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Man över bord : En analys av olyckor med beredskapsbåtar / Man overboard : An analysis of accidents involving rescue boatsIvarsson, Gabriella, Forsblom, Emelie January 2016 (has links)
Fartygets beredskapsbåt är en viktig del i sjöräddningsarbetet för att till exempel rädda en nödställd person ur vattnet, men dessvärre sker olyckor i samband med användandet av denna. Syftet med detta arbete var att undersöka varför olyckor med beredskapsbåtar inträffar, genom att analysera haverirapporter om beredskapsbåtsolyckor ombord på fartyg med anknytning till Europa. 13 rapporter analyserades med hjälp av HFACS-MA-modellen. Metoden kategoriserar orsaker till olyckor och har givit en bild av vilka faktorer som varit de mest frekvent bidragande i de undersökta olycksfallen. Resultatet visade att fel och brister i konstruktionen (av till exempel dävert, krok och säkerhetsbrytare), otillräcklig eller obefintlig dokumentation inom organisationen (checklistor, manualer och instruktioner) och den fysiska arbetsplatsen (hur arbetsplatsen var utformad) var de främsta orsakerna till att olyckor med beredskapsbåtar inträffade. Av resultatet framgick även att kategorin förutsättningar, som till exempel yttre miljö och kommunikation, var en stor bidragande faktor. / The ship's rescue boat is an important part of search and rescue, for example to rescue a person in distress from the water, but unfortunately accidents happen in conjunction with the use of the boat. The purpose of this essay was to investigate why accidents with rescue boats occur by analyzing accident reports involving rescue boat accidents on ships with a connection to Europe. 13 reports were analyzed with the HFACS-MA model. The method categorizes the causes of accidents and has provided a picture of the factors that have been most contributory in the investigated accidents. The result showed that deficiencies in the design (for example davit, hook and breaker), insufficient or nonexistent documentation within the organization (checklists, manuals and instructions) and the function of the physical workplace, were the main reasons for why accidents involving rescue boats occur. The result also showed that the category preconditions, such as the external environment and communication, was a major contributing factor.
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The role of weather in Class A Naval aviation mishaps FY 90-98Cantu, Ruben A. 03 1900 (has links)
Approved for public release, distribution is unlimited / 235 Class A Navy and Marine (Naval) aviation mishaps involving aircrew error between FY 90 and FY 98 are analyzed for the possibility of being weather related. In addition to determining the overall role of weather, weather related mishaps are compared to aircraft category, mishap characteristic, the Naval Safety Center human factors (HFACS) taxonomy, and flight phase. In addition, weather related mishap trends have been analyzed. Results show 19% of mishaps involving aircrew error are weather related with helicopter category and controlled flight into terrain (CFIT) mishap characteristic having the largest percent of weather related mishaps for their respective groupings. Visibility related weather elements account for over half of all weather related mishaps, and nearly two-thirds of all weather related mishaps were judged to be preventable with a perfect weather forecast believed by aircrew. These and other findings are presented to develop intervention strategies for reducing the number of weather related flight mishaps (FMs) per year. / Lieutenant Commander, United States Navy
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Modelle zur Bewertung der Verkehrssicherheit von Landstraßen / Models for evaluating the road safety of rural roadsBerger, Ralf 25 May 2016 (has links) (PDF)
Die Dissertationsschrift enthält die Entwicklung eines Verfahrens zur Bewertung der Verkehrssicherheit von Streckenabschnitten auf Landstraßen außerhalb von Knotenpunkten. Dabei liegt das Augenmerk auf der Abbildung von Sicherheitsgraden maßgebender Querschnitte und der Identifikation und Quantifizierung von einflussnehmenden Merkmalen. Das Verfahren stellt einen Bezug zu den aktuellen Entwurfsrichtlinien für die Anlage von Landstraßen dar und verknüpft die Bewertungsmethodik mit den Zielen zukünftiger Bewertungsverfahren, wie sie im Entwurf des Handbuchs zur Bewertung der Verkehrssicherheit von Straßen enthalten sind. Grundlage bilden die Daten eines ca. 3.600 km umfangreichen Streckenkollektivs.
