Managing unforeseen events in anesthesia: collective trade-off between "understanding" and "doing"

This study aims to describe how anesthesia teams handle unforeseen events that may affect the patients' health. More precisely, it investigates the mechanisms of decisions made by anesthesia teams to manage unthought-of situations, i.e. situations that have not been foreseen as "possible" ones before their occurrence. An empirical study, based on the analysis of simulated situations, was conducted in a pediatric anesthesia service of a university hospital in France. The results highlighted three ways of managing unthought-of situations (determined management, cautious management and overwhelmed management). They support the hypothesis of a collective cognitive trade-off, whereby teams would behave as virtual operators, with their own collective trade-off between "understanding" and "doing". The discussion of the results questions the assessment criteria, the safety perspectives we adopt and the possible ways to improve the management of unforeseen situations.     

Burnout syndrome, working conditions, and health: a reality among public high school teachers in Brazil

The objective of the study was to evaluate the occurrence of Burnout Syndrome in 100 teachers of six public high schools and its correlation with working conditions in a southeast city of Brazil. Characterization of the sample occurred after application of a socio-demographic questionnaire. Evaluation of the working conditions was done by means of an Ergonomic Working Analysis. The presence of Burnout Syndrome was evaluated by means of the Maslach Burnout Inventory. The sample presented the predominance of women, with an average age of 40.4 and the majority married with children. Roughly 50% had less than 10 years of service, and more than half of the teachers taught more than 18 classes per week. Hoarseness after work was principally reported among women, which required many days off for health treatment. Environmental conditions reflect inadequacy in relation to noise, light, humidity and temperature. Presence of pain in the upper limbs was especially high among women. Risk of musculoskeletal disorders in the upper limbs predominated as moderately important to significant. We also identified an average distance walked by teachers of 1.5 Km and an average of 4.2 Kg of school supplies carried between classes. The Burnout Syndrome presented a high score for depersonalization principally among men, but it has association with both sexes. Emotional exhaustion correlates with noise, depersonalization, and personal fulfillment, in addition to the high number of weekly lessons. It can be concluded that Burnout syndrome is present among teachers, principally in terms of depersonalization, deserving the attention of government officials and the schools, as well as the teachers themselves.     

Virtual reality based therapy for post operative rehabilitation of children with cerebral palsy

Virtual reality is the use of interactive replication created with computer hardware and software to impart users with opportunities to engage in environments that appear to feel similar to real world objects and events. The commonest rehabilitation program of cerebral palsy children involves stretching, strengthening, mobilization and various other activities, whereas the use of virtual reality based training (VRBT) for rehabilitation of cerebral palsy is not common. To understand the effect of VRBT a study was formulated. Twenty nine subjects participated (study group--14 and control group--15). Outcome measures were MACS, PBS, level of participation, motivation, cooperation and satisfaction of the child. Results revealed that balance and manual ability were significantly improved in both the groups (Balance: study: t-2.28, p<0.05; control: t-3.5, p<0.01; Manual ability: study: t-5.58, p<0.001; control: t-7.06, p<0.001). PBS had significantly greater improvement in the study group (t-t-2.02, p<0.05). Level of participation, motivation, cooperation and satisfaction of the child were also reported to be significantly higher among the study group as compared with control group. To the author's best knowledge, this is the first study on using the VR-based therapy for the postoperative rehabilitation of children with CP which need further elaboration with larger sample size.     

Design recommendations for the creation of icons for the elderly

During employment of icons in order to represent system functions, specific user requirements from elderly people have not been scientifically gathered and thus will merely be considered during the process of system design. The survey, with explicit consideration of technology acceptance and experience of 120 elderly probands, looked into the comprehension of four different classes of non-animated graphical representations. It was shown that among elderly, the use of photos compared to pictograms or clip art leads to a significantly higher recognition rate. The mapping of actions rather than objects leads to a further reduction of the error probability and is thus, especially in the context of telemedicine, preferable for the target group.     

Cognitively automated assembly processes: a simulation based evaluation of performance

The numerical control of an experimental assembly cell with two robots--termed a cognitive control unit (CCU)--is able to simulate human information processing at a rule-based level of cognitive control. To enable the CCU to work on a large range of assembly tasks expected of a human operator, the cognitive architecture SOAR is used. The CCU can plan assembly processes autonomously and react to ad-hoc changes in assembly sequences effectively. Extensive simulation studies have shown that cognitive automation based on SOAR is especially suitable for random parts supply, which reduces planning effort in logistics. Conversely, a disproportional increase in processing time was observed for deterministic parts supply, especially for assemblies containing large numbers of identical parts. In this contribution, the effect of phase-shifts in deterministic part supply is investigated for assemblies containing maximal different parts. It can be shown that the concept of cognitive automation is as well suitable for these planning problems.     

