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Journal articles on the topic "Alert burden"
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Chaparro, Juan D., Cory Hussain, Jennifer A. Lee, Jessica Hehmeyer, Manjusri Nguyen, and Jeffrey Hoffman. "Reducing Interruptive Alert Burden Using Quality Improvement Methodology." Applied Clinical Informatics 11, no. 01 (January 2020): 046–58. http://dx.doi.org/10.1055/s-0039-3402757.
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Abstract Background Increased adoption of electronic health records (EHR) with integrated clinical decision support (CDS) systems has reduced some sources of error but has led to unintended consequences including alert fatigue. The “pop-up” or interruptive alert is often employed as it requires providers to acknowledge receipt of an alert by taking an action despite the potential negative effects of workflow interruption. We noted a persistent upward trend of interruptive alerts at our institution and increasing requests for new interruptive alerts. Objectives Using Institute for Healthcare Improvement (IHI) quality improvement (QI) methodology, the primary objective was to reduce the total volume of interruptive alerts received by providers. Methods We created an interactive dashboard for baseline alert data and to monitor frequency and outcomes of alerts as well as to prioritize interventions. A key driver diagram was developed with a specific aim to decrease the number of interruptive alerts from a baseline of 7,250 to 4,700 per week (35%) over 6 months. Interventions focused on the following key drivers: appropriate alert display within workflow, clear alert content, alert governance and standardization, user feedback regarding overrides, and respect for user knowledge. Results A total of 25 unique alerts accounted for 90% of the total interruptive alert volume. By focusing on these 25 alerts, we reduced interruptive alerts from 7,250 to 4,400 per week. Conclusion Systematic and structured improvements to interruptive alerts can lead to overall reduced interruptive alert burden. Using QI methods to prioritize our interventions allowed us to maximize our impact. Further evaluation should be done on the effects of reduced interruptive alerts on patient care outcomes, usability heuristics on cognitive burden, and direct feedback mechanisms on alert utility.
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McGreevey, John D., Colleen P. Mallozzi, Randa M. Perkins, Eric Shelov, and Richard Schreiber. "Reducing Alert Burden in Electronic Health Records: State of the Art Recommendations from Four Health Systems." Applied Clinical Informatics 11, no. 01 (January 2020): 001–12. http://dx.doi.org/10.1055/s-0039-3402715.
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Abstract Background Electronic health record (EHR) alert fatigue, while widely recognized as a concern nationally, lacks a corresponding comprehensive mitigation plan. Objectives The goal of this manuscript is to provide practical guidance to clinical informaticists and other health care leaders who are considering creating a program to manage EHR alerts. Methods This manuscript synthesizes several approaches and recommendations for better alert management derived from four U.S. health care institutions that presented their experiences and recommendations at the American Medical Informatics Association 2019 Clinical Informatics Conference in Atlanta, Georgia, United States. The assembled health care institution leaders represent academic, pediatric, community, and specialized care domains. We describe governance and management, structural concepts and components, and human–computer interactions with alerts, and make recommendations regarding these domains based on our experience supplemented with literature review. This paper focuses on alerts that impact bedside clinicians. Results The manuscript addresses the range of considerations relevant to alert management including a summary of the background literature about alerts, alert governance, alert metrics, starting an alert management program, approaches to evaluating alerts prior to deployment, and optimization of existing alerts. The manuscript includes examples of alert optimization successes at two of the represented institutions. In addition, we review limitations on the ability to evaluate alerts in the current state and identify opportunities for further scholarship. Conclusion Ultimately, alert management programs must strive to meet common goals of improving patient care, while at the same time decreasing the alert burden on clinicians. In so doing, organizations have an opportunity to promote the wellness of patients, clinicians, and EHRs themselves.
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Dexheimer, Judith, Eric Kirkendall, Michal Kouril, Philip Hagedorn, Thomas Minich, Leo Duan, Monifa Mahdi, Rhonda Szczesniak, and S. Andrew Spooner. "The Effects of Medication Alerts on Prescriber Response in a Pediatric Hospital." Applied Clinical Informatics 08, no. 02 (April 2017): 491–501. http://dx.doi.org/10.4338/aci-2016-10-ra-0168.
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Summary Objective: More than 70% of hospitals in the United States have electronic health records (EHRs). Clinical decision support (CDS) presents clinicians with electronic alerts during the course of patient care; however, alert fatigue can influence a provider’s response to any EHR alert. The primary goal was to evaluate the effects of alert burden on user response to the alerts. Methods: We performed a retrospective study of medication alerts over a 24-month period (1/2013–12/2014) in a large pediatric academic medical center. The institutional review board approved this study. The primary outcome measure was alert salience, a measure of whether or not the prescriber took any corrective action on the order that generated an alert. We estimated the ideal number of alerts to maximize salience. Salience rates were examined for providers at each training level, by day of week, and time of day through logistic regressions. Results: While salience never exceeded 38%, 49 alerts/day were associated with maximal salience in our dataset. The time of day an order was placed was associated with alert salience (maximal salience 2am). The day of the week was also associated with alert salience (maximal salience on Wednesday). Provider role did not have an impact on salience. Conclusion: Alert burden plays a role in influencing provider response to medication alerts. An increased number of alerts a provider saw during a one-day period did not directly lead to decreased response to alerts. Given the multiple factors influencing the response to alerts, efforts focused solely on burden are not likely to be effective. Citation: Dexheimer JW, Kirkendall ES, Kouril M, Hagedorn PA, Minich T, Duan LL, Mahdi M, Szczesniak R, Spooner SA. The effects of medication alerts on prescriber response in a pediatric hospital. Appl Clin Inform 2017; 8: 491–501 https://doi.org/10.4338/ACI-2016-10-RA-0168
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Bubp, Jeff L., Michelle A. Park, Joan Kapusnik-Uner, Thong Dang, Karl Matuszewski, Don Ly, Kevin Chiang, Sek Shia, and Brian Hoberman. "Successful deployment of drug-disease interaction clinical decision support across multiple Kaiser Permanente regions." Journal of the American Medical Informatics Association 26, no. 10 (April 15, 2019): 905–10. http://dx.doi.org/10.1093/jamia/ocz020.
