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RATIONALE & OBJECTIVE: Infection prevention efforts in dialysis centers can avert patient morbidity and mortality but are challenging to implement. The objective of this study was to better understand how the design of the work system might contribute to infection prevention in outpatient dialysis centers. STUDY DESIGN: Mixed methods, observational study. SETTING & PARTICIPANTS: Six dialysis facilities across the United States visited by a multidisciplinary team over 8 months. ANALYTICAL APPROACH: At each facility, structured macroergonomic observations were undertaken by a multidisciplinary team using the SEIPS 1.0 model. Ethnographic observations were collected about staff encounters with dialysis patients including the content of staff conversations. Selective and axial coding were used for qualitative analysis and quantitative data were reported using descriptive statistics. RESULTS: Organizational and sociotechnical barriers and facilitators to infection prevention in the outpatient dialysis setting were identified. Features related to human performance, (eg, alarms, interruptions, and task stacking), work system design (eg, physical space, scheduling, leadership, and culture), and extrinsic factors (eg, patient-related characteristics) were identified. LIMITATIONS: This was an exploratory evaluation with a small sample size. CONCLUSIONS: This study used a systematic macroergonomic approach in multiple outpatient dialysis facilities to identify infection prevention barriers and facilitators related to human performance. Several features common across facilities were identified that may influence infection prevention in outpatient care and warrant further exploration.
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Instituciones de Atención Ambulatoria , Control de Infecciones , Diálisis Renal , Humanos , Control de Infecciones/métodos , Estados Unidos/epidemiología , Ergonomía/métodosRESUMEN
Neonatal airway management comes with exclusive anatomical, physiological, and environmental complexities, and probably higher incidences of accidents and complications. No dedicated airway management guidelines were available until the recently published first joint guideline released by a task force supported by the European Society of Anaesthesiology and Intensive Care and the British Journal of Anaesthesia and focused on airway management in children under 1 yr of age. The guideline offers a series of recommendations based on meticulous methodology including multiple Delphi rounds to complement the sparse and scarce available evidence. Getting back from Brobdingnag, the land of giants with many guidelines available, this guideline represents a foundational cornerstone in the land of Lilliput.
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Anestesia , Anestesiología , Niño , Recién Nacido , Humanos , Manejo de la Vía Aérea/métodos , Anestesiología/métodos , Cuidados Críticos/métodos , Comités Consultivos , Intubación Intratraqueal/métodosRESUMEN
Promptly calling for assistance in an anaesthetic emergency is important. However, emergency call systems are not present in all locations where anaesthesia is administered, and in those that do have an emergency call system, the call button is often obscured by other equipment or in an unfamiliar location. Placing a red stripe from the ceiling, down the wall, to the emergency call button significantly reduces delays in activating an emergency call, demonstrating a simple but effective system change to the layout of operating theatres.
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Anestesia , Quirófanos , Humanos , Anestesia/métodos , Sistemas de Comunicación entre Servicios de Urgencia , Factores de Tiempo , Servicios Médicos de Urgencia/métodosRESUMEN
BACKGROUND: Deaths from unrecognised oesophageal intubation continue despite national campaigns emphasising the importance of capnography to confirm tracheal intubation. A two-person verbal intubation check is recommended in consensus guidelines intended to prevent such deaths. This check can be performed by the intubator with their assistant, either as a one-step process (identification of sustained exhaled carbon dioxide) or as a two-step process (adding identification of the tracheal tube passing through the vocal cords during videolaryngoscopy). METHODS: In two hospitals we introduced two-person checking of tracheal intubation. In one hospital this involved the one-step process and in the other the two-step process. We used anonymous online questionnaires before, during, and after these changes to collect opinions from anaesthetists and their assistants regarding the feasibility and acceptability of these changes. RESULTS: Most intubators (116/149, 78%) and intubators' assistants (70/72, 97%) reported that the two-person verbal intubation check would reduce the likelihood of unrecognised oesophageal intubation. Benefits and lack of negative aspects were reported for both one-step and two-step two-person intubation checks in both centres. Intubators judged that the checks improved communication and teamwork (118/149, 79%); intubators' assistants reported feeling more empowered to voice concerns if needed (69/72, 96%), a flattened team hierarchy (53/72, 74%), and feeling more valued as team members (64/72, 89%). Most intubators (122/149, 82%) and intubators' assistants (68/72, 94%) planned to continue using the two-person intubation check for all future intubations. CONCLUSIONS: Our results suggest that a two-person verbal intubation check is feasible and acceptable to all members of the intubating team.
