Identifying common problems in the acquisition and deployment of large-scale,safety–critical,software projects in the US and UK healthcare systems

Public and private organisations are investing increasing amounts into the development of healthcare software. These applications are perceived to offer numerous benefits. Software systems can improve the exchange of information between healthcare facilities. They support standardized procedures that can help to increase consistency between different service providers. Electronic patient records ensure minimum standards across the trajectory of care when patients move between different specializations. Healthcare information systems also offer economic benefits through efficiency savings; for example by providing the data that helps to identify potential bottlenecks in the provision and administration of care. However, a number of high-profile failures reveal the safety concerns that arise when staff must cope with the loss of these applications. In particular, teams have to retrieve paper based records that often lack the detail of electronic systems. Individuals who have only used electronic information systems face particular problems in learning how to apply paper-based fallbacks. The following pages compare two different failures of healthcare information systems in the UK and North America. The intention is to ensure that future initiatives to extend the integration of electronic patient records will build on the ‘lessons learned’ from previous systems.     

Analysis of the experimental results of the initiation of detonation in short tubes with kerosene–oxidizer mixtures

The paper describes the experimental investigation of detonation initiation in a mixture of kerosene–oxidant in a short test tube. Various mixtures of oxygen and nitrogen were used as an oxidant, from pure oxygen to the composition of air. The goal of the study was to determine the minimum diameter of the tube and the minimum level of energy needed for the direct initiation of detonation. As a result of the measurements the pressure courses were obtained for two kinds of cases: with and without (only shock waves) of fuel injection. The results of both kinds of measurements were compared, providing information about the initiation of detonation in a fuel–oxidizer mixture. Brief analyses of the results for different initiators and different oxidizers were performed and compared with the shock wave and Chapman–Jouget velocity.     

Effects of controller-pilot communication medium,flight phase and the role in the cockpit on pilots’ workload and situation awareness

This study explores the effects of communication medium, flight phase, and the role in the cockpit on pilots’ workload and situation awareness. Eight pilots with the experience of Controller-Pilot Data Link Communications (CPDLCs) participated in this simulated experiment. Two types of communication medium (voice and datalink), three types of flight phase (departure, cruise, and arrival), and two types of role (pilot flying and pilot non-flying) were investigated in the experiment. The results indicated that flight phase is a significant factor and cruise is the most suitable phase for datalink use on pilots’ acceptance, workload, and situation awareness performance. Both medium and role were not the significant factors. Since there is no significant difference on medium when no extra tasks and interferences involved in a normal flight, that the use of CPDLC can be justified during all phases of a no-event flight. In addition, the results of usability indicated that the simulated CPDLC with command selection functions proposed in this study provides good utility for the participants. In order to use the CPDLC for all phases of flight in the future, adding more command selection functions in place of typing messages by pilots and accommodating appropriate interfaces for different phases are recommended to enhance the usability of the CPDLC unit.     

Risk and characteristics analysis of the flow-induced vibration of the dip tube in opposed multi-burner gasifier

The vibration of dip tube in multi-burner gasifier changes the stress at the connection, causing flange seal failures and high temperature gas erosions with heavy economic losses and industrial accidents. This work aims to reveal the dip tube vibration mechanism, with special focus on obtaining the effect of operational parameters on the fatigue damage and long-term stable operation of gasifiers. A three-dimensional numerical simulation of the water-scrubbing cooling chamber was conducted to obtain the excitation source in the flow field. Then a FSI (fluid-structure interaction) transient dynamics simulation was carried out to investigate the vibration characteristics. Two major flow forms were found: a vertical annular flow near the dip tube outlet in the water-scrubbing cooling chamber; and a gas-liquid coupled flow caused by the syngas entrained the liquid. These two unstable multiphase flow forms exerted an energy excitation on the dip tube, resulting in a self-excited flutter. The dip tube vibration was similar to the first mode of a cantilever beam. The peak frequency was less affected by the initial liquid level and the syngas stream inlet velocity, which was close to its own first natural frequency. Note that, the alternating load generated by vibration may cause fatigue damage, which needs to be specifically considered in the design and manufacturing process of opposed multi-burner gasifier.     

Prevalence of Musculoskeletal Disorders at Workplaces in the People’s Republic of China

This paper presents 2 musculoskeletal disorders questionnaire surveys in 10 different Chinese occupational groups. Data collected from 1,603 workers using a modified Nordic musculoskeletal disorders symptom questionnaire showed that the 12-month prevalence of musculoskeletal disorders, particularly in the low back and shoulder-neck regions, was high at many Chinese workplaces. Significant differences existed between occupational groups. Assembly workers usually had higher neck-shoulder complaints compared to workers in most other occupations. However, the nature of assembly seemed also to influence the prevalence rate. Workers at a cassette recorder and a TV set assembly plant appeared to have more neck complaints compared with a group of thermos flask assemblers.     

