Human system interface design in industrial process control is guided by industry standards, human factors best practices, and domain-specific conventions, and often there is a conflict between one or more of the sources of design input for specific design elements. In the nuclear domain, one design element for which conflict arises is the use of color to represent equipment state. This study evaluates the tradeoffs associated with using color in a process control display versus using white and shades of gray. The performance metrics were response time, accuracy, and eye movement metrics using a simplified experimental task and professional operators. Results revealed that adhering to color conventions in nuclear power yielded small advantages in simple tasks, but did not exist for more complex tasks. The results did not provide strong evidence for or against using a particular color scheme and revealed the need for further research on the use of color for commercial nuclear power plants and other process control industries.

We examined fatigue among emergency department (ED) clinicians. ED clinicians are susceptible to burnout, because of fatigue. Fatigue represents a latent hazard in ED care, being associated with impaired clinician performance, poor patient outcomes, and a negative impact on patient safety. Thirty-five pediatric clinicians were surveyed at the beginning and end of their shifts. The 20-item Swedish Occupational Fatigue Inventory survey was used to evaluate fatigue. Paired t-tests were used to examine whether fatigue scores changed over the course of a shift. The associations between the five fatigue subscales and various factors were modeled with multilevel linear regressions. Surveys (N = 827) were administered over 425 shifts. Clinician fatigue depended on time spent within the shift, shift type, clinician's gender, age, and clinician's role. Analysis showed other individual characteristics and shift factors also may affect fatigue. Clinicians with varying fatigue levels have different needs that should be considered in information technology design and evaluation.

Spatial Disorientation (SD) can cause critical aviation accidents by adversely affecting the pilot's ability to perform a flight mission. One of the strategies to improve pilots' ability to deal with SD is to perform SD training using Virtual Reality and Motion Simulator (VRMS) system. However, there is still a lack of studies that investigated the application of VRMS for SD training. Thus, the purpose of this study is to develop and validate VRMS-based SD scenarios. Twenty-two male Air Force fighter pilots (11 in the low experienced group and 11 in the high experienced group) participated in a controlled experiment in which they performed the flight task under two conditions (SD flight, non-SD flight), wherein the SD flight condition included the induction of four distinct SD illusions. Findings showed that the developed SD scenarios in the VRMS system effectively induce SD. More specifically, there were differences in the influence of flight experience and SD condition on pilots' flight performance and workload. This study suggests that the VRMS system can demonstrate several types of SD scenarios effectively and has a huge potential to be utilized as an SD training tool to improve overall flight safety.

In-vehicle Head-Up Displays (HUDs) are expected to incorporate more information in the future, necessitating deeper understandings of design properties that can enhance display safety and efficiency. However, the optimal display characteristics-particularly in terms of area and shape-remain inadequately understood. This study investigated these two factors by manipulating horizontal and vertical Field of View (FOV) angles within a simulated in-vehicle HUD. Thirty-one participants participated in this laboratory-based study they completed a digit matching task while driving within a driving simulator. The accuracy and response time of the task served as indicators for efficiency. The standard deviation of lateral position (SDLP) was employed to assess area and shape's impacts on driving performance, alongside subjective ease-of-use evaluations. Results indicated that an increase in horizontal FOV angle significantly delay response times and reduce ease-of-use ratings. We also observed significant effects of area and shape on response time and ratings; specifically, participants responded faster in smaller display area conditions, which were also rated as the easiest to use. Accuracy, however, was largely unaffected by size and shape. Importantly, most manipulations did not interfere with driving performance, except for the area 500 condition, wherein landscape shape was associated with better lane-keeping performance. Our findings provide valuable insights for the design of in-vehicle HUDs.

Emergency departments accommodate high-acuity patients in complex, high risk environments with high variability in patient flow and resource availability. Strategies for enabling adaptive capacity are necessary for adjusting activities in response to the variability of overall workload and individual patient acuity. This study aims to identify and describe the strategies used by lead-nurses to inform recommendations for training and education. 14 lead-nurses participated in focus group discussions using a table-top sandbox simulation to trigger for reflection on decisions, trade-offs and strategies for handling difficult situations during everyday work. The sandbox simulation was intended to focus the discussions on situation assessment, problem-solving strategies and cognitive challenges. The simulation and following discussions were audio- and video recorded and analysed with reflexive thematic analysis. The results illustrate how lead-nurses work towards maintaining an equilibrium between monitoring and coordinating efforts. This result underlines the complex continuous process of adjusting work and resources to situational conditions and demands. The lead-nurse's work is about balancing strategies for monitoring the ED and coordinating care. This balance is important for solving problems here and now while minimising the effects of shifting problems between parts of the ED system or to later points in time. This should be explored further with the question of what strategies that could be standardised versus which should remain adaptive before designing training regimes for adaptive strategies.