Beruhend auf den Erkenntnissen der Literaturanalyse erfolgen die Einteilung des Streckenkollektivs in Netzelemente, die Festlegung und Kategorisierung mutmaßlicher Merkmale sowie die Klassifizierung von vier Bewertungsfällen. Die Anwendung Verallgemeinerter Linearer Modelle zur Beschreibung der Unfallhäufigkeit in Abhängigkeit verschiedener Variablen stellt eine Möglichkeit dar, Einschränkungen monokausaler Sicherheitsuntersuchungen aufzulösen. Darüber hinaus bietet das Verfahren die Möglichkeit, das Unfallgeschehen in einen nicht vermeidbaren – dieser entspricht einem Grundniveau – und einen vermeidbaren Teil – Zuschläge aufgrund von Defiziten und Streckeneigenschaften – zu unterscheiden. Im Rahmen einer vergleichenden Unfallanalyse erfolgt die räumliche Abgrenzung von Knotenpunkten, Einflussbereichen und der Freien Strecke. Plangleiche Knotenpunkte weisen eine feste Länge auf, während die Länge der Einflussbereiche variiert.
Im ersten Teil der Analyse werden zur Beschreibung der Unfallhäufigkeit der Freien Strecke zwei Ansätze betrachtet. Sowohl für den Ansatz nach Unfallschwere als auch nach Unfalltyp erfolgte eine differenzierte Modellbildung auf Basis mehrerer Teilkollektive je Bewertungsfall. Dies erlaubt eine feinere Verknüpfung von Ursache und Wirkung. Allen Modellen liegt eine Prüfung auf allgemeine Anwendbarkeit zugrunde. Im Vergleich beider Ansätze zeigt sich, dass die unfalltypenfeine Betrachtung eine deutlichere konfliktbezogene Tiefe zwischen streckencharakteristischen Merkmalen und der Unfallhäufigkeit zulässt.
Als maßgebend einflussnehmende Merkmale gelten neben der Relationstrassierung und der Querschnittsausprägung auch die Seitenraumgestaltung. Der ermittelte nichtlineare Zusammenhang zwischen Unfallgeschehen und Verkehrsstärke hat zur Folge, Zuschläge als Anteilswert bezüglich des Grundniveaus zu betrachten. Es existieren verschiedene Arten von Zuschlägen. Deren ermittelte Größenordnung variiert in Abhängigkeit von der Merkmalausprägung und der Verkehrsstärke. Im Resultat liegen für alle Bewertungsfälle ein monetär bewertetes Sicherheitsgrundniveau und Zuschlagstabellen vor.
Zweiter Bestandteil der Analyse stellt die Bewertung der Einflussbereiche dar. Diese entsprechen dem Bindeglied zwischen den Streckenübergängen und der Freien Strecke. Unter der Annahme, dass die Verkehrssicherheit in diesen Bereichen sowohl von Merkmalen des Streckenübergangs als auch der Freien Strecke beeinflusst wird, erfolgt die Identifikation maßgebender Merkmale, welche den Streckenübergang charakterisieren. Im Resultat werden Einflussfaktoren ermittelt, die den Sicherheitsgrad von Freier Strecke und Einflussbereich ins Verhältnis setzen. Die Bewertung erfolgt ebenfalls auf Basis multipler Regres-sionen typendifferenzierter Unfallkollektive. Es zeigt sich, dass das Verhältnis für einige Arten von Übergängen eine Abhängigkeit von der Verkehrsstärke aufweist. Die Ergebnisse beider Analyseschritte münden in der Bereitstellung eines Verfahrens, welches die Sicherheitsanalyse von Streckenabschnitten unter gegebenen Randbedingungen ermöglicht und einen Variantenvergleich erlaubt.
