MFA-net: Object detection for complex X-ray cargo and baggage security imagery.

Deep convolutional networks have been developed to detect prohibited items for automated inspection of X-ray screening systems in the transport security system. To our knowledge, the existing frameworks were developed to recognize threats using only baggage security X-ray scans. Therefore, the detection accuracy in other domains of security X-ray scans, such as cargo X-ray scans, cannot be ensured. We propose an object detection method for efficiently detecting contraband items in both cargo and baggage for X-ray security scans. The proposed network, MFA-net, consists of three plug-and-play modules, including the multiscale dilated convolutional module, fusion feature pyramid network, and auxiliary point detection head. First, the multiscale dilated convolutional module converts the standard convolution of the detector backbone to a conditional convolution by aggregating the features from multiple dilated convolutions using dynamic feature selection to overcome the object-scale variant issue. Second, the fusion feature pyramid network combines the proposed attention and fusion modules to enhance multiscale object recognition and alleviate the object and occlusion problem. Third, the auxiliary point detection head adopts an auxiliary head to predict the new keypoints of the bounding box to emphasize the localizability without requiring further ground-truth information. We tested the performance of the MFA-net on two large-scale X-ray security image datasets from different domains: a Security Inspection X-ray (SIXray) dataset in the baggage domain and our dataset, named CargoX, in the cargo domain. Moreover, MFA-net outperformed state-of-the-art object detectors in both domains. Thus, adopting the proposed modules can further increase the detection capability of the current object detectors on X-ray security images.

Implicações para homens do afastamento do(a) filho(a) devido medida protetiva de urgência / Impacto en los hombres del distanciamiento del(la) hijo(a) debido a medida protectora de urgencia / Implications for men of separation from their children due to emergency protective measure

Resumo Objetivo Desvelar as implicações para os homens do afastamento pai-filho(a) em decorrência de medida protetiva por violência conjugal. Métodos Estudo descritivo exploratório, abordagem qualitativa, desenvolvido com nove homens que respondiam a processo judicial por violência conjugal junto às 1ª e 2ª Varas de Justiça pela Paz em Casa de Salvador, Bahia, Brasil. A pesquisa ocorreu por meio da entrevista semiestruturada, tendo seu conteúdo gravado, transcrito e, em seguida, submetido à validação pelos homens. Os dados foram sistematizados com base nos passos preconizados pela análise de conteúdo temática categorial. Resultados O estudo revela que o afastamento pai-filho em decorrência da medida protetiva de urgência suscita no rompimento do vínculo paterno, fomentando o desenvolvimento de problemas psicoemocionais, como ansiedade, depressão e ideação suicida, muitas vezes somatizados e expressos desde cefaleia até condições que necessitam de cuidados hospitalares. Conclusão O comprometimento do exercício da paternidade viola também o direito de crianças e adolescentes ao convívio com a figura paterna. Deste modo, há grande necessidade de que a Política Nacional de Atenção Integral à Saúde dos Homens contemple uma gestão que priorize ações preventivas para a violência, assim como desempenhe acompanhamento psicossocial aos homens.

Resumen Objetivo Revelar el impacto en los hombres del distanciamiento padre-hijo(a) como consecuencia de medidas protectoras por violencia conyugal. Métodos Estudio descriptivo exploratorio, enfoque cualitativo, llevado a cabo con nueve hombres que respondían a juicio por violencia conyugal en el 1º y 2º Juzgado de Justicia por la Paz en Casa de Salvador, estado de Bahia, Brasil. La investigación se realizó a través de encuesta semiestructurada, con grabación y transcripción del contenido, y luego sometido a su validación por los hombres. Los datos fueron sistematizados con base en los pasos preconizados por el análisis de contenido temático de la categoría. Resultados El estudio revela que el distanciamiento padre-hijo como consecuencia de medidas protectoras de urgencia provoca la ruptura del vínculo paterno y fomenta el desarrollo de problemas psicoemocionales, como ansiedad, depresión e ideación suicida, muchas veces somatizados y expresados desde una cefalea hasta condiciones que necesitan cuidados hospitalarios. Conclusión El comprometimiento del ejercicio de la paternidad también viola el derecho de niños y adolescentes a convivir con la figura paterna. De este modo, hay una gran necesidad de que la Política Nacional de Atención Integral a la Salud de los Hombres contemple una gestión que establezca prioridades en acciones preventivas contra la violencia, así como también realice un seguimiento psicosocial de los hombres.

