Objective: Objectives: Adopting a healthy diet like the Dietary Approach to Stop Hypertension (DASH) or Mediterranean diet (MD) represents a major lifestyle for blood pressure (BP) control in general population. Nutritional policies, such as the French Nutrition and Health Program (Programme National Nutrition Santé or PNNS), have been implemented in several countries with the aims of preventing chronic diseases. The objective of our study was to investigate association between BP and adherence to PNNS guidelines compared with adherence to DASH or MD.Design and method: Methods: We conducted a cross sectional study in 11,302 untreated participants from the NutriNet-Santé Study, a French web based cohort study. Three validated scores reflecting adherence to PNNS guidelines, DASH diet and MD were calculated from repeated 24-hour records. Three BP measurements using a standardized protocol were collected. Multivariate linear models were used to assess the associations between the dietary scores and BP. Results: Results: In women, independent of age, socio-economic status, body mass index, tobacco use, alcohol consumption and physical activity, adherence to PNNS guidelines was inversely significantly associated with systolic BP (β = −0.63, p < 0.0001). This association was of similar amplitude that between BP and adherence to DASH-style diet (β = −0.66, p < 0.0001) or MD (β = −0.63, p = 0.0002). No significant association was found in men.β Conclusions: Conclusion: Adherence to French nutritional recommendations was found negatively associated with BP at the same magnitude as adherence to well-known dietary pattern in the prevention and treatment of hypertension. Adding health benefits of these recommendations already known to be associated with reduced risk of major chronic diseases.

Limited information is available on large-scale populations regarding the socio-demographic and nutrient profiles and eating behaviour of consumers, taking into account both organic and conventional foods. The aims of this study were to draw up a typology of consumers according to their eating habits, based both on their dietary patterns and the mode of food production, and to outline their socio-demographic, behavioural and nutritional characteristics. Data were collected from 28 245 participants of the NutriNet-Santé study. Dietary information was obtained using a 264-item, semi-quantitative, organic FFQ. To identify clusters of consumers, principal component analysis was applied on sixteen conventional and sixteen organic food groups followed by a clustering procedure. The following five clusters of consumers were identified: (1) a cluster characterised by low energy intake, low consumption of organic food and high prevalence of inadequate nutrient intakes; (2) a cluster of big eaters of conventional foods with high intakes of SFA and cholesterol; (3) a cluster with high consumption of organic food and relatively adequate nutritional diet quality; (4) a group with a high percentage of organic food consumers, 14 % of which were either vegetarians or vegans, who exhibited a high nutritional diet quality and a low prevalence of inadequate intakes of most vitamins except B12; and (5) a group of moderate organic food consumers with a particularly high intake of proteins and alcohol and a poor nutritional diet quality. These findings may have implications for future aetiological studies investigating the potential impact of organic food consumption.

A higher frequency of organic food consumption was associated with a reduced risk of cancer. If these findings are confirmed, further research is necessary to determine the underlying factors involved in this association.

Vitamin D is essential regarding several health outcomes. Prevention of insufficiency (25-hydroxyvitamin D concentration ≤20 ng/mL) generally entails blood testing and/or supplementation, strategies that should target at-risk individuals because blood testing is costly, and unwarranted supplementation could result in vitamin D overload with unknown long-term consequences. Our objective was to develop a simple score (Vitamin D Insufficiency Prediction score, VDIP) for identifying adults at risk of vitamin D insufficiency. Subjects were 1557 non-vitamin D-supplemented middle-aged adults from the SU.VI.MAX cohort. Scoring points corresponded to the rounded odds ratio for each individual-level characteristic associated with vitamin D insufficiency in a multivariable logistic regression model. Receiver operating characteristic curve (area under curve), sensitivity, specificity, and positive and negative predictive values were computed. External validation was performed in an independent cohort (NutriNet-Santé, N = 781). For female sex, overweight, low physical activity, winter season, moderate sun exposure, and very fair or dark skin 1.5 points were attributed; 2 points for latitude ≥48°N and spring season; 2.5 points for obesity and late winter; 3 points for low sun exposure. Points were then summed up for each participant. The VDIP score had an AUC = 0.70 ± 0.01 (validation: 0.67 ± 0.02). With a score of 7 or more, 70% of the participants were vitamin D-insufficient (80% in those with a score ≥9), sensitivity/specificity were 0.67/0.63, and positive and negative predictive values were 0.70/0.59. The VDIP score performed well in identifying middle-aged adults at risk of vitamin D insufficiency (score ≥7, moderate risk; score≥9, high risk), using only simple individual-level characteristics easily assessable in day-to-day clinical practice. Implementation of this simple and costless score could thus obviate unwarranted supplementation and/or blood testing.

