Background. Carotid stenosis is an important cause of stroke. Carotid endarterectomy is a means of reducing the burden of stroke but is of marginal benefit in individuals with asymptomatic carotid stenosis. The identification of factors associated with increased risk of cerebral ischemic events would help select individuals who may obtain a greater benefit. / Methods. A comprehensive search was performed to identify studies examining risk factors for cerebral ischemic events in patients with asymptomatic carotid stenosis. Inclusion criteria were defined a priori. Relevant studies were reviewed, assessed for quality, and data were extracted. / Results. Thirty-four studies met the inclusion criteria. There was a suggestion of increasing neurological events with increasing severity and progression of carotid stenosis. There was some evidence for an association with carotid plaque morphology. No consistent association was found with clinical factors, impaired cerebral vasoreactivity, or cerebral embolic signals. / Conclusions. The evidence is insufficient to reliably identify individuals with asymptomatic carotid stenosis who are at a higher risk of cerebral ischemic events.

The negative social and economic results of traffic accidents are the most serious problems within the concept of traffic safety. Every year, unfortunately, a huge number of traffic accidents result in destructive losses. Especially, when the holiness of human life is concerned, traffic safety has an invaluable role for the traffic improvement strategies. In this manner, Turkey places one of the highest ranks regarding the growing rate and severity of traffic accidents that should be immediately taken under control. In this study, an innovative model that constructs a hybrid between the spatial and statistical analyses is developed in order to examine the importance of enhancing statistical analysis with georeferenced data and so location-based studies in traffic accident analysis. Meanwhile, the effects of road characteristic and environment are considered for exploring the integral role of roadway factor to the occurrence of accidents, and consequently for emphasizing easily applicable and controllable engineering safety measures. Because of the rare and random distribution of traffic accident data, logistic regression is used for the statistical part of the study in order to find the pairwise risk factors among the roadway and environmental parameters. After unifying these relative risk factors with the logic of Analytic Hierarchy Process, the finalized accident risk factors are attached to the digitized road characteristics map through Geographic Information Systems (GIS). The abilities of GIS in mapping, displaying and overlaying different data sets ensure to visualize high risked accident areas with their corresponding potential causal factors. The integration of statistical and spatial analyses is essential for developing appropriate and effective precautions in addition to its easily understandable, applicable and modifiable structure. Finally, the model is proven to be appropriate for both interpreting the existing traffic accident problem or potential future accidents and also developing comprehensive and reliable location-based safety studies.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.

Superior readiness of the inhabitants for the emergency situation caused by radiation accident is a very important condition for managing these situations, further for trouble-free adoption of measures related to the protection of life and health for each individual. Persons should be conscious of the hazard of emergency situations and within oneself be prepared to help themselves and each other. The objective of this master thesis is to examine the readiness of the inhabitants of the emergency planning zones of the Nuclear power plants in Czech Republic (Dukovany NPP) and in Slovakia (Jaslovské Bohunice NPP) to the emergency situation and to assess, if the readiness in both countries differs. The Nuclear power plants in Dukovany and in Jaslovské Bohunice were chosen for the particular reason, that both facilities were constructed and put into operation at the time of existence of the common state of Czech and Slovaks. The starting point is a working thesis that the readiness of the inhabitants for managing the emergency situation in the planning zones of the Nuclear power plants in Czech Republic and in Slovakia was on the same level. Considering the population differentiation, I analysed separately the answers of respondents in the age group of the 4165 year old. Theoretical part of my thesis initially focuses on the historical development of Nuclear power plants on the territory of the former Czechoslovakia and deals with the advantages and disadvantages of the production of electricity in a fission reaction. The other part deals with safety and operational security of the Nuclear power plants. Here is mentioned the International Nuclear and Radiological Event Scale, including the examples of nuclear facilities accidents. At the conclusion of the theoretical part is a survey of legislative regulations concerning the nuclear safety and protection of the population in both countries and a survey of measures concerning protection of the population in the event of radiation accident. The experimental part of my thesis started in form of questionnaire inquiry by the inhabitants of both emergence planning zones. Half of the 16 questions in total is analysed by the means of descriptive and mathematical statistics, the answers to the other questions refer to behavior, informedness, readiness and differing needs of individuals in case of emergency shelter in place or evacuation from the actual occurrence of radiation accident. The hypothesis was verified by applying the two-selective parametric testing. By means of the t-test it could be proved, that there is no statistically significant difference between the inhabitants readiness in the both emergence planning zones. The hypothesis was therefore accepted. By applying the chi-square test it was elicited, that the empirical distribution of both selective statistical sets can by replaced by a normal distribution, both empirical curves can by therefore replaced by a Gauss curve. This partial research focuses on the age group of the 41-65 year old. Also in this case could be proved by means of chi-square test the normality of both statistical sets. Also the application of two-selective parametric testing approved, that the readiness of the population of the age group under investigation do not vary in the both zones. The particular answers were recorded graphically and in the following discussion were commented the differences and specifics with regard to the differing knowledge, behavior and specific requirements of the people in case of evacuation. In context of the results measured in the particular zones of accident planning it could be useful to consider, if in place of the normal distribution of readiness not another for example the Poisson distribution - would be more suitable, that could possibly testify better readiness for emergency accidents. Very important role plays enlightenment and education in such form that will arouse interest in the given problems in the population.