Abstract Objective To unveil the implications for men of father-son estrangement as a result of a protective measure for conjugal violence. Methods This is an exploratory descriptive study, with a qualitative approach, developed with nine men who were responding to a lawsuit for conjugal violence at the 1st and 2nd Courts of Justice of the Peace in Casa de Salvador, Bahia, Brazil. The research took place through a semi-structured interview, with its content recorded, transcribed and then submitted for validation by the men. Data were systematized based on the steps recommended by the categorical thematic content analysis. Results The study reveals that the father-son estrangement as a result of an emergency protective measure causes paternal bond rupture, promoting the development of psycho-emotional problems, such as anxiety, depression and suicidal ideation, often somatized and expressed from headache to conditions that require hospital care. Conclusion The commitment to the exercise of paternity also violates the right of children and adolescents to live with their father figure. Thus, there is a great need for the Brazilian National Policy for Comprehensive Care for Men's Health to include a management that prioritizes preventive actions against violence as well as providing psychosocial support to men.

Opinión de estudiantes de kinesiología relacionado con precauciones estándar, vista de enfermería / Opinion of kinesiology students related to standard precautions, nursing view

INTRODUCCIÓN: Las precauciones estándar corresponden a un grupo de prácticas de prevención de infecciones que se aplican en la atención a todos los pacientes, tiene como objetivo prevenir la transmisión cruzada de microorganismos entre pacientes. OBJETIVO: Develar la opinión de las/os estudiantes de Kinesiología de la Universidad Mayor-Temuco con relación a las Precauciones Estándar. METODOLOGÍA: Estudio cualitativo, descriptivo y exploratorio, estudio intrínseco de caso, la muestra no probabilística, intencionada: 12 sujetos estudiante de kinesiología 2018; criterio de inclusión: haber aprobado la asignatura de Cuidados Básicos del Enfermo; recogida de datos: entrevistas en profundidad, se utilizaron notas de campo y se manejó el método de comparación constante, además esquema de la reducción progresiva. RESULTADOS: Para la categoría de significado de precauciones estándar surge medida de protección y seguridad para usuario y tratante; para precauciones estándar utilizadas en prácticas clínicas emerge las subcategorías de elementos y técnicas de barrera en forma análoga nace como categoría aplicabilidad de precauciones estándar de ella se desprenden campos clínicos, eventos clínicos del usuario y técnicas y procedimientos; para la categoría factores facilitadores: docente y estudiantes; en tanto factores obstaculizadores: curriculum. CONCLUSIONES: En los estudiantes existe un conocimiento deficiente y conceptos aislados sobre PE, utilizan principalmente guantes y lavado de manos; menor grado uso de mascarilla y pechera. Destaca positivamente conocimiento docente; factores obstaculizadores: aspectos teóricos deficientes curriculares; considerar modificaciones curriculares en aspectos conceptuales y procedimentales.

BACKGROUND: the standard precautions correspond to a group of infection prevention practices that are applied in the care of all patients, it aims to prevent the cross-transmission of microoganisms between patiens. OBJETIVE: to reveal the opinion of Kinesiology students at the Universidad Mayor-Temuco regarding standard precautions. METHODOLOGY: Qualitative, descriptive, and exploratory study, intrinsic case study, non-probabilistic sample, intentional: 12 subjects, kinesiology student of the year 2018; For data collection, in-depth interviews were used, field notes and the constant comparison method were used, in addition to the progressive reduction scheme. RESULTS: 173 units of meaning emerge, for the category of meaning of standard precautions, protection and security measure for user and trafficker arises; For standard precautions used in clinical practices, the subcategories of barrier elements and techniques emerge, the most mentioned, in an analogous way, the applicability of standard precautions is born as a category of clinical fields, clinical events of the user and techniques and procedures; for the category facilitating factors: teacher and student are the least mentioned; as impeding factors: curriculum. CONCLUSIONS: There is a deficient knowledge and isolated concepts about SP, mainly use gloves and hand washing; less degree the use of masks and scrubs. It is positively highlighted teacher's knowledge, and some of the hindering factors are the lack of theoretical aspects of the curriculum and the consideration for curriculum modifications to compensate conceptual and procedural aspects.

