An investigation of used car safety: final report. Volume II-Qualitative evaluation.

Mode of access: Internet.

An investigation of used car safety: final report. Volume IV. Quantitative evaluation, part 2: economic considerations.

Mode of access: Internet.

Regional safety program management seminars. Volume I of II. Final report.

National Highway Safety Bureau, Washington, D.C.

Wavelength dependence of ultraviolet-enhanced reactivation and induction of mammalian viruses /

Mode of access: Internet.

Multiple component patient safety intervention in English hospitals:controlled evaluation of second phase

Objective: To independently evaluate the impact of the second phase of the Health Foundation's Safer Patients Initiative (SPI2) on a range of patient safety measures. Design: A controlled before and after design. Five substudies: survey of staff attitudes; review of case notes from high risk (respiratory) patients in medical wards; review of case notes from surgical patients; indirect evaluation of hand hygiene by measuring hospital use of handwashing materials; measurement of outcomes (adverse events, mortality among high risk patients admitted to medical wards, patients' satisfaction, mortality in intensive care, rates of hospital acquired infection). Setting: NHS hospitals in England. Participants: Nine hospitals participating in SPI2 and nine matched control hospitals. Intervention The SPI2 intervention was similar to the SPI1, with somewhat modified goals, a slightly longer intervention period, and a smaller budget per hospital. Results: One of the scores (organisational climate) showed a significant (P=0.009) difference in rate of change over time, which favoured the control hospitals, though the difference was only 0.07 points on a five point scale. Results of the explicit case note reviews of high risk medical patients showed that certain practices improved over time in both control and SPI2 hospitals (and none deteriorated), but there were no significant differences between control and SPI2 hospitals. Monitoring of vital signs improved across control and SPI2 sites. This temporal effect was significant for monitoring the respiratory rate at both the six hour (adjusted odds ratio 2.1, 99% confidence interval 1.0 to 4.3; P=0.010) and 12 hour (2.4, 1.1 to 5.0; P=0.002) periods after admission. There was no significant effect of SPI for any of the measures of vital signs. Use of a recommended system for scoring the severity of pneumonia improved from 1.9% (1/52) to 21.4% (12/56) of control and from 2.0% (1/50) to 41.7% (25/60) of SPI2 patients. This temporal change was significant (7.3, 1.4 to 37.7; P=0.002), but the difference in difference was not significant (2.1, 0.4 to 11.1; P=0.236). There were no notable or significant changes in the pattern of prescribing errors, either over time or between control and SPI2 hospitals. Two items of medical history taking (exercise tolerance and occupation) showed significant improvement over time, across both control and SPI2 hospitals, but no additional SPI2 effect. The holistic review showed no significant changes in error rates either over time or between control and SPI2 hospitals. The explicit case note review of perioperative care showed that adherence rates for two of the four perioperative standards targeted by SPI2 were already good at baseline, exceeding 94% for antibiotic prophylaxis and 98% for deep vein thrombosis prophylaxis. Intraoperative monitoring of temperature improved over time in both groups, but this was not significant (1.8, 0.4 to 7.6; P=0.279), and there were no additional effects of SPI2. A dramatic rise in consumption of soap and alcohol hand rub was similar in control and SPI2 hospitals (P=0.760 and P=0.889, respectively), as was the corresponding decrease in rates of Clostridium difficile and meticillin resistant Staphylococcus aureus infection (P=0.652 and P=0.693, respectively). Mortality rates of medical patients included in the case note reviews in control hospitals increased from 17.3% (42/243) to 21.4% (24/112), while in SPI2 hospitals they fell from 10.3% (24/233) to 6.1% (7/114) (P=0.043). Fewer than 8% of deaths were classed as avoidable; changes in proportions could not explain the divergence of overall death rates between control and SPI2 hospitals. There was no significant difference in the rate of change in mortality in intensive care. Patients' satisfaction improved in both control and SPI2 hospitals on all dimensions, but again there were no significant changes between the two groups of hospitals. Conclusions: Many aspects of care are already good or improving across the NHS in England, suggesting considerable improvements in quality across the board. These improvements are probably due to contemporaneous policy activities relating to patient safety, including those with features similar to the SPI, and the emergence of professional consensus on some clinical processes. This phenomenon might have attenuated the incremental effect of the SPI, making it difficult to detect. Alternatively, the full impact of the SPI might be observable only in the longer term. The conclusion of this study could have been different if concurrent controls had not been used.

