical interventions for improving knowledge on radiation safety needs in terms of safety accident prevention.

Keywords: radiation safety management, factor analysis, SPSS, republic of Korea

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Authors: Aliasghar Arab

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Autonomous robots interacting with humans, as safety-critical nonlinear control systems, are complex closed-loop cyber-physical dynamical machines. Keeping these intelligent yet complicated systems safe and smooth during their operations is challenging. The aim of the safe predictive output feedback linearization control synthesis is to design a novel controller for smooth trajectory following while unsafe situations must be avoided. The controller design should obtain a linearized output for smoothness and invariance to a safety subset. Inspired by finite-horizon nonlinear model predictive control, the problem is formulated as constrained nonlinear dynamic programming. The safety constraints can be defined as control barrier functions. Avoiding unsafe maneuvers and performing smooth motions increases the predictability of the robot’s movement for humans when robots and people are working together. Our results demonstrate the proposed output linearization method obeys the safety constraints and, compared to existing safety-guaranteed methods, is smoother and performs better.

Keywords: robotics, collaborative robots, safety, autonomous robots

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Authors: Heiko Jessen, Laura Tanus, Slobodan Ruzicic

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Objectives: The efficacy of Stribild®, an integrase strand transfer inhibitor (INSTI) -based STR, has been evaluated in randomized clinical trials and it has demonstrated durable capability in terms of achieving sustained suppression of HIV-1 RNA-levels. However, differences in monitoring frequency, existing selection bias and profile of patients enrolled in the trials, may all result in divergent efficacy of this regimen in routine clinical settings. The aim of this study was to assess the virologic outcomes, safety and tolerability profile of Stribild® in a routine clinical setting. Methods: This was a retrospective monocentric analysis on HIV-1-infected patients, who started with or were switched to Stribild®. Virological failure (VF) was defined as confirmed HIV-RNA>50 copies/ml. The minimum time of follow-up was 24 weeks. The percentage of patients remaining free of therapeutic failure was estimated using the time-to-loss-of-virologic-response (TLOVR) algorithm, by intent-to-treat analysis. Results: We analyzed the data of 197 patients (56 ART-naïve and 141 treatment-experienced patients), who fulfilled the inclusion criteria. Majority (95.9%) of patients were male. The median time of HIV-infection at baseline was 2 months in treatment-naïve and 70 months in treatment-experienced patients. Median time [IQR] under ART in treatment-experienced patients was 37 months. Among the treatment-experienced patients 27.0% had already been treated with a regimen consisting of two NRTIs and one INSTI, whereas 18.4% of them experienced a VF. The median time [IQR] of virological suppression prior to therapy with Stribild® in the treatment-experienced patients was 10 months [0-27]. At the end of follow-up (median 33 months), 87.3% (95% CI, 83.5-91.2) of treatment-naïve and 80.3% (95% CI, 75.8-84.8) of treatment-experienced patients remained free of therapeutic failure. Considering only treatment-experienced patients with baseline VL<50 copies/ml, 83.0% (95% CI, 78.5-87.5) remained free of therapeutic failure. A total of 17 patients stopped treatment with Stribild®, 5.4% (3/56) of them were treatment-naïve and 9.9% (14/141) were treatment-experienced patients. The Stribild® therapy was discontinued in 2 (1.0%) because of VF, loss to follow-up in 4 (2.0%), and drug-drug interactions in 2 (1.0%) patients. Adverse events were in 7 (3.6%) patients the reason to switch from therapy with Stribild® and further 2 (1.0%) patients decided personally to switch. The most frequently observed adverse events were gastrointestinal side effects (20.0%), headache (8%), rash events (7%) and dizziness (6%). In two patients we observed an emergence of novel resistances in integrase-gene. The N155H evolved in one patient and resulted in VF. In another patient S119R evolved either during or shortly upon switch from therapy with Stribild®. In one further patient with VF two novel mutations in the RT-gene were observed when compared to historical genotypic test result (V106I/M and M184V), whereby it is not clear whether they evolved during or already before the switch to Stribild®. Conclusions: Effectiveness of Stribild® for treatment-naïve patients was consistent with data obtained in clinical trials. The safety and tolerability profile as well as resistance development confirmed clinical efficacy of Stribild® in a daily practice setting.

Keywords: ART, HIV, integrase inhibitor, stribild

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Authors: Khawaja A. Wahaj Wani, Aykut Erkal

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Pakistan's construction industry, a key player in economic development, has experienced remarkable growth. However, the surge in activities has been accompanied by dangerous working conditions, attributed to legislative gaps and flaws. Unhealthy construction practices, uncertain site conditions, and hazardous environments contribute to a concerning rate of injuries and fatalities. The principal aim of this research study is to undertake a thorough evaluation based on the assessment of the current situation of Health & Safety policies and the surveys performed by stakeholders of Pakistan with the aim of providing solution-centric methodologies for the enforcement of health and safety regulations within construction companies operating on project sites. Recognizing the pivotal role that the construction industry plays in bolstering a nation's economy, it is imperative to address the pressing need for heightened awareness among site engineers and laborers. The study adopts a robust approach, utilizing questionnaire surveys and interviews. As an exclusive investigative study, it encompasses all stakeholders: clients, consultants, contractors, and subcontractors. Targeting PEC-registered companies. Safety performance was assessed through the examination of sixty safety procedures using SPSS-18. A high Cronbach's alpha value of 0.958 ensures data reliability, and non-parametric tests were employed due to the non-normal distribution of data. The safety performance evaluation revealed significant insights. "Using Hoists and Cranes" and "Precautionary Measures (Shoring and Excavation)" exhibited commendable safety levels. Conversely, "Trainings on Safety" displayed a lower safety performance, alongside areas such as "Safety in Contract Documentation," "Meetings for Safety," and "Worker Participation," indicating room for improvement. These findings provide stakeholders with a detailed understanding of current safety measures within Pakistan's construction industry.

