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1.
Ergonomics ; 64(2): 171-183, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32930646

RESUMEN

Human factors, as perceived by the maintenance workforce, were used as the measure for comparing work areas within a petroleum company. These factors were then compared to an objective measure of reliability (Mean Time Between Failures) in order to determine which factors would be most predictive of plant reliability and process safety. Maintenance personnel were surveyed using scales based on Problem-solving, Vigilance, Design and maintenance, Job-related feedback and Information about change. Analysis of Variance was used to assess the strength of these variables in relation to Reliability Level. Significant differences were observed between different reliability levels based on workforce perceptions of problem-solving requirements and the design and maintainability of plant. Conclusions were that perceptions of human factors in the workplace can be predictive of group-level performance, and that if issues relating to design and maintainability are not addressed at the design stage, greater problem-solving abilities will be required from maintenance personnel. Practitioner summary: Workforce perceptions of plant performance could provide a statistically valid measure of current and future reliability. A survey of perceptions of human factors was conducted with maintenance personnel in a petroleum company. Results indicated significant relationships between reliability and requirements for Problem-solving, as well as Design and Maintenance of equipment. Abbreviations: HFIT: human factors investigation tool, FPSO: floating production, storage and offtake, MTBF: mean time between failures, CPS: cognitive problem- solving, WDS: work design questionnaire, SPSS: statistical package for the social sciences, PAF: principal axis factoring, ANOVA: analysis of variance, ANCOVA: analysis of co-variance, M: mean, SD: standard deviation.


Asunto(s)
Ergonomía/normas , Mantenimiento/normas , Salud Laboral/normas , Industria del Petróleo y Gas/normas , Solución de Problemas , Lugar de Trabajo/normas , Adulto , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
2.
Ergonomics ; 58(10): 1611-23, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25942433

RESUMEN

Children's computer use is rapidly growing, together with reports of related musculoskeletal outcomes. Models and theories of adult-related risk factors demonstrate multivariate risk factors associated with computer use. Children's use of computers is different from adult's computer use at work. This study developed and tested a child-specific model demonstrating multivariate relationships between musculoskeletal outcomes, computer exposure and child factors. Using pathway modelling, factors such as gender, age, television exposure, computer anxiety, sustained attention (flow), socio-economic status and somatic complaints (headache and stomach pain) were found to have effects on children's reports of musculoskeletal symptoms. The potential for children's computer exposure to follow a dose-response relationship was also evident. Developing a child-related model can assist in understanding risk factors for children's computer use and support the development of recommendations to encourage children to use this valuable resource in educational, recreational and communication environments in a safe and productive manner. PRACTITIONER SUMMARY: Computer use is an important part of children's school and home life. Application of this developed model, that encapsulates related risk factors, enables practitioners, researchers, teachers and parents to develop strategies that assist young people to use information technology for school, home and leisure in a safe and productive manner.


Asunto(s)
Atención , Computadores/estadística & datos numéricos , Enfermedades Musculoesqueléticas/epidemiología , Clase Social , Televisión/estadística & datos numéricos , Dolor Abdominal/epidemiología , Adolescente , Factores de Edad , Ansiedad/epidemiología , Australia/epidemiología , Niño , Femenino , Cefalea/epidemiología , Humanos , Masculino , Modelos Teóricos , Análisis Multivariante , Factores de Riesgo , Instituciones Académicas
3.
Ergonomics ; 57(11): 1678-86, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25116058

RESUMEN

Office workers perform tasks using different information and communication technologies (ICT) involving various postures. Adequate variation in postures and muscle activity is generally believed to protect against musculoskeletal complaints, but insufficient information exists regarding the effect on postural variation of using different ICT. Thus, this study among office workers aimed to determine and compare postures and postural variation associated with using distinct types of ICT. Upper arm, head and trunk postures of 24 office workers were measured with the Physiometer over a whole day in their natural work and away-from-work environments. Postural variation was quantified using two indices: APDF(90-10) and EVA(sd). Various ICT had different postural means and variation. Paper-based tasks had more non-neutral, yet also more variable postures. Electronics-based tasks had more neutral postures, with less postural variability. Tasks simultaneously using paper- and electronics-based ICT had least neutral and least variable postures. Tasks without ICT usually had the most posture variability. Interspersing tasks involving different ICT could increase overall exposure variation among office workers and may thus contribute to musculoskeletal risk reduction.


