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This paper describes the SPOWTT project. The intention of this project was to understand how sailing by crew transfer vessel (CTVs) to offshore wind farms affects the mental and physical wellbeing of individuals on board. The focus was on quantifying this impact, understanding the key drivers, with an aim to ensuring personnel can arrive to the wind turbines in a fit state to work safely and effectively. Impacts looked at subjective state beyond simply vomiting. Key results include the ability now to predict vessel motions from given Metocean conditions and vessel designs. We also discovered that the impact of vessel motions on seasickness is different for different symptoms and is driven not only by vertical z‐axis accelerations but also by certain frequencies of motion in the y‐axis. Frequencies other than 0.16 Hz were found to be impactful, and x‐axis movements appeared to have a longer‐lasting effect on the day's work. Through the formulation of a new, evidence‐based understanding of seasickness, we have created an operational planning tool, designed to have a direct benefit on the safety and productivity of offshore wind farm operations.

Preterm infants are at risk of developing social-emotional and behavioural difficulties. To understand the experiences of their caregivers in day-to-day life, parents (at 2 and 10 years) and teachers (at 10 years) completed a behavioural questionnaire and answered two open-ended questions addressing their concerns and the most positive aspects regarding their child and/or pupil (born

Summary box With the global increase in population density, urbanisation, and global travel and trade, the threat of widespread outbreaks of infectious diseases has increased relentlessly,1 as evidenced by recent examples of COVID-19 and Ebola. Further, although the most important causes of death shifted to non-communicable diseases, in some poorer parts of the world, communicable diseases remain the most important cause of death.2 Crucial in the prevention of and reaction to these threats is early detection, which demands an infectious disease surveillance system that can signal unusual events. How to set up and improve surveillance and how to prioritise investments are questions that need input from different scientific disciplines. Here, we focus on some economic considerations. The best recognised purpose of disease surveillance is the (early) detection of epidemics and other health threats. New diagnostic tools such as unbiased and targeted next-generation sequencing (NGS) are being explored as options to improve surveillance as these allow to determine causes of unexplained disease outbreaks, trace and link sources of disease transmission, and facilitate a better understanding of how viruses and bacteria pass from animal to humans. With NGS, the same platforms and sometimes even the same protocols can be …

Objectives: A consensus has been reached in The Netherlands that all future medical costs should be included in economic evaluations. Furthermore, internationally, there is the recognition that in countries that adopt a societal perspective estimates of future nonmedical consumption are relevant for decision makers as much as production gains are. The aims of this paper are twofold: (1) to update the tool Practical Application to Include Future Disease Costs (PAID 1.1), based on 2013 data, for the estimation of future unrelated medical costs and introduce future nonmedical consumption costs, further standardizing and facilitating the inclusion of future costs; and (2) to demonstrate how to use the tool in practice, showing the impact of including future unrelated medical costs and future nonmedical consumption in a case-study where a life is hypothetically saved at different ages and 2 additional cases where published studies are updated by including future costs. Methods: Using the latest published cost of illness data from the year 2017, we model future unrelated medical costs as a function of age, sex, and time to death, which varies per disease. The Household Survey from Centraal Bureau Statistiek is used to estimate future nonmedical consumption by age. Results: The updated incremental cost-effectiveness ratios (ICERs) from the case studies show that including future costs can have a substantial effect on the ICER, possibly affecting choices made by decision makers. Conclusion: This article improves upon previous work and provides the first tool for the inclusion of future nonmedical consumption in The Netherlands.

Background and Objectives The development of ICU-acquired hypernatremia (IAH) is almost exclusively attributed to ‘too much salt and too little water’. However, intrinsic mechanisms also have been suggested to play a role. To identify the determinants of IAH, we designed a prospective controlled study. Methods Patients with an anticipated length of stay ICU > 48 hours were included. Patients with hypernatremia on admission and/or on renal replacement therapy were excluded. Patients without IAH were compared with patients with borderline hypernatremia (≥ 143 mmol/L, IAH 143) and more severe hypernatremia (≥ 145 mmol/L, IAH 145). Results We included 89 patients, of which 51% developed IAH 143 and 29% IAH 145. Sodium intake was high in all patients. Fluid balances were slightly positive and comparable between the groups. Patients with IAH 145 were more severely ill on admission, and during admission, their sodium intake, cumulative sodium balances, serum creatinine and copeptin levels were higher. According to the free water clearance, all the patients conserved water. On multivariate analysis, the baseline serum creatinine was an independent risk factor for the development of IAH 143 and IAH 145. Also, the copeptin levels remained significant for IAH 143 and IAH 145. Sodium intake remained only significant for patients with IAH 145. Conclusions Our data support the hypothesis that IAH is due to the combination of higher sodium intake and a urinary concentration deficit, as a manifestation of the renal impairment elicited by severe illness.

© 2018 There is growing emphasis within safety science and Human Factors/Ergonomics on the benefits of applying a sociotechnical systems perspective in order to influence design and thereby improve safety in everyday operations. This article examines how viewing work as a sociotechnical system – using visual models and representations – helps in understanding how work is performed and how it contributes to safe operations. A series of five models, developed using methods from Activity Theory, Cybernetics, Cognitive Systems Engineering and Resilience Engineering, are used to illustrate the work of maritime pilots and Vessel Traffic Services operators. Each model is examined using a modelling framework for prospective safety assessment, with the conclusion that it is how the models are applied, rather than their underlying methodologies, which determines their usefulness in this context. Different models highlight different aspects of work and facilitate discussion of safety, for example in a participatory design process, and we discuss criteria to guide their use and evaluation.

