Trust-Level Risk Evaluation and Risk Control Guidance in the NHS East of England

In recent years, the healthcare sector has adopted the use of operational risk assessment tools to help understand the systems issues that lead to patient safety incidents. But although these problem-focused tools have improved the ability of healthcare organizations to identify hazards, they have not translated into measurable improvements in patient safety. One possible reason for this is a lack of support for the solution-focused process of risk control. This article describes a content analysis of the risk management strategies, policies, and procedures at all acute (i.e., hospital), mental health, and ambulance trusts (health service organizations) in the East of England area of the British National Health Service. The primary goal was to determine what organizational-level guidance exists to support risk control practice. A secondary goal was to examine the risk evaluation guidance provided by these trusts. With regard to risk control, we found an almost complete lack of useful guidance to promote good practice. With regard to risk evaluation, the trusts relied exclusively on risk matrices. A number of weaknesses were found in the use of this tool, especially related to the guidance for scoring an event's likelihood. We make a number of recommendations to address these concerns. The guidance assessed provides insufficient support for risk control and risk evaluation. This may present a significant barrier to the success of risk management approaches in improving patient safety. © 2013 Society for Risk Analysis.

Risk evaluation of diabetes mellitus by relation of chaotic globals to HRV

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Automatic risk evaluation in elderly patients based on Autonomic Nervous System assessment

Dysfunction of Autonomic Nervous System (ANS) is a typical feature of chronic heart failure and other cardiovascular disease. As a simple non-invasive technology, heart rate variability (HRV) analysis provides reliable information on autonomic modulation of heart rate. The aim of this thesis was to research and develop automatic methods based on ANS assessment for evaluation of risk in cardiac patients. Several features selection and machine learning algorithms have been combined to achieve the goals. Automatic assessment of disease severity in Congestive Heart Failure (CHF) patients: a completely automatic method, based on long-term HRV was proposed in order to automatically assess the severity of CHF, achieving a sensitivity rate of 93% and a specificity rate of 64% in discriminating severe versus mild patients. Automatic identification of hypertensive patients at high risk of vascular events: a completely automatic system was proposed in order to identify hypertensive patients at higher risk to develop vascular events in the 12 months following the electrocardiographic recordings, achieving a sensitivity rate of 71% and a specificity rate of 86% in identifying high-risk subjects among hypertensive patients. Automatic identification of hypertensive patients with history of fall: it was explored whether an automatic identification of fallers among hypertensive patients based on HRV was feasible. The results obtained in this thesis could have implications both in clinical practice and in clinical research. The system has been designed and developed in order to be clinically feasible. Moreover, since 5-minute ECG recording is inexpensive, easy to assess, and non-invasive, future research will focus on the clinical applicability of the system as a screening tool in non-specialized ambulatories, in order to identify high-risk patients to be shortlisted for more complex investigations.

Application of Deadlock Risk Evaluation of Architectural Models

Software architectural evaluation is a key discipline used to identify, at early stages of a real-time system (RTS) development, the problems that may arise during its operation. Typical mechanisms supporting concurrency, such as semaphores, mutexes or monitors, usually lead to concurrency problems in execution time that are difficult to be identified, reproduced and solved. For this reason, it is crucial to understand the root causes of these problems and to provide support to identify and mitigate them at early stages of the system lifecycle. This paper aims to present the results of a research work oriented to the development of the tool called ‘Deadlock Risk Evaluation of Architectural Models’ (DREAM) to assess deadlock risk in architectural models of an RTS. A particular architectural style, Pipelines of Processes in Object-Oriented Architectures–UML (PPOOA) was used to represent platform-independent models of an RTS architecture supported by the PPOOA –Visio tool. We validated the technique presented here by using several case studies related to RTS development and comparing our results with those from other deadlock detection approaches, supported by different tools. Here we present two of these case studies, one related to avionics and the other to planetary exploration robotics. Copyright © 2011 John Wiley & Sons, Ltd.

