A road safety performance indicator for vehicle fleet compatibility

This paper discusses the development and the application of a safety performance indicator which measures the intrinsic safety of a country's vehicle fleet related to fleet composition. The indicator takes into account both the ‘relative severity’ of individual collisions between different vehicle types, and the share of those vehicle types within a country's fleet. The relative severity is a measure for the personal damage that can be expected from a collision between two vehicles of any type, relative to that of a collision between passenger cars. It is shown how this number can be calculated using vehicle mass only. A sensitivity analysis is performed to study the dependence of the indicator on parameter values and basic assumptions made. The indicator is easy to apply and satisfies the requirements for appropriate safety performance indicators. It was developed in such a way that it specifically scores the intrinsic safety of a fleet due to its composition, without being influenced by other factors, like helmet wearing. For the sake of simplicity, and since the required data is available throughout Europe, the indicator was applied to the relative share of three of the main vehicle types: passenger cars, heavy goods vehicles and motorcycles. Using the vehicle fleet data from 13 EU Member States and Norway, the indicator was used to rank the countries’ safety performance. The UK was found to perform best in terms of its fleet composition (value is 1.07), while Greece has the worst performance with the highest indicator value (1.41).

Static Analysis of Usefulness States in Transition P Systems

Transition P Systems are a parallel and distributed computational model based on the notion of the cellular membrane structure. Each membrane determines a region that encloses a multiset of objects and evolution rules. Transition P Systems evolve through transitions between two consecutive configurations that are determined by the membrane structure and multisets present inside membranes. Moreover, transitions between two consecutive configurations are provided by an exhaustive non-deterministic and parallel application of evolution rules. But, to establish the rules to be applied, it is required the previous calculation of useful, applicable and active rules. Hence, computation of useful evolution rules is critical for the whole evolution process efficiency, because it is performed in parallel inside each membrane in every evolution step. This work defines usefulness states through an exhaustive analysis of the P system for every membrane and for every possible configuration of the membrane structure during the computation. Moreover, this analysis can be done in a static way; therefore membranes only have to check their usefulness states to obtain their set of useful rules during execution.

A Cauchy Integral Related to a Robot-safety Device System

We introduce a robot-safety device system attended by two different repairmen. The twin system is characterized by the natural feature of cold standby and by an admissible “risky” state. In order to analyse the random behaviour of the entire system (robot, safety device, repair facility) we employ a stochastic process endowed with probability measures satisfying general Hokstad-type differential equations. The solution procedure is based on the theory of sectionally holomorphic functions, characterized by a Cauchy-type integral defined as a Cauchy principal value in double sense. An application of the Sokhotski-Plemelj formulae determines the long-run availability of the robot-safety device. Finally, we consider the particular but important case of deterministic repair.

Emerging of human factor in risk analysis of home care service

Risk management in healthcare represents a group of various complex actions, implemented to improve the quality of healthcare services and guarantee the patients safety. Risks cannot be eliminated, but it can be controlled with different risk assessment methods derived from industrial applications and among these the Failure Mode Effect and Criticality Analysis (FMECA) is a largely used methodology. The main purpose of this work is the analysis of failure modes of the Home Care (HC) service provided by local healthcare unit of Naples (ASL NA1) to focus attention on human and non human factors according to the organization framework selected by WHO. © Springer International Publishing Switzerland 2014.

A randomised controlled trial of the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia:the ECLIPSE trial

