scholarly journals SYSTEM AND CYBERNETIC APPROACH TO DEFINITION OF THE CONCEPT “SAFETY”

2015 ◽  
pp. 18-25
Author(s):  
Alexandr Matveev ◽  
Vladimir Matveev
Keyword(s):  
Necessary Condition ◽  
Target Orientation ◽  
Definition Of ◽  
To Receive

The analysis of the existing approaches to definition of the concept “safety” is given. The target orientation in the course of safety is proved. The reasons capable to break safety of the operated systems are established. On the basis of system and cybernetic approach and the formalized principle of systemacity definition of the concept “safety” was received. It is revealed that a necessary condition of safety is predictability of behavior of system in the environment including and other subjects of management, due to the corresponding formation of vectors of opportunities and management of system, allowing to receive the corresponding ratio of existential conditions of system and functioning of system, allowing to reach system of the demanded efficiency indicator level (target mission). It is received that a necessary condition of steady stay of system (object) in the environment is existence of knowledge of this Wednesday, possible options of behavior of system concerning factors of the environment and skills of management of system.

Abstract P254: Dementia and Use of Cardiac Catheterization and Angioplasty in Elderly ST-Elevation Myocardial Infarction Patients

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Marianne Ketterl ◽  
James A Mortimer ◽  
Elizabeth B Pathak
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Catheterization ◽  
Coronary Intervention ◽  
Admission Diagnosis ◽  
Percutaneous Coronary ◽  
Treatment Disparities ◽  
St Elevation ◽  
The Mean ◽  
Definition Of ◽  
To Receive

Introduction_ Percutaneous coronary intervention (PCI) is the first line of treatment for ST-elevated myocardial infarction (STEMI). Few studies addressed dementia as a barrier to receiving PCI. We evaluated disparities in the use of cardiac catheterization and PCI in STEMI patients with dementia. Methods_ A retrospective analysis was performed of Florida's comprehensive inpatient surveillance system for the years 2006-2007 with admission diagnosis of STEMI (ICD-9-CM codes 410.0 - 410.6, 410.8). Data were limited to patients ≥65 years admitted to hospitals with a high annual volume of PCIs (≥400), and transfer patients were excluded. We used a broad definition of dementia (ICD-9-CM codes 294.0, 294.1, 294.8, 294.9, 331.0-331.2, 331.7, 331.81, 331.82, 331.89, 331.9, 780.93, 780.97, 797). Logistic regression analysis was used to identify disparities in the use of cardiac catheterization and PCI among all STEMI patients, and in the use of PCI only among STEMI patients who received cardiac catheterization. Results_ A total of 8,310 STEMI patients who met our inclusion criteria were identified. Of these, 77.2% were catheterized and 67.1% received PCI. The mean age of the cohort was 76.3 years (SD 7.8 yrs); with 43.3% female; 83.4% white, 4.6% black, and 12% Hispanic/other. A total of 605 (7.3%) were demented. After adjustment for age, gender, and race/ethnicity, patients with dementia were less likely to be catheterized (RR 0.4, 95% CI 0.3-0.5), and less likely to receive PCI (RR 0.4, 95% CI 0.4-0.5) than non-demented patients. However, among patients who were catheterized, there was no difference in the use of PCI for demented vs. non-demented patients (p=0.32).Women were less likely to be catheterized than males (RR 0.7, 95% CI 0.7-0.8), but if catheterized, were more likely to receive PCI then men (RR 1.3, 95% CI 1.1-1.6). After adjustment for age, gender, and dementia, blacks were less likely to be catheterized (RR 0.5, 95% CI 0.4-0.6) and less likely to receive PCI (RR 0.6, 95% CI 0.5-0.7) than whites. Conclusions_ STEMI patients with dementia were much less likely to receive cardiac catheterization and consequently PCI. Our study confirms that treatment disparities exist for elderly demented patients after controlling for age, gender and ethnicity.

