Recommendations from the Brazilian Society of Anesthesiology (SBA) for difficult airway management in adults.

Difficult airway management represents a major challenge, requiring a careful approach, advanced technical expertise, and accurate protocols. The task force of the Brazilian Society of Anesthesiology (SBA) presents a report with updated recommendations for the management of difficult airway in adults. These recommendations were developed based on the consensus of a group of expert anesthesiologists, aiming to provide strategies for managing difficulties during tracheal intubation. They are based on evidence published in international guidelines and opinions of experts. The report underlines the essential steps for proper difficult airway management, encompassing assessment, preparation, positioning, pre-oxygenation, minimizing trauma, and maintaining arterial oxygenation. Additional strategies for using advanced tools, such as video laryngoscopy, flexible bronchoscopy, and supraglottic devices, are discussed. The report considers recent advances in understanding crisis management, and the implementation seeks to further patient safety and improve clinical outcomes. The recommendations are outlined to be uncomplicated and easy to implement. The report underscores the importance of ongoing education, training in realistic simulations, and familiarity with the latest technologies available.

Recommendations from the Brazilian Society of Anesthesiology (SBA) for difficult airway management in adults

Abstract Difficult airway management represents a major challenge, requiring a careful approach, advanced technical expertise, and accurate protocols. The task force of the Brazilian Society of Anesthesiology (SBA) presents a report with updated recommendations for the management of difficult airway in adults. These recommendations were developed based on the consensus of a group of expert anesthesiologists, aiming to provide strategies for managing difficulties during tracheal intubation. They are based on evidence published in international guidelines and opinions of experts. The report underlines the essential steps for proper difficult airway management, encompassing assessment, preparation, positioning, pre-oxygenation, minimizing trauma, and maintaining arterial oxygenation. Additional strategies for using advanced tools, such as video laryngoscopy, flexible bronchoscopy, and supraglottic devices, are discussed. The report considers recent advances in understanding crisis management, and the implementation seeks to further patient safety and improve clinical outcomes. The recommendations are outlined to be uncomplicated and easy to implement. The report underscores the importance of ongoing education, training in realistic simulations, and familiarity with the latest technologies available.

Impacts of the COVID-19 Pandemic on Pedestrian Push-Button Utilization and Pedestrian Volume Model Accuracy in Utah.

This work investigated the impacts of COVID-19 on pedestrian behavior, answering two research questions using pedestrian push-button data from Utah traffic signals: How did push-button utilization change during the early pandemic, owing to concerns over disease spread through high-touch surfaces? How did the accuracy of pedestrian volume estimation models (developed pre-COVID based on push-button traffic signal data) change during the early pandemic? To answer these questions, we first recorded videos, counted pedestrians, and collected push-button data from traffic signal controllers at 11 intersections in Utah in 2019 and 2020. We then compared changes in push-button presses per pedestrian (to measure utilization), as well as model prediction errors (to measure accuracy), between the two years. Our first hypothesis of decreased push-button utilization was partially supported. The changes in utilization at most (seven) signals were not statistically significant; yet, the aggregate results (using 10 of 11 signals) saw a decrease from 2.1 to 1.5 presses per person. Our second hypothesis of no degradation of model accuracy was supported. There was no statistically significant change in accuracy when aggregating across nine signals, and the models were actually more accurate in 2020 for the other two signals. Overall, we concluded that COVID-19 did not significantly deter people from using push-buttons at most signals in Utah, and that the pedestrian volume estimation methods developed in 2019 probably do not need to be recalibrated to work for COVID conditions. This information may be useful for public health actions, signal operations, and pedestrian planning.

Augmented reality for training formation flights: An analysis of human factors.