TREF – Total Risk Evaluation Framework: integrált kockázatmenedzsment-szemléletű keretrendszer kifejlesztése és bevezetése egy magyarországi termelővállalatnál

A felhasználók, a szabványos és törvényi előírások ma már több területen kikényszerítették a kockázatok elemzését és kezelését. A jelenlegi rendszerek alapvető jellemzői, hogy a vállalatokon belüli rendszerek egymástól elkülönülten működnek. Ennek oka az eltérő időpontban, eltérő követelmények, valamint különböző felfogás szerint történt rendszerbevezetés. Az integráció elsősorban vállalati szinten történik, az elemzés szempontját alapvetően az adott funkcionális terület filozófiája határozza meg. Emiatt ritkán kerül sor egy termék vagy folyamat által hordozott összes kockázat módszeres számbavételére. A szabványosítás területén vannak törekvések az integrált szemlélet érvényesítésére. Ez részben már megjelent az ISO 9001 (Minőségirányítási Rendszer [MIR]), az ISO 14001 (Környezetközpontú Irányítási Rendszer [KIR]) és az MSZ 28001 (Munkahelyi Egészségvédelem és Biztonsági Rendszer [MEBIR]) szabványok vonatkozásában. Az ISO 31000 szabványcsalád általános útmutatást ad egy szervezeten belül a kockázatkezelési folyamat tervezésére, megvalósítására és fenntartására. A jelenlegi tanulmány alapvető célja egy olyan újszerű módszer bemutatása, amely lehetővé teszi a különböző irányítási rendszerek hierarchikus, folyamatcentrikus, kockázatmenedzsment-alapú integrációját.

Type 2 Diabetes Mellitus: Risk Evaluation and Advice in Undergraduate Students in Ashrafieh, Lebanon

Type 2 diabetes mellitus (T2DM) is a chronic lifestyle disease. It has become evident that T2DM occurs even among the younger age groups.1 In Lebanon, T2DM has a major public health impact through high disease prevalence, significant downstream pathophysiologic effects, and enormous financial liabilities.2

Sugarcane herbicide leaching risk evaluation in Guarany Aquifer.

he region of Ribeirão Preto, São Paulo State, Brazil, is located over recharge area of the Guarany aquifer, the most important source of groundwater in the South Central region of the country. This region is also the most important sugarcane producing area of the country which produces a large amount of the ethanol. This study was conducted to determine the potential risk of herbicide groundwater contamination. The leaching risk potential of herbicides to groundwater was conducted using the weather simulator ?Weather Generator? (WGEN) coupled with the model ?Chemical Movement Trough Layered Soils? (CMLS94). The following herbicides were evaluated in clayey and sandy soils (Typic Haplorthox and Typic Quartzipsamment soils) found in the region: ametryn (N-ethyl-N\'-(1- methylethyl)-6-(methylthio)-1,3,5-triazine-2,4-diamine), atrazine (6-chloro-N-ethyl-N\'-(1-methylethyl)-1,3,5-triazine- 2,4-diamine), clomazone (2-[(2-chlorophenyl)methyl]-4,4-dimethyl-3-isoxazolidinone), diuron (3,4-dichlorophenyl)- N,N-dimethylurea), halosulfuron (3-chloro-5-[(4,6-dimethoxy-2-pyrimidinyl)amino]carbonyl], hexazinone (3- cyclohexyl-6-(dimethylamino)-1-methyl-1,3,5-triazine-2,4 (1H,3H)-dione), imazapic ((±)-2-[4,5-dihydro-4-methyl-4- (1-methylethyl)-5-oxo-1H-imidazol-2-yl]-5-methyl-3-pyridinecarboxylic acid), imazapyr ((±)-2-[4,5-dihydro-4-methyl- 4-(1-methylethyl)-5-oxo-1H-imidazol-2-yl]-3-pyridinecarboxylic acid), MCPA (4-chloro-2-methylphenoxy)acetic acid), metribuzin (4-amino-6-(1,1-dimethylethyl)-3-(methylthio)-1,2,4-triazin-5(4H)-one), MSMA (Amonosodium salt of MAA), paraquat (1,1\'-dimethyl-4,4\'-bipyridinium ion), pendimethalin (N-(1-ethylpropyl)-3,4-dimethyl-2,6- dinitrobenzenamine), picloram (4-amino-3,5,6-trichloro-2-pyridinecarboxylic acid), simazine (6-chloro-N,N\'-diethyl- 1,3,5-triazine-2,4-diamine), sulfentrazone [N-[2,4-dichloro-5-[4-(difluoromethyl)-4,5-dihydro-3-methyl-5-oxo-1H- 1,2,4-triazol-1-yl]phenyl]methanesulfonamide], and tebuthiuron [N-[5-(1,1-dimethylethyl)-1,3,4-thiadiazol-2-yl]-N,N\'- dimethylurea]. Results obtained by our simulation study have shown that the herbicides picloram, tebuthiuron, and metribuzin have the highest leaching potential, in either sandy or clayey soils, with picloram reaching the root zone of sugarcane at 0.6m in less than 150 days.

Sugarcane herbicide leaching risk evaluation in Guarany Aquifer.

2008