A Health Intelligence Framework for Pandemic Response: Lessons from the UK Experience of COVID-19.

The novel coronavirus disease 2019 (COVID-19) pandemic has exposed critical failures in global public policy preparedness and response. Despite over a decade of exposure to other epidemics and pandemics, many, if not most, nation states have failed to integrate lessons learned into their pandemic preparedness and response plans. The United Kingdom's response to COVID-19 is an archetype of how the pandemic has overwhelmed traditional public health-led approaches. In this paper, we explore the UK experience and propose that pandemics constitute multivector threats meriting attention within a health intelligence framework. They employ the processes of information management used by the intelligence sector to illustrate a procedural matrix for guiding public policy during complex health security events.

Pre-trauma Growth under Terror Threat: Suggestive Communication Method in Anticipatory Trauma.

Counterterror measures put communities in a state of alertness for several years. Jewish schools in Europe respond with higher security measures, going through transformations in their daily routines and environments, marked by security rituals. Anticipating the trauma creates extreme situations that polarizes the sense of agency and alters the state of consciousness, having a collective impact. Analyzing the anticipatory trauma within the framework of the altered state of consciousness opens the possibility for intervening with suggestive communication methods that aim to increase the sense of agency. The positive effect of teachers learning the suggestive communication methods on the sense of agency was measured with the Sense of Agency Scale. The altered state of consciousness in anticipatory trauma opens the mind for the sense of agency changing in a signature pattern, in a way that is typical for a group, allowing cultural reproduction.

Safe and Supportive Neurorehabilitation Environments: Results of a Structured Observation of Physical Features Across Two Rehabilitation Facilities.

OBJECTIVE: This research aimed to identify the extent to which physical features of two neurorehabilitation units appeared to support positive patient experience and recovery. BACKGROUND: Neurorehabilitation inpatient facilities must be focused on safety management and efficiency of care, as well as being supportive of the patient experience. While occupational safety and risk management is paramount, the supportive nature of the physical setting for inpatient neurorehabilitation following spinal cord injury or acquired brain injury is unclear. METHOD: Structured observation of two physical environments using an adapted observational tool comprising 237 items across 8 area zones, and 3 major categories (patient safety, worker safety and efficiency, and holistic patient experience). RESULTS: Results indicated that across both neurorehabilitation settings, the built environment attended well to occupational safety, risk reduction, harm prevention and internal security (up to 87% in spinal injury unit [SIU] and 95% in brain injury unit [BIU] patient rooms), but with limited evidence of physical features to support psychosocial needs or promote positive user experiences (up to 30% in SIU and 45% in BIU patient rooms). CONCLUSION: The built environments observed appeared to be an underutilized resource for supporting positive psychosocial neurorehabilitation experiences (including complex behavior support) beyond hazard management.

La atención odontológica a pacientes COVID-19 positivo ¿Qué hacer ante una urgencia? / Dental care for COVID-19 positive patients: what to do in an emergency?

El pasado diciembre en China, se originó un brote de Neumonía producida por una nueva cepa viral de coronavirus o SARS-CoV-2, nunca antes vista en humanos, lo que despertó la atención en el mundo. Asimismo, el 30 de enero fue declarada una emergencia de salud pública de preocupación internacional por la OMS, marcando el inicio de una pandemia altamente patógena denominada ''enfermedad por coronavirus del 2019 (COVID-19)'' que se transmite de persona a persona por medio de secreciones respiratorias. Los principales síntomas que se presentan en los pacientes son: fiebre, tos, dolor de garganta, dificultad respiratoria, fatiga y malestar general; sin embargo existe un porcentaje de personas asintomáticas que representan un alto riesgo de contagio para los profesionales de la salud que trabajan en el área buco-nasal como lo son los cirujanos dentistas. En consecuencia, este estudio tiene como objetivo mostrar las medidas de protección que han sido exitosas en otros países para la atención de personas con COVID-19, de manera que los procedimientos sean realizados de una forma segura tanto para los pacientes como para el equipo de salud, evitando la propagación de la enfermedad.