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Abstract Objective The study sought to develop a criteria-based scoring tool for assessing drug-disease knowledge base content and creation of a subset and to implement the subset across multiple Kaiser Permanente (KP) regions. Materials and Methods In Phase I, the scoring tool was developed, used to create a drug-disease alert subset, and validated by surveying physicians and pharmacists from KP Northern California. In Phase II, KP enabled the alert subset in July 2015 in silent mode to collect alert firing rates and confirmed that alert burden was adequately reduced. The alert subset was subsequently rolled out to users in KP Northern California. Alert data was collected September 2015 to August 2016 to monitor relevancy and override rates. Results Drug-disease alert scoring identified 1211 of 4111 contraindicated drug-disease pairs for inclusion in the subset. The survey results showed clinician agreement with subset examples 92.3%-98.5% of the time. Postsurvey adjustments to the subset resulted in KP implementation of 1189 drug-disease alerts. The subset resulted in a decrease in monthly alerts from 32 045 to 1168. Postimplementation monthly physician alert acceptance rates ranged from 20.2% to 29.8%. Discussion Our study shows that drug-disease alert scoring resulted in an alert subset that generated acceptable interruptive alerts while decreasing overall potential alert burden. Following the initial testing and implementation in its Northern California region, KP successfully implemented the disease interaction subset in 4 regions with additional regions planned. Conclusions Our approach could prevent undue alert burden when new alert categories are implemented, circumventing the need for trial live activations of full alert category knowledge bases.
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Elias, Pierre, Eric Peterson, Bob Wachter, Cary Ward, Eric Poon, and Ann Marie Navar. "Evaluating the Impact of Interruptive Alerts within a Health System: Use, Response Time, and Cumulative Time Burden." Applied Clinical Informatics 10, no. 05 (October 2019): 909–17. http://dx.doi.org/10.1055/s-0039-1700869.
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Abstract Background Health systems often employ interruptive alerts through the electronic health record to improve patient care. However, concerns of “alert fatigue” have been raised, highlighting the importance of understanding the time burden and impact of these alerts on providers. Objectives Our main objective was to determine the total time providers spent on interruptive alerts in both inpatient and outpatient settings. Our secondary objectives were to analyze dwell time for individual alerts and examine both provider and alert-related factors associated with dwell time variance. Methods We retrospectively evaluated use and response to the 75 most common interruptive (“popup”) alerts between June 1st, 2015 and November 1st, 2016 in a large academic health care system. Alert “dwell time” was calculated as the time between the alert appearing on a provider's screen until it was closed. The total number of alerts and dwell times per provider per month was calculated for inpatient and outpatient alerts and compared across alert type. Results The median number of alerts seen by a provider was 12 per month (IQR 4–34). Overall, 67% of inpatient and 39% of outpatient alerts were closed in under 3 seconds. Alerts related to patient safety and those requiring more than a single click to proceed had significantly longer median dwell times of 5.2 and 6.7 seconds, respectively. The median total monthly time spent by providers viewing alerts was 49 seconds on inpatient alerts and 28 seconds on outpatient alerts. Conclusion Most alerts were closed in under 3 seconds and a provider's total time spent on alerts was less than 1 min/mo. Alert fatigue may lie in their interruptive and noncritical nature rather than time burden. Monitoring alert interaction time can function as a valuable metric to assess the impact of alerts on workflow and potentially identify routinely ignored alerts.
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Knight, Amy M., Joyce Maygers, Kimberly A. Foltz, Isha S. John, Hsin Chieh Yeh, and Daniel J. Brotman. "The Effect of Eliminating Intermediate Severity Drug-Drug Interaction Alerts on Overall Medication Alert Burden and Acceptance Rate." Applied Clinical Informatics 10, no. 05 (October 2019): 927–34. http://dx.doi.org/10.1055/s-0039-3400447.
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Abstract Objective This study aimed to determine the effects of reducing the number of drug-drug interaction (DDI) alerts in an order entry system. Methods Retrospective pre–post analysis at an urban medical center of the rates of medication alerts and alert acceptance during a 5-month period before and 5-month period after the threshold for firing DDI alerts was changed from “intermediate” to “severe.” To ensure that we could determine varying response to each alert type, we took an in-depth look at orders generating single alerts. Results Before the intervention, 241,915 medication orders were placed, of which 25.6% generated one or more medication alerts; 5.3% of the alerts were accepted. During the postintervention period, 245,757 medication orders were placed of which 16.0% generated one or more medication alerts, a 37.5% relative decrease in alert rate (95% confidence interval [CI]: −38.4 to −36.8%), but only a 9.6% absolute decrease (95% CI: −9.4 to −9.9%). 7.4% of orders generating alerts were accepted postintervention, a 39.6% relative increase in acceptance rate (95% CI: 33.2–47.2%), but only a 2.1% absolute increase (95% CI: 1.8–2.4%). When only orders generating a single medication alert were considered, there was a 69.1% relative decrease in the number of orders generating DDI alerts, and an 85.7% relative increase in the acceptance rate (95% CI: 58.6–126.2%), though only a 1.8% absolute increase (95% CI: 1.3–2.3%). Conclusion Eliminating intermediate severity DDI alerts resulted in a statistically significant decrease in alert burden and increase in the rate of medication alert acceptance, but alert acceptance remained low overall.