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The phenomena of residual curarisation and recurarisation after the use of long-acting non-depolarising neuromuscular blocking drugs such as tubocurarine and pancuronium were well recognised 60 years ago. But the incidence seemed to decline with the introduction of atracurium and vecuronium. However, recently there have been an increasing number of reports of residual and recurrent neuromuscular block. Some of these reports are a result of inappropriate doses of rocuronium, sugammadex or both, together with inadequate neuromuscular monitoring. We urge clinicians to review their practice to ensure the highest standards of clinical care when using neuromuscular blocking drugs and reversal agents. This includes the use of quantitative neuromuscular monitoring whenever neuromuscular blocking drugs are administered.
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Bloqueo Neuromuscular , Bloqueantes Neuromusculares , Fármacos Neuromusculares no Despolarizantes , Humanos , Fármacos Neuromusculares no Despolarizantes/efectos adversos , Androstanoles/efectos adversos , Rocuronio , Bromuro de VecuronioRESUMEN
The development of urbanization and the establishment of metropolitan areas causes the urban heat island to cross the original single-city scale and form a regional heat island (RHI) with a larger influence range. Due to the decreasing distance between cities, there is an urgent need to reevaluate RHI for urban agglomerations, considering all cities instead of a conventional single-city perspective. The impact of climatic conditions and human factors on heat islands still lacks a general method and framework for systematic evaluation. Therefore, we used land and night light data as background conditions to study the diurnal and seasonal changes of heat islands in the Zhengzhou metropolitan area, China. Pearson correlation analysis and random forest regression analysis were then used to explore the influence of climatic conditions and human factors on RHI and its internal relationship. We found that the daytime RHI had strong spatial heterogeneity and seasonal differences from 2001 to 2020. The daytime RHI was stronger than nighttime in spring, summer, and autumn, and the nighttime RHI was stronger than daytime in winter. From spring to winter, RHI increased first and then decreased during the daytime, while the opposite was observed at night. In this study, temperature has a greater effect on daytime RHI; CO2 and NL have a greater effect on nighttime RHI. There was strong spatial heterogeneity in the effects of climatic conditions and human factors on the RHI, with climatic conditions contributing more to the daytime RHI in the northern mountainous areas, while human factors had a greater impact on the nighttime RHI in the main urban areas of each location. The results of this study highlight more targeted and informed strategies for RHI mitigation in the Zhengzhou metropolitan area and provide helpful insights into RHI evaluation in other urban agglomerations.
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Ciudades , Calor , China , Humanos , Clima , Urbanización , Estaciones del Año , Cambio ClimáticoRESUMEN
BACKGROUND: Undeniably, robotic-assisted surgery (RAS) has become very popular in recent decades, but it has introduced challenges to the workflow of the surgical team. Non-technical skills (NTS) have received less emphasis than technical skills in training and assessment. The systematic review aimed to update the evidence on the role of NTS in robotic surgery, specifically focusing on evaluating assessment tools and their utilisation in training and surgical education in robotic surgery. METHODS: A systematic literature search of PubMed, PsycINFO, MEDLINE, and EMBASE was conducted to identify primary articles on NTS in RAS. Messick's validity framework and the Modified Medical Education Research Study Quality Instrument were utilised to evaluate the quality of the validity evidence of the abstracted articles. RESULTS: Seventeen studies were eligible for the final analysis. Communication, environmental factors, anticipation and teamwork were key NTS for RAS. Team-related factors such as ambient noise and chatter, inconveniences due to repeated requests during the procedure and constraints due to poor design of the operating room may harm patient safety during RAS. Three novel rater-based scoring systems and one sensor-based method for assessing NTS in RAS were identified. Anticipation by the team to predict and execute the next move before an explicit verbal command improved the surgeon's situational awareness. CONCLUSION: This systematic review highlighted the paucity of reporting on non-technical skills in robotic surgery with only three bespoke objective assessment tools being identified. Communication, environmental factors, anticipation, and teamwork are the key non-technical skills reported in robotic surgery, and further research is required to investigate their benefits to improve patient safety during robotic surgery.