A Recommendation for Expanding the Definition of Moral Distress Experienced in the Workplace

2013 ◽  
Vol 6 ◽  
Author(s):  
Monique Frances Crane ◽  
Piers Bayl-Smith ◽  
John Cartmill
Keyword(s):  
Decision Making ◽  
Moral Distress ◽  
Structured Interview ◽  
Institutional Constraints ◽  
Necessary Condition ◽  
Medical Doctors ◽  
Moral Framework ◽  
Definition Of ◽  
Occupational Settings ◽  
Core Problem

Despite the importance of moral distress in the nursing scholarship, little attention is paid to the phenomena in the psychological literature as an important occupational stressor. A factor limiting the application of moral distress to other occupational settings is its definitional features. First, a necessary condition of moral distress is the acknowledgment prior to behaviour initiation that behaviour will contravene personal moral ideals. Second, the definition of moral distress specifies that the inability to act in accordance with one's moral framework is driven by institutional constraints (non-autonomous behaviour). This article proposes that moral distress not be limited in these ways, and makes two central contributions to resolve this core problem. We offer a critique and extension of the conceptual definition of moral distress. Fourteen Australian medical doctors participated in a semi-structured interview regarding occupational morally distressing events. Medical doctors were chosen for our interviews because they are an occupational population with considerable decision-making autonomy. Based on the findings, two recommendations are made: (1) that the definition of moral distress is not limited to events where decision-making and behaviour is non-autonomous, and (2) moral distress should not be limited to occasions where the moral conflict is identified prior to decision-making or behaviour. An alternative definition of moral distress is proposed. We conclude that while organisational limitations are an important precipitate of moral distress, they are not a necessary condition for its emergence.

Human Trafficking: Sex Trade

2015 ◽  
Author(s):  
Kathleen Bergquist
Keyword(s):  
Human Trafficking ◽  
Sex Trafficking ◽  
Current Knowledge ◽  
Sexual Exploitation ◽  
Historical Context ◽  
Forced Labor ◽  
Public Attention ◽  
Labor Trafficking ◽  
Definition Of ◽  
To Receive

The definition of human trafficking generally includes the commercial exploitation of persons for labor or sex. Although the International Labour Organization estimated in 2012 that exploitation through forced labor trafficking is up to three times more prevalent than forced sexual exploitation, sex trafficking seems to receive greater media and public attention. This article provides a historical context for sex trafficking, some discussion about the political evolution of sex trafficking legislation, current knowledge, and practice.

Use of Plerixafor in Predicted and Proven Poor Mobilizer (according to GITMO criteria). Experience of Policlinico Universitario Tor Vergata

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4415-4415
Author(s):  
Massimiliano Postorino ◽  
Alessandro Lanti ◽  
Eleonora Fiorelli ◽  
Angelo Salvatore Ferraro ◽  
Oana Marilena Chiru ◽  
...  
Keyword(s):  
Side Effects ◽  
Conflicts Of Interest ◽  
Minimum Requirement ◽  
Correct Definition ◽  
Cd34 Cells ◽  
Minimum Number ◽  
Poor Mobilizer ◽  
Operational Criteria ◽  
Definition Of ◽  
To Receive