Pilot training has been, for decades, aided by flight simulators with different characteristics and degrees of fidelity. However, many studies indicate that, despite the recognized contribution of simulator training, actual flying practice is still necessary, depending on the trained task. This work introduces the proposal of using augmented reality for in-flight training, where elements in the environment outside the aircraft are displayed through an augmented reality headset to create a simulation scenario. The training of basic formation flight is used as an example, as it requires flying with at least two aircraft, resulting in high operational costs and risk of collision between aircraft. In this case, the augmented reality system replaces the real leader aircraft with a projection. In order to evaluate the Technology Readiness Level (TRL) of this proposal, this work presents a prototype of an augmented reality system integrated into a flight simulator to conduct an evaluation campaign. We investigate how the introduction of the augmented reality system impacts on human factors, such as stress and workload, as well as performance. Although the results obtained in a simulated environment are not equivalent to those from an in-flight campaign, the experimental campaign performed in the flight simulator provides a way of evaluating the impact on the pilot of some aspects of the proposed solution, such as the performance of occlusion routines and some ergonomic aspects of the augmented reality headset.

Climate and socioeconomic drivers of biomass burning and carbon emissions from fires in tropical dry forests: A Pantropical analysis.

Global burned area has declined by nearly one quarter between 1998 and 2015. Drylands contain a large proportion of these global fires but there are important differences within the drylands, for example, savannas and tropical dry forests (TDF). Savannas, a biome fire-prone and fire-adapted, have reduced the burned area, while the fire in the TDF is one of the most critical factors impacting biodiversity and carbon emissions. Moreover, under climate change scenarios TDF is expected to increase its current extent and raise the risk of fires. Despite regional and global scale effects, and the influence of this ecosystem on the global carbon cycle, little effort has been dedicated to studying the influence of climate (seasonality and extreme events) and socioeconomic conditions of fire regimen in TDF. Here we use the Global Fire Emissions Database and, climate and socioeconomic metrics to better understand long-term factors explaining the variation in burned area and biomass in TDF at Pantropical scale. On average, fires affected 1.4% of the total TDF' area (60,208 km2 ) and burned 24.4% (259.6 Tg) of the global burned biomass annually at Pantropical scales. Climate modulators largely influence local and regional fire regimes. Inter-annual variation in fire regime is shaped by El Niño and La Niña. During the El Niño and the forthcoming year of La Niña, there is an increment in extension (35.2% and 10.3%) and carbon emissions (42.9% and 10.6%). Socioeconomic indicators such as land-management and population were modulators of the size of both, burned area and carbon emissions. Moreover, fires may reduce the capability to reach the target of "half protected species" in the globe, that is, high-severity fires are recorded in ecoregions classified as nature could reach half protected. These observations may contribute to improving fire-management.

El área global quemada se redujo en casi una cuarta parte entre 1998 y 2015. Los bosques secos contienen una gran proporción de esos incendios globales, pero existen diferencias importantes dentro de ellos, por ejemplo, las sabanas y los bosques secos tropicales (SBC). Las sabanas, son un bioma propenso y adaptado al fuego, y que en los últimos años han reducido su área quemada. Mientras que el fuego en la SBC es uno de los factores más críticos que impactan la biodiversidad y las emisiones de carbono. Además, bajo escenarios de cambio climático, se espera que la SBC aumente su extensión actual y aumente el riesgo de incendios. A pesar de los efectos a escala regional y global, y la influencia de este ecosistema en el ciclo global del carbono, se le ha dedicado poco esfuerzo a estudiar la influencia del clima (estacionalidad y eventos extremos) y las condiciones socioeconómicas del régimen de incendios. Aquí usamos la base de datos global de emisiones de incendios y métricas climáticas y socioeconómicas para comprender mejor los factores a largo plazo que explican la variación en el área quemada y la biomasa a escala Pantropical. En promedio, los incendios afectaron el 1,4% del área total de la SBC (60 208 km2 ) y quemaron el 24,4% (259,6 Tg) de la biomasa global quemada anualmente a escala Pantropical. Los moduladores climáticos influyen en gran medida en los regímenes de incendios locales y regionales. La variación interanual del régimen de incendios está determinada por El Niño y La Niña. Durante El Niño y el año subsecuente de La Niña, se produce un incremento en la extensión (35,2% y 10,3%) y en las emisiones de carbono (42,9% y 10,6%). Los indicadores socioeconómicos como la gestión de la tierra y la población fueron moduladores del tamaño tanto del área quemada como de las emisiones de carbono. Además, los incendios pueden reducir la capacidad de alcanzar el objetivo de "protección de la mitad de las especies" en el mundo, es decir, los incendios de alta gravedad se registran en ecorregiones clasificadas como naturaleza que podría alcanzar la protección de la mitad de su biodiversidad. Estas observaciones pueden contribuir a mejorar la gestión de incendios.