Last December in China, an outbreak of pneumonia caused by a new viral strain of coronavirus or SARSCoV-2, never seen in humans, originated, which aroused worldwide attention. Likewise, on January 30, a public health emergency of international concern was declared by the WHO, marking the start of a highly pathogenic pandemic called "2019 coronavirus disease (COVID-19)" that is transmitted from person to person by means of respiratory secretions. The main symptoms that appear in patients are fever, cough, sore throat, shortness of breath, fatigue and general malaise; However, there is a percentage of asymptomatic people who represent a high risk of contagion for health professionals who work in the airway and digestive tract, such as dentist. Consequently, this study aims to show the necessary protection measures so that the health team can intervene in patients diagnosed with COVID-19 safely, avoiding the spread of the disease.

Monitorización, seguridad y eficacia en el uso de los componentes sanguíneos / Monitoring, safety and efficiency in the use of blood components

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3. Becoming a midwife - protecting the public through disclosure and barring service checks.

Becoming a midwife is the 16th series of 'Midwifery basics'targeted at practising midwives and midwifery students. The aim of these articles is to provide information to raise awareness of the impact of professionalism on women's experience, consider the implications for midwives' practice and encourage midwives to seek further information through a series of activities relating to the topic. This article looks at the need for a Disclosure and barring service (DBS) check; issues that can arise through this are used to demonstrate challenges that may affect students during recruitment or while awaiting clearance. This shows how the public are protected during recruitment procedures.

Augmenting the Deliberative Method for Ranking Risks.

The Department of Homeland Security (DHS) characterized and prioritized the physical cross-border threats and hazards to the nation stemming from terrorism, market-driven illicit flows of people and goods (illegal immigration, narcotics, funds, counterfeits, and weaponry), and other nonmarket concerns (movement of diseases, pests, and invasive species). These threats and hazards pose a wide diversity of consequences with very different combinations of magnitudes and likelihoods, making it very challenging to prioritize them. This article presents the approach that was used at DHS to arrive at a consensus regarding the threats and hazards that stand out from the rest based on the overall risk they pose. Due to time constraints for the decision analysis, it was not feasible to apply multiattribute methodologies like multiattribute utility theory or the analytic hierarchy process. Using a holistic approach was considered, such as the deliberative method for ranking risks first published in this journal. However, an ordinal ranking alone does not indicate relative or absolute magnitude differences among the risks. Therefore, the use of the deliberative method for ranking risks is not sufficient for deciding whether there is a material difference between the top-ranked and bottom-ranked risks, let alone deciding what the stand-out risks are. To address this limitation of ordinal rankings, the deliberative method for ranking risks was augmented by adding an additional step to transform the ordinal ranking into a ratio scale ranking. This additional step enabled the selection of stand-out risks to help prioritize further analysis.

The role of the health physicist in nuclear security.

Health physics is a recognized safety function in the holistic context of the protection of workers, members of the public, and the environment against the hazardous effects of ionizing radiation, often generically designated as radiation protection. The role of the health physicist as protector dates back to the Manhattan Project. Nuclear security is the prevention and detection of, and response to, criminal or intentional unauthorized acts involving or directed at nuclear material, other radioactive material, associated facilities, or associated activities. Its importance has become more visible and pronounced in the post 9/11 environment, and it has a shared purpose with health physics in the context of protection of workers, members of the public, and the environment. However, the duties and responsibilities of the health physicist in the nuclear security domain are neither clearly defined nor recognized, while a fundamental understanding of nuclear phenomena in general, nuclear or other radioactive material specifically, and the potential hazards related to them is required for threat assessment, protection, and risk management. Furthermore, given the unique skills and attributes of professional health physicists, it is argued that the role of the health physicist should encompass all aspects of nuclear security, ranging from input in the development to implementation and execution of an efficient and effective nuclear security regime. As such, health physicists should transcend their current typical role as consultants in nuclear security issues and become fully integrated and recognized experts in the nuclear security domain and decision making process. Issues regarding the security clearances of health physics personnel and the possibility of insider threats must be addressed in the same manner as for other trusted individuals; however, the net gain from recognizing and integrating health physics expertise in all levels of a nuclear security regime far outweighs any negative aspects. In fact, it can be argued that health physics is essential in achieving an integrated approach toward nuclear safety, security, and safeguards.

