Feasibility of residential air quality monitoring to address asthma outcomes.

Improving asthma outcomes for underserved populations can be addressed through interventions to improve indoor air quality (IAQ). New protocol for measuring IAQ and health outcomes are imperative given advances in IAQ monitoring technology and challenges in conducting intervention research in homes. In this pilot study HEPA air purifiers and HEPA vacuum cleaners were provided to five homes with children with asthma. For 6 weeks, eight common components of air quality were measured using a low-cost multi-channel air quality monitoring device, with data conveyed directly from participant homes via Wi-Fi connection. In conjunction with periodic surveys on asthma control, impact of asthma on quality of life and intervention compliance, outcomes compared IAQ, home characteristics, and asthma-related measures. This pilot study demonstrates the feasibility of a protocol to evaluate a dual component intervention to improve IAQ in homes, as measured with a low-cost air quality monitoring device.

Simulation analysis of high-throughput oyster cryopreservation at three scales of production.

Cryopreservation and germplasm repositories offer a variety of potential benefits to aquaculture industries. Despite this, no comprehensive repository systems exist for any prominent aquaculture species. A species that could greatly benefit from the use of cryopreserved sperm and repository storage is the eastern oyster, Crassostrea virginica. High-throughput cryopreservation protocols already exist for this species, and the easy transport of frozen sperm could facilitate selective breeding programs that address pressing challenges currently faced in the industry, such as mortality due to low-salinity conditions. This study addressed the gap between cryopreservation protocols and repository development in the oyster industry by creating simulation models to evaluate cryopreservation needs at three different scales of production. The effects of high-throughput device options and three key parameters (straws per oyster, batch size, and number of operators) on production capacity, time, and cost were evaluated. Recommendations for decisions concerning cryopreservation pathways and repository creation were given at each scale of production. Relative values of broodstock, juvenile oysters, and oyster sperm sold at hatcheries were also discussed. In general, repositories operating at higher production levels benefited from the economy of scale, could use automated high-throughput equipment options, and could hire more labor without drastically increasing production costs.

Industrial construction safety policies and practices with cost impacts in a COVID-19 pandemic environment: A Louisiana DOW case study.

There are always significant challenges in improving the safety culture by changing and adding additional safety protocols. The unknown impacts of COVID-19 and how it quickly spreads led the industry to institute essential safety protocols. This paper addresses two problem statements. The first problem statement is: what are the additional safety protocols for process safety, construction & maintenance, and personal protective equipment requirements? The second problem statement is: what are the cost and schedule impacts of industrial construction projects resulting from implementing safety protocols and process safety during construction with the added PPE? While complying with added safety protocols, the industrial construction industry cannot forget that it has a distinct reputation for high incident rates and less than desirable safety performance. In 2017, the construction industry suffered 971 fatalities. This alarming number is compared to 1123 total fatalities in 2017 for the Gulf Coast States. The objective is to share the rationale and practices of social distancing, required additional PPE, and personal hygiene practices to reduce spreading and outbreaks during a pandemic within an industrial construction environment. Before any construction work, the process safety teams must clear, isolate, and tag out process lines, equipment, and instruments to be repaired or replaced. The information presented demonstrates the significant cost and schedule impacts that industrial construction companies will encounter during a pandemic like COVID-19. This paper aims to improve safety processes, cost & schedule impacts, and prescribe additional personal protective equipment in industrial construction during a pandemic such as COVID-19. The COVID-19 pandemic spread globally in a very short period. The reactions in mitigating the spread were suggestive, with little to no data on safety protective equipment and practices. The contribution this paper addresses are how to employ efficient safety practices and policies during a pandemic in an industrial construction environment.

SIMULATION MODELING OF A HIGH-THROUGHPUT OYSTER CRYOPRESERVATION PATHWAY.

The genetic resources of oysters in Louisiana and the Gulf of Mexico are threatened due to high unexplained oyster mortality. Germplasm repositories are collections of cryopreserved genetic material stored alongside associated information that are used to protect genetics resources and facilitate breeding programs in agricultural industries. Therefore, there is great need for oyster repositories. Development of repositories has been slow despite research on high-throughput cryopreservation protocols because of logistical complexities. The goal of this study was to begin to address the gap between cryopreservation research and repository development in oyster aquaculture by modeling a cryopreservation protocol to understand and improve the process. The steps of a high-throughput cryopreservation protocol were defined and mapped in a process flow diagram. A simulation model was created using time study data, and key bottlenecks in the process were identified. Finally, model variations using alternate types of devices (tools or equipment) were created to address the identified bottlenecks. The model was found to accurately simulate the cryopreservation process. Parameters such as number of straws frozen per oyster, batch size, and number of operators significantly affected how the model performed and device choices produced substantial improvements. Simulation modeling has the potential to inform how cryopreservation pathways and repository systems in aquatic species should be structured and operated. There is ample opportunity for future work such as analyzing the impacts of production scale on cryopreservation processes.

