'Good engineering governance' - an issue for ergonomists

Engineering Governance can be summarised as two questions: 'Are we doing the right things?' and 'Are we doing those things right?'. It forms a part of Corporate Governance, and in the manufacturing domain it is the key to long-term survival amid changing commercial contexts. The paper will outline some of the ergonomics issues of importance in this topic; 'ownership' of goverrnance; implications for design, production and operation; and, perhaps most important for Ergonomists, the resulting implications for the design of jobs. These implications cover organisational discipline, the inclusion of suitable, 'effort-free' metrics in engineering processes, the allocation of responsibility and authority over resources, support for individuals, the need for trust and a culture of honesty and reliability, and the necessity for organisational follow-through

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment

Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial

Background Results of small trials indicate that fluoxetine might improve functional outcomes after stroke. The FOCUS trial aimed to provide a precise estimate of these effects. Methods FOCUS was a pragmatic, multicentre, parallel group, double-blind, randomised, placebo-controlled trial done at 103 hospitals in the UK. Patients were eligible if they were aged 18 years or older, had a clinical stroke diagnosis, were enrolled and randomly assigned between 2 days and 15 days after onset, and had focal neurological deficits. Patients were randomly allocated fluoxetine 20 mg or matching placebo orally once daily for 6 months via a web-based system by use of a minimisation algorithm. The primary outcome was functional status, measured with the modified Rankin Scale (mRS), at 6 months. Patients, carers, health-care staff, and the trial team were masked to treatment allocation. Functional status was assessed at 6 months and 12 months after randomisation. Patients were analysed according to their treatment allocation. This trial is registered with the ISRCTN registry, number ISRCTN83290762. Findings Between Sept 10, 2012, and March 31, 2017, 3127 patients were recruited. 1564 patients were allocated fluoxetine and 1563 allocated placebo. mRS data at 6 months were available for 1553 (99·3%) patients in each treatment group. The distribution across mRS categories at 6 months was similar in the fluoxetine and placebo groups (common odds ratio adjusted for minimisation variables 0·951 [95% CI 0·839–1·079]; p=0·439). Patients allocated fluoxetine were less likely than those allocated placebo to develop new depression by 6 months (210 [13·43%] patients vs 269 [17·21%]; difference 3·78% [95% CI 1·26–6·30]; p=0·0033), but they had more bone fractures (45 [2·88%] vs 23 [1·47%]; difference 1·41% [95% CI 0·38–2·43]; p=0·0070). There were no significant differences in any other event at 6 or 12 months. Interpretation Fluoxetine 20 mg given daily for 6 months after acute stroke does not seem to improve functional outcomes. Although the treatment reduced the occurrence of depression, it increased the frequency of bone fractures. These results do not support the routine use of fluoxetine either for the prevention of post-stroke depression or to promote recovery of function. Funding UK Stroke Association and NIHR Health Technology Assessment Programme

On the Habits of the Tree Trapdoor Spider of Graham\u27s Town1

Volume: 1887Start Page: 40End Page: 4

Falling Star

Adapted from John Milton\u27s Paradise Lost, Falling Star follows the story of Stan, a regular man working for a large corporation in space, after an attempted rebellion to take over the space station. Stan and his followers are thrown off the station and onto an uninhabitable planet where they must decide what they want to do: either trying to take the station back again by force or some alternative strategy. We follow Stan as he navigates what to do and how he will exact revenge on his former boss, the CEO

Global positioning system (GPS) : human factors aspects for general aviation pilots : a thesis presented in partial ...