Contribution of ergonomics and human factors to sustainable development: a systematic literature review.

Although a significant amount of research has already been published, the field of ergonomics/human factors and sustainability (E/HF-S) has not yet been systematically profiled based on recent studies. Conducting a systematic review of the literature, this article aims: (i) to identify the main emergent research themes in this subject area and (ii) to provide future directions for applied research and practice on E/HF-S. Six emergent research themes were identified in this literature allowing for a proposal to synthesise the main concepts related to E/HF-S. However, it was noted that there are still relatively few empirical papers which assess the models being developed or that apply E/HF principles to sustainability challenges. Thus, this paper identifies the opportunities for practical application related to E/HF-S. The last part of the paper explores the E/HF-S opportunities using an external framework; the United Nations' sustainable development goals.Practitioner summary: The field of ergonomics/human factors and sustainability (E/HF-S) has not yet been organised by recent studies. Conducting a systematic review of the literature, this article identifies the main emergent research themes in this subject area, and it provides future direction for applied research and practice on E/HF-S.Abbreviations: ACE: activity-centred ergonomics; E/HF: ergonomics/human factors; E/HFS: ergonomics/human factors and sustainability; IEA: International Ergonomics Association; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; SDG: Sustainable Development Goal.

A detailed alarm management report as a tool for the treatment of bad actors at a gas logistics plant.

BACKGROUND: The treatment of bad actors consists of analyzing the most triggered alarms at a plant, seeking to make modifications that provide workers with more efficient and safer operational conditions. The consideration of plant operators' practical knowledge in these proposed changes is both an opportunity and a challenge, as specific conditions are required. OBJECTIVE: To present and discuss how an alarm management report (AMR) could support the treatment of bad actors by promoting structured debates on real work situations and its contribution in improving the solutions proposed by alarm management committees (AMCs). METHODS: Data from nine AMC meetings were gathered and parsed using qualitative content analysis to classify the kind of information that the AMC used to justify the proposed changes and how these changes were decided. RESULTS: More than 60% of the changes were justified by information provided by the AMRs, indicating broad application and adoption. However, our findings suggest that the structured debates addressed variability and emerging strategies and may consider entire subsystems instead of single alarms. CONCLUSION: The use of structured debates is feasible for the treatment of bad actors and is an appropriate option that includes operating experience feedback for alarm optimization in industrial facilities.

Procedimiento para el análisis y la prevención de errores de medicación usando el enfoque de la ergonomía

Los errores de medicación representan un problema de salud pública que afecta la seguridad del paciente y la calidad de los servicios de salud a escala global. En este artículo se presenta un procedimiento para el análisis y la prevención de los errores de medicación desde la perspectiva de la ergonomía, ejemplificándose su aplicación mediante un caso de estudio ilustrativo de administración de un medicamento inyectable. Como parte del procedimiento expuesto, se incluyeron los reconocidos métodos Hierarchical Task Analysis (HTA) para el análisis de la tarea y Systematic Human Error Reduction and Prediction Approach (SHERPA) para la identificación de los modos de error. Para la valoración de riegos se empleó la matriz de riesgos propuesta en la norma ISO 45001. El procedimiento propuesto quedó conformado por cuatro etapas: 1) selección de la tarea objeto de estudio, 2) análisis detallado de la tarea, 3) predicción de la posibilidad de error y 4) desarrollo de estrategias para la reducción del error. Se espera que la utilización sistemática de este procedimiento contribuya en la mejora de la calidad de los servicios de salud, disminuyendo los errores humanos y los posibles eventos adversos.