BACKGROUND: Heavy menstrual bleeding (HMB) is a common problem, yet evidence to inform decisions about initial medical treatment is limited. OBJECTIVES: To assess the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system (LNG-IUS) (Mirena(®), Bayer) compared with usual medical treatment, with exploration of women's perspectives on treatment. DESIGN: A pragmatic, multicentre randomised trial with an economic evaluation and a longitudinal qualitative study. SETTING: Women who presented in primary care. PARTICIPANTS: A total of 571 women with HMB. A purposeful sample of 27 women who were randomised or ineligible owing to treatment preference participated in semistructured face-to-face interviews around 2 and 12 months after commencing treatment. INTERVENTIONS: LNG-IUS or usual medical treatment (tranexamic acid, mefenamic acid, combined oestrogen-progestogen or progesterone alone). Women could subsequently swap or cease their allocated treatment. OUTCOME MEASURES: The primary outcome was the patient-reported score on the Menorrhagia Multi-Attribute Scale (MMAS) assessed over a 2-year period and then again at 5 years. Secondary outcomes included general quality of life (QoL), sexual activity, surgical intervention and safety. Data were analysed using iterative constant comparison. A state transition model-based cost-utility analysis was undertaken alongside the randomised trial. Quality-adjusted life-years (QALYs) were derived from the European Quality of Life-5 Dimensions (EQ-5D) and the Short Form questionnaire-6 Dimensions (SF-6D). The intention-to-treat analyses were reported as cost per QALY gained. Uncertainty was explored by conducting both deterministic and probabilistic sensitivity analyses. RESULTS: The MMAS total scores improved significantly in both groups at all time points, but were significantly greater for the LNG-IUS than for usual treatment [mean difference over 2 years was 13.4 points, 95% confidence interval (CI) 9.9 to 16.9 points; p < 0.001]. However, this difference between groups was reduced and no longer significant by 5 years (mean difference in scores 3.9 points, 95% CI -0.6 to 8.3 points; p = 0.09). By 5 years, only 47% of women had a LNG-IUS in place and 15% were still taking usual medical treatment. Five-year surgery rates were low, at 20%, and were similar, irrespective of initial treatments. There were no significant differences in serious adverse events between groups. Using the EQ-5D, at 2 years, the relative cost-effectiveness of the LNG-IUS compared with usual medical treatment was £1600 per QALY, which by 5 years was reduced to £114 per QALY. Using the SF-6D, usual medical treatment dominates the LNG-IUS. The qualitative findings show that women's experiences and expectations of medical treatments for HMB vary considerably and change over time. Women had high expectations of a prompt effect from medical treatments. CONCLUSIONS: The LNG-IUS, compared with usual medical therapies, resulted in greater improvement over 2 years in women's assessments of the effect of HMB on their daily routine, including work, social and family life, and psychological and physical well-being. At 5 years, the differences were no longer significant. A similar low proportion of women required surgical intervention in both groups. The LNG-IUS is cost-effective in both the short and medium term, using the method generally recommended by the National Institute for Health and Care Excellence. Using the alternative measures to value QoL will have a considerable impact on cost-effectiveness decisions. It will be important to explore the clinical and health-care trajectories of the ECLIPSE (clinical effectiveness and cost-effectiveness of levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia) trial participants to 10 years, by which time half of the cohort will have reached menopause. TRIAL REGISTRATION: Current Controlled Trials ISRCTN86566246. FUNDING: This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 19, No. 88. See the NIHR Journals Library website for further project information.

Developing actions to minimise avoidable waste and its challenge to plant safety

Purpose: Considering the UK's limited capacity for waste disposal (particularly for hazardous/radiological waste) there is growing focus on waste avoidance and minimisation to lower the volumes of waste being sent to disposal. The hazardous nature of some waste can complicate its management and reduction. To address this problem there was a need for a decision making methodology to support managers in the nuclear industry as they identify ways to reduce the production of avoidable hazardous waste. The methodology we developed is called Waste And Sourcematter Analysis (WASAN). A methodology that begins the thought process at the pre-waste creation stage (i.e. Avoid). Design/methodology/ approach: The methodology analyses the source of waste, the production of waste inside the facility, the knock on effects from up/downstream facilities on waste production, and the down-selection of waste minimisation actions/options. WASAN has been applied to case studies with licencees and this paper reports on one such case study - the management of plastic bags in Enriched Uranium Residues Recovery Plant (EURRP) at Springfields (UK) where it was used to analyse the generation of radioactive plastic bag waste. Findings: Plastic bags are used in EURRP as a strategy to contain hazard. Double bagging of materials led to the proliferation of these bags as a waste. The paper reports on the philosophy behind WASAN, the application of the methodology to this problem, the results, and views from managers in EURRP. Originality/value: This paper presents WASAN as a novel methodology for analyzing the minimization of avoidable hazardous waste. This addresses an issue that is important to many industries e.g. where legislation enforces waste minimization, where waste disposal costs encourage waste avoidance, or where plant design can reduce waste. The paper forms part of the HSE Nuclear Installations Inspectorate's desire to work towards greater openness and transparency in its work and the development in its thinking.© Crown Copyright 2011.

