Runway Safety Analysis for 2015 to 2017

Reducing the risk of runway incursions or excursions in order to meet future aviation growth can be achieved two fold: by preventing and by limiting the level of damage. In order to reach an As Low As Reasonably Practicable (ALARP) level of runway safety is insight in the cost of runway safety events as well as in their mitigations required. Aircraft and Aerodrome operators could get this insight by combining the likelihood of future occurrences with their cumulative costs. On top of already existing prevention measures, new additional restrictions could face financial limits as indicated by the law of diminishing returns. That implies that either accepting the risk ‘as is’ and thus accepting higher levels of runway incursions and excursions or find cost-effective mitigations postponing the financial limits to safety. ; thus a cost-benefit approach. A method of estimating the costs of runway related an occurrence has recently been published. Combining this method with a model capable of predicting the likelihood of runway incursions or excursions tailor-made per aircraft or aerodrome operator and their mitigations opens the possibility of a cost benefit approach. Runway incidents and accidents in the period 2015-2017 are analyzed and their costs estimated at $ 11 Billion, corrected for purchasing power. Veer-offs are shown to be by far the most costly events, followed by overruns. Runway incursion analysis has showed to be the least cost event compared with the two aforementioned events. The number and severity of veer-offs are expected to rise. The costs of future veer-offs should be weighed against the costs of prevention and the cost of reducing the levels of damage. Damage reduction is the main objective of the runway strip (RESA for overruns). It appears that the level of damage and costs rise considerably when a runway strip or RESA is inadequate or inappropriate for the moment (e.g. bearing strength). A cost driven, flexible risk based system is recommended in order to reduce the risks and costs associated with runway excursions with emphasis on veer-offs and overruns. Concrete actions include a three step approach for aircraft and aerodrome operators

The potential of training specialist oncology nurses in real-life reporting of adverse drug reactions

Specialist oncology nurses (SONs) have the potential to play a major role in monitoring and reporting adverse drug reactions (ADRs); and reduce the level of underreporting by current healthcare professionals. The aim of this study was to investigate the long term clinical and educational effects of real-life pharmacovigilance education intervention for SONs on ADR reporting. This prospective cohort study, with a 2-year follow-up, was carried out in the three postgraduate schools in the Netherlands. In one of the schools, the prescribing qualification course was expanded to include a lecture on pharmacovigilance, an ADR reporting assignment, and group discussion of self-reported ADRs (intervention). The clinical value of the intervention was assessed by analyzing the quantity and quality of ADR-reports sent to the Netherlands Pharmacovigilance Center Lareb, up to 2 years after the course and by evaluating the competences regarding pharmacovigilance of SONs annually. Eighty-eight SONs (78% of all SONs with a prescribing qualification in the Netherlands) were included. During the study, 82 ADRs were reported by the intervention group and 0 by the control group. This made the intervention group 105 times more likely to report an ADR after the course than an average nurse in the Netherlands. This is the first study to show a significant and relevant increase in the number of well-documented ADR reports after a single educational intervention. The real-life pharmacovigilance educational intervention also resulted in a long-term increase in pharmacovigilance competence. We recommend implementing real-life, context- and problem-based pharmacovigilance learning assignments in all healthcare curricula

Validating a generic cancer consumer quality index in eight European countries, patient reported experiences and the influence of cultural differences

BackgroundTaking patient centeredness into account is important in healthcare. The European Cancer Consumer Quality Index (ECCQI) is a validated tool for international benchmarking of patient experiences and satisfaction.This study aimed to further validate the ECCQI in larger and more uniform groups of high volume tumours such as breast and prostate cancer. A second objective was the verification of the influence of cultural factors of the country to determine its possible use in international benchmarking.MethodsData from two survey studies in eight European countries were combined. Socio-demographic correlations were analysed with Kruskall-Wallis and Mann-Whitney tests. Cronbach's alpha was calculated to validate internal consistency. Influences of masculinity (MAS), power distance (PD) and uncertainty avoidance (UA) were determined by linear regression analysis in a general model and subgroup models.ResultsA total of 1322 surveys were included in the analysis (1093 breast- and 348 prostate cancer patients). Cronbach's alpha was good (alpha >= 0.7) or acceptable (0.5Peer reviewe

The effects of harvest date and frequency on the yield, nutritional value and mineral content of the paludiculture crop cattail (Typha latifolia L.) in the first year after planting