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Forage des données et formalisation des connaissances sur un accident : Le cas Deepwater Horizon / Data drilling and formalization of knowledge related to an accident : The Deepwater Horizon caseEude, Thibaut 18 December 2018 (has links)
Le forage de données, méthode et moyens développés dans cette thèse, redéfinit le processus d’extraction de données, de la formalisation de la connaissance et de son enrichissement notamment dans le cadre de l’élucidation d’évènements qui n’ont pas ou peu été documentés. L’accident de la plateforme de forage Deepwater Horizon, opérée pour le compte de BP dans le Golfe du Mexique et victime d’un blowout le 20 avril 2010, sera notre étude de cas pour la mise en place de notre preuve de concept de forage de données. Cet accident est le résultat d’un décalage inédit entre l’état de l’art des heuristiques des ingénieurs de forage et celui des ingénieurs antipollution. La perte de contrôle du puits MC 252-1 est donc une faillite d’ingénierie et il faudra quatre-vingt-sept jours à l’équipe d’intervention pour reprendre le contrôle du puits devenu sauvage et stopper ainsi la pollution. Deepwater Horizon est en ce sens un cas d’ingénierie en situation extrême, tel que défini par Guarnieri et Travadel.Nous proposons d’abord de revenir sur le concept général d’accident au moyen d’une analyse linguistique poussée présentant les espaces sémantiques dans lesquels se situe l’accident. Cela permet d’enrichir son « noyau de sens » et l’élargissement de l’acception commune de sa définition.Puis, nous amenons que la revue de littérature doit être systématiquement appuyée par une assistance algorithmique pour traiter les données compte tenu du volume disponible, de l’hétérogénéité des sources et des impératifs d’exigences de qualité et de pertinence. En effet, plus de huit cent articles scientifiques mentionnant cet accident ont été publiés à ce jour et une vingtaine de rapports d’enquêtes, constituant notre matériau de recherche, ont été produits. Notre méthode montre les limites des modèles d’accidents face à un cas comme Deepwater Horizon et l’impérieuse nécessité de rechercher un moyen de formalisation adéquat de la connaissance.De ce constat, l’utilisation des ontologies de haut niveau doit être encouragée. L’ontologie DOLCE a montré son grand intérêt dans la formalisation des connaissances à propos de cet accident et a permis notamment d’élucider très précisément une prise de décision à un moment critique de l’intervention. La population, la création d’instances, est le coeur de l’exploitation de l’ontologie et son principal intérêt mais le processus est encore très largement manuel et non exempts d’erreurs. Cette thèse propose une réponse partielle à ce problème par un algorithme NER original de population automatique d’une ontologie.Enfin, l’étude des accidents n’échappe pas à la détermination des causes et à la réflexion sur les « faits socialement construits ». Cette thèse propose les plans originaux d’un « pipeline sémantique » construit à l’aide d’une série d’algorithmes qui permet d’extraire la causalité exprimée dans un document et de produire un graphe représentant ainsi le « cheminement causal » sous-jacent au document. On comprend l’intérêt pour la recherche scientifique ou industrielle de la mise en lumière ainsi créée du raisonnement afférent de l’équipe d’enquête. Pour cela, ces travaux exploitent les avancées en Machine Learning et Question Answering et en particulier les outils Natural Language Processing.Cette thèse est un travail d’assembleur, d’architecte, qui amène à la fois un regard premier sur le cas Deepwater Horizon et propose le forage des données, une méthode et des moyens originaux pour aborder un évènement, afin de faire émerger du matériau de recherche des réponses à des questionnements qui échappaient jusqu’alors à la compréhension. / Data drilling, the method and means developed in this thesis, redefines the process of data extraction, the formalization of knowledge and its enrichment, particularly in the context of the elucidation of events that have not or only slightly been documented. The Deepwater Horizon disaster, the drilling platform operated for BP in the Gulf of Mexico that suffered a blowout on April 20, 2010, will be our case study for the implementation of our proof of concept for data drilling. This accident is the result of an unprecedented discrepancy between the state of the art of drilling