Inovação tecnológica: análise comparativa entre dois métodos de coleta de dados sobre riscos e danos em enfermagem

Estudo de comparação entre dois métodos de coleta de dados, através da aplicação de um software, para avaliação dos fatores de risco e danos no trabalho de enfermagem em hospital. Objetiva analisar o uso do software (eletrônico) em comparação com o uso do instrumento impresso. Trata-se de um estudo estatístico, descritivo com abordagem quantitativa, desenvolvido nas enfermarias dos Serviços de Internações Clínicas e Serviços de Internações Cirúrgicas de um Hospital Universitário, no estado do Rio de Janeiro. A população do estudo foram os trabalhadores de enfermagem das unidades. A amostra foi definida por meio de amostragem não-probabilística e alocação da amostra ocorreu de forma aleatória em dois grupos, denominados grupo impresso e grupo eletrônico, com 52 participantes cada. Previamente a coleta de dados foram implementadas estratégias de pesquisa denominada teaser, através da comunicação digital aos trabalhadores. Posteriormente, foi ofertado aos participantes do formato impresso o questionário impresso, e os participantes do formato eletrônico receberam um link de acesso a home page. Os dados foram analisados através da estatística descritiva simples. Após a aplicação do questionário nos dois formatos, obteve-se resposta de 47 trabalhadores do grupo impresso (90,3%), e 17 trabalhadores do grupo eletrônico (32,7%). A aplicação do questionário impresso revelou algumas vantagens como o número de pessoas atingidas pela pesquisa, maior interação pesquisador e participante, taxa de retorno mais alta, e quanto às desvantagens a demanda maior de tempo, erros de transcrição, formulação de banco de dados, possibilidades de resposta em branco e erros de preenchimento. No formato eletrônico as vantagens incluem a facilidade de tabulação e análise dos dados, impossibilidade de não resposta, metodologia limpa e rápida, e como desvantagens, o acesso à internet no período de coleta de dados, saber usar o computador e menor taxa de resposta. Ambos os grupos observaram que o questionário possui boas instruções e fácil compreensão, além de curto tempo para resposta. Os trabalhadores perceberam a existência dos riscos ocupacionais, principalmente os ergonômicos, biológicos e de acidentes. Os principais danos à saúde provocados ou agravos pelo trabalho percebidos pelos trabalhadores foram os problemas osteomusculares, estresse, transtornos do sono, mudanças de humor e alterações de comportamento e varizes. Pode-se afirmar que não ocorreram diferenças acentuadas de percentual ao comparar a percepção dos trabalhadores do grupo impresso e do grupo eletrônico frente aos riscos e danos à saúde. Conclui-se que os dois processos de coleta de dados tiveram boa aceitação, no entanto, deve ser indicada a aplicação do questionário eletrônico junto com a ferramenta de acesso, no caso o computador, tablet.

Consideration of reactivity initiated accidents for TRU recycling in LWRs

Response of a PWR core loaded with Combined Non-Fertile and UO2 (CONFU) fuel assemblies to control rod ejection accident was evaluated. A number of core arrangements and TRU fuel compositions were considered and the results were compared with the performance of a reference all-UO2 core. The comparison was based on the results of a simple point kinetics model with thermal reactivity feedbacks and temperature dependant materials properties. The reactivity coefficients and core average kinetics parameters were obtained from the full core 3D neutronic simulations. The results show that application of the CONFU assembly concept causes only minor deviation of fuel performance characteristics in reactivity initiated accidents. This is a consequence of relatively small loadings of TRU in the CONFU assembly and therefore dominating role of conventional UO2 fuel in the neutronic performance of the core.

Interactive support effects on career agency and occupational engagement among young adults.