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Simpao, Allan F., Luis M. Ahumada, Bimal R. Desai, Christopher P. Bonafide, Jorge A. Gálvez, Mohamed A. Rehman, Abbas F. Jawad, Krisha L. Palma, and Eric D. Shelov. "Optimization of drug–drug interaction alert rules in a pediatric hospital's electronic health record system using a visual analytics dashboard." Journal of the American Medical Informatics Association 22, no. 2 (October 15, 2014): 361–69. http://dx.doi.org/10.1136/amiajnl-2013-002538.
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Abstract Objective To develop and evaluate an electronic dashboard of hospital-wide electronic health record medication alerts for an alert fatigue reduction quality improvement project. Methods We used visual analytics software to develop the dashboard. We collaborated with the hospital-wide Clinical Decision Support committee to perform three interventions successively deactivating clinically irrelevant drug–drug interaction (DDI) alert rules. We analyzed the impact of the interventions on care providers’ and pharmacists’ alert and override rates using an interrupted time series framework with piecewise regression. Results We evaluated 2 391 880 medication alerts between January 31, 2011 and January 26, 2014. For pharmacists, the median alert rate prior to the first DDI deactivation was 58.74 alerts/100 orders (IQR 54.98–60.48) and 25.11 alerts/100 orders (IQR 23.45–26.57) following the three interventions (p<0.001). For providers, baseline median alert rate prior to the first round of DDI deactivation was 19.73 alerts/100 orders (IQR 18.66–20.24) and 15.11 alerts/100 orders (IQR 14.44–15.49) following the three interventions (p<0.001). In a subgroup analysis, we observed a decrease in pharmacists’ override rates for DDI alerts that were not modified in the system from a median of 93.06 overrides/100 alerts (IQR 91.96–94.33) to 85.68 overrides/100 alerts (IQR 84.29–87.15, p<0.001). The medication serious safety event rate decreased during the study period, and there were no serious safety events reported in association with the deactivated alert rules. Conclusions An alert dashboard facilitated safe rapid-cycle reductions in alert burden that were temporally associated with lower pharmacist override rates in a subgroup of DDIs not directly affected by the interventions; meanwhile, the pharmacists’ frequency of selecting the ‘cancel’ option increased. We hypothesize that reducing the alert burden enabled pharmacists to devote more attention to clinically relevant alerts.
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Capan, Muge, Stephen Hoover, Kristen E. Miller, Carmen Pal, Justin M. Glasgow, Eric V. Jackson, and Ryan C. Arnold. "Data-driven approach to Early Warning Score-based alert management." BMJ Open Quality 7, no. 3 (August 2018): e000088. http://dx.doi.org/10.1136/bmjoq-2017-000088.
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BackgroundIncreasing adoption of electronic health records (EHRs) with integrated alerting systems is a key initiative for improving patient safety. Considering the variety of dynamically changing clinical information, it remains a challenge to design EHR-driven alerting systems that notify the right providers for the right patient at the right time while managing alert burden. The objective of this study is to proactively develop and evaluate a systematic alert-generating approach as part of the implementation of an Early Warning Score (EWS) at the study hospitals.MethodsWe quantified the impact of an EWS-based clinical alert system on quantity and frequency of alerts using three different alert algorithms consisting of a set of criteria for triggering and muting alerts when certain criteria are satisfied. We used retrospectively collected EHRs data from December 2015 to July 2016 in three units at the study hospitals including general medical, acute care for the elderly and patients with heart failure.ResultsWe compared the alert-generating algorithms by opportunity of early recognition of clinical deterioration while proactively estimating alert burden at a unit and patient level. Results highlighted the dependency of the number and frequency of alerts generated on the care location severity and patient characteristics.ConclusionEWS-based alert algorithms have the potential to facilitate appropriate alert management prior to integration into clinical practice. By comparing different algorithms with regard to the alert frequency and potential early detection of physiological deterioration as key patient safety opportunities, findings from this study highlight the need for alert systems tailored to patient and care location needs, and inform alternative EWS-based alert deployment strategies to enhance patient safety.
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Tsang, H. C., P. Mathias, N. Hoffman, and M. B. Pagano. "Transfusion Medicine Informatics: Analysis of User Burden from Clinical Decision Support Alerts in Promoting Patient Blood Management." American Journal of Clinical Pathology 154, Supplement_1 (October 2020): S123—S124. http://dx.doi.org/10.1093/ajcp/aqaa161.270.