Keywords: construction industry, health and safety regulations, Pakistan, risk management

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Authors: Peaceman Sopazi, Mabila Mathebula, John Smallwood

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Recent health and safety (H&S) concerns and their resultant impact on railway operations, namely, the severe acute respiratory syndrome (SARS) or collectively known as SARS-CoV-2 (Covid-19) pandemic and the Fourth Industrial Revolution (4IR), which have dominated public discourse, brought into question as to whether, or not, some aspects of how we have so far managed safety oversight as railway regulatory bodies and operators will remain relevant in a changing railway environment. Railway practitioners have generally found themselves between a proverbial rock and a hard place by being confronted by emerging challenges which have brought along great opportunities for sustainability. As witnesses and participants to the progressively introduced railway safety management, and transformation regimes, this paper attempts to share gathered field experience on adaptable regulatory oversight and safety awareness. The discourse is approached from a South African context but also with an informed perspective of what seems to work and what usually does not. The authors share their own multi and transdisciplinary experience coupled with insights they have gained as researchers of global trends in general safety management and specific aspects of railway safety management, for sustainability. In addition to sharing a largely experience-based methodology for survival, suggestions are offered for consideration as a way of keeping the railway safety management discourse alive as practitioners navigate a new path which is shrouded in a cloud of untold uncertainty. The authors further believe that the right timing for the implementation of the proposed suggestions in this paper will produce beneficial outcomes. Finally, the paper will identify areas that are still open for further investigation for and by researchers and practitioners alike.

Keywords: health & safety management, safety awareness, railway safety management, railway systems sustainability

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Authors: Belyayev P. E., Makeyeva I. R., Mastyuk D. A., Pigasov E. E.

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Previously, the phrase ”hydrogen safety” was often used in terms of NPP safety. Due to the rise of interest to “green” and, particularly, hydrogen power engineering, the problem of hydrogen safety at industrial facilities has become ever more urgent. In Russia, the industrial production of hydrogen is meant to be performed by placing a chemical engineering plant near NPP, which supplies the plant with the necessary energy. In this approach, the production of hydrogen involves a wide range of combustible gases, such as methane, carbon monoxide, and hydrogen itself. Considering probable incidents, sudden combustible gas outburst into open space with further ignition is less dangerous by itself than ignition of the combustible mixture in the presence of many pipelines, reactor vessels, and any kind of fitting frames. Even ignition of 2100 cubic meters of the hydrogen-air mixture in open space gives velocity and pressure that are much lesser than velocity and pressure in Chapman-Jouguet condition and do not exceed 80 m/s and 6 kPa accordingly. However, the space blockage, the significant change of channel diameter on the way of flame propagation, and the presence of gas suspension lead to significant deflagration acceleration and to its transition into detonation or quasi-detonation. At the same time, process parameters acquired from the experiments at specific experimental facilities are not general, and their application to different facilities can only have a conventional and qualitative character. Yet, conducting deflagration and detonation experimental investigation for each specific industrial facility project in order to determine safe infrastructure unit placement does not seem feasible due to its high cost and hazard, while the conduction of numerical experiments is significantly cheaper and safer. Hence, the development of a numerical method that allows the description of reacting flows in domains with complex geometry seems promising. The base for this method is the modification of Kuropatenko method for calculating shock waves recently developed by authors, which allows using it in Eulerian coordinates. The current work contains the results of the development process. In addition, the comparison of numerical simulation results and experimental series with flame propagation in shock tubes with orifice plates is presented.

Keywords: CFD, reacting flow, DDT, gas explosion

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Authors: Özden Kuşcu, Yağmur Kuşcu, Zeynep Çetintaş, S. Sunay Yildirim Doğru

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The purpose of this work is to evaluate the effect of the subjects “personal safety” and “protection from dangers” included in primary school curriculum on the students’ levels of knowledge about safety and protection from social dangers. The study group included 469 students between 5–11 years old with 231 preschoolers and 238 primary school students and their parents and teachers. Instruments used to collect data were “Personal Safety Interview Form” for children, “Parent Interview Form” and “Teacher Interview Form”. Forms included 15 open-ended questions about personal safety. The researchers collected the research data through one-on-one interviews with children. Results of the study revealed that preschoolers and 1st, 2nd, and 3rd graders did not know their home addresses and telephone numbers and their families were not aware of that. The study also showed that those who had this information were unsure as to who to share this information with. Accordingly, more should be done to increase the levels of knowledge of preschoolers and 1st, 2nd, and 3rd graders about personal safety and protection from dangers.

Keywords: security, social danger, elementary school, preschool

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Authors: Anita Puspawati

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A failure in obtaining informed consent from patient occurs because there is not effective communication skill in doctors. Therefore, the language is very important in communication between doctor and patient. This study uses descriptive analysis method, that is a method used mainly in researching the status of a group of people, an object, a condition, a system of thought or a class of events in the present. The result of this study indicates that the communicative language between doctors and patients will increase the trust of patients to their doctors and accordingşy, patients will provide the informed consent voluntarily.

Keywords: communicative, language, doctor, patient

Procedia PDF Downloads 259