Medication errors represent a public health problem that affects patient safety and the quality of healthcare services globally. This article presents a procedure for the analysis and prevention of medication errors from the perspective of ergonomics, exemplifying its application through a case study. The well-known Hierarchical Task Analysis (HTA) and the Systematic Human Error Reduction and Prediction Approach (SHERPA) methods are included. The risk assessment was based on the risk matrix proposed in the ISO 45001 standard. The proposed procedure is structured in four stages: 1) selection of the task to be analysed, 2) detailed analysis of the task, 3) prediction of the possibility of error, 4) error reduction strategies. The use of the procedure is exemplified through a case study of the administration of an injectable drug. The systematic use of this procedure is expected to contribute to the improvement of the quality of health services by reducing human errors and possible adverse events.

Os erros de medicação representam um problema de saúde pública que afeta a segurança do paciente e a qualidade dos serviços de saúde em escala global. Este artigo apresenta um procedimento para a análise e prevenção de erros de medicação do ponto de vista ergonômico, exemplificado por um estudo de caso. Foram incluídos os métodos reconhecidos de Análise Hierárquica de Tarefas (HTA) para análise de tarefas e a Abordagem Sistemática de Redução e Previsão de Erros Humanos (SHERPA) para identificação de modos de erro. A avaliação do risco baseou-se na matriz de risco proposta na norma ISO 45001. O procedimento proposto é composto de quatro etapas: 1) seleção da tarefa em estudo, 2) análise detalhada da tarefa, 3) previsão da possibilidade de erro, 4) estratégias de redução de erros. A aplicação do procedimento é ilustrada por um estudo de caso de administração de um medicamento injetável. Espera-se que o uso sistemático deste procedimento contribua para a melhoria da qualidade dos serviços de saúde, reduzindo erros humanos e possíveis eventos adversos.

Un modelo para la evaluación de las habilidades no técnicas en anestesiología: una revisión de la literatura / A model for the assessment of non-technical skills in anesthesiology: a literature review

Resumen: Hasta 80% de los errores médicos se deben a fallas en factores humanos (mala comunicación, monitoreo inadecuado, fallas de verificación, etc.), por lo que el entrenamiento de los anestesiólogos exige el desarrollo de habilidades no técnicas en anestesiología. Las habilidades no técnicas son las habilidades cognitivas, sociales y personales que complementan las habilidades técnicas, y que contribuyen al desempeño seguro y eficiente de la tarea. En 2004 la Universidad de Aberdeen fue la primera en plantear un modelo para la definición y evaluación de estas habilidades en el ámbito médico. El modelo práctico consta de 15 elementos incluidos en cuatro categorías: manejo de la tarea, trabajo en equipo, conciencia de la situación y toma de decisiones. La herramienta es utilizada por anestesiólogos graduados para evaluar a quienes están en entrenamiento en el quirófano o mediante simulación clínica. La validez de este sistema, así como su importancia en la seguridad del paciente, ha sido demostrada por diferentes estudios.

Abstract: Close to 80% of medical errors are due to human factors (poor communication, inadequate monitoring, failure to check, etc.), which is why training for anaesthetists requires developing essential soft skills for Anaesthesiology. Soft skills are defined as specific cognitive, socio-emotional and interpersonal abilities complementing core skills which contribute to the safe and efficient carrying out of a job-specific task. In 2004, the University of Aberdeen established a first model for defining and evaluating these soft skills. The model consists of 15 elements across four categories: task management, team working, situational awareness and decision-making. The model is a tool employed by postgraduate anaesthesiologists to assess trainees in the operating theatre or through clinical simulation. The validity of this system, as well as its importance for patient safety have been demonstrated in a range of studies.