The role of drug and alcohol use and the risk of motor vehicle crashes in Shiraz,Iran, 2014: A case–crossover study

Background: Traffic accidents and traffic-related injuries and mortality have become a major public health concern in Iran. This study aimed to examine the role of drug and alcohol use in motor vehicle accidents in Iran.

Methods: This case–crossover study was conducted on 441 drivers who survived a road traffic crash and were taken to the emergency department of Shahid Rajaee trauma hospital in Shiraz, southern Iran. Data were collected using checklists that included demographic characteristics and drug and alcohol use prior to driving. Alcohol and drug use was identified through self-report, and cannabis, morphine, and methamphetamine urine tests were used to confirm drug abuse among drivers.

Results: In total 17.9% of drivers reported using drugs (cannabis, opium, or metamphetamine) and 8.84% of drivers reported consuming alcohol prior to the collision. The crude odds ratios (ORs) for having a crash for opium, cannabis, and metamphetamine were 1.94 (95% interval confidence [CI], 1.11–3.38), 2.37 (95% CI, 1.03–5.42), 5.5 (95% CI, 1.21–24.81), respectively, and for all drugs was 3.83 (95% CI, 2.28–6.43). The OR for alcohol was 3.5 (95% CI, 1.73–7.06) based on self-report.

Conclusion: Drug and alcohol use are increasing the risk of traffic crashes in Iran. Risk-reducing programs must be designed and implemented.     

The injury epidemiology of adult riders in vehicle-two-wheeler crashes in China,Ningbo, 2011–2015

Introduction: We used road crashes between vehicles and two-wheelers from Yinzhou District Ningbo in 2011–2015 from the China In-depth Accident Study (CIDAS) as sample cases. The risk factors of different injury severity grades were analyzed. Method: The classification tree model was used to screen the possible interaction items, and the corresponding regression model was constructed according to the results of the tree model to explore the influencing factors of cyclist injury. Results: The road types, weather types, gender, age of the riders, and vehicle speed were significantly correlated with the dependent variables. The interaction effect of gender*road type, weather*age, weather*speed and speed*age were obtained through a tree model. Conclusions: The risk of male casualties at the crossroads was 3.31 times higher than that of female casualties at the straight roads. On sunny days, the risk of crash casualties in Ningbo was low, and the fatality risk when the speed reached 38 km/h was 10%. Under the interaction effect of weather and age, the fatality risk in cloudy/foggy and rainy days was almost coincident, and the serious risk in cloudy/foggy conditions was the highest. Practical applications: Through factor analysis, it is confirmed that there is interaction effect among the factors, and it can provide reference for relevant departments to formulate more targeted and effective governance strategies.     

Study on Lockout Procedures for the Safety of Workers Intervening on Equipment in the Municipal Sector in Québec

In Québec, workers intervening in hazardous zones of machines, equipment and processes during maintenance, repairs and unjamming activities have to apply lockout procedures. Lockout procedures involve shutting down the equipment, isolating it, applying individual locks, releasing residual energies and verifying the absence of energies. Lockout has mostly been linked to industrial sectors. However, the municipal sector also faces challenges when it comes to controlling hazardous energies. The objectives of this research are to study serious accidents linked to our subject, study the application of lockout in different municipalities in Québec, identify the specificities for the municipal sector and propose some means to support the application of lockout. We will show that lockout procedures are required in different locations in municipalities and that they are currently being implemented in the municipal sector in Québec. Moreover, we propose a model which aims at facilitating the implementation of lockout procedures in the municipal sector.     

Tired of innovations? Learned helplessness and fatigue in the context of continuous streams of innovation implementation

The business environment faced by contemporary organizations is highly uncertain and constantly changing. Thus, organizations have adopted and implemented a continuous stream of innovations to achieve sustainable growth and survival. Considering the demand for additional resources to implement innovations, the present study explores organizational conditions that may lead to innovation‐targeted burnout and fatigue among employees, which impede their active participation in a subsequent innovation. To this end, we propose a theoretical framework that elucidates the effects of previous innovations on the subsequent implementation behavior of employees. We identify two dimensions of the cognitive appraisal of previous innovations (i.e., intensity and failure) that shape employees' beliefs regarding innovations, such as innovation‐targeted helplessness, which ultimately results in innovation fatigue. Data collected from 84 managers and 397 employees of Chinese and Korean organizations prove the significant role of employee perceptions of previous innovations in shaping the innovation‐targeted helplessness and fatigue of employees, which ultimately affect employee behavior toward a subsequent innovation. The present conceptual and empirical analyses suggest that given continuous streams of innovation implementation, managers should carefully consider employee's perceptions of previous innovations (i.e., intensity and failure) for successful implementation of a subsequent innovation. Copyright © 2017 John Wiley & Sons, Ltd.     