Kratzke, Ian M. MD; Mazur, Lukasz M. PhD; Campbell, Alana PhD; Adapa, Karthik MBBS, MPP, MPH; Meltzer-Brody, Samantha MD, MPH; Michael Farrell, Timothy MD, FACS Author Information

Given the persistent safety incidents in operating rooms (ORs) nationwide (approx. 4,000 preventable harmful surgical errors per year), there is a need to better analyze and understand reported patient safety events. This study describes the results of applying the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) supported by the Teamwork Evaluation of Non-Technical Skills (TENTS) instrument to analyze patient safety event reports at one large academic medical center. Results suggest that suboptimal behaviors stemming from poor communication, lack of situation monitoring, and inappropriate task prioritization and execution were implicated in most reported events. Our proposed methodology offers an effective way of programmatically sorting and prioritizing patient safety improvement efforts.

The field of computer vision, which is widely studied area, is basically the imitation of the human vision system with digital devices. Computer systems perform operations through digital images or video images and decide according to the result. In this context, object recognition must be performed at the first stage in order to extract meaningful information from the image. In this study, the application of object recognition was developed using the deep learning method, which is especially popular in recent years. It has also been compared with classical machine learning methods often used in recognition applications. The proposed method developed with Convolutional Neural Network (CNN) has been compared by using the Histogram of Oriented Gradient (HOG) features and classifying them with Support Vector Machines (SVM) and K-Nearest Neighbor (KNN) methods. Experimental results show that the proposed CNN method is more successful than HOG+SVM, and HOG+KNN methods.

<sec> <title>BACKGROUND</title> Approximately 4000 preventable surgical errors occur per year in the US operating rooms (ORs), many due to suboptimal teamwork and safety behaviors. </sec> <sec> <title>OBJECTIVE</title> There is a need to develop and quantify the effect of innovative and immersive training intervention on safety behaviors of surgeons in the operating rooms (ORs). </sec> <sec> <title>METHODS</title> This pilot study was conducted in a large academic medical center with 55 ORs. Safety behaviors were observed and quantified using validated Teamwork Evaluation of Non-Technical Skills (TENTS) instrument during surgical cases at baseline (101 observations; n=83 physicians) and post immersive virtual reality (VR) based intervention (post intervention: 24 observations within each group: intervention group (with VR training; n=10 physicians) and control (no VR training; n=10 physicians)). VR intervention included a 45-minute immersive VR-based training incorporating a pre- and post-debriefing based on Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) principles to improve safety behaviors. A two-tailed, two-sample t-test with adjustments for multiplicity of the tests was used to test for significance in observable safety behaviors between the groupings. </sec> <sec> <title>RESULTS</title> Pre-intervention, all safety behaviors averaged slightly above ‘acceptable’ scores, with an overall average of 2.2 (range 2.0-2.3; 0-3 scale). The ten physicians that underwent our intervention showed statistically significant improvements in 90% (18/20) of safety behaviors when compared to the ten physicians that did not receive the intervention (overall average [range]: 2.5 [2.3-2.7] vs. 2.1 [1.9-2.2]). </sec> <sec> <title>CONCLUSIONS</title> VR-based immersive training intervention focused on TeamSTEPPS principles seems effective in improving safety behaviors in the ORs as quantified via observations using the TENTS instrument. </sec> <sec> <title>CLINICALTRIAL</title> None </sec> <sec> <title>INTERNATIONAL REGISTERED REPORT</title> RR2-10.2196/40445. </sec>

Bu çalışma, tekno-stres ile psikolojik iyi oluş arasındaki ilişkide yaşamda anlamın aracı rolünü incelemiştir. Erzurum ve Erzincan illerinde çalışan muhasebeci ve mali müşavirlerden toplanan veriler, Yaşamın Anlamı, Psikolojik İyi Oluş ve Teknostres Ölçeği ile elde edilmiş ve Hayes’in Paralel Aracılık Modeli (Model 4) ile analiz edilmiştir. Bulgular, tekno-belirsizliğin psikolojik iyi oluş üzerinde toplamda -0,308’lik (p &lt; 0,001) olumsuz bir etkisi olduğunu ve bu etkinin büyük ölçüde mevcut anlam aracılığıyla gerçekleştiğini (dolaylı etki: -0,203, p &lt; 0,001) ortaya koymuştur. Tekno-iş yükü ve tekno-karmaşıklık da benzer şekilde mevcut anlam ve anlam arayışını azaltarak psikolojik iyi oluşu olumsuz etkilemiştir. Mevcut anlam güçlü bir aracı rol oynarken, anlam arayışının etkisi daha sınırlı bulunmuştur. Sonuçlar, bireylerin yaşamda anlam bulma kapasitelerinin artırılmasının, tekno-stresin olumsuz etkilerini hafifletebileceğini göstermektedir.