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Competencia Clínica , Procedimientos Quirúrgicos Robotizados , Procedimientos Quirúrgicos Robotizados/educación , Procedimientos Quirúrgicos Robotizados/normas , Humanos , Grupo de Atención al Paciente/normas , ComunicaciónRESUMEN
BACKGROUND: Despite substantial efforts to reduce operating room (OR) turnover time (TOT), delays remain a frustration to physicians, staff, and hospital leadership. These efforts have employed many systems and human factor-based approaches with variable results. A deeper dive into methodologies and their applicability could lead to successful and sustained change. The aim of this study was to conduct a systematic review to evaluate relevant research focused on improving OR TOT and clearly defining measures of successful intervention. MATERIAL AND METHODS: A systematic review of OR TOT interventions implemented between 1980 through October 2022 was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Research databases included: 1) PubMed; 2) Web of Science; and 3) OVID Medline. RESULTS: A total of 38 articles were appropriate for analysis. Most employed a pre/post intervention approach (29, 76.3%), the remaining utilized a control/intervention approach. Nine intervention methods were identified: the majority included a process redesign bundle (24, 63%), followed by overlapping induction, dedicated unit/team/space feedback, financial incentives, team training, education, practice guidelines, and redefinition of roles/responsibilities. Studies were further categorized into one of two groups: (1) those that utilized predetermined interventions based on anecdotal experience or prior literature (18, 47.4%) and (2) those that conducted a prospective analysis on baseline data to inform intervention development (20, 52.6%). DISCUSSION: There are significant variability in the methodologies utilized to improve OR TOT; however, the most effective solutions involved process redesign bundles developed from a prospective investigation of the clinical work-system.
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Quirófanos , Humanos , Eficiencia Organizacional , Quirófanos/organización & administración , Mejoramiento de la Calidad , Factores de Tiempo , Flujo de TrabajoRESUMEN
BACKGROUND: Ventricular assist devices (VADs) are effective therapy for patients with end-stage heart failure. Current VAD controllers offer improved interactivity, yet limitations of the visual, tactile, and auditory interface persist that impact patient experience and quality of life (QoL). This study explores how VAD controllers can be redesigned using a human-centered design approach to enhance the emotional and functional experience of the device for patients. METHODS: VAD patients (n = 21), caregivers (n = 4) and healthcare practitioners (n = 24) were interviewed to uncover design opportunities. From this, a series of realistic scenarios to design for emerged. A "design by analogy" method took inspiration from existing consumer products to ideate new functionality for the VAD wearable system, creating concepts for a controller interface and paired wearable device. An additional 15 patients and 2 caregivers were engaged to explore current VAD controller experiences and evaluate the future-state concepts. RESULTS: This research validated the need for increased automation and emergency functionality in VAD controllers, including remote monitoring of data, accurate communication of battery status, and automated medical alerts for critical device alarms. "Manage my health," "Feeling normal," "Social belonging," "Feeling safe," and "Sense of control" emerged as key patient concerns to be met by future VAD controller designs. CONCLUSIONS: The study demonstrated an innovative and relevant approach to improve usability of future VAD peripherals. By considering both emotional and functional perspectives in the design of lifesaving medical devices such as VADs, device manufacturers can uncover new opportunities to improve patient QoL through improved user experiences.
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Insuficiencia Cardíaca , Corazón Auxiliar , Calidad de Vida , Humanos , Masculino , Insuficiencia Cardíaca/terapia , Femenino , Persona de Mediana Edad , Cuidadores/psicología , Adulto , Diseño de Equipo , Dispositivos Electrónicos Vestibles , Anciano , Diseño Centrado en el UsuarioRESUMEN
BACKGROUND: While Human Factors (HF) methods have been applied to the design of decision support systems (DSS) to aid clinical decision-making, the role of HF to improve decision-support for population health outcomes is less understood. We sought to comprehensively understand how HF methods have been used in designing digital population health DSS. MATERIALS AND METHODS: We searched English documents published in health sciences and engineering databases (Medline, Embase, PsychINFO, Scopus, Comendex, Inspec, IEEE Xplore) between January 1990 and September 2023 describing the development, validation or application of HF principles to decision support tools in population health. RESULTS: We identified 21,581 unique records and included 153 studies for data extraction and synthesis. We included research articles that had a target end-user in population health and that used HF. HF methods were applied throughout the design lifecycle. Users were engaged early in the design lifecycle in the needs assessment and requirements gathering phase and design and prototyping phase with qualitative methods such as interviews. In later stages in the lifecycle, during user testing and evaluation, and post deployment evaluation, quantitative methods were more frequently used. However, only three studies used an experimental framework or conducted A/B testing. CONCLUSIONS: While HF have been applied in a variety of contexts in the design of data-driven DSSs for population health, few have used Human Factors to its full potential. We offer recommendations for how HF can be leveraged throughout the design lifecycle. Most crucially, system designers should engage with users early on and throughout the design process. Our findings can support stakeholders to further empower public health systems.
