A review of the use of human factors classification frameworks that identify causal factors for adverse events in the hospital setting

Various human factors classification frameworks have been used to identified causal factors for clinical adverse events. A systematic review was conducted to identify human factors classification frameworks that identified the causal factors (including human error) of adverse events in a hospital setting. Six electronic databases were searched, identifying 1997 articles and 38 of these met inclusion criteria. Most studies included causal contributing factors as well as error and error type, but the nature of coding varied considerably between studies. The ability of human factors classification frameworks to provide information on specific causal factors for an adverse event enables the focus of preventive attention on areas where improvements are most needed. This review highlighted some areas needing considerable improvement in order to meet this need, including better definition of terms, more emphasis on assessing reliability of coding and greater sophistication in analysis of results of the classification.

Practitioner Summary: Human factors classification frameworks can be used to identify causal factors of clinical adverse events. However, this review suggests that existing frameworks are diverse, limited in their identification of the context of human error and have poor reliability when used by different individuals.     

移动agent在远程医疗诊断系统中的应用

随着网络技术的发展,作为一种新的分布式计算模式,移动agent已经成为当前的一个研究热点。介绍了移动agent的相关技术,并利用移动agent的技术优势,针对远程医疗诊断系统的现状,提出了一个基于移动agent技术的远程医疗诊断系统的设计,并给出了具体的思路和解决方案,较好地解决了远程医疗诊断中智能性、灵活性等问题。     

Paramedics on the job: Dynamic trunk motion assessment at the workplace

Many paramedics' work accidents are related to physical aspects of the job, and the most affected body part is the low back. This study documents the trunk motion exposure of paramedics on the job. Nine paramedics were observed over 12 shifts (120 h). Trunk postures were recorded with the computer-assisted CUELA measurement system worn on the back like a knapsack. Average duration of an emergency call was 23.5 min. Sagittal trunk flexion of >40° and twisting rotation of >24° were observed in 21% and 17% of time-sampled postures. Medical care on the scene (44% of total time) involved prolonged flexed and twisted postures (∼10 s). The highest extreme sagittal trunk flexion (63°) and twisting rotation (40°) were observed during lifting activities, which lasted 2% of the total time. Paramedics adopted trunk motions that may significantly increase the risk of low back disorders during medical care and patient-handling activities.     

A low-cost real time virtual system for postural stability assessment at home

Background and objective

The degeneration of the balance control system in the elderly and in many pathologies requires measuring the equilibrium conditions very often. In clinical practice, equilibrium control is commonly evaluated by using a force platform (stabilometric platform) in a clinical environment.In this paper, we demonstrate how a simple movement analysis system, based on a 3D video camera and a 3D real time model reconstruction of the human body, can be used to collect information usually recorded by a physical stabilometric platform.

Methods

The algorithm used to reconstruct the human body model as a set of spheres is described and discussed. Moreover, experimental measurements and comparisons with data collected by a physical stabilometric platform are also reported. The measurements were collected on a set of 6 healthy subjects to whom a change in equilibrium condition was stimulated by performing an equilibrium task.

Results

The experimental results showed that more than 95% of data collected by the proposed method were not significantly different from those collected by the classic platform, thus confirming the usefulness of the proposed system.

Conclusions

The proposed virtual balance assessment system can be implemented at low cost (about 500$) and, for this reason, can be considered a home use medical device. On the contrary, astabilometric platform has a cost of about 10,000$ and requires periodical calibration. The proposed system does not require periodical calibration, as is necessary for stabilometric force platforms, and it is easy to use. In future, the proposed system with little integration can be used, besides being an emulator of a stabilometric platform, also to recognize and track, in real time, head, legs, arms and trunk, that is to collect information actually obtained by sophisticated optoelectronic systems.     

Event-driven,pattern-based methodology for cost-effective development of standardized personal health devices

Experiences applying standards in personal health devices (PHDs) show an inherent trade-off between interoperability and costs (in terms of processing load and development time). Therefore, reducing hardware and software costs as well as time-to-market is crucial for standards adoption. The ISO/IEEE11073 PHD family of standards (also referred to as X73PHD) provides interoperable communication between PHDs and aggregators. Nevertheless, the responsibility of achieving inexpensive implementations of X73PHD in limited resource microcontrollers falls directly on the developer. Hence, the authors previously presented a methodology based on patterns to implement X73-compliant PHDs into devices with low-voltage low-power constraints. That version was based on multitasking, which required additional features and resources. This paper therefore presents an event-driven evolution of the patterns-based methodology for cost-effective development of standardized PHDs. The results of comparing between the two versions showed that the mean values of decrease in memory consumption and cycles of latency are 11.59% and 45.95%, respectively. In addition, several enhancements in terms of cost-effectiveness and development time can be derived from the new version of the methodology. Therefore, the new approach could help in producing cost-effective X73-compliant PHDs, which in turn could foster the adoption of standards.     

异型密封条挤出模头的研制

橡胶异型密封条板式挤出模头设计的关键点是首。何使口模区各胶料质点的出口压力及流速均匀一致和如何确定口模的形状尺寸。根据流变学理论设计出初始口型曲线尺寸、并需进行试挤以修正口型曲线和尺寸。本文以一典型异型密封条挤出模头的研制为例，详细介绍了异型密封条挤出模头的设计方法及基本思路。     

中间体苯基丙酮合成新工艺

实验研究了以氯化苄为原料合成药物中间体苯基丙酮的新工艺，该工艺由苄基氯化锌和苯基丙酮的2步合成反应组成，优化的工艺条件为：原料n(氯化苄）:n(Zn):n(乙酐）为1：1．2：2．5，苄基氯化锌的合成温度60－65摄氏度，反应时间3h，苯基丙酮合成温度30－35℃ ，反应时间5h，总收率72％。     

基于Java框架的银医一卡通系统设计

介绍了一种基于信息共享的医院--银行一卡通的信息系统设计方案。该系统使用Web服务实现接口通信,通过自助服务器连接医院系统和银行系统实现医院与银行的信息共享。基于该系统,用户可以使用中国银行借记卡代替医院门诊卡就医,提供了良好的就医环境,提高了医疗效率。     

一种老人医疗求救装置设计与实现

目前,老人医疗装置是当前应用热点之一,引起广泛的关注。本文就该问题提出了一种老人的医疗求救装置的实现方案,详细阐述了该方案设计过程的各个主要模块设计和软件设计。