A research report submitted to the faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Medicine in Anaesthesiology Johannesburg, 2017 / Background Adverse events and errors are a widespread cause of morbidity and mortality in the health care environment. Adverse event and error reporting systems have been shown to potentially reduce the occurrence of these events, however there is still significant underreporting. Little is known regarding the barriers to reporting of adverse events and errors in the context of South Africa, or what emotional and attitudinal barriers may be present regarding a formal reporting system amongst anaesthetists in the Department of Anaesthesiology at the University of the Witwatersrand. Methods A prospective, descriptive, contextual study design utilizing an anonymous self-administered questionnaire was distributed to 133 anaesthetists who attended academic anaesthetic meetings. Results One hundred and eighteen questionnaires met the criteria for analysis, giving a response rate of 92%. Barriers to reporting included a “code of silence” in medicine and blame from colleagues. If a specified error as opposed to an adverse event had occurred, participants were more likely to agree with barriers regarding fear of litigation, disciplinary action, getting into trouble, as well as colleagues that may be unsupportive. Strategies to promote reporting of adverse events and errors include senior role models who encourage reporting and individualised feedback regarding reports made. Conclusions Most anaesthetists in our study disagreed with barriers to reporting an unspecified adverse event. However, if an error has occurred, reporting behaviour may be inhibited by barriers regarding fears of litigation, disciplinary action and lack of support. Senior role models that openly support reporting along with individualised feedback may increase reporting rates. / MT2017

Thesis (Ph. D.)--University of Washington, 2001. / Vita. Includes bibliographical references (p. 132-136).

Proefschrift Universiteit van Amsterdam. / Met bibliogr., lit. opg. - Met samenvatting in het Nederlands.

No description available.

L’architecture d’entreprise se préoccupe de la maintenance d’un système d’information (SI) qui nécessite une mise en phase répétée avec le pilotage de l’entreprise. En pratique, les points de vue métiers et applicatifs s’éloignent à mesure qu’évoluent la stratégie de l’entreprise et le patrimoine applicatif. Ainsi, il est difficile pour les architectes de mesurer l’impact de l’évolution des processus métiers vis-à-vis des technologies utilisées. Le risque d’incohérence devient grand et préjudiciable dans le temps. Nous considérons chaque point de vue du SI comme un modèle ; pour associer les points de vue nous proposons une définition de l’alignement au niveau méta-modèle. L’alignement est par conséquent mis en pratique à l’aide d’outils d’ingénierie des modèles. Il n’est pas imaginable d’aligner directement le code source aux modèles métiers existants. Nous avons donc défini un alignement entre modèles métiers et modèles applicatifs. Ces derniers sont construits par rétro-ingénierie du code. L’analyse du résultat de l’alignement permet de générer des indicateurs de cohérence et de complétude qui aident l’architecte dans son processus d’analyse et de décision des évolutions du système d’information. L’approche présentée est expérimentée sur plusieurs cas concrets de taille significative issus d’entreprises du secteur de l’assurance, et ouvre des perspectives intéressantes de valorisation. / Enterprise software architects take great care of information system maintenance, which requires regular adjustments in order to stay in sync with management needs. In practice, business and application viewpoints diverge as the enterprise strategy and the legacy applications evolve. Thus, it is difficult for architects to evaluate the impact of process evolution with respect to chosen technologies. Risk of inconsistency becomes more important and damaging over time. We consider each IS viewpoint as a model; to aggregate these, we propose to map the models with an alignment definition based on meta-models. This alignment is therefore supported by model engineering tools. As existing business models and source code cannot be aligned, business models is aligned with application models. These are built by performing a reverse engineering of the code. Futhermore, analysing the alignment results enables one to measure consistency and completeness indicators. They help the architect in the process of making changes to the information system. The presented approach is illustrated with various large scale french insurance companies use cases. It reveals valuable improvement perspectives.

AABS

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This master’s thesis deals with the influence of different AE sensor couplants and surface roughness on the selected acoustic emission parameters. There are compared the amplitude of the signal measured using five different couplants at 20°C and 80°C. To monitor the effect of surface roughness on the AE parameters simple measuring product was constructed. Its functionality has been verified by implementation of basic experimental measurements.

Justas Morkūnas Profesinė apšvita ir jos citogenetinio poveikio tyrimai Ignalinos AE darbuotojų limfocituose SANTRAUKA Lietuvoje Ignalinos AE darbuotojai sudaro didžiausią grupę asmenų, dirbančių tiesiogiai su jonizuojančiosios spinduliuotės (JS) šaltiniais ar su jų sąlygojama apšvita susijusį darbą. Profesinės apšvitos dozės paprastai neviršija leistinos 20 mSv metinės dozių ribos, tačiau daugelis tyrimų patvirtino, kad net mažos JS dozės gali reikšmingai padidinti chromosomų aberacijų (CA) dažnį periferinio kraujo limfocituose. Šio darbo tikslas buvo ištirti CA dažnius didžiausias apšvitos dozes gaunančių Ignalinos AE darbuotojų kraujo limfocituose ir įvertinti skirtingos profesinės apšvitos tipų bei atliekamų darbų lemiamą riziką. Visoje tirtų Ignalinos AE darbuotojų grupėje nustatytas patikimai didesnis palyginus su kontroline grupe bendras CA dažnis (3,26 vs 2,18 CA/100 ląst.), chromosominio tipo aberacijų (2,18 vs 0,82), acentrinių fragmentų (1,54 vs 0,65) ir dicentrinių chromosomų (0,51 vs 0,03) dažniai (p < 0,05). CA dažnis Ignalinos AE darbuotojų grupėje tik su išorine apšvita patikimai nesiskyrė nuo dažnio stebėto kontrolinių asmenų grupėje (2,56 vs 2,18 CA/100 ląst., p > 0,05). Ignalinos AE darbuotojų grupėje, kurioje be išorinės apšvitos buvo registruota papildoma vidinė apšvita, nustatyti patikimai didesni palyginus su kontrole bendras CA dažnis (3,61 vs 2,18), chromosominio tipo aberacijų (2,37 vs 0,82), acentrinių fragmentų (1,58 vs 0,65) ir dicentrinių... [toliau žr. visą tekstą] / Justas Morkūnas Occupational radiation exposure and cytogenetic monitoring of Ignalina Nuclear Power Plant workers SUMMARY The Ignalina Nuclear Power Plant workers (INPP) represent the largest group of workers occupationally exposed to low-level doses of ionizing radiation in Lithuania. Though individual doses of the INPP workers for many years have been declining and are retained within officially accepted limits, many reports demonstrate that low-level occupational exposure to ionizing radiation can significantly increase chromosome aberration levels in blood lymphocytes. Moreover, chromosome aberrations are believed to be a possible biomarker reflecting chromosome damage in target tissues which in turn is linked to cancer development. Therefore many studies have been dedicated to investigate the cytogenetic effects of low-level radiation in blood lymphocytes, especially trying to establish dose-effect relationship and predict possible cancer risks. The objective of the current study was to analyze chromosome aberration levels in lymphocytes of the INPP workers subjected to relatively high individual doses of occupational exposure (mean accumulated doses 280.2±44.9 mSv), taking into consideration different types of ionizing radiation. A total of 21 blood samples from INPP workers and 17 control samples were analyzed. Cytogenetic analysis revealed significantly increased CA levels in the whole group of INPP workers (3.26±0.34 CA/100 cells) and a subgroup of workers... [to full text]

Proefschrift Universiteit van Amsterdam. / Met lit. opg. - Met samenvatting in het Nederlands.