Si la formation du conducteur a connu ses débuts en même temps que la naissance de l’automobile, l’éducation routière en tant que phénomène social s’est développée à partir de la deuxième moitié du XXème siècle. Depuis cette période, les évaluations de ces actions de formation ont pointé les difficultés à réduire le nombre et la gravité des accidents de la circulation. Ce constat n’est pas faute d’investissement des pouvoirs publics : en effet, les politiques de sécurité routière n’ont cessé, jusqu’à aujourd’hui, de placer l’éducation routière au centre du dispositif de prévention. Nous avons cherché à identifier la naissance et la persistance de ce paradoxe dans la pratique des acteurs de la sécurité routière, et dans la production et la reproduction d’une culture commune du risque propre à la modernité. Nous avons exercé cette investigation à partir de l’observation et de l’analyse des pratiques d’éducation routière auxquelles nous avons accès à titre d’intervenant en formation du conducteur, d’enseignant de la conduite et de psychologue intervenant en stage de sensibilisation dans le cadre du permis à points. Notre recherche est structurée, par conséquent, autour d’un travail de terrain par immersion dans les centres de formation, alimentée par des lectures en philosophie des techniques (Illich, Canguilhem, Simondon, Stiegler) et en sociologie du risque (Beck, Douglas, Duclos) mises en perspectives avec la théorie psychosociologique de l’homéostasie du risque (Wilde). / If driving safety started at the same time as cars, the social phenomenon of road safety only started to develop in the second half of the 20th century. Ever since, comparative studies of those driving courses showed difficulties to enhance the road mortality and morbidity. Still, this has been a major issue of public policies: in fact, road safety policies had always given to road education one of the first roles in the prevention system. We tried to identify the beginning and the persistence of this paradox in the practice of the road safety actors and in the construction and transmission of a common risk culture as we can find it in our advanced modernity. We led this research from the observation of the practices of road safety education. We alternatively worked as a driving instructor, instructor trainer and traffic psychologist. This research is structured, thus, by the immersion in the field work of road safety education. Our ground theory are the philosophy of techniques (Illich, Canguilhem, Simondon, Stiegler) and the sociology of risk (Beck, Douglas, Duclos) along in perspective with the psychosociological theory of risk homeostasis (Wilde).

The risk of serious accident is increasing with the rise of the amount of chemical industry manufacturing. This accident can have immeasurable consequences. The aim of this thesis is to point out the consequences caused by leakage of dangerous substance of petrol from the biggest cistern in chemical company Synthos Kralupy a.s. and to suggest steps for emergency clearance. To fulfil the aim, examination of serious accident risks had to be carried out first. The method of Dow's Fire and Explosion Index was used for this examination which enabled evaluation of a real fire and explosion risk. Apart from these methods, another method called IAEA-TECDOC-727 was also used. Consequently, possible scenarios of dangerous substances leakage from storage cistern were created. These were simulated through software programmes ALOHA and TerEx. Acquired results were then well arranged in charts. During the research of this issue, a method of controlled interviews was used. These interviews with employees of firefighter emergency service were focused on emergency readiness of the chemical company Synthos Kralupy a.s. A cistern containing dangerous substance represents a crucial risk, even though the results showed that the accident of all petrol leakage from the cistern is very unlikely. However, this accident should not be neglected because a dangerous cloud reaching 565 m from the site of the accident would occurred. The dangerous cloud cause mortality of 70% within a distance of 2,000 m and a distance of 4,970 m to the 1 st degree burns. If all petrol leaked from the cistern, the consequences would be much bigger than just pollution. It would also include death toll, health problems and vast property damages.

Submitted by Claudinei Pracidelli (cpracide@ipen.br) on 2016-06-22T14:12:07Z No. of bitstreams: 0 / Made available in DSpace on 2016-06-22T14:12:07Z (GMT). No. of bitstreams: 0 / Dissertação (Mestrado em Tecnologia Nuclear) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP

