Micro- and macroergonomic changes in mental workload and medication safety following the implementation of new health IT

Health information technology (IT) is a promising way to achieve safer medication management in the delivery of healthcare. However, human factors/ergonomics dictates that in order to make the complex, cognitive work of healthcare delivery safer, health IT must properly support human cognition. This means, for example, that new health IT must reduce, not increase, workload during safety-critical tasks. The present study was the first to quantitatively assess the short- and long-term impact of bar coded medication administration (BCMA) IT on nurses' mental workload as well as on perceived medication safety. One-hundred seventy registered nurses across 3 dissimilar clinical units at an academic, freestanding pediatric hospital in the Midwest US participated in surveys administered before, 3 months after, and 12 months after the hospital implemented BCMA. Nurses rated their external mental workload (interruptions, divided attention, being rushed) and internal mental workload (concentration, mental effort) during medication administration tasks as well as the likelihood of each of three medication safety events: medication administration errors, medication errors on the clinical unit, and clinical unit-level adverse drug events. Clinical unit differences were assessed. Findings generally confirmed the hypothesis that external but not internal mental workload was associated with the perceived likelihood of a medication safety event. Comparisons of mental workload from pre- to post-BCMA revealed statistically significant changes in the critical care unit only. Medication safety appeared to improve over the long term in the hematology/oncology unit only. In the critical care and medical/surgical units, medication safety exhibited short-term improvements that were eliminated over time. Changes in mental workload and medication safety, two classically microergonomic constructs, were deeply embedded in macroergonomic phenomena. These included the fit between the BCMA system and the nature of nursing work, the process of BCMA implementation, and BCMA interactions with concurrent changes occurring in the hospital. Findings raise questions about achieving sustainable performance improvement with health IT as well as the balance between micro- and macroergonomic approaches to studying technology change.Relevance to industryDesigners must consider how technology changes cognitive work, including mental workload. Hospitals and other implementers of technology must ensure that new technology fits its users, their tasks, and the context of use, which may entail tailoring implementation, for example, to specific clinical units. Evaluators must look over time to assess both changes in cognitive work and implementation issues. Healthcare practitioners must also recognize that new technology means a complex transformation to an already complex sociotechnical system, which calls for a macroergonomic approach to design and analysis.     

Developing social impact assessment guidelines in a pre-existing policy context

Few jurisdictions have translated internationally agreed social impact assessment (SIA) principles into statutory provisions. Governments and regulatory bodies tend to provide developers with high-level frameworks, or require that social impacts be ‘considered’, without specifying how this is to be done. In Australia, this lack of clarity leaves all parties uncertain about requirements for SIA. The New South Wales (NSW) Government’s 2017 release of the SIA guideline for State-significant mining, petroleum and extractive industry development represents an attempt to clarify requirements and provide guidance. In this paper, we describe the process of bringing this guideline to fruition from the perspective of being directly involved in its development, and highlight the challenges involved in integrating leading-practice principles into the state’s pre-existing policy framework. While the guideline represents a significant advance in policy-based SIA guidance, some aspects leave room for improvement. The real test of the guideline’s impact will lie in its influence on SIA practice in NSW, and ultimately in social outcomes for communities affected by resources projects.     

C反应蛋白和降钙素原指导高危新生儿预防性应用抗生素的效果、安全性和经济性分析

目的:评价应用C反应蛋白（C reaction protein，CRP）和降钙素原（procalcitonin，PCT）指导高危新生儿预防性应用抗生素的效果、安全性和经济性。方法:选取2015年7月至2017年1月慈溪市妇幼保健院收治的高危新生儿124例作为研究对象，随机数表法分为对照组（62例）和实验组（62例），对照组患儿均给予预防性应用抗生素治疗，实验组根据CRP和PCT选择性应用抗生素。比较两组患儿的细菌培养阳性率、脓毒症发生率以及不良反应发生率。结果:两组患儿的CRP和PCT水平和阳性率间均不存在统计学差异（t/χ2=0.299，-0.461，0.292，0.544，0.186，P=0.766，0.646，0.589，0.461，0.666）。两组患儿治疗前后的菌培养阳性率间均不存在统计学差异（χ2=0.040，0.287，P=0.842，0.592）；两组治疗后的菌培养阳性率均明显低于治疗前（χ2=47.825，40.367，P=0.000，0.000）；两组患儿脓毒症的发生率分别为12.90%和14.52%，差异无统计学意义（χ2=0.068，P=0.794）。实验组的NICU治疗和住院时间、机械通气时间以及治疗费用均显著低于对照组（t=2.904，2.729，2.152，5.337，P=0.004，0.007，0.033，0.000），两组的机械通气率间无统计学差异（χ2=0.372，P=0.542）。对照组患儿不良反应发生率为19.35%，明显高于实验组的6.46%（χ2=4.593，P=0.032）。结论:应用CRP和PCT指导高危新生儿预防性应用抗生素的效果与普遍性应用相似，可以明显减少治疗时间和治疗费用，明显降低治疗相关不良反应。     

Effect of processing on the microbiological quality and safety of chicken carcasses at slaughterhouse

Microbiological contamination of chicken meat depends on the conditions under which the animals are reared, slaughtered and processed. The aim of this study was to determine the influence of farm origin and processing stages at slaughterhouse on the microbial safety and quality of chicken. Samples of chicken carcasses from three different farms were taken from a slaughterhouse. Mesophiles, Escherichia coli, coagulase positive Staphylococcci counts, presence of Listeria monocytogenes,Campylobacter and Salmonella were determined at five sampling points: after defeathering, after evisceration, after washing, after chilling and after cutting. Chilling reduced log numbers of mesophiles, coagulase positive Staphylococci and E. coli by 0.85, 1.52 and 2.2 log units, respectively. Salmonella was not detected after chilling. High prevalence of Campylobacter spp was observed at all the stages ranging between 84% and 100%. L. monocytogenes was not detected in chicken carcasses after defeathering. However, it was detected after evisceration and after washing and chilling. The most critical stage for L. monocytogenes contamination was the portioning operation, the prevalence in breast and legs being 88% and 84%, respectively.     