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Ergonomía , Salud Poblacional , Humanos , Sistemas de Apoyo a Decisiones Clínicas , Diseño de SoftwareRESUMEN
BACKGROUND: Checklists are a common tool used in order to mitigate risks caused by human factors and can facilitate the safe induction of anesthesia as well as handovers. SBAR (Situation, Background, Assessment, Recommendation) is a checklist recommended by the WHO and DGAI for handovers, while SOAP-M (Suction, Oxygen, Airway, Pharmaceuticals, Monitoring) is a checklist for the induction of anesthesia. This study investigates the implementation and adoption of these two checklists. METHODS: We conducted a single-center online survey one year after the implementation of SOAP-M and SBAR at a university hospital's anesthesiology department, using scales from three validated questionnaires to assess safety attitudes as well as the behavior of staff and the perceived usefulness of the checklists. RESULTS: Staff with a high score in general attitude towards patient safety, as determined by the safety attitudes questionnaire, considered both checklists useful additions to their work environment. Nurses and physicians (p = 0.102) as well as groups divided according to work experience (p = 0.077) showed no significant differences in using SOAP-M and SBAR. Perceived usefulness was significantly higher (p < 0.001) among users of the checklists, and the same goes for positive reinforcement (p < 0.001), social cues (p = 0.0215) and goal cues (p = 0.0252). CONCLUSION: SOAP-M and SBAR are perceived as useful checklists for patient handovers and anesthesia induction by tertiary referral hospital's employees with high score in general safety attitude and were therefore commonly used one year after their introduction. No significant difference in checklist adoption between occupations as well as groups divided according to work experience could be found. Perceived usefulness is significantly higher among users of the checklist, who feel using the checklists provides more support.
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Actitud del Personal de Salud , Lista de Verificación , Humanos , Alemania , Encuestas y Cuestionarios , Femenino , Masculino , Adulto , Seguridad del Paciente , Pase de Guardia/normas , Servicio de Anestesia en Hospital , Anestesiología/métodos , Persona de Mediana EdadRESUMEN
Human factors engineering involves the study and development of methods aimed at enhancing performance, improving safety, and optimizing user satisfaction. The focus of human factors engineering encompasses the design of work environments and an understanding of human mental processes to prevent errors. In this review, we summarize the history, applications, and impacts of human factors engineering on the healthcare field. To illustrate these applications and impacts, we provide several examples of how successful integration of a human factors engineer in our pediatric radiology department has positively impacted various projects. The successful integration of human factors engineering expertise has contributed to projects including improving response times for portable radiography requests, deploying COVID-19 response resources, informing the redesign of scheduling workflows, and implementation of a virtual ergonomics program for remote workers. In sum, the integration of human factors engineering insight into our department has resulted in tangible benefits and has also positioned us as proactive contributors to broader hospital-wide improvements.