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Abstract Introduction/Objective To increase efficiency of blood product ordering and delivery processes and improve appropriateness of orders, a major project to implement clinical decision support (CDS) alerts in the electronic medical record (EMR) was undertaken. A design team was assembled including hospital and laboratory medicine information technology and clinical informatics, transfusion services, nursing and clinical services from medical and surgical specialties. Methods Consensus-derived thresholds in hemoglobin/hematocrit, platelet count, INR, and fibrinogen for red blood cell (RBC), platelet, plasma, and cryoprecipitate blood products CDS alerts were determined. Data from the EMR and laboratory information system were queried from the 12-month period before and after implementation and the data was analyzed. Results During the analysis period, 5813 RBC (avg. monthly = 484), 1040 platelet (avg. monthly = 87), 423 plasma (avg. monthly = 35), and 88 cryoprecipitate (avg. monthly = 7) alerts fired. The average time it took for a user to respond was 5.175 seconds. The total amount of time alerts displayed over 12 months was 5813 seconds (~97 minutes of user time) compared to 56503 blood products transfused. Of active CDS alerts, hemoglobin/RBC alerts fired most often with ~1:5 (31141 RBC units) alert to transfusion ratio and 4% of orders canceled (n=231) when viewing the alert, platelet alerts fired with ~1:15 (15385 platelet units) alert to transfusion ratio and 6% orders canceled (n=66), INR/plasma alerts fired with ~1:21 (8793 plasma units) alert to transfusion ratio and 10% orders canceled (n=41), cryoprecipitate alerts fired with ~1:13 (1184 cryoprecipitate units) alert to transfusion ratio and 10% orders canceled (n=9). Overall monthly blood utilization normalized to 1000 patient discharges did not appear to have statistically significant differences comparing pre- versus post-go-live, except a potentially significant increase in monthly plasma usage at one facility with p = 0.34, although possibly due to an outlier single month of heavy usage. Conclusion Clinical decision support alerts can guide provider ordering with minimal user burden. This resulted in increased safety and quality use of the ordering process, although overall blood utilization did not appear to change significantly.
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Chaparro, Juan D., Jonathan M. Beus, Adam C. Dziorny, Philip A. Hagedorn, Sean Hernandez, Swaminathan Kandaswamy, Eric S. Kirkendall, Allison B. McCoy, Naveen Muthu, and Evan W. Orenstein. "Clinical Decision Support Stewardship: Best Practices and Techniques to Monitor and Improve Interruptive Alerts." Applied Clinical Informatics 13, no. 03 (May 2022): 560–68. http://dx.doi.org/10.1055/s-0042-1748856.
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AbstractInterruptive clinical decision support systems, both within and outside of electronic health records, are a resource that should be used sparingly and monitored closely. Excessive use of interruptive alerting can quickly lead to alert fatigue and decreased effectiveness and ignoring of alerts. In this review, we discuss the evidence for effective alert stewardship as well as practices and methods we have found useful to assess interruptive alert burden, reduce excessive firings, optimize alert effectiveness, and establish quality governance at our institutions. We also discuss the importance of a holistic view of the alerting ecosystem beyond the electronic health record.
Books on the topic "Alert burden"
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Judt, Tony. The burden of responsibility: Blum, Camus, Aron, and the French twentieth century. Chicago: University of Chicago Press, 1998.
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The advancement of science, and its burdens: With a new introduction. Cambridge, Mass: Harvard University Press, 1998.
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The advancement of science, and its burdens: The Jefferson lecture and other essays. Cambridge [Cambridgeshire]: Cambridge University, 1986.
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Macauley, Robert C. Forgoing Life-Sustaining Medical Treatment (DRAFT). Edited by Robert C. Macauley. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199313945.003.0006.
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Forgoing life sustaining medical treatment takes on additional complexities depending on the mode of therapy forgone, which often varies in clinical practice. Compassionate extubation of the paralyzed or alert patient requires more in-depth ethical analysis. Some cardiologists are reluctant to deactivate pacemakers, requiring thoughtful comparison of these devices with implantable defibrillators, which do not prompt such debate. Dialysis is a burdensome intervention that may not prolong life and when instituted should be considered a time-limited trial. Enteral and parenteral nutrition create distinct issues in terms of emotional connotation, burden, and benefit.
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Alert! Houghton Mifflin/Walter Lorraine Books, 2007.
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Alert en ondernemend 2.0 : Opleidingsprofiel Culturele en Maatschappelijke Vorming. 4th ed. Uitgeverij SWP, 2014. http://dx.doi.org/10.36254/978-90-8850-020-6.
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Culturele en Maatschappelijke Vorming (CMV) levert als hogere beroepsopleiding aankomende professionals af die mensen gaan ‘ondersteunen bij het vormen van zichzelf en bij het vormgeven aan hun maatschappelijk leven’. Aan wat voor vereisten moeten die professionals voldoen en hoe moeten ze daartoe worden opgeleid? Die vragen krijgen een helder antwoord in Alert en ondernemend 2.0. Dit nieuwe opleidingsprofiel schetst de context en de maatschappelijke opdracht die daaruit voor CMV’ers voortvloeit. Het plaatst CMV in internationale ontwikkelingen (zoals het ontstaan van ‘social work’ en benoemt de ‘body of knowledge’. Hoofdmoot wordt gevormd door de concrete competenties. De wereld is minder overzichtelijk geworden en het beleid weet daar niet altijd goed raad mee. CMV’ers gaan mét de burger op zoek naar houvast. Dit opleidingsprofiel schept duidelijkheid over hun rol en mogelijkheden.
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Judt, Tony. Burden of Responsibility: Blum, Camus, Aron, and the French Twentieth Century. University of Chicago Press, 2010.
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Judt, Tony. Burden of Responsibility: Blum, Camus, Aron, and the French Twentieth Century. University of Chicago Press, 1998.
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Judt, Tony. The Burden of Responsibility: Blum, Camus, Aron, and the French Twentieth Century. University Of Chicago Press, 2007.
Find full textBook chapters on the topic "Alert burden"
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Biard, Joël. "Signification et statut du concept de vide selon Albert de Saxe et Jean Buridan." In La nature et le vide dans la physique médiévale, 269–92. Turnhout: Brepols Publishers, 2012. http://dx.doi.org/10.1484/m.sa_eb.1.101021.