Thresholds of information leakage for speech security outside meeting rooms.

This paper describes an approach to provide speech security outside meeting rooms where a covert listener might attempt to extract confidential information. Decision-based experiments are used to establish a relationship between an objective measurement of the Speech Transmission Index (STI) and a subjective assessment relating to the threshold of information leakage. This threshold is defined for a specific percentage of English words that are identifiable with a maximum safe vocal effort (e.g., "normal" speech) used by the meeting participants. The results demonstrate that it is possible to quantify an offset that links STI with a specific threshold of information leakage which describes the percentage of words identified. The offsets for male talkers are shown to be approximately 10 dB larger than for female talkers. Hence for speech security it is possible to determine offsets for the threshold of information leakage using male talkers as the "worst case scenario." To define a suitable threshold of information leakage, the results show that a robust definition can be based upon 1%, 2%, or 5% of words identified. For these percentages, results are presented for offset values corresponding to different STI values in a range from 0.1 to 0.3.

Midwifery retention and coverage and impact on service utilisation in Afghanistan.

OBJECTIVE: to measure the rate of and determine factors associated with community midwifery education (CME) graduate retention in public sector health care in Afghanistan. DESIGN: cross-sectional. SETTING: performed in public health facilities of 11 Afghan provinces purposively selected by geographic location and security conditions, between October 2011 and April 2012. Facilities were selected by one of two criteria: either a registered deployment site for a CME graduate or randomly selected through population-proportionate sampling. PARTICIPANTS: facility managers and midwives employed in public facilities at the time of data collection. MEASUREMENTS: three quantitative instruments were used: a facility checklist assessed staffing and service volume, and two separate questionnaires for midwives and facility managers, which measured employment duration and perceived barriers to midwife retention. FINDINGS: at 456 surveyed facilities, 570 midwives were interviewed. Overall, 61.3% (n=209/341) of CME graduates deployed in surveyed provinces were working in public sector facilities, whereas 36.8% were working at their assigned site. Facilities without midwife staff had lower average monthly volumes of antenatal care visits (14.6 (SD ± 22.7) versus 71.5 (SD ± 72.5)), family planning visits (10.4 (SD+13.9) versus 56.8 (SD+85.0)), or facility-based deliveries (0.55 (SD ± 2.2) versus 15.7 (SD ± 18.7)). Perceived reasons for leaving employment were insecurity (civil unrest/armed conflict) (46.4%), family disagreement (28.1%), increased workload without compensation (9.9%), and lack of appropriate housing (7.8%). KEY CONCLUSIONS: CME graduate retention in public sector positions was relatively low and significantly impacted by insecurity and cultural issues related to women working outside the home. IMPLICATIONS FOR PRACTICE: culturally appropriate measures are needed to attract and retain skilled female health care providers for rural public facilities in Afghanistan and similar settings. Advocacy to encourage family and community support for midwives working in rural facilities and providing amenities such as housing, education for children, and employment for the accompanying male family member are measures most likely to improve midwife retention.

[Training to management of violence in hospital setting]. / Formation à la gestion des situations violentes en contexte hospitalier.

