Does Presenting Patients’ BMI Increase Documentation of Obesity?

Purpose: Despite the associated health consequences, obesity is infrequently documented as a problem in medical charts. The purpose of this study is to determine whether a simple intervention (routine listing of the BMI on the medical chart) will increase physician documentation of obesity in the medical record. Methods: Participants were resident physicians in a family medicine residency program. Participants were randomly assigned to either an experimental group or a control group. For experimental group physicians, the Body Mass Index was listed alongside other vital signs of patients seen in an ambulatory setting. Physician documentation of patient obesity was assessed by chart review after patient visits. Documentation was defined as inclusion of obesity on the problem list or in the progress note. Results: The intervention did not significantly increase the rate of documentation of obesity in the medical chart. Several reasons for the lack of change are explored, including the difficulty of treating obesity successfully

A review of the concept of autonomy in the context of the safety regulation of civil unmanned aircraft systems.

Civil aviation safety regulations and guidance mate- rial classify Unmanned Aircraft Systems (UAS) as ei- ther Remotely-Piloted Aircraft Systems (RPAS) or Autonomous Aircraft Systems (AAS). This distinc- tion is based on the premise that the e ective safety risk management of UAS is dependent on the degree of autonomy of the system being operated. However, it is found that there is no consensus on the concept of autonomy, on how it can be measured, or on the na- ture of the relationship between Levels of Autonomy (LoA) and the safety-performance of UAS operations. An objective of this paper is to evaluate existing LoA assessment frameworks for application in avia- tion safety regulations for UAS. The results from a comprehensive review of existing concepts of auton- omy and frameworks for assessing LoA are presented. Six case study UAS were classi ed using the pub- lished LoA frameworks. The implied LoA of UAS for existing modes of operation (e.g., teleoperation, semi- autonomous) were also assessed using the published frameworks. It was found that the existing LoA assessment frameworks, when applied to the case study UAS, do not provide a consistent basis for distinguishing between the regulatory classes of RPAS and AAS. It was also found that the existing regulatory de ni- tion of an autonomous aircraft is too broad, covering UAS of signi cantly di erent levels of capability and system complexity. Within the context of aviation safety regulations, a new LoA assessment framework for UAS is required

Mutual recognition of national military airworthiness authorities: A streamlined assessment process

The Air and Space Interoperability Council (ASIC) has adopted the European Defence Agency (EDA) process for interregulatory military airworthiness authority recognition. However, there are gaps in the application of this process to nations outside of the European Union. This paper proposes a model that can effectively map diverse technical airworthiness regulatory frameworks. This model, referred to as the Product-Behaviour-Process (PBP) Bow-Tie model, provides the systematic structure needed to represent and compare regulatory frameworks. The PBP Bow-Tie model identifies key points of difference that need to be addressed, during inter-agency recognition between the two regulatory authorities. With the intention to adopt global use of the EDA process, the proposed PBP Bow-Tie model can be used as a basis for the successful recognition of regulatory frameworks outside of the European Union. Iris plots produced from the implementation of this model are presented, and proposed as a suitable means of illustrating the outcome of an assessment, and of supporting the comparisons of results. A comparative analysis of the Australian Defence Force and New Zealand Defence Force airworthiness regulatory frameworks is used as a case study. The case study clearly illustrates the effectiveness of the model in discerning regulatory framework differences; moreover, it has offered an opportunity to explore the limitations of the Iris plot

Risk-management of UAS robust autonomy for integration into civil aviation safety frameworks

This paper discusses a model of the civil aviation reg-ulation framework and shows how the current assess-ment of reliability and risk for piloted aircraft has a limited applicability for Unmanned Aircraft Systems (UAS) as technology moves towards higher levels of autonomous decision making. Then, a new frame-work for risk management of robust autonomy is pro-posed, which arises from combining quantified mea-sures of risk with normative decision making. The term Robust Autonomy describes the ability of an au-tonomous system to either continue or abort its oper-ation whilst not breaching a minimum level of accept-able safety in the presence of anomalous conditions. The term combines reliability, safety, and robust-ness. The decision making associated with risk man-agement requires quantifying probabilities associated with the measures of risk and also consequences of outcomes related to the behaviour of autonomy. The probabilities are computed from an assessment under both nominal and anomalous scenarios described by faults, which can be associated with the aircraft's ac-tuators, sensors, communication link, changes in dy-namics, and the presence of other aircraft in the op-erational space. The consequences of outcomes are characterised by a loss function quantifies the desir-ability of the outcome

Reverse engineering of a fixed wing unmanned aircraft 6-DoF model based on laser scanner measurements

This paper describes a method for deriving sixdegree- of-freedom (6-DoF) aircraft dynamics parameters adopting reverse engineering techniques from three dimensional (3D) laser scanner measurements. In particular, the mass and aerodynamic properties of the JAVELIN Unmanned Aircraft (UA) are determined using accurate measurements from the 3D scanner and successive CAD processing of the geometric data. In order to qualitatively assess the calculated 6-DoF, the trajectory for the spiral mode excited by the engine torque of this UA is simulated and compared to that of a published 6-DoF of the popular AEROSONDE UA which has very similar geometry. Additionally, to further confirm the validity of the approach, the reverse engineering procedure is applied to a published CAD model of the AEROSONDE UA and the associated 6-DoF parameters are calculated. Using these parameters, a spiral descent trajectory is generated using both the published and calculated parameters. The trajectories match closely, providing a good qualitative verification of the reverse engineering method. In future research, the accurate knowledge of the 6-DoF dynamics will enable the development of an Aircraft Dynamics Model (ADM) virtual sensor to augment the UA navigation system in case of primary navigation sensor outages. Additionally, further refinement of the calculated 6-DoF will involve wind tunnel and flight testing activities