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Ergonomía , Pediatría , Ergonomía/métodos , Humanos , Pediatría/métodos , Servicio de Radiología en Hospital/organización & administración , Radiología/organización & administración , Radiología/métodos , COVID-19/prevención & control , SARS-CoV-2RESUMEN
As the health care industry increasingly embraces large language models (LLMs), understanding the consequence of this integration becomes crucial for maximizing benefits while mitigating potential pitfalls. This paper explores the evolving relationship among clinician trust in LLMs, the transition of data sources from predominantly human-generated to artificial intelligence (AI)-generated content, and the subsequent impact on the performance of LLMs and clinician competence. One of the primary concerns identified in this paper is the LLMs' self-referential learning loops, where AI-generated content feeds into the learning algorithms, threatening the diversity of the data pool, potentially entrenching biases, and reducing the efficacy of LLMs. While theoretical at this stage, this feedback loop poses a significant challenge as the integration of LLMs in health care deepens, emphasizing the need for proactive dialogue and strategic measures to ensure the safe and effective use of LLM technology. Another key takeaway from our investigation is the role of user expertise and the necessity for a discerning approach to trusting and validating LLM outputs. The paper highlights how expert users, particularly clinicians, can leverage LLMs to enhance productivity by off-loading routine tasks while maintaining a critical oversight to identify and correct potential inaccuracies in AI-generated content. This balance of trust and skepticism is vital for ensuring that LLMs augment rather than undermine the quality of patient care. We also discuss the risks associated with the deskilling of health care professionals. Frequent reliance on LLMs for critical tasks could result in a decline in health care providers' diagnostic and thinking skills, particularly affecting the training and development of future professionals. The legal and ethical considerations surrounding the deployment of LLMs in health care are also examined. We discuss the medicolegal challenges, including liability in cases of erroneous diagnoses or treatment advice generated by LLMs. The paper references recent legislative efforts, such as The Algorithmic Accountability Act of 2023, as crucial steps toward establishing a framework for the ethical and responsible use of AI-based technologies in health care. In conclusion, this paper advocates for a strategic approach to integrating LLMs into health care. By emphasizing the importance of maintaining clinician expertise, fostering critical engagement with LLM outputs, and navigating the legal and ethical landscape, we can ensure that LLMs serve as valuable tools in enhancing patient care and supporting health care professionals. This approach addresses the immediate challenges posed by integrating LLMs and sets a foundation for their maintainable and responsible use in the future.
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Inteligencia Artificial , Personal de Salud , Confianza , Humanos , Personal de Salud/psicología , Lenguaje , AprendizajeRESUMEN
BACKGROUND: Electronic health record-based clinical decision support (CDS) tools can facilitate the adoption of evidence into practice. Yet, the impact of CDS beyond single-site implementation is often limited by dissemination and implementation barriers related to site- and user-specific variation in workflows and behaviors. The translation of evidence-based CDS from initial development to implementation in heterogeneous environments requires a framework that assures careful balancing of fidelity to core functional elements with adaptations to ensure compatibility with new contexts. OBJECTIVE: This study aims to develop and apply a framework to guide tailoring and implementing CDS across diverse clinical settings. METHODS: In preparation for a multisite trial implementing CDS for pediatric overweight or obesity in primary care, we developed the User-Centered Framework for Implementation of Technology (UFIT), a framework that integrates principles from user-centered design (UCD), human factors/ergonomics theories, and implementation science to guide both CDS adaptation and tailoring of related implementation strategies. Our transdisciplinary study team conducted semistructured interviews with pediatric primary care clinicians and a diverse group of stakeholders from 3 health systems in the northeastern, midwestern, and southeastern United States to inform and apply the framework for our formative evaluation. RESULTS: We conducted 41 qualitative interviews with primary care clinicians (n=21) and other stakeholders (n=20). Our workflow analysis found 3 primary ways in which clinicians interact with the electronic health record during primary care well-child visits identifying opportunities for decision support. Additionally, we identified differences in practice patterns across contexts necessitating a multiprong design approach to support a variety of workflows, user needs, preferences, and implementation strategies. CONCLUSIONS: UFIT integrates theories and guidance from UCD, human factors/ergonomics, and implementation science to promote fit with local contexts for optimal outcomes. The components of UFIT were used to guide the development of Improving Pediatric Obesity Practice Using Prompts, an integrated package comprising CDS for obesity or overweight treatment with tailored implementation strategies. TRIAL REGISTRATION: ClinicalTrials.gov NCT05627011; https://clinicaltrials.gov/study/NCT05627011.