Asunto(s)
Postura , Lugar de Trabajo , Adulto , Brazo , Fenómenos Biomecánicos , Computadores , Femenino , Cabeza , Humanos , Masculino , Análisis y Desempeño de Tareas , Tórax , Interfaz Usuario-Computador
4.
J Bronchology Interv Pulmonol ; 31(2): 188-198, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-37975519

RESUMEN

BACKGROUND: To evaluate optimal settings of probe size, freezing time, and distance to the pleura that influence the size and quality of biopsy specimens during transbronchial lung cryobiopsies in ESPD. METHODS: We prospectively recruited 17 patients undergoing lung transplantation. We created a nonperfused ex vivo bronchoscopy setting to perform multiple cryobiopsies with different probe sizes (1.7, 1.9, and 2.4 mm), freezing times (3, 5, 7, 10, 20, 30 seconds), and probe distance from pleura (5, 10, and 20 mm). Alveolated pulmonary parenchyma area≥50% in histology was considered a good quality biopsy, with a minimum procedural artifact. We used logistic regression to identify independent parameters as risk factors for histologic adequacy. RESULTS: A total of 545 cryobiopsies were obtained from 34 explanted lungs after pneumonectomy for lung transplantation. The mean maximum diameter of the specimen achieved with the 1.7 probe was larger (13.5 mm) than those obtained with 1.9 and 2.4 mm probes (11.3 and 10.7 mm, P= 0.07). More pleural macroscopic damage and pleural tissue in histology occurred with the 2.4 mm probe ( P <0.001). There was no difference in the quality of specimens between the different freezing times and the distance from the pleura. CONCLUSIONS: Freezing time and distance from the pleura did not affect the histologic quality for diagnosing ESPD in severely damaged lungs. Smaller cryoprobe size did not negatively affect sample adequacy.


Asunto(s)
Criocirugía , Enfermedades Pulmonares , Trasplante de Pulmón , Humanos , Pulmón/cirugía , Pulmón/patología , Biopsia/efectos adversos , Pleura/cirugía , Pleura/patología , Broncoscopía/efectos adversos , Enfermedades Pulmonares/patología , Criocirugía/efectos adversos
5.
Semin Thorac Cardiovasc Surg ; 35(1): 189-199, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-34838953

RESUMEN

To compare post-operative outcomes associated with thymectomy performed using either open or robotic approaches. Retrospective cohort study from a single-center prospective registry consisting of patients undergoing thymectomy between 2000 and 2020. Patients were grouped according to surgical approach (open vs robotic). A propensity-score matching analysis was performed in a 2:1 open to robotic ratio, and surgical outcomes were evaluated. We analyzed 234 thymectomies (155 open; 79 robotic). Myasthenia gravis was present in 23.2% and 32.9% (P = 0.249) in the open and in the robotic group, respectively. All covariates were balanced in the matched groups (open n = 114; robotic n =5 9), except lesion size. The robotic approach was significantly associated with shorter surgical time (median 95 vs 65 minutes, P < 0.001), lesser clinical (21.1% vs 6.8%, P = 0.016) and surgical (11.4% vs 1.7%, P = 0.036) complications during the same hospitalization, less Clavien-Dindo grade 2 or higher complication rates (28.1 vs 15.3%, P = 0.048), chest tube duration (median: 3 vs 0 days, P < 0.001) and in-hospital length of stay (median: 5 vs 0 days, P < 0.001). Bleeding (P = 0.214), ICU length of stay (P = 0.167), reoperation rate (open, 1.8% vs robotic 0%), 90-day mortality (P = 0.341) and readmission rate post discharge (P = 0.277) were similar between the groups. In the matched population with primary thymic epithelial tumors, the completeness of resection rate was similar (open, 92.1% vs robotic 96.8%, P = 0.66.). Robotic thymectomy is associated with improved post-operative outcomes when compared to open thymectomy, without compromising the goals of oncologic surgery. Longer follow-up is needed to ensure oncologic equivalence.


Asunto(s)
Procedimientos Quirúrgicos Robotizados , Timectomía , Humanos , Estudios Retrospectivos , Cuidados Posteriores , Resultado del Tratamiento , Alta del Paciente , Tiempo de Internación , Complicaciones Posoperatorias
6.
Ann Thorac Surg ; 114(5): 1834-1841, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-34736929