Abstract Abstract 4415 BACKGROUND. Autologous stem cell transplantation (ASCT) of PBSCs has become a widely applied treatment for Multiple Mieloma (MM), non- Hodgking's lymphoma (NHL) and Hodgking's lymphoma (HL). Successful engraftment correlates with the number of CD34 hemopoietic progenitors cells infused. However, a part of MM or lymphoma patients (5% to 40%) fail to mobilize adequate numbers of PBSCs and thus cannot undergo to ASCT. The success of PBSCs mobilization is usually assessed by the total number of CD34+ stem cells collected, with a cutoff of 2.0–2.5 ×106 CD34+ cells/kg recipient body weight being considered as a minimum requirement for transplant. Poor mobilization of PBSCs is a major limitation to ASCT. Recently GITMO Working Group worked to define operational criteria for the identification/prediction of the poor mobilizer (PM) patients (Olivieri et al. 2011). Plerixafor, a CXCR4 chemochine antagonist, has been showed to improve significantly PBSC mobilization in PM patients. We present our experience using Plerixafor in PM patients classified according to GITMO criteria. METHODS. Between September 2009 and June 2012, a total of 17 patients (9F-8M) were enrolled. The diagnosis were: 10 MM (5F-5M), 1HL (1M), 6 NHL (4F-2M). The median age was 57 (range 15–66). 7 patients (3MM, 4NHL) were defined “Proven PM” and 10 patients (7MM, 2NHL, 1HL) “Predicted PM” according to GITMO criteria. The mobilization protocol included G-CSF, administered at a dose of 10μg/kg daily on 4 consecutive days. In the evening of the fourth day, patients received subcutaneous plerixafor at a dose of 0,24 mg/kg. Apheresis was initiated on the fifth day, 10–12 h after plerixafor and 1 h after G-CSF administration. Apheresis and daily administration of G-CSF and plerixafor continued until the patient collected enough CD34+ cells for auto- HSCT (> 2 ×106/kg; max 7 plerixafor injections if required). PBSC collection was initiated if peripheral CD34+ cells count was >10μl. A successful mobilization was defined as a total yeld of > 2×106/kg. RESULTS. 13 patients (76,5%) collected the minimum number of CD34 cells > 2×106/kg. The diagnosis were: 8MM, 1HL,1 NHL. 7 patients (2NHL; 4 MM; 1 LH; 7 predicted) were able to collect > 5×106/Kg. Only 4 patients (3 MM; 1 LNH; 4 proven) failed the mobilization because the numbers of cells CD34 were < 10μL and these patients did not undergo to apheresis procedures. The collection target of 2×106/Kg was reached in a median of 2 apheresis session (range 1–3). The technical characteristics of the procedures were (median value): blood volume processed 12 L (range 9–14), total CD34+/Kg collected 3,06 × 106(range 2,21-8,62), procedure efficiency 47,5% (range 35,3–79), duration of the procedure 261 minutes (range 210–309). Plerixafor was well tolerated and mild side effects were: reactions in the injection site, gastrointestinal disturbs, muscle pain. During administration of plerixafor we did not observe any significant laboratory abnormalities of liver or renal function. CONCLUSION. Unsuccessful mobilization represents an important limitation to ASCT in lymphoma and MM. In our experience plerixafor allowed to collect an appropriate amount of CD34 also in patients defined “proven PM” significantly reducing the percentage of patients that could not undergo ASCT (target value obtained in 43% of “proven PM”). Confirming the recent literature plerixafor is well tolerated with minimal side effects. We retrospectively applied GITMO criteria for PM patients and our experience, although limited, confirm that the use of a correct definition of PM allows the appropriate use of new mobilizing agents like plerixafor increasing significantly the therapeutic options also in patients who had no possibilities to receive an ASCT with the traditional mobilizing therapy. Disclosures: No relevant conflicts of interest to declare.

Instability and Uncertainty of Human Life Way Development at Life Bifurcuration Points

2020 ◽  
pp. 9-12
Author(s):  
A.V. Rukin
Keyword(s):  
Research Methods ◽  
Scientific Explanation ◽  
Human Life ◽  
Self Organization ◽  
Necessary Condition ◽  
Way Of Life ◽  
Complex Objects ◽  
Main Research ◽  
Life Path ◽  
Definition Of

Man and his individual way of life are the most complex objects of scientific research. In modern humanitarian knowledge, the question of the nature of man and his life path is debatable. The article continues the cycle of author's works devoted to the development of an informational approach to self-organization of a person and his life path. The relevance of the study is due to the need for a scientific explanation of the phenomena of self-organization in the development of human life. The purpose of this work is to identify the effect of instability and uncertainty on the development of a person’s life path at points of vital bifurcation. The article gives the author’s definition of a person’s life path, analyzes the existence of a person in conditions of intrapersonal instability and uncertainty, and the development of human life at points of vital bifurcation. The results of the study allow us to consider instability and uncertainty as a necessary condition for the emergence of processes of self-organization of a person’s life path at the point of vital bifurcation. The main research methods are reflection and modeling.