Activity analysis: contributions to the innovation of projects for aircrafts cabins

This article presents results obtained from some ergonomics intervention in the project for the conception of aircraft's cabins. The study's aim is to analyze the contribution of the method adopted in the passengers' activities analysis in reference situations, real-use situations in aircraft's cabins, applied to analyze typical activities performed by people in their own environment. Within this perspective, the study shows two analyses which highlight the use of electronic device. The first analysis has been registered through a shooting filming in a real commercial flight. In the second one, the use is developed within the domestic environment. The same method has been applied in both contexts and it is based on activity analysis. Starting with the filming activity, postures and actions analysis, self-confrontation interviews, action course reconstruction and elaboration of postures envelopes. The results point out that the developed method might be applied to different contexts, evincing different ways of space occupation to meet human personal needs while performing an activity, which can help us with the anticipation of the users' needs, as well as indicate some innovation possibilities.     

Promoting work ability and well-being in hospital nursing: the interplay of age, job control, and successful ageing strategies

Previous research shows that work ability of nurses decreases with age. In our study we therefore addressed the following questions: Do successful ageing strategies at work in terms of selection, optimization, and compensation (SOC) support the work ability of nurses? Does SOC mediate the relationship between job control (i.e., decision opportunities at work) and work ability? Does the mediation differ between age-groups? 438 nurses (Age Range 21-63 years) completed a questionnaire in the course of an employee survey. Results show that SOC is positively related with work ability. The positive effect of job control on work ability is significantly mediated by SOC. There are stronger mediating effects for elder nurses than for younger nurses. Results indicate that the interplay of job control and SOC at work helps to maintain the work ability of nurses in nursing care.     

Consolidated findings from 6 years research on the age-differentiated design of human-computer interaction

The fast aging of many western and eastern societies and their increasing reliance on information technology create a compelling need to reconsider older users' interactions with computers. This paper summarizes the results of 6 years of research on the age-differentiated design of human-computer interaction. The well-known model of human information processing served as the theoretical framework. The model components 'sensory processing', 'perception', 'working memory', 'decision and response selection' and 'response execution' were analyzed exemplarily in task settings on project management. In seven empirical studies with a total number of 405 participants between 20 and 77 years the human-computer interaction was analyzed regarding effectiveness, efficiency and user satisfaction. For most but not all studies the results reveal that age-induced differences in human-computer interaction can best be compensated by an ergonomic 'design for all'. In some cases however an age-specific approach is favorable.     

Supporting the scholar role in intensive care nursing

This study investigates how future informatics applications can support and challenge intensive care nurses (ICU nurses) to grow and learn continuously. To this end a research-and-design tool is introduced which is based on a model of the nursing process that starts from the idea that a nurse fulfills three different roles: the role of practitioner (using information immediately to base actions upon), the role of scholar (using information later on to learn from) and the role of human (coping with stress and dealing with emotions). In this paper the focus is on the scholar role. Twenty-eight intensive care staff members from six different hospitals were asked to recount an imposing experience from the perspective of each role. Regarding the scholar role, the participants mentioned 77 learning strategies they adopt for individual as well as organizational learning. Individual learning concerned reflection on former patient cases, reflection on current patient cases to anticipate a change in the patient's condition and reflection on personal behavior and decisions. Organizational learning concerned reflection on former patient cases. Examples of specific strategies were formal team evaluations focused on procedure and understanding the perspective of team members, being present at autopsies, and giving feedback on the nursing skills of colleagues. Based on these strategies design implications are defined for future nursing informatics applications, which will be presented.     

Contributions from the activity analysis to the products development project: case study based on a project of innovation and comfort in aircraft's cabins

Comfort is an issue that has gained relevance within the aeronautical industry due to the necessity of manufacturers and airline companies of differentiating themselves in a market that has become more and more competitive each day. This study's aim is to analyze the comfort/discomfort of passengers, based on the analysis of the activities performed in the aircrafts' cabin during real flights, in order to create ergonomics requirements and a methodology of comfort analysis. The study has been performed during domestic commercial flights, and the adopted data collection techniques have been: the application of 219 questionnaires to passengers, 44 registrations of postures and actions through filmings and 12 semistructured interviews. The method has made possible the reconstruction of the user's action course in performing activities in real flight situations, and the calculation of the area occupied by the passenger during his or her actions. The integrated analysis of the results corroborates data from previous studies in which both the space made available to each passenger and the activity performed interfere in their perception of comfort. From this study it has been concluded that the method constitutes itself as an innovative tool within the process of aircrafts' cabins project enabling the calculation of the action space based on the reconstructed course.