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Sivabalakrishnan, M., R. Menaka, and S. Jeeva. "Critical Video Surveillance and Identification of Human Behavior Analysis of ATM Security Systems." In Advances in Digital Crime, Forensics, and Cyber Terrorism, 93–118. IGI Global, 2016. http://dx.doi.org/10.4018/978-1-5225-0193-0.ch007.
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Video surveillance cameras are placed in many places such as bank, hospital, toll gates, airports, etc. To take advantage of the video in real time, a human must monitor the system continuously in order to alert security officers if there is an emergency. Besides, for event detection a person can observe four cameras with good accuracy at a time. Therefore, this requires expensive human resources for real time video surveillance using current technology. The trajectory of one or more targets obtains for object tracking while recording above space and time. By tracking various objects, the burden of detection by human sentinels is greatly alleviated. Efficient and reliable automatic alarm system is useful for many ATM surveillance applications. ATM Video monitoring systems present many challenging research issues in human abnormal behaviors detection approaches. The framework of ATM video surveillance system encompassing various factors, such as image acquisition, background estimation, background subtraction, segmentation, people counting and tracking are briefly discussed in this chapter.
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Sivabalakrishnan, M., R. Menaka, and S. Jeeva. "Critical Video Surveillance and Identification of Human Behavior Analysis of ATM Security Systems." In Censorship, Surveillance, and Privacy, 315–41. IGI Global, 2019. http://dx.doi.org/10.4018/978-1-5225-7113-1.ch018.
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Video surveillance cameras are placed in many places such as bank, hospital, toll gates, airports, etc. To take advantage of the video in real time, a human must monitor the system continuously in order to alert security officers if there is an emergency. Besides, for event detection a person can observe four cameras with good accuracy at a time. Therefore, this requires expensive human resources for real time video surveillance using current technology. The trajectory of one or more targets obtains for object tracking while recording above space and time. By tracking various objects, the burden of detection by human sentinels is greatly alleviated. Efficient and reliable automatic alarm system is useful for many ATM surveillance applications. ATM Video monitoring systems present many challenging research issues in human abnormal behaviors detection approaches. The framework of ATM video surveillance system encompassing various factors, such as image acquisition, background estimation, background subtraction, segmentation, people counting and tracking are briefly discussed in this chapter.
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"‘We have buried our sovereign’." In Albert. I.B. Tauris, 2012. http://dx.doi.org/10.5040/9780755622955.ch-007.
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"Albert der Grosse und Johannes Buridan." In Albertus Magnus und der Albertismus, 91–105. BRILL, 1995. http://dx.doi.org/10.1163/9789004450974_007.
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Wilmarth Jr., Arthur E. "Frenzy." In Taming the Megabanks, 31–49. Oxford University Press, 2020. http://dx.doi.org/10.1093/oso/9780190260705.003.0003.
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Large commercial banks and their securities affiliates helped to finance an unsustainable credit boom and stock market bubble during the 1920s. Charles Mitchell of National City Bank and Albert Wiggin of Chase National Bank pioneered a new universal banking (“financial department store”) business model for large commercial banks. The rise of universal banks resulted in frenzied competition between those institutions and private investment banks. That rivalry resulted in the widespread marketing and sale of speculative, high-risk securities to unsophisticated, poorly informed investors. More than $80 billion of debt and equity securities were issued in the U.S. between 1919 and 1930. The easy availability of financing during the 1920s caused many American companies and households to overexpand and take on excessive debts. Those debt burdens left businesses and consumers in a highly vulnerable position when the credit boom suddenly ended in late 1929.
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"Skeptical Issues In Commentaries On Aristotle’S Posterior Analytics: John Buridan And Albert Of Saxony." In Rethinking the History of Skepticism, 193–213. BRILL, 2009. http://dx.doi.org/10.1163/ej.9789004170612.i-238.58.
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Osterlind, Steven J. "Related to Relativity." In The Error of Truth, 265–84. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780198831600.003.0015.
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This chapter provides the context for the early twentieth-century events contributing to quantification. It was the golden age of scientific exploration, with explorers like David Livingstone, Sir Richard Burton, and Sir Ernest Shackleton, and intellectual pursuits, such as Hilbert’s set of unsolved problems in mathematics. However, most of the chapter is devoted to discussing the last major influencer of quantification: Albert Einstein. His life and accomplishments, including his theory of relativity, make up the final milestone on our road to quantification. The chapter describes his time in Bern, especially in 1905, when he published several famous papers, most particularly his law of special relativity, and later, in 1915, when he expanded it to his theory of general relativity. The chapter also provides a layperson’s description of the space–time continuum. Women of major scientific accomplishments are mentioned, including Madame Currie and the mathematician Maryam Mirzakhani.
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Dal Prete, Ivano. "The Medieval Earth." In On the Edge of Eternity, 36—C2.P58. Oxford University PressNew York, 2022. http://dx.doi.org/10.1093/oso/9780190678890.003.0003.
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Abstract Chapter 2 discusses medieval models of the physical changes of the globe, which often entailed the possibility or “probability” of an ancient Earth. The Bible was not the only source that described the destruction of humankind by a catastrophic flood: Plato, Aristotle, Ovid, and Seneca all posited that a physically and morally “corrupt” Earth was periodically renovated by deluges of water or fire, either universal or local, occasioned by particular astral conjunctions. Scholars like Jean Buridan and Albert of Saxony deployed impressive intellectual efforts to show that new mountains could replace aging ones as they were eroded, since the absence of such a mechanism would have denied the possibility of an ancient Earth. While they could not determine when the world began, they went to great extents to demonstrate that its extreme antiquity was physically plausible as well as compatible with the faith.