OBJECTIVES: Stereotactic body radiation therapy (SBRT) can improve therapeutic ratios and patient convenience, but delivering higher doses per fraction increases the potential for patient harm. Incident learning systems (ILSs) are being increasingly adopted in radiation oncology to analyze reported events. This study used an ILS coupled with a Human Factor Analysis and Classification System (HFACS) and barriers management to investigate the origin and detection of SBRT events and to elucidate how safeguards can fail allowing errors to propagate through the treatment process. METHODS: Reported SBRT events were reviewed using an in-house ILS at 4 institutions over 2014-2019. Each institution used a customized care path describing their SBRT processes, including designated safeguards to prevent error propagation. Incidents were assigned a severity score based on the American Association of Physicists in Medicine Task Group Report 275. An HFACS system analyzed failing safeguards. RESULTS: One hundred sixty events were analyzed with 106 near misses (66.2%) and 54 incidents (33.8%). Fifty incidents were designated as low severity, with 4 considered medium severity. Incidents most often originated in the treatment planning stage (38.1%) and were caught during the pretreatment review and verification stage (37.5%) and treatment delivery stage (31.2%). An HFACS revealed that safeguard failures were attributed to human error (95.2%), routine violation (4.2%), and exceptional violation (0.5%) and driven by personnel factors 32.1% of the time, and operator condition also 32.1% of the time. CONCLUSIONS: Improving communication and documentation, reducing time pressures, distractions, and high workload should guide proposed improvements to safeguards in radiation oncology.

Cognitive Workload (CWL) is a fundamental concept in predicting healthcare professionals' (HCPs) objective performance. The study aims to compare the accuracy of the classical model (utilizes all six dimensions of the National Aeronautics and Space Administration Task Load Index (NASA-TLX)) and novel models (utilize four or five dimensions of NASA-TLX) in predicting HCPs' objective performance. We use a dataset from our previous human factors research studies and apply a broad selection of supervised machine learning classification techniques to develop data-driven computational models and predict objective performance. The study findings confirm that classical models are better predictors of objective performance than novel models. This has practical implications for research in health informatics, human factors and ergonomics, and human-computer interaction in healthcare. Findings, although promising, cannot be generalized as they are based on a small dataset. Future studies may investigate additional subjective and physiological measures of CWL to predict HCPs' objective performance.

Healthcare professionals practicing in the Emergency Department (ED) play a critical role in providing care in our societies. They interact with an assortment of sub-systems of the hospital and collaborate with various specialties across inpatient and outpatient settings. Research shows that &gt;60% of ED physicians report burnout and, thus, it is important to understand the key factors contributing to their burnout. Over a ten-week period we used a mixed-method, theory-based, participatory, and data-driven approach based on survey, focus groups, and contextual inquiries to collect and analyze data and prioritize improvement efforts. Key areas of improvement were: i) workflows and patient monitoring that add to high cognitive load and stress levels; ii) low staffing, particularly among sitters, nurses, technicians, secretaries, and security staff; iii) suboptimal therapeutic atmosphere for psychiatric patients; iv) disrespectful and violent patients and visitors; v) communication issues, especially between the ED and other departments; and vi) frequent problems with the telecommunication system. We learned that EDs must take time to rigorously evaluate contributing factors to burnout while engaging their people who best know how to change systems to achieve positive and sustainable results.

PurposeThis study aimed to assess the effect of monitoring 2 versus 3 collocated displays on radiation therapist technologists’ (RTTs) workload (WL) and situation awareness (SA) during routine treatment delivery tasks.Methods and MaterialsSeven RTTs completed 4 simulated treatment delivery scenarios (2 scenarios per experimental condition; 2 vs 3 collocated displays) in a within-subject experiment. WL was subjectively measured using the National Aeronautics and Space Administration (NASA) Task Load Index, and objectively measured using eye activity measures. SA was subjectively measured using the SA rating technique, and objectively measured using the SA global assessment technique. Two-tailed paired t tests were conducted to test for differences in means when parametric assumptions were satisfied, otherwise Wilcoxon signed-rank tests were conducted. A .05 level of significance was applied to all statistical tests.ResultsNo statistically and clinically significant differences were observed between monitoring 2 versus 3 monitors on eye tracking measures (blink rate: 9.4 [4.8] vs 9.6 [4.0]; task evoked pupillary response: 0.16 [0.14] vs 0.21 [0.15]; NASA Task Load Index: 34.7 [19.8] vs 35.3 [20.4]; SA rating technique: 19.3 [6.2] vs 19.5 [7.0]; and SA global assessment technique scores: 100 [0] vs 100 [0]).ConclusionsOur preliminary findings suggest that monitoring 3 collocated displays by 1 RTT does not impact WL and SA compared with monitoring 2 collocated displays. Only 2 of many possible configurations were investigated. If institutions removed the 3rd display based on the results of this study, there could be unforeseen error(s) if that display helped in situations not assessed in this study.