Thermal comfort in operating theatres is a less addressed research component of the in-door environment in operating theatres. The air quality naturally gets most attention when considering the risk of surgical site infections. However, the importance of thermal comfort must not be underestimated. In this research, the current thermal comfort situation of staff members is investigated. Results show that the thermal comfort for the members of a surgical team is perceived as not optimal. Application of the PMV and DR models needs further attention when applied for operating theatres. For the investigated ventilation systems, the differences in thermal comfort outcomes are small.
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Medical equipment is implemented in highly complex hospital environments, such as operating rooms, in hospitals around the world. In operating rooms (ORs), technological equipment is used for surgical activities and activities in support of surgeries. The implementation of government policies in hospitals has resulted in varying implementation activities for (medical) equipment. These result in varying lead times and success rates. An integral and holistic protocol for implementation does not yet exist. In this study, we introduce a protocol for the implementation of (medical) equipment in ORs that consists of implementation factors and implementation activities. Factors and activities are based on data from a systematic literature review and an explorative survey among surgical support staff on factors for the successful implementation of technological and (medical) equipment in ORs. The protocol consists of five factors and related implementation activities: the establishment of a project plan, organisational preparation, technological preparation, maintenance, and training.
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A local operating theater ventilation device to specifically ventilate the wound area has been developed and investigated. The ventilation device is combined with a blanket which lies over the patient during the operation. Two configurations were studied: Configuration 1 where HEPA-filtered air was supplied around and parallel to the wound area and Configuration 2 where HEPA-filtered air was supplied from the top surface of the blanket, perpendicular to the wound area. A similar approach is investigated in parallel for an instrument table. The objective of the study was to verify the effectiveness of the local device. Prototype solutions developed were studied experimentally (laboratory) and numerically (CFD) in a simplified setup, followed by experimental assessment in a full scale mock-up. Isothermal as well as non-isothermal conditions were analyzed. Particle concentrations obtained in proposed solutions were compared to the concentration without local ventilation. The analysis procedure followed current national guidelines for the assessment of operating theater ventilation systems, which focus on small particles (<10 mm). The results show that the local system can provide better air quality conditions near the wound area compared to a theoretical mixing situation (proof-of-principle). It cannot yet replace the standard unidirectional downflow systems as found for ultraclean operating theater conditions. It does, however, show potential for application in temporary and emergency operating theaters
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from the Article: "Operating rooms (ORs) more and more evolve into high-tech environments with increasing pressure on finances, logistics, and a not be neglected impact on patient safety. Safe and cost-effective implementation of technological equipment in ORs is notoriously difficult to manage, specifically as generic implementation activities omit as hospitals have implemented local policies for implementations of technological equipment. )e purpose of this study is to identify success factors for effective implementations of new technologies and technological equipment in ORs, based on a systematic literature review. We accessed ten databases and reviewed included articles. )e search resulted in 1592 titles for review, and finally 37 articles were included in this review. We distinguish influencing factors and resulting factors based on the outcomes of this research. Six main categories of influencing factors on successful implementations of medical equipment in ORs were identified: “processes and activities,” “staff,” “communication,” “project management,” “technology,” and “training.” We identified a seventh category “performance” referring to resulting factors during implementations. We argue that aligning the identified influencing factors during implementation impacts the success, adaptation, and safe use of new technological equipment in the OR and thus the outcome of an implementation. The identified categories in literature are considered to be a baseline, to identify factors as elements of a generic holistic implementation model or protocol for new technological equipment in ORs."