Spatio-Temporal Dynamics of the Global Medical Tourism

2018 ◽  
Vol 9 (2) ◽  
pp. 267
Author(s):  
Anatoliy I. CHISTOBAEV ◽  
Zoya A. SEMENOVA
Keyword(s):  
Medical Tourism ◽  
Temporal Dynamics ◽  
Asian Countries ◽  
Public And Private ◽  
The Public ◽  
Spatio Temporal ◽  
Receive Treatment ◽  
Definition Of ◽  
Medical Infrastructure ◽  
To Receive

The study focuses on the emergence and development of medical tourism at the global and country levels. Article provides a definition of a medical tourism, reveals the stages of its formation – from the origin at ancient cultures to modern high technologies of biomedicine. The country ranking results held on the basis of an integrated index, featuring the assessment of the level of equipment at the medical infrastructure, the maintenance of hospitals, the availability of qualified specialists is discussed. The best practices of medical tourism are analyzed. It is shown that due to lower prices and higher service quality, the geographic vector of those wishing to receive treatment abroad is shifting to Asian countries. The need to strengthen the attention of government agencies to the development of medical tourism in the public and private health sectors is noted.

A NEW SUBFAMILY OF PHRYGANEID CADDISFLIES FROM WESTERN NORTH AMERICA (TRICHOPTERA: PHRYGANEIDAE)

1962 ◽  
Vol 40 (5) ◽  
pp. 879-891 ◽  
Author(s):  
Glenn B. Wiggins
Keyword(s):  
Single Species ◽  
Mountain Streams ◽  
Phylogenetic Implications ◽  
The Family ◽  
Systematic Relationships ◽  
Definition Of ◽  
Egg Stages ◽  
And Behavior ◽  
To Receive ◽  
Unique Species

The discovery of the larval, pupal, and egg stages of the western North American caddisfly, Yphria californica (Banks), has provided the necessary evidence for a re-evaluation of the family designation and systematic relationships of this unique species. In accordance with this evidence, the species is removed from the family Kitagamiidae (or Limnocentropodidae), to which it had been previously assigned on the basis of evidence from adults alone, and re-assigned to the family Phryganeidae. A new subfamily, the Yphriinae, is, however, created in the Phryganeidae to receive this single species, and the definition of the family emended to include males with five segments, as well as four, in the maxillary palpi. Descriptions of all stages of Yphria californica are given.The species has been collected in several localities in California and Oregon, where it lives in cool mountain streams. Observations on the ecology and behavior are given. One significant aspect of the case-making behavior is that the pupal case is composed of materials quite different from those in the larval case, and neither case shows any close similarity to the cases of other members of the Phryganeidae. The phylogenetic implications of this new subfamily are considered.

General Agreement on Tariffs and Trade

1961 ◽  
Vol 15 (1) ◽  
pp. 206-207 ◽  
Keyword(s):  
Free Trade ◽  
Latin American ◽  
Harmful Effect ◽  
Free Trade Area ◽  
Trade Association ◽  
Additional Information ◽  
Trade Area ◽  
European Free Trade Association ◽  
Definition Of ◽  
To Receive

The seventeenth session of the contracting parties to the General Agreement on Tariffs and Trade (GATT) was held in Geneva from October 31 to November 19, 1960, under the chairmanship of Mr. Edmundo Penna Barbosa da Silva (Brazil). One of the main items of discussion was regional economic integration, considered in terms of the European Free Trade Association (EFTA), the proposed Latin American free trade area, and the European Economic Community (EEC). Examination of the Stockholm Convention establishing EFTA, begun at the sixteenth session, was resumed, with the contracting parties concluding that the provisions concerning the setting up, within the time limit set forth in the convention, of a free trade area were within the definition of such an area, as contained in Article XXIV of GATT. Delegates felt, however, that there remained some legal and practical issues which could be more fruitfully discussed in the light of experience of the operation of the convention, and thus welcomed the willingness of EFTA members to furnish additional information as the organization evolved. In examining the Montevideo Treaty proposing a Latin American free trade area, delegates reached much the same conclusions. In response to the report on developments within EEC, particularly with regard to tariffs, delegates expressed a desire to receive details on the common agricultural policy of the Community, and raised queries as to the harmful effect of the Community's progressively favorable treatment of the associated territories on the trade of certain outside countries with EEC.

scholarly journals Estimand Framework in AML Based on a Randomized, Placebo-Controlled, Phase 3 Study Investigating the Effect of Adding Midostaurin to Standard Chemotherapy in Patients with Newly Diagnosed AML without a FLT3 Mutation