An Initial Approach to Increase Job Satisfaction Through Workplace Spirituality.

Job satisfaction is a widely discussed topic in work psychology, but what might be the contributions of recent discussions of workplace spirituality? This research allows a qualitative measure of workplace spirituality relevance by workforce perspective that can be reproduced in other organizations through a questionnaire application. The spiritual factors of the workplace were classified according to the Kano model that identifies the potential for actions and investments to be transformed into job satisfaction. In this application, it was identified that investments in the coherence and purpose of work factors can generate more than proportional satisfaction in the individuals of this organization. The identity, values, cohesion, meaning, and climate of work factors could generate a proportional satisfaction to the investments. The inner life and community factors cannot generate satisfaction, but when investment levels in these factors did not meet the expectations, it potentially generates dissatisfaction. Finally, investments in belonging, connection, and environmental factors were indifferent to the satisfaction level in this organization. The researchers also pointed out opportunities of investments to the organization.

Online-synchronized clinical simulation: an efficient teaching-learning option for the COVID-19 pandemic time and: beyond.

Face-to-face clinical simulation has been a powerful methodology for teaching, learning, and research, and has positioned itself in health science education. However, due to the COVID-19 pandemic, social distancing has forced universities to abandon simulation centers and make use of alternatives that allow the continuation of educational programs safely for students and teachers through virtual environments such as distance simulation. In Latin America, before the pandemic, the use of non-presential simulation was very limited and anecdotal. This article has three main objectives: to establish the efficacy of online-synchronized clinical simulation in the learning and performance of medical students on the management of patients with COVID-19 in simulation centers of three Latin American countries, to determine the quality of the online debriefing from the students' perspective, and to deepen the understanding of how learning is generated with this methodology.

Surgimiento y evolución de la ergonomía como disciplina: reflexiones sobre la escuela de los factores humanos y la escuela de la ergonomía de la actividad / Emergence and evolution of ergonomics as a discipline: reflections on the school of human factors and the school of ergonomics of the activity / Surgimento e evolução da ergonomia como disciplina: reflexões sobre a escola dos fatores humanos e a escola de ergonomia da atividade

Resumen La ergonomía es considerada, en la actualidad, una disciplina científica consolidada, que se expande continuamente a nivel global. Este escenario actual es el resultado de diferentes visiones que han permeado la evolución de la ergonomía. En este artículo se hace un recorrido histórico de la ergonomía como disciplina, tomando en cuenta la escuela de los factores humanos y la escuela de la ergonomía de la actividad. Se presentan los orígenes de estas escuelas, sus paradigmas subyacentes y se realiza una comparación entre ellas. Las reflexiones presentadas en el artículo en torno a la ergonomía parten de la idea que, desde las diferencias y la diversidad, se erige el desarrollo. Los autores de este artículo son partidarios de abordar la ergonomía como una única disciplina, reconociendo la convergencia y la complementariedad entre las dos escuelas. Más allá de las diferencias existentes, la práctica de la ergonomía debe enfocarse en el diseño de los sistemas de trabajo, tomando como eje central al ser humano. Se espera que estas reflexiones permitan a los profesionales de la ergonomía y de otras diciplinas afines ganar mayor comprensión de cómo abordar la actividad humana para transformarla positivamente.

Abstract Ergonomics is now considered a consolidated scientific discipline that is continually expanding globally. This current scenario is the result of different visions that have permeated the evolution of ergonomics. This article presents a historical overview of ergonomics as a discipline considering human factors and the activity-oriented ergonomics schools. The origins of these two schools of thought on ergonomics and their underlying paradigms are presented, and a comparison between them is made. The reflections presented in the article on ergonomics are based on the idea that progress is built on differences and diversity. The authors of this article support the idea of approaching ergonomics as a single discipline, recognizing the convergence and complementarity between the two schools. Beyond the existing differences, ergonomics' practice should be focused on the design of human-centered work systems. It is hoped that the reflections made in this article will enable professionals in ergonomics and other related disciplines to understand how to approach human at work to transform working conditions positively.