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Bugalho, Lourdes, Luisa Mendes, Maria José Monteiro, Paulo Pinto, João Rio, and Manuel João Lopes. "Monitoring wildfire smoke dispersion using concentrations of PM10 and PM2.5." In Advances in Forest Fire Research 2022, 298–303. Imprensa da Universidade de Coimbra, 2022. http://dx.doi.org/10.14195/978-989-26-2298-9_47.
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Portugal as a member of the European Union (EU) follows the air quality legislation regulated by Directive 2008/50/EC that states that “Member States shall ensure that timely information about actual or predicted exceedances of alert thresholds, and any information threshold is provided to the publicâ€. The southern European countries have biogenic contributions, mainly resulting from the long-distance transport of particulate matter, originated in arid regions, and from large forest fires, whose pollutants loads cannot be imposed limits. These sources lead to an additional contribution of atmospheric pollutants mainly during the spring and summer seasons. Climate change is increasing the vulnerability of the environment to extreme events, such as those that enhance the likelihood of forest fires. Due to the forecast increase in temperatures and decrease in precipitation and humidity it is likely there will be an increase in the frequency and intensity of forest fires in certain regions of the Mediterranean basin as is the case of Portugal. Monitoring the concentration of particles matters in the network of air quality stations can be a way of detecting the dispersion of smoke and giving possible alerts to affected populations. The analysis of PM10 and PM2.5 of the air quality network stations, from June to October, in the period 2010-2020, showed very high concentration values coincident with the years and periods of forest fires. This data was analysed for all stations by considering the average value of the concentration in the 2 days before the day of registration of fires with burned area, daily and by district, greater than 500ha, on the day of the fire occurrence and on two days later. Back trajectory analysis was performed using HYSPLIT Model to confirm the origin of the particles observed at the stations. It was observed that the percentage increase in the daily average value of PM10 concentration, between one day before and the day of the event, is variable but with 26% as an average value for the wildfire above 500ha district daily value, in the period 2010-2020 . This difference depends on the proximity of the forest fire, the area burned as an indication of its strength, the stability of the atmosphere and the height of the boundary layer. Dust episodes with origin in the deserts in Northern Africa often affect the southern regions of Portugal which leads to an increase the concentration of PM10 and PM2.5 particles. The days with high values of PM10 particles (and PM2.5), in the summer months, were studied in order to distinguish the days that could be related to dust particles, in general larger particles, from those which referred to smoke particles from forest fires, usually smaller particles. For this purpose, the relationship between the concentrations of PM2.5 in relation to PM10, in the data coincidence period, was considered. For the large fires of 2017, a more detailed assessment of these characteristics was made by studying the optical thickness of the aerosols and the Angstrom exponent of the VIIRS radiometer on board the Suomi NPP satellite.
Conference papers on the topic "Alert burden"
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Paola Moreno Alarcon, Diana, and Corinne Bieder. "Co-Development Approach integrating Training into the Design Process." In 13th International Conference on Applied Human Factors and Ergonomics (AHFE 2022). AHFE International, 2022. http://dx.doi.org/10.54941/ahfe1002389.
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Since the introduction of advanced automation technology within highly dynamic and complex systems, traditional approaches to training no longer appear to be adequate in preparing end-users of such technologies (Carroll and Olson, 1988). Advances in design processes have resulted in the creation of user-centered designs that employ an iterative design process that follows a cyclical pattern, where the prototype is designed, created and evaluated, throughout multiple loops. Once the final design solution is validated, a training session is organized to prepare the end-user for the Human in the loop Simulation. Since the training sessions and the preparation of these training sessions are conceived after the completion and validation of the design; any issues with the design often result in extended training sessions to compensate for human factors that were overlooked in the initial design. Nonetheless, such enhanced training “cannot and should not be a fix for bad design” (Sarter, Woods & Billings, 1997.p.1936). This research intended to consider the training from the onset of the design in order to avoid transferring the burden of a poor design onto the training. This was not fully possible in the framework of the SAFEMODE project, where this research was conducted, as some design iterations had already taken place prior to the implementation of the proposed training considerations. Instead, a training approach involving future users as part of the system design, hereafter referred to as “Co-Development”, was proposed and tested during the creation of a safety net or alert for air-traffic controllers. Building on this added value to user-centered design, we investigated: To what extent does the co-development of the training with end-users improve the training, the design, and the acceptability of the designed alert?This paper presents this Co-Development approach and the outcome of its first implementation; particularly in terms of its impact on the training, the design, and the acceptability of the alert. Specifically, this system design approach allows for human factor issues to be identified and hence corrected early in the design stage, thus yielding a potential impact on the acceptability and usability of the alert, while simultaneously affecting safety through an improved user-centered design experience. This paper also proposes a future research direction that consists of a joint training and design approach that considers training right from the onset of the first iteration of the design. As a result, the training is conceived jointly and evolves simultaneously with each design loop, further improving the design, and thus reducing the burden placed onto the training due to design shortfalls and impossible design challenges that are seemingly improbable to meet.
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Swartz, R. Andrew, Baibhav Rajbandari, and Benjamin D. Winter. "Autonomous Scour Monitoring of Bridges and Embankments Using Bio-Inspired Whisker Flow Sensor Arrays." In ASME 2014 Conference on Smart Materials, Adaptive Structures and Intelligent Systems. American Society of Mechanical Engineers, 2014. http://dx.doi.org/10.1115/smasis2014-7694.