The PIC model by Gati and Asher describes three career decision making stages: pre-screening, in-depth exploration, and choice of career options. We consider the role that three different forms of support (general career support by parents, emotional/instrumental support, and informational support) may play for young adults in each of these three decision-making stages. The authors further propose that different forms of support may predict career agency and occupational engagement, which are important career decision precedents. In addition, we consider the role of personality traits and perceptions (decision-making window) on these two outcomes. Using an online survey sample (N = 281), we found that general career support was important for career agency and occupational engagement. However, it was the combination of higher general career support with either emotional/instrumental support or informational support that was found to lead to both greater career agency and higher occupational engagement. Personality also played a role: Greater proactivity also led to greater occupational engagement, even when there was little urgency for participants to make decisions (window of decision-making was wide open and not restricted). In practical terms, the findings suggest that the learning required in each of the three PIC processes (pre-screening, in-depth exploration, choice of career options may benefit when the learner has access to the three support measures.

Urinary naphthalene and phenanthrene as biomarkers of occupational exposure to polycyclic aromatic hydrocarbons.

OBJECTIVES: The study investigated the utility of unmetabolised naphthalene (Nap) and phenanthrene (Phe) in urine as surrogates for exposures to mixtures of polycyclic aromatic hydrocarbons (PAHs). METHODS: The report included workers exposed to diesel exhausts (low PAH exposure level, n = 39) as well as those exposed to emissions from asphalt (medium PAH exposure level, n = 26) and coke ovens (high PAH exposure level, n = 28). Levels of Nap and Phe were measured in urine from each subject using head space-solid phase microextraction and gas chromatography-mass spectrometry. Published levels of airborne Nap, Phe and other PAHs in the coke-producing and aluminium industries were also investigated. RESULTS: In post-shift urine, the highest estimated geometric mean concentrations of Nap and Phe were observed in coke-oven workers (Nap: 2490 ng/l; Phe: 975 ng/l), followed by asphalt workers (Nap: 71.5 ng/l; Phe: 54.3 ng/l), and by diesel-exposed workers (Nap: 17.7 ng/l; Phe: 3.60 ng/l). After subtracting logged background levels of Nap and Phe from the logged post-shift levels of these PAHs in urine, the resulting values (referred to as ln(adjNap) and ln(adjPhe), respectively) were significantly correlated in each group of workers (0.71 < or = Pearson r < or = 0.89), suggesting a common exposure source in each case. Surprisingly, multiple linear regression analysis of ln(adjNap) on ln(adjPhe) showed no significant effect of the source of exposure (coke ovens, asphalt and diesel exhaust) and further suggested that the ratio of urinary Nap/Phe (in natural scale) decreased with increasing exposure levels. These results were corroborated with published data for airborne Nap and Phe in the coke-producing and aluminium industries. The published air measurements also indicated that Nap and Phe levels were proportional to the levels of all combined PAHs in those industries. CONCLUSION: Levels of Nap and Phe in urine reflect airborne exposures to these compounds and are promising surrogates for occupational exposures to PAH mixtures.

Occupational lead neurotoxicity: A behavioural and electrophysiological evaluation. study design and year one results.

To evaluate the effects of chronic lead exposure on the nervous system in adults, a set of neurobehavioural and electrophysiological tests was administered to 99 lead exposed foundry employees and 61 unexposed workers. Current and past blood lead concentrations were used to estimate the degree of lead absorption; all previous blood lead concentrations had been less than or equal to 90 micrograms/100 ml. Characteristic signs (such as wrist extensor weakness) or symptoms (such as colic) of lead poisoning were not seen. Sensory conduction in the sural nerve was not affected. By contrast, various neurobehavioural functions deteriorated with increasing lead burden. Workers with blood lead concentrations between 40 and 60 micrograms/100 ml showed impaired performance on tests of verbal concept formation, visual/motor performance, memory, and mood. Thus impairment in central nervous system function in lead exposed adults occurred in the absence of peripheral nervous system derangement and increased in severity with increasing lead dose.

Occupational lead neurotoxicity: Improvement in behavioural effects after reduction of exposure.