Resumo A ergonomia é considerada, na atualidade, uma disciplina científica consolidada, que se expande continuamente a nível global. Este cenário atual es el resultado de diferentes visões que han permeado la evolución de la ergonomía. Neste artigo se tem uma recorrido histórico da ergonomia como disciplina, tomando na cuenta a escola dos fatores humanos e a escola da ergonomia da atividade. Se presentan los orígenes de estas escuelas, sus paradigmas subyacentes y se una realiza comparación entre ellas. Las reflexiones presentadas en el artículo en torno a la ergonomía parten de la idea that, from las diferencias y la diversidad, se erige el desarrollo. Los autores de este artículo son partidarios de abordar la ergonomía como una única disciplina, reconociendo la convergencia y la complementariedad entre las dos escuelas. Más allá de las diferencias existentes, la práctica de la ergonomía debe enfocarse en el diseño de los sistemas de trabajo, tomando como eje central al ser humano. Se espera que estas reflexiones permitan a los profesionales de la ergonomía y de otras diciplinas afines ganar mayor comprensión de cómo abordar la actividad humana para transformarla positivamente.

Ergonomic Risk Factors of Teleworking in Ecuador during the COVID-19 Pandemic: A Cross-Sectional Study.

Due to the COVID-19 global pandemic, guidelines for people's confinement have been implemented to prevent the disease's spread. As a result of this, companies have implemented teleworking as an emerging way to work from home using information technology. This cross-sectional study was conducted in Ecuador, with a sample of 204 teleworkers in the city of Quito. The results show that the teleworkers rearranged their bedrooms to carry out their activities. The respondents in each age group stated they did not perceive more significant ailments than those experienced before beginning teleworking. The relationships between the variables were analyzed utilizing the Chi-Square test and Fisher's exact test, finding a relationship between neck ailments and age of p = 0.031 * and between arm/forearm ailments of p = 0.032 *. This study contributes to a greater understanding of the ergonomic situation of the teleworkers and provides us with information to mitigate the ergonomic risks to which they are exposed.

Human and climate drivers of global biomass burning variability.

Biomass burning is one of the most critical factors impacting vegetation and atmospheric trends, with important societal implications, particularly when extreme weather conditions occur. Trends and factors of burned area (BA) have been analysed at regional and global scales, but little effort has been dedicated to study the interannual variability. This paper aimed to better understand factors explaining this variation, under the assumption that the more human control of fires the more frequently they occur, as burnings will be less dependent of weather cycles. Interannual variability of BA was estimated from the coefficient of variation of the annual BA (BA_CV) estimated from satellite data at 250 m, covering the period from 2001 to 2018. These data and the explanatory variables were resampled at 0.25-degree resolution for global analysis. Relations between this variable and explanatory factors, including human and climate drivers, were estimated using Random Forest (RF) and generalized additive models (GAM). BA_CV was negatively related to BA_Mean, implying that areas with higher average BA have lower variability as well. Interannual BA variability decreased when maximum temperature (TMAX) and actual and potential evapotranspiration (AET, PET) increased, cropland and livestock density increased and the human development index (HDI) values decreased. GAM models indicated interesting links with AET, PET and precipitation, with negative relation with BA_CV for the lower ranges and positive for the higher ones, the former indicating fuel limitations of fire activity, and the latter climate constrains. For the global RF model, TMAX, AET and HDI were the main drivers of interannual variability. As originally hypothesised, BA_CV was more dependent on human factors (HDI) in those areas with medium to large BA occurrence, particularly in tropical Africa and Central Asia, while climatic factors were more important in boreal regions, but also in the tropical regions of Australia and South America.