The journey to leave: Understanding the roles of perceived ease of movement,proactive personality,and person–organization fit in overqualified employees' job searching process

Despite intensive research on perceived overqualification, empirical evidence on overqualified employees' job search behavior remains relatively insufficient. Notably, no studies have explored the possible link between perceived overqualification and internal job searching behaviors. In the present study, we consider whether—and more importantly when—employees with high perception of overqualification search for internal and external job opportunities. Applying the ability–motivation–opportunity (AMO) framework, we propose and test a model that specifies how motivation and opportunity to move or stay activate differential effects in overqualifiers' job searching process. Results from two studies surveying employees in Taiwan (Study 1: N = 268; Study 2: N = 210) show that overqualifiers displayed greater intentions to leave the current job and, in turn, engaged in more external job search behaviors; this relation was strongest for those whose perceived ease of movement and proactive personality increased or person–organization (PO) fit decreased. Furthermore, overqualifiers displayed greater intentions to leave the current job and also increased their internal job search behaviors; this relation was strongest for those whose perceived ease of movement and PO fit increased. A series of supplemental analyses also lends support to our theorizing.     

Explosions of gasoline–air mixture in the tunnels containing branch configuration

In order to investigate the effects of branch tunnels on explosion propagation, experiments were performed in five different configuration tunnels (straight configuration and configurations with 1 branch, 2 branches, 3 branches and 4 branches). Pressure and flame transducers were used to record the history of the pressure development and track the velocity of the flame front. It was shown that the branch tunnels had ability to enhance the maximum overpressure, rate of overpressure rise, and deflagration index (K_G) of the gasoline–air mixture explosion due to the turbulence induced by the branch tunnels. The overpressure rise rate and K_G of the explosion increased as a function of the number of branch tunnels. Experiments also showed that the maximum flame speed increased as the branch number increasing from 0 to 3 due to the enlargement of turbulence induced by the branch tunnels. However, an increase of branch number did not always lead to an enhancement of flame speed because the heat loss was intensified resulting from the increase of flame surface caused by the branch tunnels. When the number of branch tunnels exceeded 3, the maximum flame speed dropped.     

Ergonomic Diagnosis of the Driver’s Workplace in an Electric Locomotive

This paper deals with research aimed at developing a method for ergonomic analysis of the driver’s workplace in an electric locomotive. It presents the structure of the diagnosis and its assumptions, and includes a re-evaluation of the questionnaire-expert method in ergonomic research. The article presents research data on weights and evaluations including their standard deviations for particular priority features. Ergonomic levels of the studied operator’s cabin in locomotives are compared.     

Learning lessons from tunnel accidents – Recommendations in support of the implementation of Article 15 on Reporting of the EU Directive 2004/54/EC

Tunnels in the trans-European road network (TEN) facilitate the transport of persons and goods on European roads. Following a series of major tunnel accidents European Union Directive 2004/54/EC was adopted to support the achievement of uniform and high tunnel safety levels. With future accident prevention and mitigation in mind and in support of the effective implementation of Article 15 on Reporting of the Directive we outline a procedure for learning lessons and discuss every step in the process with specific regard for its implications on Article 15. This includes accident investigation, reporting, data collection and analysis, learning lessons and their implementation. The realization that validated information on tunnel accidents is not easily available or accessible, or suffers from a lack of detail or accuracy fed into the development of a data-collection template. By its very nature the template development also guided the formulation of key recommendations for accident investigation and reporting as the main information source. In addition, key recommendations on data analysis, learning lessons and implementation were also made to assist the actors responsible for reporting or sharing information under the EU Directive.     

Structural equation model of the influence of noise annoyance on miners’ unsafe behavior in coal mines

Miners' unsafe behavior (UB) is the main cause of coal mine accidents. Previous research has suggested that excessive noise in tunnels impacts miners' temperaments and safe production behavior. To explore the influence of noise on UB, four different dimensions of noise annoyance were identified: cognitive, emotional, communication, and physical mechanism annoyance. The coal mine noise annoyance scale, miners' unsafe behavior intention (UBI) scale, and miners’ UB scale were developed according to different dimensions. In the first survey, a total of 200 questionnaires were distributed in the two coal mines, and 193 valid questionnaires were recovered. Exploratory factor analysis was conducted, and invalid items were removed according to the analysis results to form the final scale. Then, 500 final scales were distributed in two Chinese coal mines, and 482 valid questionnaires were collected. Confirmatory factor analysis was conducted by collating the data of the second questionnaire. Based upon the structural equation model (SEM), the SEM of the influence of noise annoyance degree on UB and the path analysis with latent variable path analysis with the latent variables (PA-LVs) mediating model of the effect of UBI on UB were established, and the path coefficients with fitting data of the model were analyzed. The results indicated that the four dimensions of coal mine noise annoyance had a strong positive impact on UB, which was reduced by less noise annoyance. In addition, the Bootstrap method was used to verify the mediating method among the four dimensions of noise annoyance, cognitive annoyance, emotional annoyance, with communication annoyance indirectly affecting UB through UBI. The research results provide theoretical support for reducing the UB of miners and improving coal mine safety levels.