Reviewing the evidence base for the Children and Young People Safety Thermometer (CYPST):a mixed studies review

The objective was to identify evidence to support use of specific harms for the development of a children and young people's safety thermometer (CYPST). We searched PubMed, Web of Knowledge, and Cochrane Library post-1999 for studies in pediatric settings about pain, skin integrity, extravasation injury, and use of pediatric early warning scores (PEWS). Following screening, nine relevant articles were included. Convergent synthesis methods were used drawing on thematic analysis to combine findings from studies using a range of methods (qualitative, quantitative, and mixed methods). A review of PEWS was identified so other studies on this issue were excluded. No relevant studies about extravasation injury were identified. The synthesized results therefore focused on pain and skin integrity. Measurement and perception of pain were complex and not always carried out according to best practice. Skin abrasions were common and mostly associated with device related injuries. The findings demonstrate a need for further work on perceptions of pain and effective communication of concerns about pain between parents and nursing staff. Strategies for reducing device-related injuries warrant further research focusing on prevention. Together with the review of PEWS, these synthesized findings support the inclusion of pain, skin integrity, and PEWS in the CYPST.

Analysis of Hue Spectra During Storage of Pepper (Capsicum annuum)

Color information is widely used in non-destructive quality assessment of perishable horticultural produces. The presented work investigated color changes of pepper (Capsicum annuum L.) samples received from retail system. The effect of storage temperature (10±2°C and 24±4°C) on surface color and firmness was analyzed. Hue spectra was calculated using sum of saturations. A ColorLite sph850 (400-700nm) spectrophotometer was used as reference instrument. Dynamic firmness was measured on three locations of the surface: tip cap, middle and shoulder. Significant effects of storage conditions and surface location on both color and firmness were observed. Hue spectra responded sensitively to color development of pepper. Prediction model (PLS) was used to estimate dynamic firmess based on hue spectra. Accuracy was very different depending on the location. Firmness of the tip cap was predicted with the highest accuracy (RMSEP=0.0335). On the other hand, middle region cannot be used for such purpose. Due to the simplicity and rapid processing, analysis of hue spectra is a promising tool for evaluation of color in postharvest and food industry.

Systematic review and analysis of evidences on clinical efficacy and cost-effectiveness of biological drugs for the treatment of Ankylosing Spondylitis

Technology: Infliximab and comparator biological such as adalimumab, etanercept, golimumab. Conditions: Ankylosing spondylitis (AS) Issue: Infliximab is registered to be used in patients with AS. The aim of the Report is to evaluate the clinical efficacy and safety of infliximab and comparator biologicals for the treatment of adult AS. Methods: Systematic literature review and analysis as well as meta-analysis (direct and indirect comparison) of published randomised controlled clinical trials (RCT) were performed, all relevant health economics literature were identified ad analysed. Results: Clinical efficacy of biological therapies is based on good clinical evidences regarding to all clinical efficacy endpoints (ASAS20, ASAS40, ASAS 5/6, and BASDAI 50% response). Altogether, 22 trials are included in our meta-analysis, 12 infliximab, 3 adalimumab studies, 6 etanercept and 1 golimumab. Efficacy of biological treatments for the treatment of AS has been established by clinical scientific evidences, significant improvement at all outcomes considered was confirmed. According to the results of indirect comparison, there were no significant difference between biological treatments and placebo in terms of safety and tolerability endpoints. We found no significant difference between the clinical efficacy and safety of infliximab, adalimumab, etanercept and golimumab therapies. Cost-utility analysis of adalimumab and/or infliximab, etanercept and golimumab treatment for AS were performed in the UK, Canada, The Netherlands, Germany, Spain and France. There are no cost-utility studies from Eastern Central Europe. Implications for decision making: Efficacy of infliximab and comparator biologicals for the treatment of Ankylosing Spondylitis (AS) was proved by clinical evidence, significant improvement at all outcomes considered was confirmed. We found no significant differences in efficacy and safety of different biological treatments. Health economics results suggest that biological therapies are cost-effective alternatives for the treatment of AS in group of developed high income countries. There is a lack of health economics results in Central-Eastern European countries however these data are more and more required by governments and funders as part of the company economic dossiers.

Efficacy and safety of infliximab-biosimilar compared to other biological drugs in rheumatoid arthritis: a mixed treatment comparison.