Background : L’accident Vasculaire Cérébral (AVC) est la deuxième cause de décès au Liban et dans le monde. Il existe une pénurie d'informations fiables concernant l'épidémiologie de l'AVC au Liban. L’objectif de cette étude est d’identifier les facteurs de risque et les symptômes d'AVC dans la population libanaise et de développer un score pour la future prédiction de l'AVC et un score pour le diagnostic de l'AVC en situation d'urgence.Méthodes : Une étude cas-témoin a été menée pour la génération des scores. Les données ont été collectées à l’aide d’une fiche de collecte de données conçue dans deux hôpitaux tertiaires au Liban entre le 1er janvier 2012 et le 31 décembre 2014. Une régression logistique a permis de déterminer les facteurs de risque et les symptômes d'AVC. Les coefficients arrondis ont engendré un score pour le risque d’AVC (ROSS) et un score de diagnostic de l'AVC (DS-Stroke). Une autre étude cas-témoin a été menée pour la validation des scores, où les données ont été collectées à l'aide d'un questionnaire normalisé dans cinq différents hôpitaux tertiaires entre le 1er janvier 2015 et le 31 décembre 2016. Le ROSS et le DS-Stroke ont été validés en les comparant au diagnostic final des hôpitaux.Résultats : En total, 732 participants ont été inclus dans l'étude de génération du score (202 cas d'AVC et 530 contrôles sans AVC) et 650 participants ont été inclus dans l'étude de validation du score (205 cas et 445 contrôles sans AVC). Plusieurs facteurs de risque et symptômes ont été associés à l'AVC au Liban. Le ROSS et le DS-Stroke ont été construits et évalués avec des hautes zones sous la courbe et des valeurs négatives et positives prédictives élevées.Conclusion : Le ROSS est un bon outil d'évaluation des risques pour améliorer la prévision de l'AVC dans la population libanaise et serait particulièrement intéressant dans le cadre des soins primaires afin de réduire l'incidence de l'AVC. Le DS-Stroke est un autre outil précieux à utiliser pour le diagnostic de l'AVC à l'urgence et serait intéressant pour l'utilisateur afin d'avoir un diagnostic précis de l'AVC, appeler à d'autres tests d'urgence si nécessaire et d’accélérer le traitement pour les patients AVC. / Background: Stroke is the second leading cause of death in Lebanon and worldwide. There is a scarcity of reliable information about the epidemiology of stroke in Lebanon. We aim to identify stroke risk factors and symptoms in the Lebanese population and develop a score for future stroke prediction and another for stroke diagnosis at emergency.Methods: A case-control study was conducted for the scores generation. Data were collected through a designed data collection sheet at two tertiary hospitals in Lebanon between January 1st, 2012 and December 31st, 2014. A logistic regression determined stroke risk factors and symptoms and the rounded coefficients generated a Risk of Stroke Score (ROSS) and a Diagnosis Score for Stroke (DS-Stroke). Another case-control study was conducted for the scores validation where data were collected through a standardized questionnaire at five different tertiary hospitals between January 1st, 2015 and December 31st, 2016. ROSS and DS-Stroke were validated by comparing them to the hospitals final diagnosis.Results: In total, 732 participants were included in the score generation study (202 stroke cases and 530 stroke-free controls) and 650 participants were included in the score validation study (205 cases and 445 stroke-free controls). Many risk factors and symptoms were found to be associated with stroke in Lebanon. ROSS and DS-Stroke were constructed and validated with high areas under the curve and high negative and positive prediction values.Conclusion: ROSS is a good risk assessment tool for use to improve the prediction of stroke in the Lebanese population and would be of particular interest in the primary care setting to reduce stroke incidence. DS-Stroke is another valuable tool to use for stroke diagnosis at emergency and would be interesting to user in order to have an accurate diagnosis of stroke, call for further emergency testing if necessary and speed up the treatment for stroke patients.

At the nuclear power plant accident, the radionuclides with very short half-life come to enviroment, they decay the period from several second to several months. On the other sides come to enviroment radionuclides with long half-life. Their radionuclides occur in surrounding of the power plant for hundreds of years before they decay totally. Immediately after a nuclear power plant accident, radioiodine represents the most severe health hazard for population. Because it is a radionuclide with short half-life, it causes the danger during first months after the accident. Its health hazard lies in the fact, that it gets to food chains and irradiates a man, who consumed contaminated water and food. Radiocaesium and radiostrontiom are the next important radionuclides. They have long half-lifes, it means that will decay after hundred years after the accident and they endanger population a long time after the accident yet.

The catastrophic accident of the ferry Herald of Free Enterprise made it clear that the development of accident prevention in the maritime domain must not only rely on negative events but rather on proactive measures.Near-miss reporting is becoming widespread as a proactive tool for accident prevention in various domains. This thesis aims to examine and identify barriers to near-miss reporting through studying the national reporting system INSJÖ and local company specific systems in the Swedish maritime domain.Interviews with representatives from Swedish shipping companies (designated persons responsible for safety work in each company and officers responsible for the reporting at sea) were conducted as a means of data collection. Based on the data two separate analyses were made; one in a naturalistic fashion and one using a framework of barriers and incentives derived from various social technical domains in which near-miss reporting has been institutionalized.The results of the two analyses highlight differences regarding how and with whom information should be shared. The therapeutic factor, to teach and learn from others was emphasized as important by the majority of the interviewees. Further, potential external influences, issues concerning anonymity and the risk of rehearsed benefits of reporting are also made visible. Finally, critique against the accident-ratio models, that introduced the near-miss concept, is presented and it is argued that these models might be too simplistic to explain why accidents occur.It is concluded that, in order to create effective reporting systems and to decrease the risk of creating a disparity between rehearsed benefits and how the system is used in reality, it is important to give the personnel ownership of their own reporting system and the knowledge of how and why to use it. Nevertheless, near-miss reporting might be used as a powerful tool and incentive for proactive work and accident prevention.