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5196-5196 ◽  
Author(s):  
Bourras-Rezki Bengoudifa ◽  
Hans Weber ◽  
Insa Gathmann ◽  
Albert Hoenekopp ◽  
Noah Berkowitz
Keyword(s):  
Induction Treatment ◽  
Newly Diagnosed ◽  
Standard Chemotherapy ◽  
Phase 3 ◽  
Scientific Question ◽  
Treatment Policy ◽  
Flt3 Mutation ◽  
Induction Failure ◽  
Definition Of ◽  
To Receive

Abstract In the ongoing randomized, placebo-controlled, phase 3 study in patients with newly diagnosed FLT3-mutation-negative acute myeloid leukemia (AML; NCT03512197) investigating the effect of adding midostaurin to standard chemotherapy, event-free survival (EFS) is the primary endpoint. EFS is a standard endpoint in clinical studies in AML. In a recent FDA submission, EFS was confirmed by an advisory committee to be clinically meaningful in AML (https://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/OncologicDrugsAdvisoryCommittee/UCM570800.pdf. Accessed August 1, 2018). With the release of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) E9 draft addendum, we describe EFS in the estimand framework to address the scientific question of interest and illustrate the power of this concept to transparently define the relevant population, the variable of interest, and the management of relevant incidents that can occur in a clinical trial ("intercurrent events"). The objective is to determine the benefit of adding midostaurin to the whole standard chemotherapy sequence, consisting of induction, consolidation therapy, hematopoietic stem cell transplant (HSCT; if applicable), and postconsolidation therapy, in patients with newly diagnosed AML without a FLT3 mutation. The main interest is the interventional effect of the whole treatment sequence and not the contribution of an individual part of it. The study population includes all randomized patients following the treatment policy approach. Patients can be randomized only if there is confirmation from the central laboratory that there is no FLT3 mutation. EFS is a composite endpoint defined as the time from randomization until death, relapse, or induction failure. Induction failure is defined as no achievement of remission until end of the induction period. The definition of induction failure also includes instances in which HSCT is conducted as salvage therapy in nonresponding patients. Per convention, the EFS event date of induction failure is set to the randomization date. The option to receive HSCT can be an outcome of the treatment. Therefore, clinical benefit is assessed regardless of whether patients received HSCT. This treatment policy approach mandates collection of disease assessments after HSCT has been completed. In the same consideration, the option to receive consolidation and postconsolidation treatment is also an outcome of the induction treatment as only patients achieving remission with induction qualify to continue with consolidation and postconsolidation treatment. As such, the benefit is assessed regardless of treatment duration. The analysis plan defines a supportive estimand to assess the treatment effect of midostaurin, excluding potential benefit from HSCT. Another supportive estimand assesses the effect of discontinuation of induction treatment due to toxicities. This approach addresses a hypothetical scenario in which patients did not receive HSCT, for instance, to estimate the midostaurin-only effect. However, the outcome of the treatment is not limited to the direct effect of an experimental compound but also includes which new treatment option the compound allows for the patients (eg, HSCT). The estimand framework is an efficient tool to ensure consistency between the scientific question and the definition of the study objectives. It ensures transparency in unfavorable yet unavoidable situations in clinical trials ("intercurrent events"). It facilitates communication within the clinical team and with health authorities. The outcome of studies that are following the estimand framework can be interpreted in a consistent manner. Disclosures Bengoudifa: Novartis: Employment. Weber:Novartis: Employment. Gathmann:Novartis: Employment. Hoenekopp:Novartis: Employment. Berkowitz:Novartis: Employment.

scholarly journals Analysis of approaches to the definition of abilities in psychological and pedagogical research

2019 ◽  
pp. 46-48
Author(s):  
Natalia Vladimirovna Telesheva
Keyword(s):  
Human Activity ◽  
Necessary Condition ◽  
Points Of View ◽  
Definition Of ◽  
Pedagogical Research

The article analyzes the main approaches to the study of the concept of abilities in psychological and pedagogical research. The author identifies and describes different points of view on the essence of human abilities and their connection with inborn inclinations. The analysis of the concept under study helped to highlight the activities and human activity as a necessary condition for the development of certain abilities. The lack of available research in the definition of human abilities emphasizes the relevance of the topic of the article.

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