OBJECTIVE: The aim of this meta-analysis was to compare the efficacy and safety of infliximab-biosimilar and other available biologicals for the treatment of rheumatoid arthritis (RA), namely abatacept, adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, rituximab and tocilizumab. METHODS: A systematic literature review of MEDLINE database until August 2013 was carried out to identify relevant randomized controlled trials (RCTs). Bayesian mixed treatment comparison method was applied for the pairwise comparison of treatments. Improvement rates by the American College of Rheumatology criteria (ACR20 and ACR50) at week 24 were used as efficacy endpoints, and the occurrence of serious adverse events was considered to assess the safety of the biologicals. RESULTS: Thirty-six RCTs were included in the meta-analysis. All the biological agents proved to be superior to placebo. For ACR20 response, certolizumab pegol showed the highest odds ratio (OR) compared to placebo, OR 7.69 [95 % CI 3.69-14.26], followed by abatacept OR 3.7 [95 % CI 2.17-6.06], tocilizumab OR 3.69 [95 % CI 1.87-6.62] and infliximab-biosimilar OR 3.47 [95 % CI 0.85-9.7]. For ACR50 response, certolizumab pegol showed the highest OR compared to placebo OR 8.46 [3.74-16.82], followed by tocilizumab OR 5.57 [95 % CI 2.77-10.09], and infliximab-biosimilar OR 4.06 [95 % CI 1.01-11.54]. Regarding the occurrence of serious adverse events, the results show no statistically significant difference between infliximab-biosimilar and placebo, OR 1.87 [95 % CI 0.74-3.84]. No significant difference regarding efficacy and safety was found between infliximab-biosimilar and the other biological treatments. CONCLUSION: This is the first indirect meta-analysis in RA that compares the efficacy and safety of biosimilar-infliximab to the other biologicals indicated in RA. We found no significant difference between infliximab-biosimilar and other biological agents in terms of clinical efficacy and safety.

Nonlinear dynamics and chaos simulation system analysis for improved design

Small errors proved catastrophic. Our purpose to remark that a very small cause which escapes our notice determined a considerable effect that we cannot fail to see, and then we say that the effect is due to chance. Small differences in the initial conditions produce very great ones in the final phenomena. A small error in the former will produce an enormous error in the latter. When dealing with any kind of electrical device specification, it is important to note that there exists a pair of test conditions that define a test: the forcing function and the limit. Forcing functions define the external operating constraints placed upon the device tested. The actual test defines how well the device responds to these constraints. Forcing inputs to threshold for example, represents the most difficult testing because this put those inputs as close as possible to the actual switching critical points and guarantees that the device will meet the Input-Output specifications. ^ Prediction becomes impossible by classical analytical analysis bounded by Newton and Euclides. We have found that non linear dynamics characteristics is the natural state of being in all circuits and devices. Opportunities exist for effective error detection in a nonlinear dynamics and chaos environment. ^ Nowadays there are a set of linear limits established around every aspect of a digital or analog circuits out of which devices are consider bad after failing the test. Deterministic chaos circuit is a fact not a possibility as it has been revived by our Ph.D. research. In practice for linear standard informational methodologies, this chaotic data product is usually undesirable and we are educated to be interested in obtaining a more regular stream of output data. ^ This Ph.D. research explored the possibilities of taking the foundation of a very well known simulation and modeling methodology, introducing nonlinear dynamics and chaos precepts, to produce a new error detector instrument able to put together streams of data scattered in space and time. Therefore, mastering deterministic chaos and changing the bad reputation of chaotic data as a potential risk for practical system status determination. ^

An analysis of teachers' perceptions of informal science professional development

Science professional development, which is fundamental to science education improvement, has been described as being weak and fragmentary. The purpose of this study was to investigate teachers' perceptions of informal science professional development to gain an in-depth understanding of the essence of the phenomenon and related science-teaching dispositions. Based on the frameworks of phenomenology, constructivism, and adult learning theory, the focus was on understanding how the phenomenon was experienced within the context of teachers' everyday world. ^ Data were collected from eight middle-school teachers purposefully selected because they had participated in informal programs during Project TRIPS (Teaching Revitalized Through Informal Programs in Science), a collaboration between the Miami-Dade school district, government agencies (including NASA), and non-profit organizations (including Audubon of Florida). In addition, the teachers experienced hands-on labs offered through universities (including the University of Arizona), field sites, and other agencies. ^ The study employed Seidman's (1991) three-interview series to collect the data. Several methods were used to enhance the credibility of the research, including using triangulation of the data. The interviews were transcribed, color-coded and organized into six themes that emerged from the data. The themes included: (a) internalized content knowledge, (b) correlated hands-on activities, (c) enhanced science-teaching disposition, (d) networking/camaraderie, (e) change of context, and (f) acknowledgment as professionals. The teachers identified supportive elements and constraints related to each theme. ^ The results indicated that informal programs offering experiential learning opportunities strengthened understanding of content knowledge. Teachers implemented hands-on activities that were explicitly correlated to their curriculum. Programs that were conducted in a relaxed context enhanced teachers' science-teaching dispositions. However, a lack of financial and administrative support, perceived safety risks, insufficient reflection time, and unclear itineraries impeded program implementation. The results illustrated how informal educators can use this cohesive model as they develop programs that address the supports and constraints to teachers' science instruction needs. This, in turn, can aid teachers as they strive to provide effective science instruction to students; notions embedded in reforms. Ultimately, this can affect how learners develop the ability to make informed science decisions that impact the quality of life on a global scale. ^

