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At least 919 records · Page 51Linked to original sources
PubMed2002

Surgeon workload and motion efficiency with robot and human laparoscopic camera control.

BACKGROUND: Surgeons are now being assisted by robotic systems in a wide range of laparoscopic procedures. Some reports have suggested that robot-assisted camera control (RACC) may be superior to a human driver in terms of quality of view and directional precision, as well as long-term cost savings. Therefore, we setout to investigate the impact of RACC of surgeon motion efficiency. METHODS: Twenty pigs were randomized to undergo a standardized laparoscopic Nissen fundoplication with either a human or RACC system, the AESOP 2000. All procedures were performed by the same surgical fellow. Time was recorded for dissection and suture phases. Inertial motion sensors were used to monitor both the surgeon's hands and the camera. Digitized data were analyzed to produce summary measures related to overall motion. RESULTS: The operative times were slightly longer with RACC (mean 80.2 +/- 20.6 vs 73.1 +/- 15.4 min, not significant). With regard to operative times and surgeon motion measures, the only statistically significant differences were for setup and breakdown times, which contributed <15% to the total time for the procedure. CONCLUSION: In terms of impact on surgeon motion efficiency and operative time under normal surgical conditions, RACC is essentially the same as an expert human driver. However, careful planning and structuring of the surgical suite may yield some small gains in operative time.

Animals↗
PubMed2006

Classification of metabolic and respiratory demands in fire fighting activity with extreme workloads.

Fire fighting work comprises work tasks requiring an energy yield at maximal or close to maximal levels of the individual. Due to the very nature of fire fighting more complex physiological variables are difficult to measure. We measured metabolic and respiratory responses in 15 male, professional fire fighters during simulated work tasks on a test ground. Work time was on the average 22 min with individual components of work tasks lasting 2-4 min. The mean oxygen consumption for the whole exercise (22 min) was 2.75+/-0.29 l/min. The most demanding work task demanded an oxygen uptake of 3.55+/-0.27 l/min. Corresponding values for respiratory minute volumes were 82+/-14 and 102+/-14l/min, respectively. Heart rates averaged 168+/-12 for the whole test and 179+/-13 beats/min for the heaviest work task. Two new classes for classification of intensive and exhausting, short term physical work are proposed for inclusion in ISO8996 and values for relevant parameters are proposed.

Adult↗
PubMed2004

The physical workload of nursing personnel: association with musculoskeletal discomfort.

Direct care-nursing personnel around the world report high numbers of work-related musculoskeletal disorders. This cross-sectional study examined the association between the performance of high-risk patient-handling tasks and self-reported musculoskeletal discomfort in 113 nursing staff members in a veterans' hospital within the United States. Sixty-two percent of subjects reported a 7-day prevalence of moderately severe musculoskeletal discomfort. There was a significant association between wrist and knee pain and the number of highest-risk patient-handling tasks performed per hour interacting with the load lifted. On units where lifting devices are readily available, musculoskeletal risk may have shifted to the wrist and knee.

Adult↗
PubMed2005

A qualitative and quantitative survey of Forensic Medical Examiner workload in the Northumbria Police Force area October 2002-January 2003.

This force-wide study in the Northumbria Police area provides an audit of the quality and quantity of work carried out by Forensic Medical Examiners (FMEs) over a three month period. Approximately 25% of all arrests during the period of the audit resulted in a request for FME assessment of the detainee. About 79% of consultations were performed to establish fitness to detain, in which over 30% of detainees were intoxicated and over 40% addicted to drugs and/or alcohol. Over 30% of those queried for fitness to detain also required advice and occasionally prescription for medication, both for the management of addiction and the treatment of chronic illness. In comparison to prior work this study found lower rates of mental illness in alcohol and drug dependent populations (13% and 6%, respectively). It is hoped this study will provide information in respect of the specific competencies not only required by future FMEs but also nurses working with detainees within the custody suites.

Coroners and Medical Examiners↗
PubMed2004

Precision of measurements of physical workload during standardised manual handling. Part I: surface electromyography of m. trapezius, m. infraspinatus and the forearm extensors.

Though surface electromyography (EMG) has been widely used in studies of occupational exposure, its precision in terms of the variance between-days and between-subjects has seldom been evaluated. This study aimed at such an evaluation. Six women performed three different work tasks: 'materials picking', 'light assembly', and 'heavy assembly', repeated on 3 different days. EMG was recorded from m. trapezius, m. infraspinatus and the forearm extensors. Normalisation was made to a maximal (MVE), and a submaximal (RVE), reference contraction. Variance components between days (within subjects) and between subjects were derived for the 10th, 50th and 90th percentiles, as well as for muscular rest parameters. For the task 'heavy assembly', the coefficient of variation between days (CV(BD)) was 8% for m. trapezius (right side, 50th percentile, MVE normalised values). Larger variabilities were found for m. infraspinatus (CV(BD) 15%), and the forearm extensors (CV(BD) 33%). Between-subjects variability (CV(BS)) was greater, 16% for m. trapezius and 57% for m. infraspinatus, 29% for the forearm extensors. RVE normalisation resulted in larger CV(BD), while reducing CV(BS). The between-days and between-subjects variability may be used to optimise sampling strategy, and to assess the bias in epidemiological studies. The bias caused by measurement procedures per se is acceptable.