Neurophysiological investigations for the diagnosis of non-epileptic attack disorder in neuropsychiatry services:from safety standards to improved effectiveness

OBJECTIVE: The discipline of clinical neuropsychiatry currently provides specialised services for a number of conditions that cross the traditional boundaries of neurology and psychiatry, including non-epileptic attack disorder. Neurophysiological investigations have an important role within neuropsychiatry services, with video-electroencephalography (EEG) telemetry being the gold standard investigation for the differential diagnosis between epileptic seizures and non-epileptic attacks. This article reviews existing evidence on best practices for neurophysiology investigations, with focus on safety measures for video-EEG telemetry. METHODS: We conducted a systematic literature review using the PubMed database in order to identify the scientific literature on the best practices when using neurophysiological investigations in patients with suspected epileptic seizures or non-epileptic attacks. RESULTS: Specific measures need to be implemented for video-EEG telemetry to be safely and effectively carried out by neuropsychiatry services. A confirmed diagnosis of non-epileptic attack disorder following video-EEG telemetry carried out within neuropsychiatry units has the inherent advantage of allowing diagnosis communication and implementation of treatment strategies in a timely fashion, potentially improving clinical outcomes and cost-effectiveness significantly. CONCLUSION: The identified recommendations set the stage for the development of standardised guidelines to enable neuropsychiatry services to implement streamlined and evidence-based care pathways.

Safety habits promoted by Hispanic parents for school-aged and adolescent children

Accidents are the leading cause of death among children. Compliance with safety measures have been shown to reduce morbidity and mortality in children. However, Hispanic parents and children have not been adequately studied in the literature in regard to trauma and safety habits utilized. In this exploratory-descriptive study, a convenience sample of 48 Hispanic parents were questioned about their child's activities. The purpose was to determine what safety equipment was used during these activities and how often they were used. Responses to an English/Spanish questionnaire were summarized by frequencies and percentages. Findings suggested that these Hispanic children were at risk for injury due to a low percentage of children wearing the necessary protective equipment. Therefore, education must stress consistent use of safety equipment if injuries are to be prevented. ^

(Table 1) Maximal daily erythemally effective UVB radiation and total ozone content at Vernadsky Station, Antarctica

One of the research programs carried out within the Czech-Ukrainian scientific co-operation is the monitoring of global solar and ultraviolet radiation at the Vernadsky Station (formerly the British Faraday Station), Antarctica. Radiation measurements have been made since 2002. Recently, a special attention is devoted to the measurements of the erythemally effective UVB radiation using a broadband Robertson Berger 501 UV-Biometer (Solar Light Co. Inc., USA). This paper brings some results from modelling the daily sums of erythemally effective UVB radiation intensity in relation to the total ozone content (TOC) in atmosphere and surface intensity of the global solar radiation. Differences between the satellite- and ground-based measurements of the TOC at the Vernadsky Station are taken into consideration. The modelled erythemally effective UVB radiation differed slightly depending on the seasons and sources of the TOC. The model relative prediction error for ground- and satellite-based measurements varied between 9.5% and 9.6% in the period of 2002-2003, while it ranged from 7.4% to 8.8% in the period of 2003-2004.

Combined effects of solar UV radiation and CO2-induced seawater acidification on photosynthetic carbon fixation of phytoplankton assemblages in the South China Sea, 2010

We carried out short term pCO2/pH perturbation experiments in the coastal waters of the South China Sea to evaluate the combined effects of seawater acidification (low pH/high pCO2) and solar UV radiation (UVR, 280-400 nm) on photosynthetic carbon fixation of phytoplankton assemblages. Under photosynthetically active radiation (PAR) alone treatments, reduced pCO2 (190 ppmv) with increased pH resulted in a significant decrease in the photosynthetic carbon fixation rate (about 23%), while enriched pCO2 (700 ppmv) with lowered pH had no significant effect on the photosynthetic performance compared to the ambient level. The apparent photosynthetic efficiency decreased under the reduced pCO2 level, probably due to C-limitation as well as energy being diverged for up-regulation of carbon concentrating mechanisms (CCMs). In the presence of UVR, both UV-A and UV-B caused photosynthetic inhibition, though UV-A appeared to enhance the photosynthetic efficiency under lower PAR levels. UV-B caused less inhibition of photosynthesis under the reduced pCO2 level, probably because of its contribution to the inorganic carbon (Ci)-acquisition processes. Under the seawater acidification conditions (enriched pCO2), both UV-A and UV-B reduced the photosynthetic carbon fixation to higher extents compared to the ambient pCO2 conditions. We conclude that solar UV and seawater acidification could synergistically inhibit photosynthesis.

Spatio-temporal Variability of Atmospheric Ozone over Indian Subcontinent and its Relation to Meteorological Parameters

Ozone present in the atmosphere not only absorbs the biologically harmful ultraviolet radiation but also is an important ingredient of the climate system. The radiative absorption properties of ozone make it a determining factor in the structure of the atmosphere. Ozone in the troposphere has many negative impacts on humans and other living beings. Another significant aspect is the absorption of outgoing infrared radiation by ozone thus acting as a greenhouse gas. The variability of ozone in the atmosphere involves many interconnections with the incoming and outgoing radiation, temperature circulation etc. Hence ozone forms an important part of chemistry-climate as well as radiative transfer models. This aspect also makes the quantification of ozone more important. The discovery of Antarctic ozone hole and the role of anthropogenic activities in causing it made it possible to plan and implement necessary preventive measures. Continuous monitoring of ozone is also necessary to identify the effect of these preventive steps. The reactions involving the formation and destruction of ozone are influenced significantly by the temperature fluctuations of the atmosphere. On the other hand the variations in ozone can change the temperature structure of the atmosphere. Indian subcontinent is a region having large weather and climate variability which is evident from the large interannual variability of monsoon system over the region. Nearly half of Indian region comprises the tropical region. Most of ozone is formed in the tropical region and transported to higher latitudes. The formation and transport of ozone can be influenced by changes in solar radiation and various atmospheric circulation features. Besides industrial activities and vehicular traffic is more due to its large population. This may give rise to an increase in the production of tropospheric ozone which is greenhouse gas. Hence it becomes necessary to monitor the atmospheric ozone over this region. This study probes into the spatial distribution and temporal evolution of ozone over Indian subcontinent and discusses the contributing atmospheric parameters.

