A novel coronavirus disease, named coronavirus disease 2019 or COVID-19, which sparked an outbreak in Wuhan, China in December 2019, is now a pandemic. The rapid spread of this disease from one to more than 155 regions worldwide in 2.5 months highlights the need for better preparation to manage a pandemic. In this commentary, we describe how Human Factors and Ergonomics (HFE) can contribute to the COVID-19 pandemic response. Specifically, we provide an example of how HFE methodologies informed workflow redesigns implemented as part of COVID-19 pandemic preparations in an academic pediatric ambulatory clinic. We then identify key mechanisms and areas where HFE can contribute to and improve the effectiveness of a pandemic response: Just-in-time (JIT) training development, adapting workflows and processes, restructuring teams and tasks, developing effective mechanisms and tools for communication, engaging patient and families to follow the recommended practices (e.g., social distancing, revised hospital visitation policies), identifying and mitigating barriers to implementation of plans, and learning from failures and successes to improve both the current and future pandemic responses. We recommend integrating HFE approaches and tools across health care systems, state health organizations, and the Centers for Disease Control and Prevention (CDC) as they confront this pandemic.
Background: The chromosomal location of CUL-5 (11q 22-23) is associated with LOH in breast cancer, suggesting that CUL-5 may be a tumor suppressor. The purpose of this research was to determine if there is differential expression of CUL-5 in breast epithelial cells versus breast cancer cell lines, and normal human tissues versus human tumors. The expression of CUL-5 in breast epithelial cells (HMEC, MCF-10A), and breast cancer cells (MCF-7, MDA-MB-231) was examined using RT-PCR, Northern blot analysis, and Western blot analysis. The expression of mRNA for other CUL family members (CUL-1, -2, -3, -4A, and -4B) in these cells was evaluated by RT-PCR. A normal human tissue expression array and a cancer profiling array were used to examine CUL-5 expression in normal human tissues and matched normal tissues versus tumor tissues, respectively.
Objectives: Falls are the leading cause of pediatric injury and account for the majority of emergency department injury visits, costing US $5 billion in medical costs annually. Epidemiology of pediatric falls has primarily been studied at single hospital centers and has not been analyzed statewide. We assessed pediatric falls across Maryland and geographically mapped them by census tract and block group.
Methods:The study used Maryland Health Services Cost Review Commission discharge data to retrospectively analyze the demographics and cross-sectional incidence rates of fall injuries in Maryland from 2013 to 2015. Geographical clusters were calculated for pediatric falls in Maryland and Baltimore City.Results: From 2013 to 2015, Maryland hospitals discharged 738,819 pediatric patients, of whom 77,113 had fall injuries. Falls were more prevalent among males (56%), white race (55%), and patients with public insurance (56%). Over this period, 2 children who presented with fall injuries died. The incidence of falls did not vary from 2013 (27,481 children) to 2014 (27,261) and 2015 (26,451). Mapping fall injuries across Maryland identified Baltimore City as the primary cluster and rural pockets as secondary clusters of high incidence rates. Baltimore City maps showed a stable high-incidence cluster in the southwest region across all 3 years.Conclusions: Pediatric fall injuries comprise a large volume of emergency department visits yet have a low mortality. Geographic mapping shows that fall incidence varies across the state and persists over time. Statewide geographic information can be used to focus resource management and target prevention strategies.
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