Negative events

The presence of corrosion products is not always a negative event some small degree of surface corrosion of all steel heat exchanger surfaces is generally beneficial. Under the reducing conditions normally found on the surfaces of pre-boiler FW heaters, FW lines, and boiler surfaces, black magnetite naturally forms by the direct thermal reaction of water with steel. The development of this self-limited magnetite film is most desirable, and optimum formation is achieved at pH levels of 10.5 to 11.5. 

Event-free survival The length of time after treatment that a person remains free of certain negative events. 

With all of the recent negative events in her life, she felt ... 

In the DTA measurement, an exothermic reaction is plotted as a positive thermal event, while an endothermic reaction is usually displayed as a negative event. Unfortunately, the use of power-compensation DSC results in endothermic reactions being displayed as positive events, a situation which is counter to IUPAC recommendations [38]. When the heat-flux method is used to detect the thermal phenomena, the signs of the DSC events concur with those obtained using DTA, and also agree with the IUPAC recommendations. 

The team identifies negative events, conditions, and actions that made major contributions to the incident. Tools such as Barner Analysis or Change Analysis may be used. 

Analysis, that can assist with the identihcation of causal factors. The concepts of incident causation encompassed in these tools are fundamental to the majority of investigation methodologies. (See Chapter 3 for information about the Domino Theory, System Theory, and HBT Theory.) The simplest approach involves reviewing each unplanned, unintended, or adverse item (negative event or undesirable condition) on the timeline and asking, Would the incident have been prevented or mitigated if the item had not existed If the answer is yes, then the item is a causal factor. Generally, process safety incidents involve multiple causal factors. 

Find the facts in the main sequence on the Causal Factor Chart that describe a component failure or a human error. Ensure the fact is not describing a management system failure (i.e., ensure the fact is not a root cause, near root cause, or root cause category). The identified negative events/conditions are candidate causal factors. Any candidate causal factor that is not dependent on another candidate causal factor is a valid causal factor. 

Once the evidence has heen collected, a timeline or sequence diagram developed, and the actual scenario confirmed, the investigation can proceed to the next stage, the identification of causal factors. These causal factors are the negative events and actions that made a major contrihution to the incident. 

The investigator may streamline this technique by focusing upon each unplanned, unintended, and/or adverse fact (negative event or undesirable condition) on the timeline. It is also important to recognize those items that are still speculative and based on an assumption, as these will need to be tested later to verify if they are accurate facts. 

Causal Factor— is a major unplanned, unintended contributor to the incident (a negative event or undesirable condition), that if eliminated would have either prevented the occurrence, or reduced its severity or frequency. (Also known as a critical causal factor or contributing cause.)... 

Factors associated with increased risk for recurrence in naturalistic studies of depressed children and adolescents may serve as guidance to the clinician to decide who needs maintenance treatment. These factors include history of prior depressive episodes, female sex, late onset, suicidality, double depression, subsyndromal symptoms, poor functioning, personality disorders, exposure to negative events (e.g., abuse, conflicts), and family history of recurrent MDD (<2 episodes) (Birmaher et ah, 1996 a,b Goodyer et ah, 1998 Fewin-sohn et ah, 1999 Rao et ah, 1999 Rueter et al., 1999 Weissman et ah, 1999a, b Klein et ah, 2001). 

The battle over nuclear power waxed hot and heavy for several years, swaying back and forth as incidents unfolded. The publication of the government-sponsored Reactor Safety Study in 1975, which showed that there would be very modest consequences from nearly all reactor accidents, was a positive event. The report concluded that the average number of fatalities from a meltdown would be about 400 and that there might be one meltdown in every 20,000 years of plant operation, or 0.02 deaths per year versus about 25 deaths per year due to air pollution from a coal-burning plant.8 It received little notice outside the scientific community. The movie The China Syndrome (released in 1979), which implied that a reactor meltdown accident would have— not possibly might have—very horrible consequences, was an important negative event. 

Risk is considered as the probability of a negative event occurring and can be quantified. However, this form of risk can be understood as "danger." The perception of risk is a socially constructed phenomenon, and is more difficult to measure. Psychological risk is based on perception rather than... 

A systematic review of quetiapine included 12 studies [69]. The attrition rate in the four placebo-controlled studies was almost as high as in the olanzapine studies (quetiapine -53%, placebo -60%), the RR being 0.84 (Cl 0.7-0.9 NNT 11 Cl 7-55) thus, it is rather difficult to interpret the data with such Cl-values. [RR = relative risk in randomized controlled trials, the ratio of rate of negative events in the exposed group to the rate in controls.]... 

After a process incident at a facility, the company involved has an opportunity to turn a negative event into a positive learning experience. By utilizing information obtained by the investigating team, the company can assess the effectiveness of its safety programs and determine if and to what extent changes are needed in their safety program. 

Todd, M. (2004). Daily processes in stress and smoking Effects of negative events, nicotine dependence, and gender. Psychology of Addictive Behaviors, IS, 31-39. 

Magnification - the tendency to exaggerate the importance of negative events and blow them out of proportion, such as, I got question nine wrong, without reference to the fact that all the other answers were right, or Last Tuesday evening was awful, without acknowledging that the other six days of last week were enjoyable. 

The supervisor now develops something but this again makes no recourse to the incident in terms of practice or people, rather it is constructed with direct reference to the impact on the target of zero, and belittled, considered stupid. Whilst the safety incident is positioned as a negative event, it is only considered as negative through its direct association with Brand Zero. 

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