The need to train non-technical skills (NTS) has seen a growing emphasis in recent literature, as they have been associated with improved patient outcomes. NTS training often utilizes live simulations where healthcare workers can practice these skills, but simulations like this can be expensive and resource intensive to run. Training technical skills using extended reality tools (e.g., virtual, augmented, or mixed reality) has seen a growth in popularity across healthcare domains, however, the use of XR to train specific interpersonal and cognitive skills comprises a smaller part of the literature. As such, this study aims to scope the literature to identify how NTS have been trained through XR-based systems. The specific aims were to identify: 1) which NTS are being trained in healthcare, 2) which modality of XR these skills are being trained in, 3) what specialties are using XR to train NTS in healthcare, and 4) potential areas for future work. Based on consistent search terms for each database, 18,984 articles were initially retrieved, and articles were removed per the screening criteria. Results from the 15 included articles show that the most common NTS construct evaluated was communication (80%), the most common XR modality was virtual reality (80%), and the most common healthcare domain was surgery (46.7%). These articles found that training NTS in XR can lead to comparable, or better, learning outcomes compared to traditional methods. However, future work may look to consider additional NTS in training, improve interaction with XR environments, and measure NTS with XR technology.

Managing multiple tasks simultaneously often results in performance decrements due to limited cognitive resources. Task prioritization, requiring effective cognitive control, is a strategy to mitigate these effects and is influenced by the stability-flexibility dilemma. While previous studies have investigated the stability-flexibility dilemma in fully manual multitasking environments, this study explores how cognitive control modes interact with automation reliability. While no significant interaction between control mode and automation reliability was observed in single multitasking performance, our findings demonstrate that overall task performance benefits from a flexible cognitive control mode when automation is reliable. However, when automation is unreliable, a stable cognitive control mode improves manual takeover performance, though this comes at the expense of secondary task performance. Furthermore, cognitive control modes and automation reliability independently affect various eye-tracking metrics and mental workload. These findings underscore the need to integrate cognitive control and automation reliability into adaptive assistance systems, particularly during the perceive stage, to enhance safety in human-machine systems.

Remotely Piloted Aircraft Systems (RPAS) are a rapidly expanding technology that operates within the larger complex aviation system. As a result, protective frameworks and risk controls for supporting safe operation are still developing. Adverse events are occurring, yet it is unclear what systemic factors interact to create them. To identify vulnerabilities in the broader Australian RPAS network, this study used AcciMap to analyse a set of adverse RPAS events investigated by the Australian Transport Safety Bureau. Investigation reports into RPAS incidents in Australia (n = 14) were identified and analysed in-depth with AcciMap; individual AcciMaps were constructed for each adverse event. The data was then aggregated to create a network of contributory factors across the RPAS network in Australia. The findings revealed 232 individual contributory factors across five of the six AcciMap levels. The contributory factors were then coded using a pre-existing classification scheme to identify 31 contributory factor themes. The highest proportion of contributory factors were at the lower operational and equipment levels of the system; these factors included Equipment, technology and resources; Activity, work and operations; and Compliance with procedures, violations and unsafe acts. According to systems theory and previous analyses using AcciMap, we would expect to find organisational, regulatory and government contributory factors, yet such factors were limited in this sample. Further research is required to explore the factors across the entire sociotechnical system that contribute to adverse RPAS events.

Home care workers are affected by musculoskeletal disorders caused by biomechanical factors. This study investigated the effect of three exoskeletons devices (HAPO, HAPO FRONT and Japet.W) during load mobilization tasks at three bed heights in order to reduce physical risk factor. Anterior deltoid and longissimus bilateral muscular activities were recorded by EMG, a force platform was used to record center of pressure (CoP) displacement, and perceived exertion parameters were assessed using the Borg scale while nineteen healthy subjects performed a load manipulation. The use of the HAPO FRONT decreased global muscular activity by 5,6% and deltoid activity by 10,7%, exoskeletons reduced perceived effort, from 42% to 25%. Bed height has an inverse effect on deltoid and longissimus activity. These findings show that exoskeletons can reduce perceived effort and for overall and deltoids muscular activity. Therefore, the combination of shoulder and low back assistance appears as an interesting line of thought.