RESUMEN

BACKGROUND: There is a literature gap for hospitals in single-payer health care systems quantifying the influence of hospital volume on outcomes after major lung cancer resection. We aimed to determine the effect of hospital volume on mortality and length of stay. METHODS: A retrospective cohort study using administrative, population-based data from a single-payer universal health care system was performed in adults with non-small cell lung cancer who underwent lobectomy or pneumonectomy between 2008 and 2017. Hospital volume was defined as the average annual number of major lung resections performed at each institution. Length of stay and postoperative mortality were compared using multivariable linear and nonlinear regression between hospital volume categories and continuously. Adjusted association between hospital volume and postoperative mortality was determined by multivariable logistic regression. RESULTS: In all, 10 831 lung resections were performed: 1237 pneumonectomies and 9594 lobectomies. Patients undergoing lobectomy at high-volume hospitals had shorter median length of stay (6 vs 8 days, P = .001) compared with low-volume hospitals. After adjusting for confounders, surgery at a high-volume center was significantly associated with shorter length of stay after lobectomy and overall resections (P ≤ .001), but not after pneumonectomy (P = .787). Surgery at a high-volume center was positively associated with improved 90-day mortality in lobectomy and overall procedures (odds ratio 0.607 [95% confidence interval, 0.399 to 0.925], and 0.632 [95% confidence interval, 0.441 to 0.904], respectively). Volume was not a predictor of 90-day mortality after pneumonectomy (odds ratio 0.533 [95% confidence interval, 0.257 to 1.104], P = .090). CONCLUSIONS: Surgery at a high-volume center was positively correlated with improved 90-day survival and shorter hospital length of stay. The results support regionalized lung cancer care in a single-payer health care system.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Adulto , Humanos , Tiempo de Internación , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Estudios Retrospectivos , Neoplasias Pulmonares/cirugía , Sistema de Pago Simple , Resultado del Tratamiento , Neumonectomía/métodos , Hospitales de Bajo Volumen , Complicaciones Posoperatorias/cirugía , Mortalidad Hospitalaria
7.
J Am Coll Surg ; 235(6): 914-924, 2022 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-36377904

RESUMEN

BACKGROUND: For surgical patients, operating room expenses are significant drivers of overall hospitalization costs. Surgical teams often lack awareness of the costs associated with disposable surgical supplies, which may lead to unnecessary expenditures. The aim of this study is to evaluate whether a Surgical Cost Awareness Program would reduce operating room costs. STUDY DESIGN: A prototype software displays the types and costs of disposable instruments used in real-time during surgery and generates insight-driven operative cost reports, which are automatically sent to the surgeons. A prospective pre-post controlled trial of thoracoscopic lobectomy procedures performed by 7 surgeons at a single academic center was conducted. Control and intervention groups consisted of consecutive cases from February 2nd through June 23, 2021, and from June 28th through December 22, 2021, respectively. The primary outcome was mean per case surgical disposables cost. RESULTS: Three hundred twenty-two lobectomies were evaluated throughout the study period (control: n = 164; intervention: n = 158). Baseline characteristics were comparable between groups. Mean disposables cost per case was $3,320.73 ± $814.83 in the control group compared with $2,567.64 ± $594.59 in the intervention group, representing a mean cost reduction of $753.08 (95% CI, $622.29 to $883.87; p < 0.001). All surgeons experienced a reduction in disposable costs after the intervention. Intraoperative and postoperative outcomes did not differ between the cohorts. CONCLUSIONS: Providing real-time educational feedback to surgical teams significantly reduced costs associated with disposable surgical equipment without compromising perioperative outcomes for lobectomy. Integrating the novel AssistIQ software across other procedural settings may generate further data insights with the potential for significant cost savings on a larger scale.


Asunto(s)
Quirófanos , Cirujanos , Humanos , Ahorro de Costo , Equipos Desechables , Estudios Prospectivos
8.
BMC Public Health ; 11: 654, 2011 Aug 18.
Artículo en Inglés | MEDLINE | ID: mdl-21851587

RESUMEN

BACKGROUND: A healthy start to life requires adequate motor development and physical activity participation. Currently 5-15% of children have impaired motor development without any obvious disorder. These children are at greater risk of obesity, musculoskeletal disorders, low social confidence and poor mental health. Traditional electronic game use may impact on motor development and physical activity creating a vicious cycle. However new virtual reality (VR) game interfaces may provide motor experiences that enhance motor development and lead to an increase in motor coordination and better physical activity and mental health outcomes. VR games are beginning to be used for rehabilitation, however there is no reported trial of the impact of these games on motor coordination in children with developmental coordination disorder. METHODS: This cross-over randomised and controlled trial will examine whether motor coordination is enhanced by access to active electronic games and whether daily activity, attitudes to physical activity and mental health are also enhanced. Thirty children aged 10-12 years with poor motor coordination (≤ 15th percentile) will be recruited and randomised to a balanced ordering of 'no active electronic games' and 'active electronic games'. Each child will participate in both conditions for 16 weeks, and be assessed prior to participation and at the end of each condition. The primary outcome is motor coordination, assessed by kinematic and kinetic motion analysis laboratory measures. Physical activity and sedentary behaviour will be assessed by accelerometry, coordination in daily life by parent report questionnaire and attitudes to physical activity, self-confidence, anxiety and depressed mood will be assessed by self report questionnaire. A sample of 30 will provide a power of > 0.9 for detecting a 5 point difference in motor coordination on the MABC-2 TIS scale (mean 17, sd = 5). DISCUSSION: This is the first trial to examine the impact of new virtual reality games on motor coordination in children with developmental coordination disorder. The findings will provide critical information to understand whether these electronic games can be used to have a positive impact on the physical and mental health of these children. Given the importance of adequate motor coordination, physical activity and mental health in childhood, this project can inform interventions which could have a profound impact on the long term health of this group of children. TRIAL REGISTRATION: Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000400965.