The use of drained peatlands as dairy grasslands leads to long-term organic matter losses, CO2 emissions and soil subsidence. It also yields grass with increased N and P contents compared to grass grown on mineral soils due to peat mineralisation, which often leads to greater farm surpluses of these elements. Growing Typha latifolia as a forage crop on rewetted peatlands (paludiculture) could reduce these issues. Therefore, the effects of harvest date and frequency on yield and nutritional value were studied in three experiments during the first growing season after establishment of two different T. latifolia plantations. T. latifolia produced 40–68 shoots m-2 and maximum dry matter (DM) yields of 9.81–10.89 Mg ha-1. Harvesting before flowering resulted in the highest nutritional value per kg DM, of 563–575 g in vitro digestible organic matter (IVDOM), 120–128 g crude protein (CP), 287–300 g crude fibre (CF) and 1.5 g P. Surprisingly, harvesting at intervals of three or six weeks resulted in similar cumulative DM yields (p = 0.190). Also, average nutritional values per kg DM, especially of biomass harvested at 3-week intervals, remained similar to a May yield of 466–591 g IVDOM, 103–134 g CP and 286–303 g CF. Growing T. latifolia fodder for inclusion in grass-based diets could reduce the environmental impacts of dairy farming on peat

Mechanochemical endovenous Ablation versus RADiOfrequeNcy Ablation in the treatment of primary great saphenous vein incompetence (MARADONA):Study protocol for a randomized controlled trial

BACKGROUND: Radiofrequency ablation (RFA) is associated with an excellent outcome in the treatment of great saphenous vein (GSV) incompetence. The use of thermal energy as a treatment source requires the instillation of tumescence anesthesia. Mechanochemical endovenous ablation (MOCA) combines mechanical endothelial damage, using a rotating wire, with the infusion of a liquid sclerosant. Tumescence anesthesia is not required. Preliminary experiences with MOCA showed good results and low post-procedural pain. METHODS/DESIGN: The MARADONA (Mechanochemical endovenous Ablation versus RADiOfrequeNcy Ablation) trial is a multicenter randomized controlled trial in which 460 patients will be randomly allocated to MOCA or RFA. All patients with primary GSV incompetence who meet the eligibility criteria will be invited to participate in this trial. The primary endpoints are anatomic and clinical success at a one-year follow-up, and post-procedural pain. The secondary endpoints are technical success, complications, operation time, procedural pain, disease-specific quality of life, time taken to return to daily activities and/or work, and cost-efficiency analyses after RFA or MOCA. Both groups will be evaluated on an intention to treat base. DISCUSSION: The MARADONA trial is designed to show equal results in anatomic and clinical success after one year, comparing MOCA with RFA. In our hypothesis MOCA has an equal anatomic and clinical success compared with RFA, with less post-procedural pain. TRIAL REGISTRATION: Clinicaltrials NCT0193616

Ecological changes in historically polluted soils: Metal(loid) bioaccumulation in microarthropods and their impact on community structure

International audienceSoil pollution by persistent metal(loid)s present environmental and sanitary risks. While the effects of metal(loid)s on vegetation and macrofauna have been widely studied, their impact on microarthropods (millimetre scale) and their bioaccumulation capacity have been less investigated. However, microarthropods provide important ecosystem services, contributing in particular to soil organic matter dynamics. This study focussed on the impact of metal(loid) pollution on the structure and distribution of microarthropod communities and their potential to bioaccumulate lead (Pb). Soil samples were collected from a contaminated historical site with a strong horizontal and vertical gradient of Pb concentrations. Microarthropods were extracted using the Berlese method. The field experiments showed that microarthropods were present even in extremely polluted soils (30,000 mg Pb kg− 1). However, while microarthropod abundance increased with increasing soil C/N content (R2 = 0.79), richness decreased with increasing pollution. A shift in the community structure from an oribatid-to a springtail-dominated community was observed in less polluted soils (R2 = 0.68). In addition, Pb bioamplification occurred in microarthropods, with higher Pb concentrations in predators than in detritivorous microarthropods. Finally, the importance of feeding and reproductive ecological traits as potentially relevant descriptors of springtail community structures was highlighted. This study demonstrates the interest of microarthropod communities with different trophic levels and ecological features for evaluating the global environmental impact of metal(loid) pollution on soil biological quality