Cockpit automation has brought significant benefits in terms of mental workload and fatigue. However, the way primary flight instruments are monitored by pilots may be negatively affected by the high confidence in systems. We examined the effects of automation level on mental workload, manual flight performance and visual strategies. Twenty professional pilots performed six landing scenarios at three levels of automation depending on flight director (flight path guidance) and autothrust (automatic management of the speed) engagements. Higher levels of automation increased flight performance and reduced mental workload, but were associated with a decrease in vigilance to primary instruments, particularly flight path indicators and engines' thrust. We also found that gaze entropy was sensitive to pilot role (pilot flying vs pilot monitoring) and automation level. These results confirmed the risks of adverse effects of automation on visual monitoring. Designing procedures for pilots to actively monitor automated cockpit systems should be encouraged.

Fall injuries resulting from trips are a major health concern. Virtual reality (VR) offers an effective way of training obstacle avoidance while walking due to its ability to provide safe and meaningful real-time feedback during rehabilitation. This proof-of-concept study examined the benefit of providing physical feedback during obstacle avoidance gait training using VR.

This study investigated the user affective (Kansei) evaluation of foldable smartphone creases. Twenty-five participants assessed twenty foldable smartphone display prototypes with various multi-crease patterns, for four affective dimensions (crease invisibility, flawlessness, luxuriousness and harmoniousness) using an 11-point rating scale, and, for overall goodness using a 7-point adjective-anchored scale. The adjectives for overall goodness evaluation represented different crease grade categories. Principal component analysis identified a composite measure, termed Affective Quality Score (AQS), which integrates the four affective dimensions. A regression model was developed to predict AQS based on physical features of a multi-crease pattern. Also, a crease grading system was established that determines the adjective grade category of a multi-crease pattern using its AQS. The regression model along with the crease grading system enables predicting and grading the affective quality of a given multi-crease pattern. The research outcomes would support design goal setting and continuous quality improvement for foldable smartphone products.

Ectopic pregnancies are uncommon among women presenting for abortion. However, where suspected, rapid referral for definitive diagnosis is essential to prevent harm. We assessed whether implementation of a standardised decision-making tool, an algorithmic representation of the clinical decisions and associated actions defined in policy, in a British abortion service was associated with a reduction in missed opportunities to escalate care where indicated. We compared two cohorts: pre-implementation 01/03/2018-28/02/2019 (n = 2191) and post-implementation 01/08/2019-29/02/2020 (n = 1837). Implementation was associated with improved management: Escalation post-implementation was significantly higher in cases with uncertain menstrual dating (12.8% vs 8.9%), gestation by last menstrual period over 5 weeks (86.9% vs. 23.0%), prior tubal surgery (0.9% vs. 0.3%), and pain (54.1% vs. 44.5%). Missed escalation of care was lower post-intervention than pre-intervention (0.33 % vs. 1.14%, respectively, p = 0.004). Escalation resulting in an ectopic pregnancy diagnosis occurred more often post-implementation [n = 129 (7.0%)] than pre-implementation [n = 116 (5.3%)], p = 0.03.

The aim of this review was to identify, collect, appraise, and synthesise research profiling paramedic job tasks, injuries sustained, and current fitness levels, to guide optimal workplace performance and enhance injury mitigation efforts.

Order picking tasks require repetitive trunk and upper arms movements that may increase the risk of developing musculoskeletal disorders, particularly among older workers due to the decline of their physical capabilities with aging. We proposed an approach based on a limited number of wearable inertial sensors to assessed exposures to non-neutral trunk and upper arms postures among both older and young workers during their regular work-shifts. The obtained data were processed accordingly to international standards (ISO 11226 and EN 1005-4) to detect the existence of possible differences associated with age-specific working strategies. While the results indicate similar trunk and upper arms movement frequencies in both groups, older workers spend a significantly smaller percentage of time in the most demanding (>60°) postures for both districts. Such findings suggest the adoption of specific strategies to reduce the biomechanical risk which might be originated by a combination of awareness of physical limits and superior working experience. In this context, the instrumental monitoring of upper body in the logistic sector may result useful to highlight critical conditions potentially able to promote the onset of musculoskeletal disorders, thus supporting the decision processes pertaining to workers' health management and aging worker retainment.