Asunto(s)
Trastornos de la Destreza Motora/psicología , Desempeño Psicomotor , Proyectos de Investigación , Interfaz Usuario-Computador , Juegos de Video , Niño , Estudios Cruzados , Humanos , Salud Mental , Actividad Motora , Trastornos de la Destreza Motora/rehabilitación , Evaluación de Resultado en la Atención de Salud
9.
Ergonomics ; 54(11): 1017-28, 2011 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22026945

RESUMEN

BACKGROUND: Computer use is associated with musculoskeletal complaints among office workers. Insufficient exposure diversity between tasks is a proposed etiological factor, but little information exists on diversity of tasks and information and communication technologies (ICT) among office workers. METHOD: Direct observation and self-report data were collected on tasks performed and ICT used among 24 office workers, over 12 h in work and non-work environments. Self-reports were repeated on four additional days. RESULTS: Observations were for a mean [SD] 642[40] min. Productive tasks comprised 63% of observations, instrumental 17%, self-care 12% and leisure 8%. Non-ICT tasks comprised 44% of observations; New electronic-based ICT 36%; Old paper-based ICT 15%, and Combined ICT tasks 4%. Proportions of tasks and ICT use differed between environments and days. CONCLUSION: Information about diversity in tasks and ICT provides the basis for future investigations into exposure variation in ICT-intensive environments and possible musculoskeletal health risks. STATEMENT OF RELEVANCE: Information and communication technologies (ICT) provide office workers access to perform work-related tasks after work hours and in away-from-work locations. Musculoskeletal disorder risk assessment for office workers should account for actual tasks performed over a work day, including away from work exposures. This study provides rich, detailed data on occurrence of tasks performed and ICT used by office workers throughout the day.


Asunto(s)
Personal Administrativo , Salud Laboral , Interfaz Usuario-Computador , Adulto , Australia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Musculoesqueléticas/etiología , Observación , Exposición Profesional/prevención & control , Autoinforme
10.
Ann Thorac Surg ; 111(4): 1150-1155, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-32866480

RESUMEN

BACKGROUND: Dilation in patients with malignant esophageal strictures precluding the passage of the endoscopic ultrasonography (EUS) scope allows complete evaluation; however, it may be associated with complications. This study evaluates the safety and clinical value of balloon dilation to complete EUS in patients with stenotic esophageal cancers. METHODS: This study consists of a phase I clinical trial. One-hundred-and fifty patients were recruited. Endoscopic balloon dilation was performed before EUS in patients with high-grade stenosis. The analysis was focused on the ability to complete an endosonographic examination after dilation, 30-day morbidity, and change in the final stage or definitive management based on the completed endosonographic examination. RESULTS: Dilation was required in 55 patients (36.7%), with a complication rate of 10.9% (n = 6). Dilation allowed completion of EUS in 53 patients (96.4%), leading to a modification of the clinical stage for 18 patients (34%) and a deviation in the treatment plan in 7 patients (13.2%). No differences were found in these variables when compared with the group that did not require dilation (26.3% and 14.7%, P = .33 and P = .79, respectively). Dilation was associated with more advanced disease on final pathology among patients who underwent surgical resection (P = .006). CONCLUSIONS: High-grade malignant esophageal strictures that preclude the passage of the ultrasound probe are associated with advanced stage disease. Owing to the high risk of perforation and the limited benefit in staging, balloon dilation to complete the EUS staging should be avoided. (Clinicaltrials.gov identifier: NCT01950442.).