OBJECTIVE: Evaluate the typology of violence in hospital setting, study the psychophysiological state of care givers dealing with the aggression and provide appropriate training. STUDY DESIGN: Single centre, observational. PATIENTS AND METHODS: A first anonymous questionnaire was given to a sample of emergency and intensive care providers in Narbonne Hospital. The parameters studied included: demographics data, the Trait Anxiety Inventory test, the typology of aggressions, and the psycho-physiological state of subjects dealing with the aggression. Robert Paturel, an instructor of French Special Forces (Recherche-Assistance-Intervention-Dissuasion [RAID]), has provided training for the management of violence. A second questionnaire assessed satisfaction for proposed formation. RESULTS: Forty-one questionnaires were returned. The rates of verbal and physical violence touching care givers were respectively 97 % and 41 % (median of 7years [1-36] experience on the job). Eighty-five percent of care givers wanted training in psychology of conflict and 93 % wanted a formation with a self-defense aspect. The first reason of violence was drugs and alcohol abuse. The "tunnel effect" during stress was identified in 34 % of care givers, and 20 % were unaware of its nature. Twenty-one percent of care givers spontaneously adopting a safe distance of more than 1m during a conflict had been physically assaulted versus 63 % for those staying less than 1m (P=0.03). The proposed formation, including psychology of conflict and self-defense, was satisfactory to all care givers who participated (median score 9/10 [7-10]). CONCLUSION: The verbal and physical violence affecting emergency departments is a common phenomenon warranting appropriate training. The proposed formation included the comprehension of the conflict causality, self-defense and self-control.

Burnout/stress management: how to reduce burnout and stress in the workplace.

We all encounter various forms of stress every single day. Stress can be caused by family issues, relationships, children and especially work. With the ever-growing demands that are placed on Healthcare Security professionals today, career burnout associated with stress is becoming more and more common. In this article, the author discusses some signs and symptoms, as well as giving some stress reduction exercises that may be able to help your officers reduce their stress.

Normas básicas de seguridad durante el manejo de equipos de radiaciones no ionizantes / Safety basic rules when handling non-ionizing radiation equipment

La preocupación creciente de los trabajadores hacia los posibles efectos nocivos de la exposición a campos electromagnéticos, está suponiendo una percepción desproporcionada de los riesgos derivados de la exposición. En la actualidad, no existe evidencia científica sobre dichos efectos nocivos, siendo aconsejable la vigilancia sobre las exposiciones que están fuera de los límites de seguridad. Desde este Servicio de Prevención y en colaboración con el Servicio de Física Médica, hemos elaborado un procedimiento que garantice, mediante criterios preventivos básicos, la seguridad y salud de los trabajadores que manejan equipos emisores de radiaciones no ionizantes, en nuestro hospital y centros de especialidades. Para la elaboración de este procedimiento hemos revisado la literatura científica relativa a los efectos de los campos electromagnéticos sobre la salud, reuniones periódicas de trabajo entre ambos servicios, identificación y ubicación de los equipos de radiaciones no ionizantes, y asesoramiento por expertos en la materia. El procedimiento establece medidas de control para los trabajadores, y medidas de control para los equipos. Con la finalidad de conseguir una buena difusión e implantación de dicho procedimiento, hemos elaborado dípticos y carteles, donde reflejamos las medidas de control para trabajadores y equipos: Onda Corta, Microondas, Magnetoterapia, Resonancia Magnética Nuclear, Láser y Ultravioleta El procedimiento con sus carteles explicativos ha sido distribuido específicamente por servicios, realizando formación e información de los trabajadores que maneja dichos equipos (AU)

Employee increasing concern about possible dangerous effects of the exposure to electromagnetic fields is meaning a distorted perception of the exposure related risks. Currently, there is no scientific evidence of the dangerous effects mentioned although surveillance over the exposures out of the safety limits is recommended. Within this Prevention Department in cooperation with The Medical Physics Department a procedure based on basic preventive criteria has been elaborated to guarantee health and safety of the employees who handle non-ionizing radiation emitting equipment in our hospital and specialized centers. To draw the procedure: scientific literature related to the electromagnetic fields effects over health has been checked, periodical working meetings have been held between both above mentioned departments; non-ionizing radiation equipment have been identified as well as the places they are based or used; and expert people advice has been used. The procedure sets control and follow-up measurements both for people and equipment such as follows: Shortwave, microwave and magnetic therapy, Nuclear magnetic resonance, Laser, Ultraviolet radiation. The procedure and illustrative posters have been deployed to the linked departments, the information and training having been given to the employees who work with kind of equipment (AU)