Workplace distractions in the digital era – are smartphones a threat to safety or an essential tool?

Anaesthesia is a technology‐dependant specialty. While the impact of total intravenous anaesthesia, video laryngoscopes and ultrasound‐guidance – to name but a few influential recent technologies – have been extensively studied [e.g. 1-4], the professional use of smartphones in anaesthesia remains relatively under‐investigated. This is perhaps an oversight considering that this ubiquitous accessory now reaches into nearly every aspect of our lives, from communication to study, shopping and dining, and indeed – to professional practice. In this issue of Anaesthesia, van Harten et al. report “An observational study of distractions in the operating theatre” [5], which among other findings, highlights the (distracting) role played by smartphones. In this editorial, we consider the utility and methodology of van Harten et al.’s work, reflect on the extent to which smartphones may threaten patient safety in anaesthesia, and ask how this can be balanced against their prominent and increasing role as a professional tool

Mid-Pleistocene climate transition drives net mass loss from rapidly uplifting St. Elias Mountains, Alaska

Erosion, sediment production and routing on a tectonically active continental margin reflect both tectonic and climatic processes; partitioning the relative importance of these processes remains controversial. Gulf of Alaska contains a preserved sedimentary record of Yakutat Terrane collision with North America. Because tectonic convergence in the coastal St. Elias orogen has been roughly constant for 6 Myr, variations in its eroded sediments preserved in the offshore Surveyor Fan constrain a budget of tectonic material influx, erosion, and sediment output. Seismically imaged sediment volumes calibrated with chronologies derived from Integrated Ocean Drilling Program boreholes shows that erosion accelerated in response to Northern Hemisphere glacial intensification (~2.7 Ma) and that the 900-km long Surveyor Channel inception appears to correlate with this event. However, tectonic influx exceeded integrated sediment efflux over the interval 2.8-1.2 Ma. Volumetric erosion accelerated following the onset of quasi-periodic (~100-kyr) glacial cycles in the mid-Pleistocene climate transition (1.2-0.7 Ma). Since then erosion and transport of material out of the orogen has outpaced tectonic influx by 50-80%. Such a rapid net mass loss explains apparent increases in exhumation rates inferred onshore from exposure dates and mapped out-of-sequence fault patterns. The 1.2 Myr mass budget imbalance must relax back toward equilibrium in balance with tectonic influx over the time scale of orogenic wedge response (Myrs). The St. Elias Range provides a key example of how active orogenic systems respond to transient mass fluxes, and the possible influence of climate driven erosive processes that diverge from equilibrium on the million-year scale

Pathways towards coexistence with large carnivores in production systems

Coexistence between livestock grazing and carnivores in rangelands is a major challenge in terms of sustainable agriculture, animal welfare, species conservation and ecosystem function. Many effective non-lethal tools exist to protect livestock from predation, yet their adoption remains limited. Using a social-ecological transformations framework, we present two qualitative models that depict transformative change in rangelands grazing. Developed through participatory processes with stakeholders from South Africa and the United States of America, the models articulate drivers of change and the essential pathways to transition from routine lethal management of carnivores towards mutually beneficial coexistence. The pathways define broad actions that incorporate multiple values in grazing systems including changes to livestock management practices, financial support, industry capacity building, research, improved governance and marketing initiatives. A key fnding is the new concept of ‘Predator Smart Farming’, a holistic and conscientious approach to agriculture, which increases the resilience of landscapes, animals (domesticated and wild) and rural livelihoods. Implementation of these multiple pathways would lead to a future system that ensures thriving agricultural communities, secure livelihoods, reduced violence toward animals, and landscapes that are productive and support species conservation and coexistence

The effect of divided attention on novices and experts in laparoscopic task performance

Background\ud Attention is important for the skilful execution of surgery. The surgeon’s attention during surgery is divided between surgery and outside distractions. The effect of this divided attention has not been well studied previously. We aimed to compare the effect of dividing attention of novices and experts on a laparoscopic task performance.\ud Methods\ud Following ethical approval, 25 novices and 9 expert surgeons performed a standardised peg transfer task in a laboratory setup under three randomly assigned conditions: silent as control condition and two standardised auditory distracting tasks requiring response (easy and difficult) as study conditions. Human reliability assessment was used for surgical task analysis. Primary outcome measures were correct auditory responses, task time, number of surgical errors and instrument movements. Secondary outcome measures included error rate, error probability and hand specific differences. Non-parametric statistics were used for data analysis.\ud Results\ud 21109 movements and 9036 total errors were analysed. Novices had increased mean task completion time (seconds) (171 ± 44SD vs. 149 ± 34, p < 0.05), number of total movements (227 ± 27 vs. 213 ± 26, p < 0.05) and number of errors (127 ± 51 vs. 96 ± 28, p < 0.05) during difficult study conditions compared to control. The correct responses to auditory stimuli were less frequent in experts (68 %) compared to novices (80 %). There was a positive correlation between error rate and error probability in novices (r 2 = 0.533, p < 0.05) but not in experts (r 2 = 0.346, p > 0.05).\ud Conclusion\ud Divided attention conditions in theatre environment require careful consideration during surgical training as the junior surgeons are less able to focus their attention during these conditions