Asunto(s)
Dilatación/métodos , Endosonografía/métodos , Neoplasias Esofágicas/diagnóstico , Estenosis Esofágica/terapia , Estadificación de Neoplasias/métodos , Anciano , Neoplasias Esofágicas/complicaciones , Estenosis Esofágica/diagnóstico , Estenosis Esofágica/etiología , Esofagoscopía , Femenino , Humanos , Masculino , Persona de Mediana Edad
11.
Innovations (Phila) ; 16(5): 463-469, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34338070

RESUMEN

OBJECTIVE: Transbronchial lung cryobiopsy (TBLC) is a promising technique that can provide a histologic diagnosis in interstitial lung diseases (ILD) and is an alternative to surgical lung biopsy. The main concerns with the procedure are safety and diagnostic accuracy. The technique is applicable in patients unable to undergo surgical biopsy due to severe comorbidities or when patient transport to the operating room is dangerous. This study reports the initial experience with TBLC on a thoracic surgical service as a first attempt at diagnosis in patients with diffuse parenchymal lung diseases (DPLD). METHODS: Between May 2018 and July 2020, 32 patients underwent TBLC using bedside flexible bronchoscopy for suspected ILD on a thoracic surgical endoscopy service. Retrospective evaluation of the procedure details, complications, and diagnostic yield were analyzed and reported. RESULTS: A total of 89 pathological samples were obtained (mean 2.8 per patient). Pneumothorax and minor bleeding occurred in 25% and 16.7% of patients, respectively. Sixty-seven percent of complications occurred with use of the 2.4 mm cryoprobe (P = 0.036). Concordance between the histologic diagnosis and final clinical diagnosis was observed in 62.5% of patients and the pathology guided the final treatment in 71% (P = 0.027) with Kappa-concordance of 0.60 (P < 0.001). CONCLUSIONS: Cryobiopsy is becoming part of the diagnostic evaluation in patients with indeterminate DPLD or hypoxemic respiratory failure. TBLC is easy to perform and has a favorable safety profile. Thoracic specialists should consider adding TBLC to their procedural armamentarium as a first option for patients with indeterminate PLD.


Asunto(s)
Enfermedades Pulmonares Intersticiales , Quirófanos , Biopsia , Broncoscopía , Humanos , Pulmón/cirugía , Enfermedades Pulmonares Intersticiales/diagnóstico , Estudios Retrospectivos
12.
BMC Public Health ; 9: 212, 2009 Jun 29.
Artículo en Inglés | MEDLINE | ID: mdl-19563680

RESUMEN

BACKGROUND: Many children are reported to have insufficient physical activity (PA) placing them at greater risk of poor health outcomes. Participating in sedentary activities such as playing electronic games is widely believed to contribute to less PA. However there is no experimental evidence that playing electronic games reduces PA. There is also no evidence regarding the effect of different types of electronic games (traditional sedentary electronic games versus new active input electronic games) on PA. Further, there is a poor understanding about how characteristics of children may moderate the impact of electronic game access on PA and about what leisure activities are displaced when children play electronic games. Given that many children play electronic games, a better understanding of the effect of electronic game use on PA is critical to inform child health policy and intervention. METHODS: This randomised and controlled trial will examine whether PA is decreased by access to electronic games and whether any effect is dependent on the type of game input or the child's characteristics. Children aged 10-12 years (N = 72, 36 females) will be recruited and randomised to a balanced ordering of 'no electronic games', 'traditional' electronic games and 'active' electronic games. Each child will participate in each condition for 8 weeks, and be assessed prior to participation and at the end of each condition. The primary outcome is PA, assessed by Actical accelerometers worn for 7 days on the wrist and hip. Energy expenditure will be assessed by the doubly labelled water technique and motor coordination, adiposity, self-confidence, attitudes to technology and PA and leisure activities will also be assessed. A sample of 72 will provide a power of > 0.9 for detecting a 15 mins difference in PA (sd = 30 mins). DISCUSSION: This is the first such trial and will provide critical information to understand whether access to electronic games affects children's PA. Given the vital importance of adequate PA to a healthy start to life and establishing patterns which may track into adulthood, this project can inform interventions which could have a profound impact on the long term health of children. TRIAL REGISTRATION: This trial is registered in the Australia and New Zealand Clinical Trials Registry (ACTRN 12609000279224).