To evaluate critical exposure levels and the reversibility of lead neurotoxicity a group of lead exposed foundry workers and an unexposed reference population were followed up for three years. During this period, tests designed to monitor neurobehavioural function and lead dose were administered. Evaluations of 160 workers during the first year showed dose dependent decrements in mood, visual/motor performance, memory, and verbal concept formation. Subsequently, an improvement in the hygienic conditions at the plant resulted in striking reductions in blood lead concentrations over the following two years. Attendant improvement in indices of tension (20% reduction), anger (18%), depression (26%), fatigue (27%), and confusion (13%) was observed. Performance on neurobehavioural testing generally correlated best with integrated dose estimates derived from blood lead concentrations measured periodically over the study period; zinc protoporphyrin levels were less well correlated with function. This investigation confirms the importance of compliance with workplace standards designed to lower exposures to ensure that individual blood lead concentrations remain below 50 micrograms/dl.

The meaning of environmental control systems (ECS) for people with spinal cord injury: An occupational therapist explores an intervention

Environmental Control Systems (ECS), enable people with high cervical Spinal Cord Injury (high SCI) to control and access everyday electronic devices. In Ireland, however, access for those who might benefit from ECS is limited. This study used a qualitative approach to explore the insider experience of an ECS starter-pack developed by the author, an occupational therapist. The primary research questions: what is it really like to live with ECS, and what does it mean to live with ECS, were explored using a phenomenological methodology conducted in three phases. In Phase 1 fifteen people with high SCI met twice in four focus groups to discuss experiences and expectations of ECS. Thematic analysis (Krueger & Casey, 2000), influenced by the psychological phenomenological approach (Creswell, 1998), yielded three categories of rich, practical, phenomenological findings: ECS Usage and utility; ECS Expectations and The meaning of living with ECS. Phase 1 findings informed Phase 2 which consisted of the development of a generic electronic assistive technology pack (GrEAT) that included commercially available constituents as well as short instructional videos and an information booklet. This second phase culminated in a one-person, three-week pilot trial. Phase 3 involved a six person, 8-week trial of the GrEAT, followed by individual in-depth interviews. Interpretative Phenomenological Analysis IPA (Smith, Larkin & Flowers, 2009), aided by computer software ATLAS.ti and iMindmap, guided data analysis and identification of themes. Getting used to ECS, experienced as both a hassle and engaging, resulted in participants being able to Take back a little of what you have lost, which involved both feeling enabled and reclaiming a little doing. The findings of this study provide substantial insights into what it is like to live with ECS and the meanings attributed to that experience. Several practical, real world implications are discussed.

Mainstream technology as an occupational therapy tool: technophobe or technogeek?

Occupational therapists need to embrace the use of mainstream technology in their quest to ensure that therapy remains current and meaningful to their clients. Technology can be useful to improve both functional independence and occupational performance. This opinion piece introduces how occupational therapists can apply mainstream technologies, including information and communication technologies such as the internet, computer software, portable devices and computer games, in their everyday interventions.

Irish occupational therapists' views of electronic assistive technology

Introduction: Electronic assistive technology (EAT) includes computers, environmental control systems and information technology systems and is widely considered to be an important part of present-day life. Method: Fifty-six Irish community occupational therapists completed a questionnaire on EAT. All surveyed were able to identify the benefits of EAT. Results: While respondents reported that they should be able to assess for and prescribe EATs, only a third (19) were able to do so, and half (28) had not been able to do so in the past. Community occupational therapists identified themselves as havinga role in a multidisciplinary team to assess for and prescribe EAT. Conclusion: Results suggest that it is important for occupational therapists to have up-to-date knowledge and training in assistive and computer technologies in order to respond to the occupational needs of clients.

