Ergonomics
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The design and evaluation of healthcare work systems requires an understanding of the cognitive work involved in healthcare tasks. Previous studies suggest that a formative approach would be particularly useful to examine healthcare activities for this purpose. In the present study, methods from cognitive work analysis and cognitive task analysis are combined in a formative examination of managing acute kidney injury, an activity that occurs across primary and secondary healthcare settings. ⋯ The approach taken provided a rich understanding of the cognitive work involved, as well as generating suggestions for the design of work systems to support the clinical task. Practitioner summary: Healthcare tasks often require decision-making in complex and dynamic circumstances, potentially involving collaboration across different practitioner roles and locations. We demonstrate the use of a formative analysis to understand the cognitive work in managing a clinical syndrome across primary and secondary care settings, and consider the implications for work design.
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Human Factors Analysis and Classification System (HFACS) is based upon Reason's organizational model of human error which suggests that there is a 'one to many' mapping of condition tokens (HFACS level 2 psychological precursors) to unsafe act tokens (HFACS level 1 error and violations). Using accident data derived from 523 military aircraft accidents, the relationship between HFACS level 2 preconditions and level 1 unsafe acts was modelled using an artificial neural network (NN). This allowed an empirical model to be developed congruent with the underlying theory of HFACS. ⋯ However, the correct classification rate was superior for decision- and skill-based errors, than for perceptual errors and violations. Practitioner Summary: A model to predict unsafe acts (HFACS level 1) from their preconditions (HFACS level 2) was developed from the analysis of 523 military aircraft accidents using an artificial NN. The results could correctly predict approximately 74% of errors.
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Sleepiness is a common complaint during the night shift and may impair performance. The current study aims to identify bio-psycho-social factors associated with subjective sleepiness during the night shift. Ninety-two female nurses working rotating shifts completed a sociodemographic questionnaire, the Munich ChronoType Questionaire for shift workers, the Pittsburg Sleep Quality Index, and the Pre-sleep Arousal Scale. ⋯ Practitioner Summary: This study aims to identify bio-psycho-social factors associated with subjective sleepiness of female nurses during the night shift. Increasing sleepiness was associated with increased age in nurses with early chronotypes and with more children. Increased cognitive pre-sleep arousal, but not sleep, was associated with increased sleepiness, especially in late chronotypes.
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Research on the feeling of embitterment at work is still in its infancy. The present study investigated the predictors and consequences of the feeling of embitterment at work. It was hypothesised that organisational injustice as well as over-controlling supervision would predict embitterment at work and that embitterment would be associated with work-related rumination. ⋯ Findings suggest that breaches in organisational justice can generate feelings of embitterment at work, which in turn can interfere with employees' ability to adequately recover from work. Practitioner Summary: The purpose of this study was to investigate predictors and consequences of embitterment in the workplace using an online questionnaire. Findings suggest that perceived unfairness, because of structural and organisational aspects, predicts feelings of embitterment and that feeling embittered at work can prevent employees from adequately recovering from work.
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Comparative Study
The effect of training on lumbar spine posture and intervertebral disc degeneration in active-duty Marines.
Military training aims to improve load carriage performance and reduce risk of injuries. Data describing the lumbar spine (LS) postural response to load carriage throughout training are limited. We hypothesised that training would reduce the LS postural response to load. ⋯ The lumbar posture of 27 Marines was measured from upright MR images, with and without load throughout infantry training. No changes in posture or IVD degeneration were found across training. Marines with degeneration at the L5-S1 level had larger sacral postural perturbations in response to load.