engineers' heuristics and that of pollution response engineers. The loss of control of the MC 252-1 well is therefore an engineering failure and it will take the response party eighty-seven days to regain control of the wild well and halt the pollution. Deepwater Horizon is in this sense a case of engineering facing extreme situation, as defined by Guarnieri and Travadel.First, we propose to return to the overall concept of accident by means of an in-depth linguistic analysis presenting the semantic spaces in which the accident takes place. This makes it possible to enrich its "core meaning" and broaden the shared acceptance of its definition.Then, we bring that the literature review must be systematically supported by algorithmic assistance to process the data taking into account the available volume, the heterogeneity of the sources and the requirements of quality and relevance standards. In fact, more than eight hundred scientific articles mentioning this accident have been published to date and some twenty investigation reports, constituting our research material, have been produced. Our method demonstrates the limitations of accident models when dealing with a case like Deepwater Horizon and the urgent need to look for an appropriate way to formalize knowledge.As a result, the use of upper-level ontologies should be encouraged. The DOLCE ontology has shown its great interest in formalizing knowledge about this accident and especially in elucidating very accurately a decision-making process at a critical moment of the intervention. The population, the creation of instances, is the heart of the exploitation of ontology and its main interest, but the process is still largely manual and not without mistakes. This thesis proposes a partial answer to this problem by an original NER algorithm for the automatic population of an ontology.Finally, the study of accidents involves determining the causes and examining "socially constructed facts". This thesis presents the original plans of a "semantic pipeline" built with a series of algorithms that extract the expressed causality in a document and produce a graph that represents the "causal path" underlying the document. It is significant for scientific or industrial research to highlight the reasoning behind the findings of the investigation team. To do this, this work leverages developments in Machine Learning and Question Answering and especially the Natural Language Processing tools.As a conclusion, this thesis is a work of a fitter, an architect, which offers both a prime insight into the Deepwater Horizon case and proposes the data drilling, an original method and means to address an event, in order to uncover answers from the research material for questions that had previously escaped understanding.
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Sistemas de investigação dos acidentes aeronáuticos da aviação geral: uma análise comparativa / Accident investigation systems for the general aviation: a comparative analysisFajer, Marcia 03 September 2009 (has links)
Descreve o panorama do surgimento da aviação e das teorias de investigação de acidentes aeronáuticos. Objetivo - Analisar a investigação dos acidentes e incidentes aeronáuticos ocorridos na Aviação Geral no Estado de São Paulo no período de 2000 a 2005 e verificar sua associação a fatores organizacionais. Método - Foram comparadas as atuações das agências de investigação de acidentes aeronáuticos dos Estados Unidos, União Européia e Brasil, identificado os métodos de investigação de acidentes empregados. Foi realizado o levantamento das ocorrências com as aeronaves classificadas na categoria de aviação geral no estado de São Paulo no período 2000 a 2005 e feita a análise comparativa de 36 relatórios finais de acidentes utilizados pelo Centro de Investigação e Prevenção de Acidentes (CENIPA) com o Human Factors Analysis and Classification System (HFACS). Resultados Identificou-se que as agências de investigação dos Estados Unidos e União Européia atuam de forma sistêmica e a brasileira atua isoladamente. Foi constatado que houve 636 ocorrências com aeronaves da aviação geral, sendo que 92 por cento foram incidentes, que não foram investigados. Dos acidentes, 5,5 por cento possuíam relatórios finais concluídos. A análise dos relatórios finais, segundo o CENIPA, apontou 163 fatores contribuintes, sendo que o principal fator foi o deficiente julgamento presente em 80,5 por cento dos acidentes. A utilização do modelo HFACS