Frontiers in human factors: integrating human factors and ergonomics to improve safety and quality in Latin American healthcare systems.

BACKGROUND: The importance of human factors/ergonomics (HFE) is well established in all high-reliability systems but only applied in the healthcare sector relatively recently. Across many sectors, low-/middle-income countries (LMICs) lag behind more economically developed countries in their application of this safety science, due to resource and, in some cases, awareness and expertise. Most previous applications of HFE related to occupational ergonomics rather than healthcare safety. METHODS: The paper details how the reputation of HFE is being developed within healthcare communities of Latin America (LatAm), through increasing awareness and understanding of its role as safety science in the healthcare sector. It starts by articulating the need for HFE and then provides examples from Mexico, Colombia and Peru. RESULTS: The practical examples for research and education illustrate a developing awareness of the relevance of HFE to the healthcare sectors in LatAm and an appreciation of its worth to improve health service quality and patient safety through healthcare community engagement. A new LatAm Network of HFE in Healthcare Systems (RELAESA) was formed in 2019, which has provided a platform for HFE advice during the COVID-19 pandemic. CONCLUSION: There is a real opportunity in LatAm and other LMIC health services to make more rapid and sustainable progress in healthcare-embedded HFE than has been experienced within healthcare services of more developed nations.

An ergonomics educational training program to prevent work-related musculoskeletal disorders to novice and experienced workers in the poultry processing industry: A quasi-experimental study.

This quasi-experimental study was conducted in a poultry processing industry with the aim of assessing the benefits of ergonomics educational training for novice and experienced workers in preventing work-related musculoskeletal disorders. Sociodemographic and occupational questionnaires were used to evaluate age, marital status, education, time in job, musculoskeletal complaints and pain intensity, perceived effort, biomechanical exposure, and perception of ease or difficulty in adoption of ergonomics educational training. Musculoskeletal complaints in the neck, back, and wrists were reduced with training, but pain intensity was reduced only in the wrist region. A reduction in the occupational biomechanical exposure from the baseline to immediately post-training and 2 months after training both for novice and experienced workers was also observed. The novice workers group differed from the experienced workers by presenting a higher reduction of biomechanical exposure in the cutting room. All workers in this study benefited from the ergonomics educational training in the short and medium term. However, the success of training was highly dependent on the content and approach of the training.

When silence goes viral, Africa sneezes! A perspective on Africa's subdued research response to COVID-19 and a call for local scientific evidence.

By mid-September 2020, over 1.33 million confirmed COVID-19 cases and 32 thousand deaths had been reported in Africa. Global research on COVID-19 went 'viral' with a record 3487 research contributions comprising of 2062 journal papers and 1425 preprints published within the first three months following the outbreak of COVID-19. Surprisingly, the silence of the African research community has been unprecedented - contributing a paltry 0.6% (22 contributions), a figure nearly matched by Colombia (18 publications). Until now, a comprehensive perspective on the reasons for this subdued research response, and COVID-19 themes critical to Africa has been missing. We posit that while a milieu of factors accounts for this silence, unprecedented research opportunities exist to support COVID-19 decision and policy formulation in Africa. The subdued response reflects weak research systems, characterized by deep-rooted challenges, including severe lack of research expertise, funding, and infrastructure, coupled with poor working conditions. Hence, Africa's contribution to research on infectious diseases, including COVID-19, remains weak. Perceptions and attitudes among researchers and policy-makers on COVID-19, and the role of science in decision and policy-making also exist. Moreover, COVID-19 and earlier severe acute respiratory syndromes are considered as 'imported diseases' originating from outside Africa. Thus, notions may exist that the control methods will come from outside Africa through 'technology-transfer' or 'capacity-building'. Yet local COVID-19 research is needed to address knowledge gaps, including; (1) potential novel transmission of SARS-CoV-2, (2) adaption of generic COVID-19 control measures to suit African settings, (3) occurrence and persistence of SARS-CoV-2 in solid waste, wastewaters, on-site sanitation systems, and drinking water, and (4) the 'human factor' including the role of gender, perceptions, myths, attitudes, and religious beliefs in the transmission and control of COVID-19. Therefore, there is a need to: (1) strengthen local research capacity and evaluation systems, (2) consider biosafety and ethical issues, (3) initiate cross-disciplinary research and global collaboration on COVID-19, and (4) integrate science communication in COVID-19 programs.