Asunto(s)
Ejercicio Físico , Juegos de Video , Actitud Frente a la Salud , Niño , Equipos y Suministros Eléctricos , Metabolismo Energético , Femenino , Humanos , Masculino , Actividad Motora , Juegos de Video/psicología
13.
PLoS One ; 12(3): e0175011, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28362868

RESUMEN

Government initiatives have tried to ensure uniform computer access for young people; however a divide related to socioeconomic status (SES) may still exist in the nature of information technology (IT) use. This study aimed to investigate this relationship in 1,351 Western Australian children between 6 and 17 years of age. All participants had computer access at school and 98.9% at home. Neighbourhood SES was related to computer use, IT activities, playing musical instruments, and participating in vigorous physical activity. Participants from higher SES neighbourhoods were more exposed to school computers, reading, playing musical instruments, and vigorous physical activity. Participants from lower SES neighbourhoods were more exposed to TV, electronic games, mobile phones, and non-academic computer activities at home. These patterns may impact future economic, academic, and health outcomes. Better insight into neighbourhood SES influences will assist in understanding and managing the impact of computer use on young people's health and development.


Asunto(s)
Brecha Digital , Factores Socioeconómicos , Adolescente , Australia , Niño , Conducta Infantil , Ejercicio Físico , Femenino , Humanos , Masculino , Juego e Implementos de Juego , Lectura , Recreación , Televisión , Juegos de Video
14.
Int J Infect Dis ; 58: 22-26, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28267595

RESUMEN

BACKGROUND: Herpes zoster (HZ) is characterized by debilitating pain and blistering dermatomal rash. The most common complication of HZ is postherpetic neuralgia (PHN), a persistent pain that can substantially affect patients' quality of life. HZ has significant impact on patients' lives with considerable implications for healthcare systems and society. The purpose of this study was to evaluate the healthcare resource utilization (HCRU) and medical costs associated with HZ in Latin America. METHOD: We conducted a pooled-analysis of three prospective cohort studies of HZ patients ≥50 years of age in Argentina (n=96); Brazil (n=145) and Mexico (n=142). Patients were recruited at different time-points during their HZ episode and were followed for six months. The incidence of PHN was defined as a worst ZBPI pain score of ≥3, persisting or appearing more than 90 days after the onset of rash. Work effectiveness was measured on a 100-point Likert scale where 100 was described as completely effective (able to work like before HZ began) and 0 as not effective at all. Direct costs included costs due to use of antiviral medications and all medical services used to treat HZ. Indirect cost was based on foregone earnings from patients due to work loss and presenteeism, and work loss by family caretakers. One-way sensitivity analysis was performed to assess the impact on total costs. All costs are reported in 2015 USD currency. RESULTS: 383 HZ patients were included and PHN incidence was 38.6%. The most commonly used resources were visits to the doctor's office (79.1% of patients), the emergency room (48.8%) and a specialist (37.9%); hospitalization was reported for 5.7% of patients. The overall direct cost per case was $763.19 USD, indirect cost was $701.40, for a total of $1,464.59 per HZ episode in Latin America. Total cost associated with HZ in patients with PHN was markedly higher compared to patients without PHN ($2,001.13 vs. $867.72, respectively) with indirect costs accounting for the most part of this difference. The sensitivity analysis was generally robust to changes in the assumptions made. CONCLUSION: HZ and its sequelae impose a substantial economic burden in Latin America which is expected to rise as the population ages and the number of HZ cases increases. The results support the need for early intervention, preventative strategies and improved disease management to reduce the HZ-associated disease burden in Latin America.


Asunto(s)
Costo de Enfermedad , Herpes Zóster/economía , Anciano , Antivirales/economía , Antivirales/uso terapéutico , Servicio de Urgencia en Hospital/economía , Femenino , Herpes Zóster/epidemiología , Herpesvirus Humano 3 , Hospitalización/economía , Humanos , Incidencia , América Latina/epidemiología , Masculino , Persona de Mediana Edad , Neuralgia Posherpética/epidemiología , Estudios Prospectivos , Calidad de Vida
15.
PLoS One ; 9(3): e92879, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24667839

RESUMEN

Organizational culture is a commonly studied area in industrial/organizational psychology due to its important role in workplace behaviour, cognitions, and outcomes. Jung et al.'s [1] review of the psychometric properties of organizational culture measurement instruments noted many instruments have limited validation data despite frequent use in both theoretical and applied situations. The Organizational Culture Assessment Instrument (OCAI) has had conflicting data regarding its psychometric properties, particularly regarding its factor structure. Our study examined the factor structure and criterion validity of the OCAI using robust analysis methods on data gathered from 328 (females = 226, males = 102) Australian employees. Confirmatory factor analysis supported a four factor structure of the OCAI for both ideal and current organizational culture perspectives. Current organizational culture data demonstrated expected reciprocally-opposed relationships between three of the four OCAI factors and the outcome variable of job satisfaction but ideal culture data did not, thus indicating possible weak criterion validity when the OCAI is used to assess ideal culture. Based on the mixed evidence regarding the measure's properties, further examination of the factor structure and broad validity of the measure is encouraged.