identificou a presença de 370 fatores contribuintes e os erros de habilidade, de decisão e planejamento inadequado foram os principais fatores contribuintes com 86,1 por cento . Considerações Finais O estudo possibilitou a identificação da falta de integração de diversos órgãos governamentais na investigação dos acidentes aeronáuticos. A ausência de investigação de incidentes aeronáuticos dificultando a prevenção. A análise do CENIPA não contempla de forma adequada os fatores organizacionais. O HFACS não deve ser uma ferramenta apenas quantificadora das causas de acidentes aeronáuticos / Introduction Describes the birth of aviation and aeronautical accidents factors. investigation theories. Objective Analyze the investigation of aeronautical accidents and incidents occurring in the General Aviation in the State of São Paulo during the period of 2000 through 2005 and verify their association with organizational factors. Method The air accident agencies of the United States, European Union and Brazil were studied, identifying and comparing the accident investigation methods used. It was registered the number of events with aircrafts in the State of Sao Paulo from 2000 to 2005, and performed the comparative analysis of 36 accident final reports used by the Centro de Investigação e Prevenção de Acidentes (CENIPA; Accident Prevention and Investigation Center) using the Human Factors Analysis and Classification System (HFACS). Results It was observed that the investigation agencies of the United States and the European Union work in a systemic way, and that the Brazilian one works alone. It was observed that there were 636 events with aircrafts of the general aviation, of which 92 per cent were not-investigated incidents. Of the accidents, 5.5 per cent had their final reports finished. The analysis of the final reports according to CENIPA pointed out 163 contributing factors, being the main factor \"inadequate evaluation\", present in 80.5 per cent of the accidents. The HFACS model identified 370 contributing factors, and the \"skill errors\", \"decision\" and \"inadequate planning\" were the main contributing factors, being present in 86.1 per cent of the cases. Final Considerations The study allowed identifying the lack of integration of several administration agencies when investigating air accidents. The non investigation of air incidents hinders the prevention. The CENIPA analysis does not study properly the organizational factors. HFACS must not be just a quantifying tool of the air accidents causes.
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Auxílio-acidente: uma análise da estrutura de sua norma jurídicaAguiar, Rafael Perales de 14 December 2016 (has links)
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Previous issue date: 2016-12-14 / This thesis aims to conduct a study on social security benefit accident assistance, in order to
demonstrate the exact extent of coverage of this benefit today and its main features, focus on
the latest legislative changes. The work will make a historical analysis of accident assistance,
demonstrating how it has evolved and for which reason the benefit was structured in the
current manner, integrating the social security protection, after leaving an nature origin of
private obligatory insurance to the employer for accidents work to their employees. Also
dedicate a part of this study to explain some general concepts important Social Security Law
directly related to the comprehension of the accident assistance. Besides to promote a
discussion about current basis of this benefit as your possible new nature. This study will
follow the methodology of deduction, through legal and doctrinal analysis of the benefit;
induction, analysis of a specific case to explain the general through case law and; dialectic
opposition of ideas to discuss and understand all the issues addressed in the dissertation.
Regarding the research technique applied, a collection of doctrinal and jurisprudential data on
the subject and review and analysis of collected data and arguments will be made, and will be
an analysis of the relevant legislation to retirement benefits for disability, sickness and
accident assistance / A presente dissertação tem por finalidade realizar um estudo sobre o benefício previdenciário
auxílio-acidente, com o objetivo de demonstrar a extensão exata da cobertura deste benefício,
hoje, e suas principais características, sob o enfoque das mais recentes alterações legislativas.