The allied disciplines of psychology and human factors within aviation are well established. Moreover, the benefits that their research efforts have brought to the underlying theoretical and practical application of technology within aviation are well documented. The introduction of the Global Positioning System (GPS) is a new technology in this context that has not yet received much attention in terms of its human factors implications. GPS is a satellite based navigation system, available as a non-standardised "add-on" navigation system for General Aviation (GA) aircraft. While GPS has been established within the military environment for some time it has only recently been made available to the civil aviation market. To date there has been little human factors research conducted on its use by pilots, especially in the GA industry where it has rapidly become an extremely popular navigation aid. This study aimed to utilise the fundamental principles of psychology and human factors to examine GA pilots' use of GPS. Particular reference was made to the equipment design ergonomics, the psychological attitudes and behaviours displayed when using GPS, and the implications GPS has for flight safety. The study sought information to determine whether formal training was required and to suggest the format for such training. A survey of 172 GA pilots using GPS in New Zealand was carried out to investigate five research questions proposed to provide a basis for future research. The results found that GPS was rated highly for its design and ease of use, however specific areas of GPS design needing improvement were identified. GPS was rated in a similar fashion by pilots irrespective of their individual demographic sub-groupings. While the majority of pilots were found to have positive attitudes and behaviours using GPS, some users had developed negative attitudes previously associated with automation such as over-confidence, reliance, and complacency. This had resulted in certain inappropriate behaviours. These included operating without backup means, discarding standard navigation procedures such as maintaining reference to maps and charts, and navigating with GPS before gaining an acceptable level of knowledge and competency with its use. The results appeared to be generalisable to the wider pilot population. The results suggest that formalised training incorporating human factors was required for operators to use GPS to its full potential and to avoid committing errors with possible hazardous consequences

The swimming performance and post-swim body ion concentrations of juvenile pink salmon, and the effect of parasitic sea lice on these parameters

Pink salmon (Oncorhynchus gorbuscha Walbaum) stocks in the Broughton Archipelago BC have seen a general decline in recent years. This is thought to be due to parasitism by sea lice, Lepeophtheirus salmonis (Krøyer, 1837), on pink salmon during early marine life stage. To investigate this, I measured swimming performance, an integrated measure of fish health, and post-swim body ion concentrations, a secondary stress response, of control and sea lice infected juvenile pink salmon (mass < 3.0 g). Using five different protocols (ranging in duration from 8 – 112 min), four constant acceleration tests (rates between 0.005 - 0.053 cm s₋²) and a repeated critical swim speed test, it was found that the final swimming speed of juvenile pink salmon (mass 0.05). Given this finding, estimates of swim performance in juvenile pink salmon can be accurately measured with an acceleration test lasting < 10 minutes. Using a repeated, constant acceleration (0.05 cm s₋²) protocol, the effects of sea lice on swimming performance and post-swim body ion concentrations were measured in artificially infected river-caught (RC-fish, mean body mass 0.3 + 0.05 g) and ocean-caught infected (OC-fish, mean body mass 1.1 + 0.1 g) juvenile pink salmon. Infection levels ranged in intensity (1 - 4 sea lice per fish) and development stage (chalimus 1 - adult). Swimming performance of RC-fish was not affected by lice intensity (P>0.05) but was affected by lice stage with swimming performance decreasing at chalimus 3 stage (-20.4%) and even further at more advanced sea lice stages (chalimus 4, -26.5%; motile, -37.9%). Sea lice parasitism had no significant effect on the swimming performance of larger OC-fish when compared to control. The absence of an additive effect on swimming performance of 1 to 3+ sea lice per fish suggests drag forces induced by the ectoparasite was not a major factor. In contrast, post-swim body Na⁺ and Cl- concentrations were typically elevated in infected compared to control RC-fish (P 0.05).Science, Faculty ofZoology, Department ofGraduat

A compendium of the operations, vertues, and use of Dr. Nendicks applauded antipancronicon [electronic resource] : that most successful medicine, which is so deservedly called the popular-pill, for its special vertues, safety and success, against that dangerous and our nations popular disease, the scurvy.

Caption title.Signed on p. 8: ... published by me Humphrey Nendick.Imprint suggested by Wing.Reproduction of original in British Library.WingElectronic reproduction