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This paper is a plea for involving creative writers in the developmentprocess of robot identities. Writers for theatre, film, games or ’old-fashioned’ novels have the gift of bringing a fictional character tolife on blank paper. These characters can often move us. If we wantto develop rich and layered robot identities, we need to involvecreative writers. Not only for developing the robot identity itself,but also for developing the operating system that manages therobot identity, and we even see a task for writers in the form ofguardianship of the created robot identity
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The Nature Spectacle: On Images, Money, and Conservation Capitalism by Jim Igoe is, as its Preface states, an ambitious book that seeks to make connections between diverse times and places. The preface also, in many ways, tells more about the background and intention of the book than its chapters do, tying together the author’s origins and motivation. Igoe recalls his childhood in St. Louis, Missouri, much of which he spent “in front of a television and at a neighborhood movie theatre” (p. XII), once watching a musical, which was “essentially an extended Chevrolet commercial set among the geysers of Yellowstone” (P. 109). It is the mix of such absurd and comical observations of commercialism merging with Nature, and much heavier criticism of the capitalist cult of economic growth, development, and also conservation that characterizes The Nature of Spectacle. Much of Igoe’s outdoor experiences were shaped by green spaces, created in St. Louis as part of commodity exhibits at the 1904 World’s Fair. The author admits to feeling both critical and nostalgic of those places that have merged (sub)urban aesthetics with that of industrially developed commercial “spaces” (p. XII) – important concepts that form a leitmotif throughout the book. https://doi.org/10.1080/03066150.2018.1488355 https://www.linkedin.com/in/helenkopnina/
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The Co-Design Pressure Cooker was set up to gather knowledge on co-design in product development activities of Small-to-Medium Enterprises(SMEs). This booklet gives an impression of ten projects conducted in the Province of Utrecht, the Netherlands. In these ten projects, a total of 22 companies were involved. 5000 booklets have already been printed in Dutch and handed out to SMEs for knowledge dissemination. We have received ample requests from the international community, which leads us to believe that there is an international audience for the cases conducted and knowledge gathered. This is why we decided to publish an English version of this booklet. The booklet will be followed by a scientific publication on the knowledge gathered for the academic community. Feel free to contact us for more information on this project
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Humidification is not a common procedure in many buildings in the Netherlands. An exception are buildings used for healthcare, especially hospitals. There, e.g. in operating theatres, relative humidity (RH) generally is controlled stringently at levels around 50%. From an energy point-of-view humidification is an energy-intensive activity. Currently, more than 10% of the total energy used in healthcare buildings is spent on humidification. The basis for an RH of around 50%, however, is not clear. Therefore, we pursued a scoping review to find evidence for specific RH thresholds in such facilities. In addition, an inventory was made of the current practice in the Netherlands. After analyzing the title and abstracts, the remaining references were read by two persons and scored on several topics. Guidelines and current practice were analyzed by referring to existing (inter)national guidelines and standards, and by contacting experts from Dutch hospitals through a survey and semi-structured interviews. Outcomes from the literature review were grouped into four different topics: 1) micro-organisms and viruses, 2) medical devices, 3) human physiology and 4) perception. No scientific evidence was found for the currently generally applied RH set-point of ~50%. Some studies suggest a minimum RH of 30% but the evidence is weak, with exception of medical devices if specifications require it. A lack of research that addresses more long-term exposure (a couple of days) and includes frail subjects, is noted. It was found that RH requirements are strictly followed in all hospitals consulted, some only focusing on the hot zones, but in many cases extended to the whole hospital. Steam humidification is mostly applied for hygienic reasons. but is quite energy-intensive. The conclusion t is that there is no solid evidence to support the RH-setpoints as currently applied in the Netherlands. It merely appears a code of practice. Therefore, there appears room for quick and significant energy savings, and CO2 emission reductions, when considering control at lower RH values or refraining from humidification at all, while still fulfilling the indoor environment requirements and not negatively influencing the health risk. This outcome can be applied directly in current practice with the available techniques.
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Purpose Non-technical skills have gained attention, since enhancement of these skills is presumed to improve the process of trauma resuscitation. However, the reliability of assessing non-technical skills is underexposed, especially when using video analysis. Therefore, our primary aim was to assess the reliability of the Trauma Non-Technical Skills (T-NOTECHS) tool by video analysis. Secondarily, we investigated to what extent reliability increased when the T-NOTECHS was assessed by three assessors [average intra-class correlation (ICC)] instead of one (individual ICC). Methods As calculated by a pre-study power analysis, 18 videos were reviewed by three research assistants using the T-NOTECHS tool. Average and individual degree of agreement of the assessors was calculated using a two-way mixed model ICC. Results Average ICC was ‘excellent’ for the overall score and all five domains. Individual ICC was classified as ‘excellent’ for the overall score. Of the five domains, only one was classified as ‘excellent’, two as ‘good’ and two were even only ‘fair’. Conclusions Assessment of non-technical skills using the T-NOTECHS is reliable using video analysis and has an excellent reliability for the overall T-NOTECHS score. Assessment by three raters further improve the reliability, resulting in an excellent reliability for all individual domains.
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For environmental governance to be more effective and transformative, it needs to enhance the presence of experimental and innovative approaches for participation. This enhancement requires a transformation of environmental governance, as too often the (public) participation process is set up as a formal obligation in the development of a proposed intervention. This article, in search of alternatives, and in support of this transformation elaborates on spaces where participatory and deliberative governance processes have been deployed. Experiences with two mediated participation methodologies – community art and visual problem appraisal – allow a demonstration of their potential, relevance and attractiveness. Additionally, the article analyzes the challenges that result from the nature of these arts-based methodologies, from the confrontational aspects of voices overlooked in conventional approaches, and from the need to rethink professionals’ competences. Considering current environmental urgencies, mediated participation and social imaginaries still demonstrate capacities to open new avenues for action and reflection.
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