O trabalho fará uma análise histórica do auxílio-acidente, demonstrando como evoluiu e por
qual razão o benefício foi estruturado da atual maneira, integrando a proteção da Seguridade
Social, depois de partir de uma origem de natureza privada obrigacional do empregador de
fazer seguro para acidentes de trabalho aos seus empregados. Também se dedicará uma parte
deste estudo para explicar alguns conceitos gerais importantes do Direito Previdenciário
relacionados diretamente com a compreensão do auxílio-acidente, além de promover uma
discussão sobre o atual fundamento deste benefício e sua possível nova natureza. Este estudo
seguirá a metodologia da dedução, através da análise legal e doutrinária do benefício;
indução, análise de um caso específico para explicar o geral através de jurisprudência e;
dialética, contraposição de ideias para discutir e entender todos os problemas abordados na
dissertação. Já em relação à técnica de pesquisa aplicada, será feita uma coleta de dados
doutrinários e jurisprudenciais acerca do tema e revisão e análise destes dados e argumentos
coletados, assim como, será feita uma análise da legislação pertinente aos benefícios
aposentadoria por invalidez, auxílio-doença e auxílio-acidente
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La notion juridique de faute dans les accidents : un concept à géométrie variable / The legal concept of fault in road accidents in variable geometryMohammadi, Samira 11 December 2014 (has links)
Depuis l’apparition de l’automobile, l’action du conducteur est mise en avant comme l’une des principales causes de l’insécurité routière. Or, la recherche en accidentologie montre que la conduite est une activité plus complexe qu'il n'y paraît, le conducteur n'étant qu'un opérateur final, intervenant à la jonction de composantes qu’il n'a pas toujours la capacité de maîtriser . En effet, l’accident résulte d’un dysfonctionnement dans l’interaction des éléments d’un système articulé qui comprend l’environnement routier, le véhicule et l’intervenant humain. Ainsi, il est possible de trouver, très en amont du choc, des faits ayant contribué à la mise en place de la situation accidentogène. Le conducteur doit en permanence ajuster son activité à l’environnement dans lequel il évolue et faire face à des situations conflictuelles. Pourtant, cette complexité est rarement prise en compte dans l’appréciation des faits . Lorsqu'il est question d'accident de la circulation, tout un chacun a fortement tendance à raisonner en termes de responsabilité et de faute, attribuable à tel ou tel protagoniste, notamment, celui qui se trouve en première ligne : le conducteur. Or, la notion de faute du conducteur reste une notion ambigüe dans la mesure où elle se présente d’une part comme un fait, générateur d’un dommage causé à autrui (et imputable à la conduite du sujet de droit), et d’autre part comme une qualité de ce fait, résultant de l’appréciation portée par un juge (le manquement à la norme). Ainsi, il est demandé au juge d’apprécier dans chaque cas d’espèce le caractère à risque des situations auxquelles sont confrontés les conducteurs. Les indices élaborés en accidentologie, sur la base de connaissances et de vérités de type scientifique, permettent théoriquement d’établir des constats qui reflètent la réalité des faits et aident les juges dans l’appréciation des événements soumis à leur examen. Ainsi, dans chaque cas, le risque inhérent à la circulation routière rend nécessaire une relecture fine du comportement erroné ou fautif du conducteur.Le travail présenté ici ne s’intéressera qu’accessoirement à la question de savoir si le conducteur est « fautif » ou « responsable ». Notre interrogation portera plutôt sur les moyens de faire évoluer la situation juridique du conducteur et de permettre au juge d’appréhender à la fois le pouvoir et les moyens dont le conducteur dispose potentiellement mais aussi les difficultés inhérentes à l’activité de conduite.La thèse mobilise les compétences en droit civil et en droit pénal pour dresser un bilan des textes applicables, de la doctrine, et de la jurisprudence qui aborde les questions telles que les circonstances contributives à l’accident, mettant en jeu différents facteurs. La forte évolution de l'utilisation des véhicules au cours des dernières décennies appelle la mise en œuvre de mesures juridiques ciblées qui s'appuient sur les résultats de la recherche en accidentologie, notamment celle qui analyse le comportement du conducteur en le resituant dans un système d’une grande complexité. / For many decades, the problem of road safety was primarily focused on drivers behaviour. Further studies in accident research show that driving is a complex activity; the driver is only the final regulatory mechanism that cannot always be controlled. Accidents result from different malfunctions within different interactions of these following elements : humans, vehicles and road environments. The malfunctions can be predictable. The situations governing the accidents can be related back to occurrences prior to their happening. Often the legal complications of an accident result from varying proportions of fault. Factors might include conditions in the general atmosphere of the occurrence. Implications of fact can also be qualified differently depending on the level of driving skills of people involved.The range of participants in legal proceedings spans private and public figures as well as legal advisors. These partakers must determine levels of fault and thus help direct judgment. The thesis herein is intended to mobilize experts in several areas of law: criminal law, civil law and labor law. Research sources for this writing were primarily public court records related to accidents, as well as the minutes and recorded details of accident studies done by IFSTTAR. Further resources include research of experts in the field of accidentology, including assessments of expert studies by IFSTTAR.
