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.     

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.     

关于信息化测绘时代工程测量发展的思考

如今我国信息化技术全面发展，尤其对于工程测量工作领域来讲，不管是在工程建设和管理方面都产生不小的支撑引导效用。由此，笔者具体结合如今工程建设信息化测绘核心任何以及设备布置细节，进行结构整体安全管理周期和周边地理空间信息技术发展能效整理解析，试图将工程测量最新发展机遇和技术挑战问题处理完全。希望能够借此为日后一定时期范围内相关工程测量规划主体提供合理指导性建议内容，最终为我国各类工程事业可持续发展前景绽放奠定深刻适应基础。     

Survey of domestic food purchases and related home handling practices in the Abruzzo region (central Italy): Data collection and analysis through a language-independent classification system

A telephone survey was carried out on 13,486 randomly selected households located in the Abruzzo region (central Italy). Three questionnaires were specifically designed in relation to three different groups of foods (Meat and meat products, Fishery products, Fruit and vegetables). Questions were mainly focused on the amount and number of purchases, type of retailer, and home food handling practices with respect to the week prior to the interview. Data were classified according to a multilingual thesaurus system (LanguaL). Results allowed to estimate domestic purchases (in kg) per capita for different food categories. The category “Red meat/Cattle” accounted for a large part of purchases in the “meat and meat products” group (10.9 kg per capita/year; 32.2% of purchases in the group) while the category “Fish or related organism/Fish” was the most purchased in the “fishery products” group (6.9 kg per capita/year; 63.3%). The aggregation of more detailed characteristics enabled the identification of popular categories of foods, such as “Red meat/Cattle/Divided into pieces” (25% of the “meat and meat products” group). Significant differences (p < 0.05) were found between the four different provinces (L'Aquila, Chieti, Pescara and Teramo) with respect to “Poultry/Chicken” and “Red meat/Cattle” categories. Householders were also asked about post-purchase food handling practices that might be hazardous to food safety. More than 20% of those surveyed stated that they thawed frozen meat at room temperature. The degree of doneness after cooking of different food categories was generally high: over 90% of products purchased in the majority of meat and fish categories were properly cooked. However a noticeable proportion of householders (about 15%) reported medium or rare cooking of “Red meat/Cattle” and “Red meat/Swine”. Differences (p < 0.05) were also found between consumers of different ages, with people over 65 years old being more prone to freeze meat and cook it thoroughly.The survey was carried out in a specific geographic area and on a statistically significant sample of households, thus allowing a collection of data on domestic habits relating to food purchases and home food handling practices. This information should be included in the framework of quantitative microbial risk assessment (QMRA) models as a measure of the actual exposure of consumers to pathogenic microorganism. The LanguaL system also proved to be a practical language-independent method useful not only to identify and describe food items but also to classify them according to specific food safety characteristics.     

论精神损害的国家赔偿责任

国家的侵权行为造成相对人的精神损害应当承担赔偿责任是当今世界国家赔偿制度的发展潮流与趋势.确立精神损害的国家赔偿责任对社会公平正义的实现、人权的保护及促使国家公职人员依法行使职权具有重大的意义,因而应在基于我国国情的基础上,构建我国的精神损害国家赔偿制度.     

自喷井电动清蜡绞车的研制

针对目前石油钻采用清蜡绞车总体结构设计不合理以及实用性不强等技术难题,研制开发了自喷井电动清蜡绞车。该绞车的核心部件包括过载保护安全装置、牙嵌离合器轴套、自动/手动互换装置、计量装置以及密封装置。在清蜡绞车自动工作中,当清蜡刮刀遇到较大阻力时,清蜡绞车将接收到反馈信号,可实现智能停车,自动转换为手动状态,以便操作人员检查和排除故障,从而确保了操作的安全性,延长了设备的使用寿命。1000余台电动清蜡绞车的现场应用表明,该产品可以大大降低原油的开采成本,具有良好的经济效益和社会效益。     

用快切装置替代备自投装置提高厂用电安全可靠性

指出目前厂用电切换装置存在的不足，分析了快切装置的基本原理以及厂用电事故下的成功快切对电厂安全生产的意义，说明了在厂用电切换中尽快应用快切装置的必要性。     

Occupational airway diseases in the metalworking industry Part 1: Respiratory infections, pneumonia, chronic bronchitis and emphysema

Occupational airway diseases are now receiving attention in industry, although study is hampered by a lack of readily-available data. The interpretation of the data that is available, and also of the root problems themselves, is itself a difficult problem. This paper has been written as a literature review which it is hoped that other researchers can take either as a starting point or as a refresher.     

靳善忠副省长在全省煤炭工业工作会议上的讲话(节选)

煤炭作为山西经济发展的支柱产业，在实现全面建设小康社会的奋斗目标过程中，要做出突出贡献，任务非常艰巨，要实现这一奋斗目标，2003年要努力做好6个方面的工作，在新型煤炭工业化道路上迈出更大步伐。     

大朝山水电站地下洞室安全监测资料分析

大朝山水电站引水发电系统为地下工程，根据各项安全监测物理量的主要观测成果，对最大观测值分析其对工程的安全影响，为保证其安全运行具有重要意义。为此，分别对大朝山水电站的主要地下建筑物，包括压力引水隧洞、地下厂房、尾水调压室的最大观测值进行了分析研究，并提出了一些建议，有较大的参考价值。