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Detection of damage to the boundary conditions of structures can be equally important as detection of structural damage. Civil structures sit on foundations which are, ideally, constant over time and are integral to collapse prevention. Any processes that compromise the foundations or the soil around them also constitutes damage to the structure. Bridge structures as well as embankments near roadways and viaducts can be particularly prone to this kind of attack when high-velocity water flows transport sediment away from the bridge foundation (scour). This process can be difficult to detect because 1) it happens out of sight, underwater; and 2) scour holes tend to grow and shrink at time progresses and materials are either carried away or deposited by the water. In this study, use of a buried-rod scour detection system based on magnetostrictive and magnetic flow sensor arrays is investigated. For buried-rod scour detection systems, an array of small, flexible, strain-sensitive rod sensors is distributed around the foundations which generate dynamic signals they are waterborne and static signals when buried. The pattern of static and dynamic signals reveals the depth of scour around the structure. Magnetostrictive sensors are appealing for this application due to their robustness. In this paper the effectiveness signal processing and scour detection algorithms are explored for water-coupled magnetostrictive whisker sensors of varying geometries to determine their sensitivity and the thresholds for false alarms and missed alert conditions at varying flow rates. Experimental laboratory data is utilized for this study.
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Jagadeesh, A., B. Sunil, and R. Mahalakshmi. "An Intuitive Alert System for Fault Detection and Fuse Burn out Recognition at the Distribution Transf ormer." In 2021 International Conference on Artificial Intelligence and Smart Systems (ICAIS). IEEE, 2021. http://dx.doi.org/10.1109/icais50930.2021.9395795.
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Seixas da Rocha, Renato, A´lvaro Maia da Costa, Cla´udio dos Santos Amaral, Ana Lu´cia Lodi da Cruz, Anderson Oliveira Soares, Edgard Poiate Ju´nior, Lis Maria Leoni Rabaco, Alexandre Farias Lins, Lino Francisco Rodrigues Moreira, and Jose´ Pereira Soares. "Geotechnical Data Management System of TRANSPETRO Pipe Routes: GeoRisco." In 2004 International Pipeline Conference. ASMEDC, 2004. http://dx.doi.org/10.1115/ipc2004-0598.
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The integrity management of an extensive pipeline mesh requests the acquisition, transmission, storage, analysis and control of a great amount of data. Guarantee the quality of the data in each one of those stages is of extreme importance in the execution of an effective decision process. Among several fields or disciplines that are related to the structural integrity of on-shore pipelines, the Geotechnics is receiving the right importance. More and more a buried pipeline has been considered as a geotechnical work, once the interaction of the foundation soil with the pipes has been demonstrating to be an important phenomenon to be monitored, with the objective of maintaining acceptable levels of strain and stress in the pipe. Therefore, the whole process of reading the geotechnical instrumentation installed in the piperoute domain has a great impact on the management of the pipeline integrity. As examples of that instrumentation we have: inclinometers, piezometers, strain-gages, etc. This work presents the information system and the methodology that were implanted by TRANSPETRO in the data management of its geotechnical instrumentation and that was named GeoRisco System. The GeoRisco System almost embraces all the stages of the monitoring process where geotechnical instrumentation exists. The monitoring process begins with the standardization of the readings supply. For this purpose, a program was created to generate XML files that facilitate the transmission and sharing of data on the Web. To store the readings of the field instrumentation it was implemented a database that centralizes these data and can be accessed in all the units of the Company. In order to facilitate for the technicians the analysis of these data, a computer program was created, where several types of graphs and spreadsheets were implemented for each instrument type. Finally, a program was developed to alert for critical changes in the measured variables that were selected to control the pipelines safety.
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Wilson, Brent M., and Andrew Martin. "Bearing Condition Monitoring Using Wireless Technology to Reduce the Risk of Bearing Failure." In ASME 2012 Rail Transportation Division Fall Technical Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/rtdf2012-9441.
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With the need for rail systems to provide long distance and highly reliable operations, problems that could arise should be quickly detected and addressed such that they do not become major issues. If undetected, sudden component faults can result in costly and difficult repair scenarios, and in the worst case, derailments, which can be catastrophic if they occur in populated areas. One such problem, Bearing Burn-off, can result in significant damage to the cars as well as to the rail infrastructure, often before the symptoms can be detected by rail crews and in most situations by wayside mounted infrastructure. A system developed by IONX for railroad operations is designed to monitor rail car bearings to detect potential burn-off conditions before they arise and before they become destructive. This system is comprised of a Central Monitoring Unit (CMU) and Wireless Sensor Nodes (WSNs) which continuously monitor bearing temperatures as well as the current ambient temperature. The application of various algorithms not only conducts trend analysis to anticipate burn-off events, but also reports events at predetermined temperature limits to provide early warning and immediately actionable feedback to locomotive engineers. With these alerts, the driver or train controller can then decide on the appropriate action to be taken and destructive consequences can be avoided saving operational and infrastructure costs. For this pilot study, a total of ten freight cars and fifteen locomotives were equipped, operated, and monitored for an initial three month period. This paper presents preliminary operational results for these tests demonstrating the benefits of predictive condition monitoring systems in real-world applications.
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Salguero, Gualberto Chiriboga. "Geotechnical Management in OCP Pipeline." In 2012 9th International Pipeline Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/ipc2012-90154.