Asunto(s)
Satisfacción en el Trabajo , Psicología Industrial , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Masculino
16.
Hum Factors ; 56(2): 306-21, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24689250

RESUMEN

OBJECTIVE: This research aimed to identify the most frequently occurring human factors contributing to maintenance-related failures within a petroleum industry organization. Commonality between failures will assist in understanding reliability in maintenance processes, thereby preventing accidents in high-hazard domains. BACKGROUND: Methods exist for understanding the human factors contributing to accidents. Their application in a maintenance context mainly has been advanced in aviation and nuclear power. Maintenance in the petroleum industry provides a different context for investigating the role that human factors play in influencing outcomes. It is therefore worth investigating the contributing human factors to improve our understanding of both human factors in reliability and the factors specific to this domain. METHOD: Detailed analyses were conducted of maintenance-related failures (N = 38) in a petroleum company using structured interviews with maintenance technicians. The interview structure was based on the Human Factor Investigation Tool (HFIT), which in turn was based on Rasmussen's model of human malfunction. RESULTS: A mean of 9.5 factors per incident was identified across the cases investigated.The three most frequent human factors contributing to the maintenance failures were found to be assumption (79% of cases), design and maintenance (71%), and communication (66%). CONCLUSION: HFIT proved to be a useful instrument for identifying the pattern of human factors that recurred most frequently in maintenance-related failures. APPLICATION: The high frequency of failures attributed to assumptions and communication demonstrated the importance of problem-solving abilities and organizational communication in a domain where maintenance personnel have a high degree of autonomy and a wide geographical distribution.


Asunto(s)
Ergonomía , Industria Procesadora y de Extracción/organización & administración , Petróleo , Análisis y Desempeño de Tareas , Accidentes de Trabajo/prevención & control , Accidentes de Trabajo/psicología , Comunicación , Análisis de Falla de Equipo , Humanos , Entrevistas como Asunto , Mantenimiento , Psicología Industrial
17.
Clin Rheumatol ; 33(10): 1495-500, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25034080

RESUMEN

Psoriatic arthritis (PsA) is a chronic T cell-mediated inflammatory spondyloarthropathy affecting 10-40 % of psoriasis (PSO) patients (0.3-1.0 % of the general population). Recent epidemiological studies have shown an increased prevalence of cardiovascular (CV) risk factors and/or morbidity among PSO or PsA patients as compared to control individuals. The aim of this study is to describe the CV profile of PsA patients in Newfoundland, Canada. The possible impact of duration of chronic inflammation on CV variables was also explored. PsA patients were selected from a registry of PSO and PsA patients in Newfoundland. PsA patients diagnosed as per the CASPAR criteria are entered in the registry at the time of diagnosis, questioned on their medical history, and are followed indefinitely. Based on the duration since PsA diagnosis patients were classified as having early (<2 years) or established (≥2 years) PsA. CV risk was assessed using both conventional (hypertension, hypercholesterolemia, diabetes, obesity) and non-conventional (markers of chronic inflammation) factors. A total of 196 PsA patients were included; 42.9 % had early PsA and 57.1 % had established PsA. The prevalence of hypercholesterolemia, obesity, hypertension, diabetes mellitus, anxiety/depression, and coronary heart disease was 61.6, 59.7, 32.7, 13.8, 13.8, and 8.7 %, respectively. The prevalence of comorbidities was generally comparable between cohorts with exception of anxiety/depression, which was considerably higher in patients with established PsA compared to early PsA and obesity which was more common among male patients with established PsA. However, upon adjusting for age and gender differences, no statistically significant between-group differences were observed. Overall, these results suggest that PsA, even at early stages, is associated with significant CV comorbidity. These conditions should be taken into consideration when assessing the PsA burden of illness in epidemiological and health outcomes studies. Furthermore, early detection and management of these conditions could improve the patients' disability and quality of life.


Asunto(s)
Artritis Psoriásica/complicaciones , Artritis Psoriásica/epidemiología , Enfermedades Cardiovasculares/epidemiología , Adulto , Estudios de Casos y Controles , Comorbilidad , Diabetes Mellitus/epidemiología , Femenino , Humanos , Hipercolesterolemia/epidemiología , Hipertensión/epidemiología , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Factores de Riesgo
18.
Games Health J ; 3(4): 260-6, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-26192374