Pilots and vessel traffic services (VTS) operators work to improve the safety of navigation of seagoing vessels. As in many other safety-critical domains, work is increasingly characterized by the integration and dissemination of information between humans and technology, across disciplines, and over multiple geographical locations. Empirical studies of navigational assistance were analyzed with the Functional Resonance Analysis Method (FRAM) to understand what pilots and VTS operators do and how it contributes toward maritime safety. Successful assistance was found to be dependent on (1) the use of local knowledge, preparation, and foresight to integrate information from a range of sources and (2) communication and trust between the pilot, VTS operator, and the master and crew of the vessel to provide timely assistance to vessels. FRAM was found to be a valuable tool for describing sociotechnical work but was enriched by borrowing from ethnographically inspired work studies traditions, with their strong grounding in empirical studies and themes of “making work visible,” symmetry between human and nonhuman, and work as activity. This approach indicates that bringing ideas from different traditions together to understand a real work practice may bring us closer to describing “work as done” and its contribution to safe everyday operations.

The benefits of a human-centred approach to design have been widely recognised throughout industry, in the research community and by regulatory bodies. In the maritime domain, it is also beginning to make an impact. This article explores how a human-centred approach may successfully be achieved within the context of ship design using a case study from a project to create conceptual designs for two offshore wind turbine installation vessels. Using vessel designs as a mediating tool between designers, users and human factors specialists, basic task analysis and link analysis methods were used to incorporate operational knowledge into the design process. After applying this to the integration of a dynamic positioning system on one of the vessels, the designers concluded that a human-centred approach had improved not only ship safety, but also safety, efficiency and cost-effectiveness in operations.

BACKGROUND: The more complex and perilous a sociotechnical system is, the more crucial it is to have users and other relevant stakeholder groups in focus throughout its design lifecycle. In the design and development of ships and ship systems, there has been resistance towards the integration of ergonomic principles through a human-centred approach as well as to involving the user. This inattention can result in an inadequate design, which may have negative repercussions on usability, ultimately threatening the safety of onboard operations, overall system performance and the well-being of the crew. OBJECTIVE: This study explores the perceived success factors of participatory ergonomics based on the standpoint of young seafarers. METHODS: Such is achieved by examining a focus group with cadets inspired by Grounded Theory approach. RESULTS: The findings reveal user participation as a designer’s essential contact with reality, provided that a set of pre-conditions that supports the success of participatory ergonomics can be fulfilled: involving the right users and filling in the gap between end-user needs and ship-owner requirements. The consequent success factors are described at a usability level, an intrinsic level for the end-users, and ultimately at the level of increased safety and efficiency. CONCLUSIONS: User input may not only affect design as an outcome, it may also influence the way participatory ergonomics is performed in the maritime sector.

There has been considerable debate on the extent to which future costs should be included in cost-effectiveness analyses of health technologies. In this article, we summarize the theoretical debates and empirical research in this area and highlight the conclusions that can be drawn for current practice. For future related and future unrelated medical costs, the literature suggests that inclusion is required to obtain optimal outcomes from available resources. This conclusion does not depend on the perspective adopted by the decision maker. Future non-medical costs are only relevant when adopting a societal perspective; these should be included if the benefits of non-medical consumption and production are also included in the evaluation. Whether this is the case currently remains unclear, given that benefits are typically quantified in quality-adjusted life-years and only limited research has been performed on the extent to which these (implicitly) capture benefits beyond health. Empirical research has shown that the impact of including future costs can be large, and that estimation of such costs is feasible. In practice, however, future unrelated medical costs and future unrelated non-medical consumption costs are typically excluded from economic evaluations. This is explicitly prescribed in some pharmacoeconomic guidelines. Further research is warranted on the development and improvement of methods for the estimation of future costs. Standardization of methods is needed to enhance the practical applicability of inclusion for the analyst and the comparability of the outcomes of different studies. For future non-medical costs, further research is also needed on the extent to which benefits related to this spending are captured in the measurement and valuation of health benefits, and how to broaden the scope of the evaluation if they are not sufficiently captured.

This paper reports the design, implementation, and evaluation of a teleseminar on instructional design (ID) and computer-mediated communication (CMC) for the purposes of staff development at The University of Southern Queensland, Toowoomba, Australia. Participation was open to any staff with an involvement or interest in distance education. This study was motivated by the following research questions: Is CMC a viable medium for the professional development of staff in distance education? Does the nature of moderation of CMC-based discussions influence the nature of contributions from subscribers? Do participants use different strategies (interactive, cognitive, and metacognitive) in CMC-based discussions? To address these questions a teleseminar was instituted with a focus on the issues of ID and CMC. CMC-based moderation techniques were used to manage the discussion. Both qualitative and quantitative evaluation tools were used to measure the outcomes of the teleseminar. Results of these evaluation data show that CMC proved to be a viable medium for the professional development of staff, that the moderation strategies influenced the nature of contributions from the subscribers, and that participants used a range of strategies to manage the discussion and their participation in it.