Investigation of the causes of serious injury and fatal crashes: An analysis using econometric models

The rate of fatal crashes in Florida has remained significantly higher than the national average for the last several years. The 2003 statistics from the National Highway Traffic Safety Administration (NHTSA), the latest available, show a fatality rate in Florida of 1.71 per 100 million vehicle-miles traveled compared to the national average of 1.48 per 100 million vehicle-miles traveled. The objective of this research is to better understand the driver, environmental, and roadway factors that affect the probability of injury severity in Florida. ^ In this research, the ordered logit model was used to develop six injury severity models; single-vehicle and two-vehicle crashes on urban freeways and urban principal arterials and two-vehicle crashes at urban signalized and unsignalized intersections. The data used in this research included all crashes that occurred on the state highway system for the period from 2001 to 2003 in the Southeast Florida region, which includes the Miami-Dade, Broward and Palm Beach Counties.^ The results of the analysis indicate that the age group and gender of the driver at fault were significant factors of injury severity risk across all models. The greatest risk of severe injury was observed for the age groups 55 to 65 and 66 and older. A positive association between injury severity and the race of the driver at fault was also found. Driver at fault of Hispanic origin was associated with a higher risk of severe injury for both freeway models and for the two-vehicle crash model on arterial roads. A higher risk of more severe injury crash involvement was also found when an African-American was the at fault driver on two-vehicle crashes on freeways. In addition, the arterial class was also found to be positively associated with a higher risk of severe crashes. Six-lane divided arterials exhibited the highest injury severity risk of all arterial classes. The lowest severe injury risk was found for one way roads. Alcohol involvement by the driver at fault was also found to be a significant risk of severe injury for the single-vehicle crash model on freeways. ^

Achieving zero accidents—A strategic framework for continuous safety improvement in the construction industry

In the U.S., construction accidents remain a significant economic and social problem. Despite recent improvement, the Construction industry, generally, has lagged behind other industries in implementing safety as a total management process for achieving zero accidents and developing a high-performance safety culture. One aspect of this total approach to safety that has frustrated the construction industry the most has been “measurement”, which involves identifying and quantifying the factors that critically influence safe work behaviors. The basic problem attributed is the difficulty in assessing what to measure and how to measure it—particularly the intangible aspects of safety. Without measurement, the notion of continuous improvement is hard to follow. This research was undertaken to develop a strategic framework for the measurement and continuous improvement of total safety in order to achieve and sustain the goal of zero accidents, while improving the quality, productivity and the competitiveness of the construction industry as it moves forward. The research based itself on an integral model of total safety that allowed decomposition of safety into interior and exterior characteristics using a multiattribute analysis technique. Statistical relationships between total safety dimensions and safety performance (measured by safe work behavior) were revealed through a series of latent variables (factors) that describe the total safety environment of a construction organization. A structural equation model (SEM) was estimated for the latent variables to quantify relationships among them and between these total safety determinants and safety performance of a construction organization. The developed SEM constituted a strategic framework for identifying, measuring, and continuously improving safety as a total concern for achieving and sustaining the goal of zero accidents.

Overcoming Barriers to Restaurant Food Safety

Food safety is critical to the success of restaurants. Yet current methods of controling foodborne illness are inadequate, including time and temperature control, safe food handling procedures, good employee hygiene, cleaning and sanitizing techniques, and Hazard Analysis and Critical Control Points (HACCP) plan. Several barriers to food safety in restaurants are identified and recommendations for management are suggested.