The performance of machine learning (ML) algorithms is dependent on which dataset it has been trained on. While ML algorithms are increasingly used for lift risk assessment, many algorithms are often trained and tested on controlled simulation datasets, lacking the diversity of the lifting conditions. Consequently, concerns arise regarding their applicability in real-world scenarios characterized by substantial variations in lifting scenarios and postures. Our study investigates the impact of different lifting scenarios on the performance of ML algorithms trained on surface electromyography (sEMG) armband sensor data to classify hand-load levels (2.3 and 6.8 kg). Twelve healthy participants (6 male and 6 female) performed repetitive lifting tasks employing various lifting scenarios, including symmetric (S), asymmetric (A), and free-dynamic (F) techniques. Separate algorithms were developed using diverse training datasets (S, A, S+A, and F), ML classifiers, and sEMG features, and tested using the F dataset, representing unconstrained and naturalistic lifts. The mean accuracy and sensitivity were significantly lower in models trained on constrained (S) datasets compared to those trained on naturalistic lifts (F). The accuracy, precision, and sensitivity of models trained with frequency-domain sEMG features were greater than those trained with the time-domain features. In conclusion, ML algorithms trained on controlled symmetric lifts showed poor performance in predicting loads for dynamic, unconstrained lifts; thus, particular attention is needed when using such algorithms in real-world scenarios.

Road traffic is largely defined by clear rules and laws. However, there are certain situations that are ambiguous and in which explicit communication between road users is needed to resolve such misjudgements or ambiguities. Especially hand gestures can be used to coordinate traffic by conveying different intentions, which refer to one's own behaviour or the change in the behaviour of others. This paper aims to identify such gestures focusing on the pedestrian-driver communication. The paper follows two approaches: Firstly, an experimental study (N = 20) was conducted analysing gestures in predetermined scenarios in a virtual and real environment. Secondly, traffic observations were conducted to analyse and compare natural occurring gestures with those identified in the study. As a result, 18 relevant pedestrian gestures were identified. The type of gestures and the expressiveness of the execution did not differ between the virtual or real study environment. From this, it can be concluded that the virtual environment is an appropriate study environment for identifying and analysing gestures. Furthermore, the type of gestures did not differ between the experimental study and the traffic observations, but the naturally occurring gestures were executed less expressively compared to those from the study. Finally, the paper presents a suitable approach on how pedestrian gestures can be studied and provides a foundation for further research on the communication between pedestrians and automated vehicles (AVs).

Manufacturing companies constantly seek opportunities to improve operational efficiency without compromising employee well-being. Ergonomics can contribute to both goals, but its role is often limited to well-being. This longitudinal corporate case study followed retrospectively the effects of work development for five years in a manufacturing company's assembly line and welding unit. The aim was to analyse how these development activities impacted employee well-being and productivity. In the assembly line, ergonomics-oriented development processes led to a profit of EUR 1,130,810 and a reduced physical workload. In contrast, the welding unit implemented only two development activities, resulting in a smaller profit of EUR 278,721, with no noticeable decrease in physical workload. This study suggests that continuous activity in production development utilising ergonomics data collected from the work leads to sustainable productivity and improvements in employee well-being.

Grocery warehouse workers continue to experience high rates of musculoskeletal disorders largely due to the repetitive lifting performed during the product selection and palletizing process. This project aimed to describe ergonomics practices that have been implemented within grocery distribution centers in the United States that could help reduce musculoskeletal disorders. Ninety-seven management personnel from 30 distribution centers were interviewed regarding ergonomics practices in place within their respective facilities. Through this process 44 ergonomics practices were identified. Thirteen practices address how the facility is set up. Two practices focused on options within the warehouse's computer management system. Six practices targeted order selector tools. Seven practices focused on things that can be done in full-case pick operations. Eight organizational practices were identified that could facilitate ergonomics efforts. And finally, eight practices focused on reducing exposures to ergonomic hazards in piece-pick operations. For each identified practice implementation data were obtained.

Patient ergonomics advances understanding of patient work to support individuals in managing health and health care, which can be expanded to include health research. While health research enables improvements in care delivery and health outcomes, participant recruitment, enrollment, and retention challenges hamper effective research participation, impede success of research studies, and influence the validity and generalizability of findings. Recent trends in health research create new opportunities to engage patients in research but require careful attention to patient ergonomics and human factors considerations to ensure they successfully address participant needs and contexts. This article describes the research participation process and related patient ergonomics considerations, summarizes patient ergonomic factors identified in the literature that influence participation, discusses how patient ergonomics can be expanded to understand and address challenges to health research participation using two exemplar research programs, and identifies opportunities to include health research participation as part of patient ergonomics.