Resource evaluation framework for total knee arthroplasty.

PURPOSE: This article describes a framework for evaluating efficiency of OR procedures incorporating time measurement, personnel activity, and resource utilization using traditional industrial engineering tools of time study and work sampling. METHODS: The framework measures time using time studies of OR procedures and work sampling of personnel activities, ultimately classified as value-added or non-value-added. Statistical methods ensure that the collected samples meet adequate levels of confidence and accuracy. Resource utilization is captured through documentation of instrument trays used, defects in instruments, and trash weight and classification at the conclusion of surgeries. FINDINGS: A case study comprising 12 observations of total knee arthroplasty surgeries illustrates the use of the framework. The framework allows researchers to compare time, personnel, and resource utilization simultaneously within the OR setting. PRACTICAL IMPLICATIONS: The framework provides a holistic evaluation of methods, instrumentation and resources, and staffing levels and allows researchers to identify areas for efficiency improvement. ORIGINALITY/VALUE: The methods presented in this article are rooted in traditional industrial engineering work measurement methods but are applied to a healthcare setting in order to efficiently identify areas for improvement including time, personnel, and processes in operating rooms.

Community Paramedics' Perception of Frequent ED Users and the Community Paramedicine Program: A Mixed-Methods Study.

Community paramedicine (CP) model of care integrates existing emergency medical service (EMS) resources with primary care, public health, social services and community engagement. However, published studies about CP programs in the U.S. are sparse. To understand how paramedics perceive CP programs and patients in the program, we surveyed and interviewed 16 community paramedics (10 men and 6 women) who are currently delivering health care within a CP program. Our analyses highlighted that community paramedics: (1) defined CP patients in sympathetic terms; (2) reported patient and systemic factors contributing to ED overuse; and (3) expressed their frustrations and commendations for CP programs. Several suggestions were identified to improve CP program (all modifiable elements). Further, the frustrations expressed by paramedics highlight the barriers to health care access for underserved communities. We discuss the implications of this research for practice and recommend future qualitative studies on longer operating CP programs.

Making safety an integral part of 5S in healthcare.

BACKGROUND: Healthcare faces major challenges with provider safety and rising costs, and many organizations are using Lean to instigate change. One Lean tool, 5S, is becoming popular for improving efficiency of physical work environments, and it can also improve safety. OBJECTIVE: This paper demonstrates that safety is an integral part of 5S by examining five specific 5S events in acute care facilities. We provide two arguments for how safety is linked to 5S:1. Safety is affected by 5S events, regardless of whether safety is a specific goal and 2. Safety can and should permeate all five S's as part of a comprehensive plan for system improvement. METHODS: Reports of 5S events from five departments in one health system were used to evaluate how changes made at each step of the 5S impacted safety. RESULTS: Safety was affected positively in each step of the 5S through initial safety goals and side effects of other changes. CONCLUSIONS: The case studies show that 5S can be a mechanism for improving safety. Practitioners may reap additional safety benefits by incorporating safety into 5S events through a safety analysis before the 5S, safety goals and considerations during the 5S, and follow-up safety analysis.

What to expect from immersive virtual environment exposure: influences of gender, body mass index, and past experience.

For those interested in using head-coupled PC-based immersive virtual environment (VE) technology to train, entertain, or inform, it is essential to understand the effects this technology has on its users. This study investigated potential adverse effects, including the sickness associated with exposure and extreme responses (emesis, flashbacks). Participants were exposed to a VE for 15 to 60 min, with either complete or streamlined navigational control and simple or complex scenes, after which time measures of sickness were obtained. More than 80% of participants experienced nausea, oculomotor disturbances, and/or disorientation, with disorientation potentially lasting > 24 hr. Of the participants, 12.9% prematurely ended their exposure because of adverse effects; of these, 9.2% experienced an emetic response, whereas only 1.2% of all participants experienced emesis. The results indicate that designers may be able to reduce these rates by limiting exposure duration and reducing the degrees of freedom of the user's navigational control. Results from gender, body mass, and past experience comparisons indicated it may be possible to identify those who will experience adverse effects attributable to exposure and warn such individuals. Applications for this research include military, entertainment, and any other interactive systems for which designers seek to avoid adverse effects associated with exposure.