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Sistemas de investigação dos acidentes aeronáuticos da aviação geral: uma análise comparativa / Accident investigation systems for the general aviation: a comparative analysisMarcia Fajer 03 September 2009 (has links)
Descreve o panorama do surgimento da aviação e das teorias de investigação de acidentes aeronáuticos. Objetivo - Analisar a investigação dos acidentes e incidentes aeronáuticos ocorridos na Aviação Geral no Estado de São Paulo no período de 2000 a 2005 e verificar sua associação a fatores organizacionais. Método - Foram comparadas as atuações das agências de investigação de acidentes aeronáuticos dos Estados Unidos, União Européia e Brasil, identificado os métodos de investigação de acidentes empregados. Foi realizado o levantamento das ocorrências com as aeronaves classificadas na categoria de aviação geral no estado de São Paulo no período 2000 a 2005 e feita a análise comparativa de 36 relatórios finais de acidentes utilizados pelo Centro de Investigação e Prevenção de Acidentes (CENIPA) com o Human Factors Analysis and Classification System (HFACS). Resultados Identificou-se que as agências de investigação dos Estados Unidos e União Européia atuam de forma sistêmica e a brasileira atua isoladamente. Foi constatado que houve 636 ocorrências com aeronaves da aviação geral, sendo que 92 por cento foram incidentes, que não foram investigados. Dos acidentes, 5,5 por cento possuíam relatórios finais concluídos. A análise dos relatórios finais, segundo o CENIPA, apontou 163 fatores contribuintes, sendo que o principal fator foi o deficiente julgamento presente em 80,5 por cento dos acidentes. A utilização do modelo HFACS identificou a presença de 370 fatores contribuintes e os erros de habilidade, de decisão e planejamento inadequado foram os principais fatores contribuintes com 86,1 por cento . Considerações Finais O estudo possibilitou a identificação da falta de integração de diversos órgãos governamentais na investigação dos acidentes aeronáuticos. A ausência de investigação de incidentes aeronáuticos dificultando a prevenção. A análise do CENIPA não contempla de forma adequada os fatores organizacionais. O HFACS não deve ser uma ferramenta apenas quantificadora das causas de acidentes aeronáuticos / Introduction Describes the birth of aviation and aeronautical accidents factors. investigation theories. Objective Analyze the investigation of aeronautical accidents and incidents occurring in the General Aviation in the State of São Paulo during the period of 2000 through 2005 and verify their association with organizational factors. Method The air accident agencies of the United States, European Union and Brazil were studied, identifying and comparing the accident investigation methods used. It was registered the number of events with aircrafts in the State of Sao Paulo from 2000 to 2005, and performed the comparative analysis of 36 accident final reports used by the Centro de Investigação e Prevenção de Acidentes (CENIPA; Accident Prevention and Investigation Center) using the Human Factors Analysis and Classification System (HFACS). Results It was observed that the investigation agencies of the United States and the European Union work in a systemic way, and that the Brazilian one works alone. It was observed that there were 636 events with aircrafts of the general aviation, of which 92 per cent were not-investigated incidents. Of the accidents, 5.5 per cent had their final reports finished. The analysis of the final reports according to CENIPA pointed out 163 contributing factors, being the main factor \"inadequate evaluation\", present in 80.5 per cent of the accidents. The HFACS model identified 370 contributing factors, and the \"skill errors\", \"decision\" and \"inadequate planning\" were the main contributing factors, being present in 86.1 per cent of the cases. Final Considerations The study allowed identifying the lack of integration of several administration agencies when investigating air accidents. The non investigation of air incidents hinders the prevention. The CENIPA analysis does not study properly the organizational factors. HFACS must not be just a quantifying tool of the air accidents causes.