Adult↗
PubMed2005

Precision of measurements of physical workload during standardised manual handling. Part II: Inclinometry of head, upper back, neck and upper arms.

For measuring the physical exposure/workload in studies of work-related musculoskeletal disorders, direct measurements are valuable. However, the between-days and between-subjects variability, as well as the precision of the method per se, are not well known. In a laboratory, six women performed three standardised assembly tasks, all of them repeated on three different days. Triaxial inclinometers were applied to the head, upper back and upper arms. Between-days (within subjects) and between-subjects (within tasks) variance components were derived for the 10th, 50th and 90th percentiles of the angular and the angular velocity distributions, and for the proportion of time spent in predefined angular sectors. For percentiles of the angular distributions, the average between-days variability was 3.4 degrees , and the between-subjects variability 4.0 degrees . For proportion of time spent in angular sectors, the variability depended on the percentage of time spent in the sector; the relative variability was scattered and large, on average 103% between days and 56% between subjects. For the angular velocity percentiles, the average between-days variability was 7.9%, and the average between-subjects variability was 22%. The contribution of the measurement procedure per se to the between-days variability, i.e., the imprecision of the method, was small: less than 2 degrees for angles and 3% for angular velocity.

Acceleration↗
PubMed2003

Using a personal digital assistant to streamline the OR workload.

PERSONAL DIGITAL ASSISTANTS (PDAs), are handheld minicomputers used for tasks such as referencing, documentation, and data storage and retrieval. THESE DEVICES can help perioperative nurses solve problems associated with updating, maintaining, and retrieving surgical preference cards and accessing treatment and medication references. CHOOSING A PDA and accessories, finding basic software, and writing a perioperative nursing program can be painless, even for a novice. NURSING DOCUMENTATION can be accelerated and streamlined with the use of PDAs, which leaves perioperative nurses more time for quality patient care.

Computers, Handheld↗
PubMed1999

Assessment of workload and arm position during different work sequences: a study with portable devices on construction workers.

It is recognised that work related shoulder pain is overrepresented among construction workers compared to other occupations. Studies have shown that working with hands above shoulder level increases the shoulder load. Most studies have been confined to the laboratory. The present project was carried out to map the muscular engagement and postures of construction workers undertaking ceiling fitting, and to compare the results to those of the laboratory studies. Two ambulatory devices were used, one allowing recording of electromyographic (EMG) signals bilaterally from the trapezius muscle, and the other to record the position of both arms and back by means of measuring the angles between the vertical line and the back and both upper arms. These recordings were performed during 1.5-2 h work sequences. The results show that the work was mostly performed in an upright position, that both arms were used to a similar amount and that the workers for a large proportion of their working time had their upper arms at levels that are considered harmful in view of shoulder load. The EMG data showed that nearly 50% of the work was spent with trapezius activity that exceeded that of the reference contraction used (about 15% of maximal voluntary contraction) and that the time spent in muscular relaxation was 10%. It was concluded that the exposure of construction workers undertaking ceiling fitting meets the criteria formulated on the basis of laboratory experiments with respect to a high risk of acquiring chronic shoulder pain, due to rotator cuff tendinitis.

Adult↗
PubMed1995

Influence of clinician workload and patterns of treatment on survival from breast cancer.

Chemotherapy and hormone therapy prolong disease-free and overall survival for patients with breast cancer in the clinical-trial setting, but it is not clear if this translates into a benefit on a population basis. It is also not clear if surgical caseload has any influence on survival. We used cancer-registry data from 12,861 patients with breast cancer treated in Yorkshire, UK, between 1979 and 1988, and found that patients of surgeons with higher rates of usage of chemotherapy and hormone therapy (regional mean usage 9.3%, range 0-46%) had prolonged survival. There was considerable variation in survival of breast cancer patients between surgeons, but their rate of use of chemotherapy and hormone therapy explained about 26% of this survival variation. Had the practice of the surgeons with the better outcomes been used by all treating clinicians, 5-year survival would have increased by about 4-5%. Examination of differences in survival as a function of consultant caseload demonstrated poorer results amongst those surgeons treating less than 30 new cases of breast cancer per year (risk ratio [95% CI] for treating > 30 compared with < 10 = 0.85 [0.77-0.93]). We recommend that patients with breast cancer be dealt with only by clinicians who see more than 30 new cases per year and who have a full range of treatment options available within a multidisciplinary setting.

Aged↗