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Sistemas de Apoyo a Decisiones Clínicas , Humanos , Niño , Diseño Centrado en el Usuario , Registros Electrónicos de Salud , Atención Primaria de SaludRESUMEN
Compared to traditional lower-limb prostheses (LLPs), intelligent LLPs are more versatile devices with emerging technologies, such as microcontrollers and user-controlled interfaces (UCIs). As emerging technologies allow a higher level of automation and more involvement from wearers in the LLP setting adjustments, the previous framework established to study human factors elements that affect wearer-LLP interaction may not be sufficient to understand the new elements (e.g., transparency) and dynamics in this interaction. In addition, the increased complexity of interaction amplifies the limitations of the traditional evaluation approaches of wearer-LLP interaction. Therefore, to ensure wearer acceptance and adoption, from a human factors perspective, we propose a new framework to introduce elements and usability requirements for the wearer-LLP interaction. This paper organizes human factors elements that appear with the development of intelligent LLP technologies into three aspects: wearer, device, and task by using a classic model of the human-machine systems. By adopting Nielsen's five usability requirements, we introduce learnability, efficiency, memorability, use error, and satisfaction into the evaluation of wearer-LLP interaction. We identify two types of wearer-LLP interaction. The first type, direct interaction, occurs when the wearer continuously interacts with the intelligent LLP (primarily when the LLP is in action); the second type, indirect interaction, occurs when the wearer initiates communication with the LLP usually through a UCI to address the current or foreseeable challenges. For each type of interaction, we highlight new elements, such as device transparency and prior knowledge of the wearer with the UCI. In addition, we redefine the usability goals of two types of wearer-LLP interaction with Nelson's five usability requirements and review methods to evaluate the interaction. Researchers and designers for intelligent LLPs should consider the new device elements that may additionally influence wearers' acceptance and the need to interpret findings within the constraints of the specific wearer and task characteristics. The proposed framework can also be used to organize literature and identify gaps for future directions. By adopting the holistic usability requirements, findings across empirical studies can be more comparable. At the end of this paper, we discuss research trends and future directions in the human factors design of intelligent LLPs.
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Miembros Artificiales , Humanos , Extremidad Inferior/fisiología , Interfaz Usuario-Computador , Diseño de Prótesis , Sistemas Hombre-Máquina , Ergonomía , Inteligencia ArtificialRESUMEN
Sport and sports research are inherently complex systems. This appears to be somewhat at odds with the current research paradigm in sport in which interventions are aimed are fixing or solving singular broken components within the system. In any complex system, such as sport, there are places where we can intervene to change behaviour and, ideally, system outcomes. Meadows influential work describes 12 different points with which to intervene in complex systems (termed "Leverage Points"), which are ordered from shallow to deeper based on their potential effectiveness to influence transformational change. Whether research in sport is aimed at shallow or deeper Leverage Points is unknown. This study aimed to assess highly impactful research in sports science, sports nutrition/metabolism, sports medicine, sport and exercise psychology, sports management, motor control, sports biomechanics and sports policy/law through a Leverage Points lens. The 10 most highly cited original-research manuscripts from each journal representing these fields were analysed for the Leverage Point with which the intervention described in the manuscript was focused. The results indicate that highly impactful research in sports science, sports nutrition/metabolism, sports biomechanics and sports medicine is predominantly focused at the shallow end of the Leverage Points hierarchy. Conversely, the interventions drawn from journals representing sports management and sports policy/law were focused on the deeper end. Other journals analysed had a mixed profile. Explanations for these findings include the dual practitioner/academic needing to "think fast" to solve immediate questions in sports science/medicine/nutrition, limited engagement with "working slow" systems and method experts and differences in incremental vs. non-incremental research strategies.
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Medicina Deportiva , Deportes , Humanos , Deportes/fisiología , Fenómenos Biomecánicos , Factor de Impacto de la Revista , Publicaciones Periódicas como Asunto , BibliometríaRESUMEN
BACKGROUND: Non-Technical Skills (NTS) are cognitive, social, and personal resource skills that are crucial in complex and high-risk environments. The aims of our research are to determine the prevalence and content of NTS in the surgical rotation teaching guides of the Medicine Degree programs in Spanish Universities, to identify the most prevalent types and subtypes of NTS, and to analyze factors associated with the prevalence of surgical NTS in Medical Schools in Spain. METHODS: Descriptive observational cross-sectional study involving the identification and collection of competencies outlined in the surgical rotation teaching guides of Spanish Medical Schools. Information regarding university performance was obtained from the Foundation for Knowledge and Development Ranking webpage. The "Non-Technical Skills for Surgeons" (NOTSS) system was used to classify each competency in the teaching guides as NTS (categories and elements) and technical skills. Disagreements were resolved through group consensus. RESULTS: A total of 1,846 competencies were analyzed in surgical rotations of the Medicine Degree programs across 40 Spanish Universities, with 99 competencies identified as surgical NTS, accounting for 5% of the total. The most frequently identified surgical NTS were "Decision Making" (46%), "Communication & Teamwork" (25%), and "Leadership" (19%). Additionally, several NOTSS were not identified in any institution. Public universities and those including a greater number of competencies had a higher rate of surgical NTS competencies, and we did not find a correlation between surgical NTS competencies and quality indices of University Centers. CONCLUSIONS: There is a limited presence of surgical NTS in the educational plans of Spanish Universities.