A pilot feasibility, safety and biological efficacy multicentre trial of therapeutic hypercapnia after cardiac arrest: study protocol for a randomized controlled trial

BACKGROUND: Cardiac arrest causes ischaemic brain injury. Arterial carbon dioxide tension (PaCO2) is a major determinant of cerebral blood flow. Thus, mild hypercapnia in the 24 h following cardiac arrest may increase cerebral blood flow and attenuate such injury. We describe the Carbon Control and Cardiac Arrest (CCC) trial. METHODS/DESIGN: The CCC trial is a pilot multicentre feasibility, safety and biological efficacy randomized controlled trial recruiting adult cardiac arrest patients admitted to the intensive care unit after return of spontaneous circulation. At admission, using concealed allocation, participants are randomized to 24 h of either normocapnia (PaCO2 35 to 45 mmHg) or mild hypercapnia (PaCO2 50 to 55 mmHg). Key feasibility outcomes are recruitment rate and protocol compliance rate. The primary biological efficacy and biological safety measures are the between-groups difference in serum neuron-specific enolase and S100b protein levels at 24 h, 48 h and 72 h. Secondary outcome measure include adverse events, in-hospital mortality, and neurological assessment at 6 months. DISCUSSION: The trial commenced in December 2012 and, when completed, will provide clinical evidence as to whether targeting mild hypercapnia for 24 h following intensive care unit admission for cardiac arrest patients is feasible and safe and whether it results in decreased concentrations of neurological injury biomarkers compared with normocapnia. Trial results will also be used to determine whether a phase IIb study powered for survival at 90 days is feasible and justified. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12612000690853 .

2015 Annual Safety and Security Report

The information contained in this Annual Safety and Security Report is provided to new and prospective students and employees, as well as their families, and all current members of the campus community. It contains Public Safety Services and Programming,Building Threat and Vulnerability Assessment Program,Campus Security authorities, Annual Preparation of Crime Statistics, Disclosure of Crime Statistics, Daily Crime Log, How to Report a Crime, Suspicious Activity or Emergency, Silent Witness Program, Relationship with Local Authorities, Off-Campus Violations & Criminal Activity, Confidential Reporting, Timely Warning Procedures, Emergency Response, Notification and Evacuation Procedures Activation Authority, Available Communications Media, Emergency Notification Tests, Emergency Evacuation Procedures, Shelter-in-Place Procedures,Crime Prevention and Safety Awareness Programs, Emergency Telephones, Access To Facilities, Maintenance of Buildings and Grounds, Alcohol and Other Drugs, Domestic Violence, Dating Violence, Sexual Assault, and Stalking, Sex Offender Registration, Weapons on Campus, Referrals for Disciplinary Action, Crime Information: Definitions and Statistics, Uniform Crime Reporting Definitions, Reporting Areas. Crime Statistics

Láser Q-Switched en el manejo de ocronosis exógena: revisión sistemática de la literatura

Antecedentes: La ocronosis Exógena (OE) es una enfermedad subdiagnosticada y de difícil manejo (1). El láser Q-Switched (QS) surge como una alternativa para el tratamiento de esta (2). Objetivo: Describir las características de los pacientes, del láser QS y los desenlaces en el tratamiento de OE. Métodos: Se realizó una búsqueda de la literatura en las bases PubMed, Embase, PMC, Scielo, Elselvier, BMJ Case Reports, Journal of Medical Case Reports, Cases Journal e International Medical Case Reports Journal, desde enero del 2000 a marzo del 2016, pacientes con ocronosis exógena, 18 a 70 años, tratados con láser QS. Los artículos fueron evaluados mediante la herramienta de evaluación de validez y valor educativo de reportes de caso descrito por Pierson (3). Resultados: Se encontraron 256 artículos, 63 fueron seleccionados: 28 repetidos y 31 no cumplieron criterios de inclusión. Se escogieron 4 artículos que reportan 12 casos de pacientes con ocronosis exógena diagnosticada mediante estudio histopatológico y tratada con láser QS. Discusión: Hay poca experiencia con el láser QS en OE. En la práctica clínica se usa para tatuajes y patologías pigmentarias dérmicas con resultados satisfactorios. El pigmento dérmico en OE y la corta duración de pulso de láser QS, podrían ser el pilar de tratamiento para OE. Conclusión: El láser QS puede ser útil para el tratamiento en OE, con nivel de evidencia 3 y grado de recomendación D. Se sugiere realizar estudios clínicos con mayor grado de evidencia.