The Haemostasis Traffic Light, a user-centred coagulation management tool for acute bleeding situations: a simulation-based randomised dual-centre trial.

The Haemostasis Traffic Light is a cognitive aid with a user-centred design to enhance and simplify situation awareness and decision-making during peri-operative bleeding. Its structure helps to prioritise therapeutic interventions according to the pathophysiology and the severity of the bleeding. This investigator-initiated, randomised, prospective, international, dual-centre study aimed to validate the Haemostasis Traffic Light by adapting it to the local coagulation protocols of two university hospitals. Between 9 January and 12 May 2020, we recruited 84 participants at the University Hospital Zurich, Switzerland, and the Italian Hospital of Buenos Aires, Argentina. Each centre included 21 resident and 21 staff anaesthetists. Participants were randomly allocated to either the text-based algorithm or the Haemostasis Traffic Light. All participants managed six bleeding scenarios using the same algorithm. In simulated bleeding scenarios, the design of the Haemostasis Traffic Light algorithm enabled more correctly solved cases, OR (95%CI) 7.23 (3.82-13.68), p < 0.001, and faster therapeutic decisions, HR (95%CI) 1.97 (1.18-3.29, p = 0.010). In addition, the tool improved therapeutic confidence, OR (95%CI) 4.31 (1.67-11.11, p = 0.003), and reduced perceived work-load coefficient (95%CI) -6.1 (-10.98 to -1.22), p = 0.020). This study provides empirical evidence for the importance of user-centred design in the development of haemostatic management protocols.

Human factors and ergonomics in the context of COVID-19: Planning for concepts insertion in a productive systems discipline.

BACKGROUND: The COVID-19 pandemic is challenging companies worldwide and undergraduate courses need to consider this context within their disciplines, especially regarding human factors and ergonomics. For this, professors should plan how to insert this knowledge into the program content of their discipline. OBJECTIVE: This commentary aims to present how this insertion will be conducted in the second academic semester of 2020 in the discipline "Productive Systems" of the mechanical engineering undergraduate course offered by a Brazilian university. METHODS: This commentary is based on the authors' points of view and experiences. However, the presented discussion is based on institutional websites and international articles. RESULTS: It is possible to verify that human factors and ergonomic aspects related to the pandemic can be debated in several topics of the analyzed discipline. CONCLUSIONS: Besides presenting the planning of inserting these aspects, this commentary expands the debates on the subject.

Naturalistic Driving Study in Brazil: An Analysis of Mobile Phone Use Behavior while Driving.

Mobile phone use (MPU) while driving is an important road safety challenge worldwide. Naturalistic driving studies (NDS) emerged as one of the most sophisticated methodologies to investigate driver behavior; however, NDS have not been implemented in low- or middle-income countries. The aim of this research is to investigate MPU while driving and compare the results to those reported in international studies. An analysis of 61.32 h and 1350 km driven in Curitiba (Brazil) showed that MPU lasted for an average of 28.51 s (n = 627) and occurred in 58.71% of trips (n = 201) with an average frequency of 8.37 interactions per hour (n = 201). The proportion of the trip time using a mobile phone was 7.03% (n = 201), and the average instantaneous speed was 12.77 km/h (n = 627) while using the phone. Generally, drivers spent less time on more complex interactions and selected a lower speed when using the phone. MPU was observed more during short duration than longer trips. Drivers in this study engaged in a larger number of MPU compared to drivers from Netherlands and the United States; and the percentage of trip time with MPU was between North American and European values.