Ergonomic Assessment of Septorhinoplasty Maneuvers During Simulated Pregnancy

ObjectiveWomen represent an increasing proportion of the otolaryngology workforce. Work-related musculoskeletal disorders (WRMSD) are a little-studied yet important impediment to career completion. Scant attention has been directed to study the impact of pregnancy on surgeon posture and ergonomics. We piloted the use of a pregnancy simulation suit (Empathy Belly) to assess the risk of ergonomic compromise when performing open septorhinoplasty.Study designSurgical simulation.SettingSingle session, training simulation lab at academic medical center.MethodsMedical students and surgical residents performed the initial steps of a rhinoplasty procedure without and with a pregnancy simulation suit and were filmed with an artificial intelligence-based video analysis app from Kinetica Labs that calculates joint angles and categorizes the ergonomic risk factors. Still images from videos were taken and analyzed using validated posture-based analysis rubrics. Participants were asked to complete a qualitative questionnaire after the session.ResultsTwelve medical students and surgical residents participated in the study. Posture-based analysis indicated increased ergonomics risk factors among trainees when performing a rhinoplasty while wearing the pregnancy suit. Video analysis indicated trends of worsening back angle and shoulder postures. Trainees reported experiencing pain in the neck, suprapubic area, and lower back. They acknowledged the importance of ergonomics in otolaryngology and desired further education about workplace injury risk mitigation.ConclusionPregnancy impacts the ergonomics of performing septorhinoplasty and further investigation is required into interventions to reduce risk of WRMSDs

The dynamics of industrial development in a resource-rich developing society: A political economy analysis

© 2018 SAGE Publications. This article criticizes the resource curse thesis for neglecting the interplay of international factors and domestic politics, that is the political settlement, in explaining industrial performance in a resource-dependent society – Trinidad and Tobago. Using political settlement, analysis secondary as well as interview data, it examines the dynamics at the macro and sectoral levels in iron and steel and telecommunications in Trinidad and Tobago. The historical evidence reveals that anti-colonial mobilizations spurred critical public investments in developmental institutions and industrial projects responsible for improving the country’s productive base and technological capability in the post- Black Power period. These investments were bolstered by a favorable geopolitical climate and the 1973 commodity boom. Sectoral case studies reveal how shifts in the country’s political settlement affected late-industrializing accumulation of accumulation technological capabilities. Hereafter neoliberal policies facilitated an increased role for external actors in economic policy and ethnic-based clientelism within the political economy