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Competencia Clínica , Liderazgo , Humanos , Comunicación , Estudios Transversales , UniversidadesRESUMEN
The success of developing and implementing Smart Cities (SC) projects depends on a varied set of factors, where the availability of a qualified technical workforce is a critical one. The combination of ICT requirements, like the effectiveness and quality of solutions merging IoT, cloud computing, sensors, and communications with the work from many varied disciplines (e.g., civil engineering, architecture, etc.), mixed with aspects of environmental and business sustainability, makes the management of these projects really challenging. Reports forecast a scarcity of qualified candidates, given this complexity and the growth of activity in SC projects. The European project SMACITE has addressed the requirements of the qualification of an ICT workforce with an analysis of multiples sources of information from the labor market, feedback from involved stakeholders, and the literature. The goal was the development of two occupational ICT profiles as a reference for training and for the availability of candidates for job vacancies. The result is two ICT role profiles for engineers and technicians, mapped with the European skills frameworks ESCO and EN16234. The profiles determined the whole set of requirements, including not only the technical areas and soft skills, but also additional technical areas and sustainability and managerial skills and the analysis of different sources of information. Our work has also determined which existing ESCO occupations are similar to the two reference profiles, so they are better adapted to SC projects. The training activities of SMACITE have also suggested the amount of training expected for a varied sample of candidates who want to be qualified for SC projects.
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Cooperative intelligent transport systems (C-ITSs) are mass-produced and sold in Europe, promising enhanced safety and comfort. Direct vehicle communication, known as vehicle-to-everything (V2X) communication, is crucial in this context. Drivers receive warnings about potential hazards by exchanging vehicle status and environmental data with other communication-enabled vehicles. However, the impact of these warnings on drivers and their inclusion in accident reconstruction remains uncertain. Unlike sensor-based warnings, V2X warnings may not provide a visible reason for the alert, potentially affecting reaction times and behavior. In this work, a simulator study on V2X warnings was conducted with 32 participants to generate findings on reaction times and behavior for accident reconstruction in connection with these systems. Two scenarios from the Car-2-Car Communication Consortium were implemented: "Stationary Vehicle Warning-Broken-Down Vehicle" and "Dangerous Situation-Electronic Emergency Brake Lights". Volkswagen's warning concept was utilized, as they are the sole provider of cooperative vehicles in Europe. Results show that V2X warnings without visible reasons did not negatively impact reaction times or behavior, with average reaction times between 0.58 s (steering) and 0.69 s (braking). No significant distraction or search for warning reasons was observed. However, additional information in the warnings caused confusion and was seldom noticed by subjects. In this study, participants responded correctly and appropriately to the shown false-positive warnings. A wrong reaction triggering an accident is possible but unlikely. Overall, V2X warnings showed no negative impacts compared with sensor-based systems. This means that there are no differences in accident reconstruction regarding the source of the warning (sensors or communication). However, it is important that it is known that there was a warning, which is why the occurrence of V2X warnings should also be saved in the EDR in the future.
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Accidentes de Tránsito , Conducción de Automóvil , Tiempo de Reacción , Humanos , Conducción de Automóvil/psicología , Tiempo de Reacción/fisiología , Accidentes de Tránsito/prevención & control , Masculino , Adulto , Femenino , Simulación por Computador , Automóviles , Comunicación , Adulto JovenRESUMEN
This paper presents a model for generating expressive robot motions based on human expressive movements. The proposed data-driven approach combines variational autoencoders and a generative adversarial network framework to extract the essential features of human expressive motion and generate expressive robot motion accordingly. The primary objective was to transfer the underlying expressive features from human to robot motion. The input to the model consists of the robot task defined by the robot's linear velocities and angular velocities and the expressive data defined by the movement of a human body part, represented by the acceleration and angular velocity. The experimental results show that the model can effectively recognize and transfer expressive cues to the robot, producing new movements that incorporate the expressive qualities derived from the human input. Furthermore, the generated motions exhibited variability with different human inputs, highlighting the ability of the model to produce diverse outputs.