Reinnervation of Free Nipple Grafts Associated With Improved Erection Function.

Background: Most patients undergoing breast surgery with free nipple grafts lose nipple erection (NE) function. This study aimed to evaluate the effect of nerve preservation and reconstruction with targeted nipple-areola complex reinnervation (TNR) on NE following gender-affirming mastectomy with free nipple grafting.

Methods: Patients undergoing gender-affirming mastectomy with free nipple grafts were prospectively enrolled.

Testing With Intent in Mosaic Conditions: A Case-Based Review.

Recent advancements in genetic testing have revealed cases of mosaicism, demonstrating the phenomenon may be more common than once thought. Broadly defined, mosaicism describes the presence of two genotypically different cell lineages within the same organism. This can arise from small mutations or errors in chromosome segregation, as early as in gametes, before or after fertilization.

The use of fault reporting of medical equipment to identify latent design flaws.

Background And Purpose: Poor device design that fails to adequately account for user needs, cognition, and behavior is often responsible for use errors resulting in adverse events. This poor device design is also often latent, and could be responsible for "No Fault Found" (NFF) reporting, in which medical devices sent for repair by clinical users are found to be operating as intended. Unresolved NFF reports may contribute to incident under reporting, clinical user frustration, and biomedical engineering technologist inefficacy.

Human factors perspectives on a systemic approach to ensuring a safer medication delivery process.

The current, prevailing approach to addressing medication delivery safety issues has been to apply solutions at the point of failure with direct, local remediation. These include computerized physician order entry to address transcription and prescribing problems, tall man lettering for label clarity and smart pump systems to address programming use errors. We discuss the lack of a systemic, holistic approach to addressing medication delivery issues that has led to fragmented solutions that do not address the problem as intended and introduce new, unintended patient safety issues.

Simultaneous determination of cefepime, vancomycin and imipenem in human plasma of burn patients by high-performance liquid chromatography.

A liquid chromatographic method with UV detection for simultaneous determination of cefepime, vancomycin and imipenem has been developed. Cefuroxime was used as internal standard. After the clean up of samples by plasma protein precipitation, 5 microl of the extract were injected into the chromatograph and peaks were eluted from the Sulpelcosil LC-18 column using a mobile phase consisting of 0.

Bibliometric analysis of Human Factors (1970-2000): a quantitative description of scientific impact.

Bibliometric analyses use the citation history of scientific articles as data to measure scientific impact. This paper describes a bibliometric analysis of the 1682 papers and 2413 authors published in Human Factors from 1970 to 2000. The results show that Human Factors has substantial relative scientific influence, as measured by impact, immediacy, and half-life, exceeding the influence of comparable journals.

Designing effective human-automation-plant interfaces: a control-theoretic perspective.

In this article, we propose the application of a control-theoretic framework to human-automation interaction. The framework consists of a set of conceptual distinctions that should be respected in automation research and design. We demonstrate how existing automation interface designs in some nuclear plants fail to recognize these distinctions.

Problems with medical devices may be severely under-reported.

The purposes of this study were to determine whether registered nurses are familiar with the Health Canada Medical Device Problem Report Form, and if so, how often they use it to report problems and concerns compared to how often they experience problems and concerns with medical devices. A survey was mailed to a random sample of 1,000 Ontario nurses to collect demographic information and to determine their familiarity with the aforementioned form, as well as the frequency with which they encounter problems/concerns with medical devices. Seventy-two and a half percent of the nurses reportedly have problems/concerns with medical devices at least yearly, yet 94.

Usability assessment of pacemaker programmers.

There is a perception among clinicians of usability differences in the user interface of pacemaker programmers, but there is an absence of literature in this area. The purpose of this study was to describe usability differences in pacemaker programmers. Forty-two programmer users completed self-administered questionnaires and two usability experts independently performed heuristic evaluation to identify features that violated general usability principles.

What does it take? A case study of radical change toward patient safety.

Background: Adopting a human factors engineering approach to patient safety requires a radical behavioral shift from "blame and shame," which emphasizes further training, to systems thinking, which also emphasizes improved system design. A medical device manufacturer appeared to initiate this radical shift after exhibiting the traditional approach for years.