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L'écriture de l'accident dans la fiction de Rick Moody / The writing of the accident in Rick Moody’s fictionChapuis, Sophie 10 December 2012 (has links)
L’œuvre de Rick Moody échappe à toute tentative de catégorisation générique, elle est à la croisée de styles qui s’entrechoquent et se heurtent pour donner naissance à une prose hétéroclite. Cette fiction protéiforme n’en demeure pas moins traversée par la répétition d’un motif invariant : l’accident. C’est le paradoxe de cette observation qui constitue le point de départ de cette thèse. Comment l’accident, dont le surgissement paraît toujours fulgurant, instantané et unique, peut-il se voir répété, décliné et transformé en un principe structurant qui préside à la composition de l’oeuvre de Rick Moody ? Pour répondre à cette question, il faut nécessairement changer le présupposé sur lequel repose la définition de l’accident pour qu’il ne soit plus seulement envisagé comme ce qui arrive de manière accidentelle mais pour que soit révélée également sa dimension essentielle. Cela revient à proposer l’hypothèse que l’accident est toujours déjà là, qu’il est ontologique. Ce changement de perspective, rendu possible par une manipulation temporelle, encourage, sur le plan de l’analyse littéraire, une étude de la temporalité de l’accident. Son surgissement induit plus largement la question de la représentation de la réalité tandis que sa répétition autorise son inscription dans une durée. Provoquant toujours une rupture, la temporalité de l’accident est double car elle a la possibilité à la fois de mettre un terme et de faire éclore un nouveau début. L’accident crée des formes et des cycles, il surgit, dure, détruit, mais aussi régénère. / The books of Rick Moody evade all possibility for a generic categorization. They standat the crossroads of different styles which collide with one another and give birth to a heterogeneous prose. However, at the heart of Moody’s protean fiction is to be found a recurring motif : the accident. The repetition of this pattern and the paradox it arises are what started this dissertation. How can such a motif be repeated and transformed into an unvarying organization principle since, at its core, the accident is supposed to happen in a flash, only once? The answer to this question lies in a change of perspective. The definition of the accident needs to be challenged so that it allows for the possibility to consider it not only as what happens accidentally but what is bound to happen by necessity. It all amounts to suggesting that the accident is ontological ; it is always already present, on the verge of happening. This temporal shift makes it necessary, in aliterary perspective, to analyze the temporality of the accident. The sudden appearance of the accident raises questions about the strategies fiction has at its disposal torepresent reality. The repetition of the accident induces also a reflection on its duration.The break-up it necessarily generates reveals its dual temporality: it either comes as an ending or as a possibility for a new beginning. The accident creates different shapes, forms and cycles as it comes up, destroys and regenerates.
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An Integrated Decision-support System For Industrial AccidentsGirgin, Serkan 01 March 2008 (has links) (PDF)
Availability of data on accidents and chemical inventories, together with assessment and analysis tools is a prerequisite for integrated control of industrial accidents. Although Turkey has a developing industry, legislative measures for control of industrial accidents are lacking, past accidents are not systematically enlisted and industrial facilities and hazardous substances thereof are not properly registered. While some accident data is available in international databases, they are incomplete and erroneous.
In the present study, a decision support system has been developed for collection and analysis of past accident information, assessment of current accident potentials of industrial establishments and modeling of probable accidents to reveal risks possessed thereby. The system supports web based multilingual and multi-user environment,and aims contribution of all interested parties in a collaborative manner. Information on technological accidents can be systematically archived together with reference data and visual materials. Initial data covering a time period of 30 years has been provided. The system is capable of storing hazard classifications and physico-chemical properties of substances, and providing standardized data for calculations. It can determine major-accident potential of industrial facilities as dictated by the 96/82/EC Directive of the EU and update relevant information automatically as required. An easy to use accident model for rapid assessment of off-site consequences of industrial accidents is also featured.
Developed system allows integrated management of data on industrial accidents and provides decision support tools for assessing current and future accident potential,which can be used for national as well as the EU needs.
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