RESUMEN

OBJECTIVE: Active-input videogames could provide a useful conduit for increasing physical activity by improving a child's self-confidence, physical activity enjoyment, and reducing anxiety. Therefore this study evaluated the impact of (a) the removal of home access to traditional electronic games or (b) their replacement with active-input videogames, on child self-perception, enjoyment of physical activity, and electronic game use anxiety. SUBJECTS AND METHODS: This was a crossover, randomized controlled trial, conducted over a 6-month period in participants' family homes in metropolitan Perth, Australia, from 2007 to 2010. Children 10-12 years old were recruited through school and community media. Of 210 children who were eligible, 74 met inclusion criteria, and 8 withdrew, leaving 66 children (33 girls) for analysis. A counterbalanced randomized order of three conditions sustained for 8 weeks each: No home access to electronic games, home access to traditional electronic games, and home access to active-input electronic games. Perception of self-esteem (Harter's Self Perception Profile for Children), enjoyment of physical activity (Physical Activity Enjoyment Scale questionnaire), and anxiety toward electronic game use (modified Loyd and Gressard Computer Anxiety Subscale) were assessed. RESULTS: Compared with home access to traditional electronic games, neither removal of all electronic games nor replacement with active-input games resulted in any significant change to child self-esteem, enjoyment of physical activity, or anxiety related to electronic games. CONCLUSIONS: Although active-input videogames have been shown to be enjoyable in the short term, their ability to impact on psychological outcomes is yet to be established.

19.
Hum Factors ; 55(5): 911-23, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24218901

RESUMEN

OBJECTIVE: To determine differences in muscle activity amplitudes and variation of amplitudes when using different information and communication technologies (ICT). BACKGROUND: Office workers use different ICT to perform tasks. Upper body musculoskeletal complaints are frequently reported by this occupational group. Increased muscle activity and insufficient variation are potential risk factors for musculoskeletal complaints. METHOD: Muscle activity of right and left upper trapezius and right wrist extensor muscle bundle (extensor carpi radialis longus and brevis) of 24 office workers (performing their usual tasks requiring different ICT at work and away from work) were measured continuously over 10 to 12 hours. Muscle activity variation was quantified using two indices, amplitude probability distribution function and exposure variation analysis. RESULTS: There was a trend for electronics-based New ICT tasks to involve less electromyography (EMG) variation than paper-based Old ICT tasks. Performing Combined ICT tasks (i.e., using paper- and electronics-based ICT simultaneously) resulted in the highest muscle activity levels and least variation; however, these Combined ICT tasks were rarely performed. Tasks involving no ICT (Non-ICT) had the greatest muscle activity variation. CONCLUSION: Office workers in this study used various ICT during tasks at work and away from work. The high EMG amplitudes and low variation observed when using Combined ICT may present the greatest risk for musculoskeletal complaints, and use of Combined ICT by workers should be kept low in office work. Breaking up combined, New, and Old ICT tasks, for example, by interspersing highly variable Non-ICT tasks into office workers' daily tasks, could increase overall muscle activity variation and reduce risk for musculoskeletal complaints.


Asunto(s)
Músculo Esquelético/fisiología , Dolor Musculoesquelético/fisiopatología , Salud Laboral , Automatización de Oficinas , Análisis y Desempeño de Tareas , Adulto , Dorso/fisiología , Electromiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor Musculoesquelético/prevención & control
20.
Work ; 38(4): 401-12, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21508529

RESUMEN

OBJECTIVE: School children use information and communication technology (ICT) on a regular basis for a variety of purposes. The purpose of this study was to document how school children spend their time and the different types of ICT they use. METHODS: Nine Australian primary school children were observed in their school and away-from-school environments during one school day to record their ICT usage, comparing self-report exposures with direct observations. Self-reported discomfort scores were obtained throughout the day. RESULTS: Paper-based ICT (Old ICT) was mostly used for productive occupations at school, while electronic-based ICT (New ICT) was mostly used during leisure in away-from-school locations. Tasks involving no ICT (Non-ICT) accounted for the largest proportion of time in both locations during self-care, leisure and instrumental occupations. End-of-day self-reported time performing different occupations was consistent with data from independent observations. Self reported time using Old ICT and New ICT was marginally over-estimated, and time spent using Non-ICT was marginally under-estimated. CONCLUSION: The children in this study used a variety of ICT in the performance of daily occupations in their natural environments. New ICT use was primarily for leisure, but time spent was less than reported in other studies. Discomfort reports among the participants were low. Participants' self-reports of occupations performed and ICT use was reliable and could be useful as an exposure assessment metric.


Asunto(s)
Computadores/estadística & datos numéricos , Autoinforme , Telecomunicaciones/estadística & datos numéricos , Niño , Femenino , Humanos , Actividades Recreativas , Masculino , Reproducibilidad de los Resultados , Trabajo
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