Methodology: The research focused on a patient-controlled analgesia device.

Less is (sometimes) more in cognitive engineering: the role of automation technology in improving patient safety.



 There is a tendency to assume that medical error can be stamped out by automation. Technology may improve patient safety, but cognitive engineering research findings in several complex safety critical systems, including both aviation and health care, show that more is not always better. Less sophisticated technological systems can sometimes lead to better performance than more sophisticated systems.

Designing for adaptation to novelty and change: functional information, emergent feature graphics, and higher-level control.

Ecological interface design (EID) is a theoretical framework that aims to support worker adaptation to change and novelty in complex systems. Previous evaluations of EID have emphasized representativeness to enhance generalizability of results to operational settings. The research presented here is complementary, emphasizing experimental control to enhance theory building.

Programming errors contribute to death from patient-controlled analgesia: case report and estimate of probability.

Purpose: To identify the factors that threaten patient safety when using patient-controlled analgesia (PCA) and to obtain an evidence-based estimate of the probability of death from user programming errors associated with PCA.

Clinical Features: A 19-yr-old woman underwent Cesarean section and delivered a healthy infant. Postoperatively, morphine sulfate (2 mg bolus, lockout interval of six minutes, four-hour limit of 30 mg) was ordered, to be delivered by an Abbott Lifecare 4100 Plus II Infusion Pump.

Ecological interface design: progress and challenges.

Ecological interface design (EID) is a theoretical framework for designing human-computer interfaces for complex sociotechnical systems. Its primary aim is to support knowledge workers in adapting to change and novelty. This literature review shows that in situations requiring problem solving, EID improves performance when compared with current design approaches in industry.

Patient safety, potential adverse drug events, and medical device design: a human factors engineering approach.

Adverse drug events are the single leading threat to patient safety. Human factors engineering has been repeatedly proposed, but largely untested, as the key to improving patient safety. The value of this approach was investigated in the context of a commercially available patient-controlled analgesia device that has been linked with several alleged patient injuries and deaths.

Modeling a medical environment: an ontology for integrated medical informatics design.

Modern medical environments have seen an increase in technological complexity and pressures of handling more patients with fewer resources, resulting in higher demands on medical practitioners. Medical informatics designers will have to focus on the problem of organizing medical information more effectively to enable practitioners to cope with these challenges. This article addresses this research problem for the particular area of medical problem solving in patient care.

Relative influence of age, resting heart rate and sedentary life style in short-term analysis of heart rate variability.

In order to assess the relative influence of age, resting heart rate (HR) and sedentary life style, heart rate variability (HRV) was studied in two different groups. The young group (YG) consisted of 9 sedentary subjects aged 15 to 20 years (YG-S) and of 9 nonsedentary volunteers (YG-NS) also aged 15 to 20. The elderly sedentary group (ESG) consisted of 16 sedentary subjects aged 39 to 82 years.

Making the most of ecological interface design: the role of individual differences.

As advanced control rooms for new process control plants are being designed, the question arises as to whether operators of the future need to have a particular set of cognitive characteristics to make the most of those advanced control rooms. This issue was investigated by examining the interaction between ecological interface design (EID) and individual differences in the context of a process control microworld. A number of potential predictors of performance were investigated, including: demographic data, type of interface, type of instruction, and data from two cognitive style tests.

Revisiting the constraint attunement hypothesis: reply to Ericsson, Patel, and Kintsch (2000) and Simon and Gobet (2000).

This article is part of an exchange concerning the contributions of the constraint attunement hypothesis (CAH) to the understanding of expertise effects in memory recall. K. A.

A framework for epistemological analysis in empirical (laboratory and field) studies.

In their search for generalizable behavioral patterns and design principles, cognitive field researchers should reflect on the epistemological limitations of empirical studies. In this paper we describe a framework for epistemological analysis that can help serve this purpose and discuss its application to two prototypical cases of cognitive engineering research: laboratory experiments and field studies. The framework examines two, often implicit, processes in empirical research: the abstraction from empirical data and the substantiation of theoretical constructs and principles.