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Landslides are one of the main threats in maintaining pipeline integrity and depend directly on natural geological and geotechnical conditions. External factors such as weather, rainfall, and others, can trigger land movements and displace the pipeline. The Ecuadorian OCP (Heavy Crude Oil Pipeline) is a buried pipeline going in an East to West direction, crossing 485 kilometers of the Ecuadorian territory. It starts in the Amazon Region (approximately 300 meters above sea level), and then climbs the Andes Mountains (4060 meters above sea level in its tallest portion), to then descend to the shores of the Pacific Ocean. The OCP pipeline crosses many regions with varying climates, varying rainfall patterns, variable morphologies, diversity of soils, and areas affected by tectonic faults, among others. In order to prevent pipeline failures, OCP Ecuador has instituted programs to perform preventive and corrective actions in order to handle the following geological concerns: • Intervention of a specialized geotechnical team to identify and monitor critical points along the pipeline route. This team identifies unstable sites based on the observations of cracks, land movements, or other visual deformations of the pipeline route and its surroundings. • Upkeep of the preventive program. • Execution of third-level studies required to understand specific unstable zones in detail: nature of the subsoil, underground water level, geo-mechanic characteristics, stability factor, and stabilization works. • Geotechnical instrumentation used: inclinometers to search the spread of movement, shifting direction, speed, (landslide location); strain gauges for preventive control of pipeline strain, alert levels, efficiency of stabilization works; and topographic surveys to monitor superficial movements. • Data processing and mapping on GIS Software. • Annual over-flights to detect massive landslides. • Internal inspectors (online-ILI) providing a wide range of information: geometry measurements, curvature monitoring, pipeline displacement, etc. In addition, it allows detection of probable zones depicting soil movement. The purpose of this technical paper is to present the methodology applied by OCP Ecuador to prevent failure of the pipeline along its route.
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Godfrey, Alastair, David Hill, Chris Minto, John Williams, and Jerry Worsley. "Pipeline Leak Detection Using Four Mode Fibre-Optic Based Distributed Sensing." In 2014 10th International Pipeline Conference. American Society of Mechanical Engineers, 2014. http://dx.doi.org/10.1115/ipc2014-33083.
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Fibre-optic based Distributed Acoustic Sensing (DAS), is now commonly used around the world for providing pipeline operators with real-time and early warning of intrusions on their pipeline Right of Ways. Also open to analysis within the DAS signal return are multiple signatures derived from the egress of product leaking from pipelines. Over the last three years, focussing attention on these alternative signals, OptaSense have developed a novel 4-mode External Leak Detection capability, fusing outputs from both DAS, Negative Pressure Pulse (NPP) and Distributed Temperature Gradient Sensing (DTGS) signals (the latter not to be confused with Distributed Temperature Sensing or DTS). The first commercially deployed 4-mode Leak Detection products are now being seen on the market, for both gas and liquids pipelines. In this paper, we report how DAS can be used to provide these four modes of leak detection — including (listed in order of typical detection latency, fastest to slowest) i) negative pressure waves created in the pipeline product from the leak event ii) acoustic noise from turbulent flow through the leak orifice iii) temperature gradients in the soil due to the presence of the leaked product (positive and negative), and iv) local strain/ground heave due to soil displacement by the leaked product. These acoustic, temperature and strain measurements using a fibre-optic cable buried next to a pipeline can be fused together to provide highly sensitive and reliable alerts for pipeline leaks. The pipeline industry has always sought to detect smaller leaks faster, with better locational accuracy. This paper, which draws upon industry sponsored test results and commercial deployment data, provides an update to the industry on leak detection possibilities using DAS.
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Parker, Ken R., Jeff Allen, and Anupam Sanyal. "Benchmarking Software for Slagging, Fouling and Other Parameters to Improve Coal-Fired Power Plant Load Factor, Efficiency and Emission." In ASME 2006 Power Conference. ASMEDC, 2006. http://dx.doi.org/10.1115/power2006-88249.
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For a 500 MW unit, a 1 % reduction in boiler efficiency equates to a coal cost in the order of $ 1/2 million/annum, while a 5 % unit derate, needed to meet emission compliance, can equate to an annual revenue loss of up to $ 12 million. Many software products are in use, which based on the present plant performance, identify and optimize the operational parameters for the best plant capacity, utilization and efficiency. While they are effective in tuning up the unit, they are applied to an operating plant firing a given coal for the given performance. But what if there were a means of predicting how a coal will perform with respect to slagging, fouling and every other single parameter involved in the use of that coal for capacity, efficiency maximization and emission control without firing even a lb of coal? This would enable the operator to know in advance what to expect and thereby, adjust the operating variables to get the best out of that coal. Such a software product – SCES (Steam Coal Evaluation & Services) has been developed based on the fundamental principles of combustion, mineral matter transformation and emission of particulates, NOx, SO2 and mercury, based on only the standard ASTM coal and ash analyses. The operational parameters evaluated are: Slagging and fouling as well as Grindability, Abrasion of the grinding elements; Combustibility & Unburnt carbon, Corrosion and Erosion; Emission of particulates, the oxides of sulfur and nitrogen (both primary and secondary DeNOx) as well as mercury when data are available. Its advantage over the existing products is its ability to predict, amongst others parameters, corrosion, erosion of convective tubes and the life of grinding elements none of which are discernible from the existing software products or from a limited test burn. These parameters however play important roles in the bottom line O & M costs. The implementation of SCES in providing meaningful rankings alerts the plant operators to the performance they can expect and any measures that need to be taken to be able the plant to operate at its highest load factor and efficiency while under emission compliance with minimum impact on O & M cost. No separate coal sample or small-scale laboratory evaluation work is required in the derivation of the rankings. Because of its simplicity of use and immediate availability of results, SCES can also be used as a routine analytical tool, accompanying the coal analyses by the plant or supplied with each delivery of coal. It is applicable to all coals irrespective of rank and country of origin, it has been used and validated on coals from the US, UK, Russia, Columbia and India. The paper describes the fundamental properties coal used in the development of the software and cites case histories of its validation on US (Bituminous & Sub-bituminous) coals.