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.     

Simulation studies on a rotating ring disk electrode: Effects of ionic migration with kinetic complication-disk results

In continuation to my previous work (Guha S. AIChE J. 2013;59(4):1390-1399), in this work, effects of ionic migration are evaluated for disk region of a rotating ring disk electrode system by numerically solving complex differential equations, developed for mass transfer along with kinetic complication in presence of ionic migration under limiting current condition. The system for simulation is 0.01 M Fe₂(SO₄)₃ solution with H₂SO₄ as supporting electrolyte. Simulation cases are presence and absence of ionic migration with kinetic complication (oxidation of Fe²⁺ to Fe³⁺ under O₂ pressure). Results show that concentration boundary layer thickness of reactant Fe³⁺ reduces appreciably and steady-state disk current reduces substantially in presence of migration. Simulated steady-state disk current in absence of migration case agrees well with published data. Results indicate higher Fe²⁺ concentration in presence of migration and thereby higher rate of oxidation of Fe²⁺ to Fe³⁺ at all rate constant values.     

Bulging in incremental sheet forming of cold bonded multi-layered Cu clad sheet: Influence of forming conditions and bending

Bulge is a defect that causes geometrical inaccuracy and premature failure in the innovative incremental sheet forming (ISF) process. This study has two-fold objectives: (1) knowing the bulging behavior of a Cu clad tri-layered steel sheet as a function of forming conditions, and (2) analyzing the bending effect on bulging in an attempt to identify the associated mechanism. A series of ISF tests and bending analysis are performed to realize these objectives. From the cause-effect analysis, it is found that bulge formation in the layered sheet is sensitive to forming conditions in a way that bulging can be minimized utilizing annealed material and performing ISF with larger tool diameter and step size. The bending under tension analysis reveals that the formation of bulge is an outgrowth of bending moment that the forming tool applies on the sheet during ISF. Furthermore, the magnitude of bending moment depending upon the forming conditions varies from 0.046 to 10.24 N·m/m and causes a corresponding change in the mean bulge height from 0.07 to 0.91 mm. The bending moment governs bulging in layered sheet through a linear law. These findings lead to a conclusion that the bulge defect can be overcome by controlling the bending moment and the formula proposed can be helpful in this regards.     

A suitable computational strategy for the parametric analysis of problems with multiple contact

The aim of the present work is to develop an application of the LArge Time INcrement (LATIN) approach for the parametric analysis of static problems with multiple contacts. The methodology adopted was originally introduced to solve viscoplastic and large‐transformation problems. Here, the applications concern elastic, quasi‐static structural assemblies with local non‐linearities such as unilateral contact with friction. Our approach is based on a decomposition of the assembly into substructures and interfaces. The interfaces play the vital role of enabling the local non‐linearities, such as contact and friction, to be modelled easily and accurately. The problem on each substructure is solved by the finite element method and an iterative scheme based on the LATIN method is used for the global resolution. More specifically, the objective is to calculate a large number of design configurations. Each design configuration corresponds to a set of values of all the variable parameters (friction coefficients, prestress) which are introduced into the mechanical analysis. A full computation is needed for each set of parameters. Here we propose, as an alternative to carrying out these full computations, to use the capability of the LATIN method to re‐use the solution to a given problem (for one set of parameters) in order to solve similar problems (for the other sets of parameters). Copyright © 2003 John Wiley & Sons, Ltd.     

Electrochemical mass transfer between an impinging jet and a rotating disk in a confined system

This paper presents the mass transfer results from an impinging liquid jet to a rotating disk. The mass transfer coefficients were measured using the electrochemical limiting diffusion current technique (ELDCT). Rotational Reynolds number (Re_r) in the range of 3.4 × 10⁴–1.2 × 10⁵, jet Reynolds number (Re_j) 1.7 × 10⁴–5.3 × 10⁴ and non-dimensional jet-to-disk spacing (H/d) 2–8 were taken into consideration as parameters. It was found that the jet impingement resulted in a substantial enhancement in the mass transfer compared to the case of the rotating disk without jet.     

Midplane-symmetry breaking in the flow between two counter-rotating disks

This paper considers the axisymmetric steady flow driven by exact counter rotation of two co-axial disks of finite radius. At the edges of the rotating disks one of three conditions is (typically) imposed: (i) zero velocity, corresponding to a stationary, impermeable, cylindrical shroud (ii) zero normal velocity and zero tangential fluid traction, corresponding to a (confined) free surface and (iii) an edge constraint that is consistent with a similarity solution of von Kármán form. The similarity solution is valid in an infinite geometry and possesses a pitchfork bifurcation that breaks the midplane symmetry at a critical Reynolds number. In this paper, similar bifurcations of the global (finite-domain) flow are sought and comparisons are made between the resulting bifurcation structure and that found for the similarity solution. The aim is to assess the validity of the nonlinear similarity solutions in finite domains and to explore the sensitivity of the solution structure to edge conditions that are implicitly neglected when assuming a self-similar flow. It is found that, whilst the symmetric similarity solution can be quantitatively useful for a range of boundary conditions, the bifurcated structure of the finite-domain flow is rather different for each boundary condition and bears little resemblance to the self-similar flow.     

改善磁盘阵列性能的方法

磁盘阵列是解决计算机Ｉ／Ｏ瓶颈问题的有效方法之一，通过对现有磁盘阵列结构的研究，提出了４种改善磁盘阵列性能的方法，即良分利用磁盘带宽，平衡多盘的负载，减少奇偶检验数据存取时间和磁盘阵列Ｃａｃｈｅ技术等，分析结果表明：在事务处理应用领域，利用Ｃａｃｈｅ来把小写转化为大写可大大改善目前一般情况下，以一道数据大小来作为磁盘的基本存取大小是合适的选择，磁盘阵列负载平衡设计不足是指正常模式下系统请求在多盘间     

基于小波变换的医学图象压缩编码

本文研究了医学图象小波变换系数的统计特征。根据医学图象的特点，提出了基于小波变换的医学图象编码方法。实验表明，这种方法具有较好的压缩编码性能，优于JPEG标准。同时，它支持逐次浮现式传输，从而能满足医学图象存储、通信、检索的需要。     

凸轮机构基圆半径的确定方法及其分析

基圆半径的确定方法，除了用图解法和试算法外，还可用解析法和图解分析法求解。４种方法各有优缺点，设计时要根据具体情况选择。