Health of the older worker in Ireland - occupational physical and psychosocial factors in the autumn of work life

Introduction: Worldwide, governments are striving to keep people in work to an older age. However, little is known about the effects of work on an older workforce. This thesis aims to investigate the importance of job characteristics to the antecedents and evolution of cardiovascular disease and functional limitations for the older worker (50+ years). Methods: Three studies were used in this thesis. The 5C (Cork Coronary Care Case- Control) Study investigated the association between job strain and a coronary event in males (n=208) 35-74 years old. The Mitchelstown Study examined the association between job characteristics and positive lifestyle behaviours and further, job characteristics and blood pressure for males and females 50-69 years (n=2,047). Finally, the Cork & Kerry Study investigated the physical effects of manual work and reported functional limitations/disabilities in a sample of 60-80 year olds (n=362). Results: Results from the 5C Study show a clear difference between younger (<50 years) and older (≥50 years) workers, with older workers who had a coronary event more likely to have high job strain and low job control. Data from the Mitchelstown Study showed workers with intermediate possibility for development or high quantitative demands (versus low) at work significantly more likely to have co-occurrence of positive lifestyle behaviours. Further, those who had high possibility for development were more likely to have high systolic blood pressure with no indication of recovery from this activation at night. Physically demanding work as reported by the participants of the Cork & Kerry Study was associated with functional limitations and activities of daily living disability for both the paid and unpaid worker. Discussion: The findings from this piece of work highlight the necessity to examine job characteristics and health outcomes in isolation for the over fifties. The challenge is to get this information into the workplace.

Computer modelling of human behaviour in aircraft fire accidents

The mathematical simulation of the evacuation process has a wide and largely untapped scope of application within the aircraft industry. The function of the mathematical model is to provide insight into complex behaviour by allowing designers, legislators, and investigators to ask ‘what if’ questions. Such a model, EXODUS, is currently under development, and this paper describes its evolution and potential applications. EXODUS is an egress model designed to simulate the evacuation of large numbers of individuals from an enclosure, such as an aircraft. The model tracks the trajectory of each individual as they make their way out of the enclosure or are overcome by fire hazards, such as heat and toxic gases. The software is expert system-based, the progressive motion and behaviour of each individual being determined by a set of heuristics or rules. EXODUS comprises five core interacting components: (i) the Movement Submodel — controls the physical movement of individual passengers from their current position to the most suitable neighbouring location; (ii) the Behaviour Submodel — determines an individual's response to the current prevailing situation; (iii) the Passenger Submodel — describes an individual as a collection of 22 defining attributes and variables; (iv) the Hazard Submodel — controls the atmospheric and physical environment; and (v) the Toxicity Submodel — determines the effects on an individual exposed to the fire products, heat, and narcotic gases through the Fractional Effective Dose calculations. These components are briefly described and their capabilities and limitations are demonstrated through comparison with experimental data and several hypothetical evacuation scenarios.

The AASK database V4.0: aircraft accident statistics and knowledge. A database to record human experience of evacuation in aviation accidents

This paper describes the AASK database. The AASK database is unique as it is a record of human behaviour during survivable aviation accidents. The AASK database is compiled from interview data compiled by agencies such as the NTSB and the AAIB. The database can be found on the website http://fseg.gre.ac.uk

Aircraft accident statistics and knowledge database: analyzing passenger behavior in aviation accidents

The Aircraft Accident Statistics and Knowledge (AASK) database is a repository of passenger accounts from survivable aviation accidents/incidents compiled from interview data collected by agencies such as the US NTSB. Its main purpose is to store observational and anecdotal data from the actual interviews of the occupants involved in aircraft accidents. The database has wide application to aviation safety analysis, being a source of factual data regarding the evacuation process. It also plays a significant role in the development of the airEXODUS aircraft evacuation model, where insight into how people actually behave during evacuation from survivable aircraft crashes is required. This paper describes the latest version of the database (Version 4.0) and includes some analysis of passenger behavior during actual accidents/incidents.