仪器仪表产品脉冲耐压试验要求和保护器件的选择

仪器仪表产品的脉冲耐压试验是产品型式试验、例行试验中的基本内容。通过对GB4793.1标准的整理,归纳了仪器仪表产品的脉冲耐压试验要求。通过对试验方法和设备特性的梳理,总结了特性参数,并介绍了应对脉冲耐压试验可采取的保护器件的类别及选用方法。     

Skeletal Muscle Health and Cognitive Function: A Narrative Review

Sarcopenia is the loss of skeletal muscle mass and function with advancing age. It involves both complex genetic and modifiable risk factors, such as lack of exercise, malnutrition and reduced neurological drive. Cognitive decline refers to diminished or impaired mental and/or intellectual functioning. Contracting skeletal muscle is a major source of neurotrophic factors, including brain-derived neurotrophic factor, which regulate synapses in the brain. Furthermore, skeletal muscle activity has important immune and redox effects that modify brain function and reduce muscle catabolism. The identification of common risk factors and underlying mechanisms for sarcopenia and cognition may allow the development of targeted interventions that slow or reverse sarcopenia and also certain forms of cognitive decline. However, the links between cognition and skeletal muscle have not been elucidated fully. This review provides a critical appraisal of the literature on the relationship between skeletal muscle health and cognition. The literature suggests that sarcopenia and cognitive decline share pathophysiological pathways. Ageing plays a role in both skeletal muscle deterioration and cognitive decline. Furthermore, lifestyle risk factors, such as physical inactivity, poor diet and smoking, are common to both disorders, so their potential role in the muscle–brain relationship warrants investigation.     

Why do small business butcher shops fail to fully implement HACCP?

This study aims to assess the degree of HACCP implementation in small business butcher shops and understand which factors most influence butchers' intention to fully implement it, through the application of the Theory of Planned Behaviour. One hundred and one butchers managing or owning small butcher's responded to the interview regarding their Attitudes, Subjective Norm, Perceived Behavioural Control, Personal Norm, and Knowledge with regard to their Intention to fully implement a HACCP system in their shops. Before the interviews, a certified veterinarian visited all the shops. Visits included an inspection of the establishments using the Official Portuguese Control Plan checklist for meat retailers. Conformance level measured past performance regarding food safety practices. Based on past performance, butchers were divided into “high performers” and “low performers”. “High performers” yielded high values of Attitude and Intention towards the Behaviour. For these, Attitude and Personal Norm emerge as predictors of the Intention to fully implement a HACCP system. For “low performers”, Personal Norm was the strongest predictor of Intention, with results pointing to the need for an intervention from the authorities to promote increased conformance to food safety practices. For both groups, neither Social Norm nor Perceived Behavioural Control acted as significant predictors of Intention.     

Symptoms and risks for musculoskeletal disorders among male and female footwear industry workers

BackgroundConsidering the growing participation of woman in the labor market and the high prevalence of the musculoskeletal disorders (MSD) in the footwear industry workers, the aim of this study was to evaluate and compare female and male footwear industry workers in relation to their demographics, occupational characteristics, stress levels, MSD symptoms prevalence, physical activity levels, alcohol and tobacco use.MethodsThe study included 175 female and 182 male footwear industry workers. Data was collected using the Perceived Stress Scale – 10, the Standardized Nordic Questionnaire, the International Physical Activity Questionnaire, the Alcohol Use Disorders Identification Test, and the Fagerstrom test for Nicotine Dependence.ResultsThe female workers were younger, had less time in the company and in the current job. They reported more stress (p = 0.001), had less time for physical activity (p = 0.004), higher prevalence of MSD symptoms in the last 12 months (p = 0.003), and consumed less alcohol (p = 0.006) than the male workers.ConclusionsFemale and male footwear industry workers presented significant differences in their demographics, occupational characteristics, stress levels, MSD prevalence, physical activity levels, alcohol and tobacco use. These differences should be taken into consideration in the implementation of intervention programs for optimum outcomes.Relevance to industryFemale footwear industry workers were more stressed, presented higher prevalence of MSD symptoms, and reported less time for physical activity than male footwear industry workers. The differences between male and female workers should be taken into consideration in the implementation of MSD prevention programs.     

基于“天空地”一体化技术的安全监测系统建设与应用

西藏江达县白格村金沙江右岸于2018年10月11日和2018年11月3日先后发生2次大规模滑坡—堰塞湖堵江事件,溃堰洪水对下游拉哇库区不良地质体的稳定性造成不同程度的影响。为保障下游水电站建设安全,对拉哇库区主要不良地质体建立了基于星载InSAR技术、无人机技术和地面传感器实时监测的“天空地”一体化监测预警体系,以多维空间采集技术获取变形信息,通过智能监控平台对信息及时进行处理、分析和可视化呈现,利用平台、短信等方式向相关人员进行分级告警,取得了较好的应用效果。