Tuesday, January 29, 2013

Man allegedly follows GPS directions to wrong house; shot dead

CNET 29 January 2013 by Chris Matyszczyk

Friends say a man in his early 20s was picking up one more of their group to go skating, when his GPS took him to the wrong house and the home-owner allegedly shot him dead, later saying he feared a home invasion.

 According to Yeson Jimenez, 15, one of the passengers, Diaz pulled into a driveway; then 69-year-old Phillip Sailors peered out of a window of the house.

He allegedly came out, went back inside, then emerged again, firing a gun into the air.
Jimenez says Sailors said nothing to them but "Shut up!"

Jimenez insists they tried to drive away and that as they did, Sailors fired his .22 gun and shot Diaz fatally in the head.

Sailors' lawyer, Michael Puglise, told the Journal-Constitution: "He is very distraught over the loss of life from the defense of his home. This incident happened late in the evening hours when he was home with his wife and he assumed it was a home invasion and he maintains his innocence."

Monday, January 28, 2013

That Daily Shower Can Be a Killer (low risk but frequent activity)

The New York Times 28 January 2013 by Jared Diamond

The other morning, I escaped unscathed from a dangerous situation. No, an armed robber didn’t break into my house, nor did I find myself face to face with a mountain lion during my bird walk. What I survived was my daily shower.

You see, falls are a common cause of death in older people like me. (I’m 75.) Among my wife’s and my circle of close friends over the age of 70, one became crippled for life, one broke a shoulder and one broke a leg in falls on the sidewalk. One fell down the stairs, and another may not survive a recent fall.
“Really!” you may object. “What’s my risk of falling in the shower? One in a thousand?” My answer: Perhaps, but that’s not nearly good enough. 

Life expectancy for a healthy American man of my age is about 90. (That’s not to be confused with American male life expectancy at birth, only about 78.) If I’m to achieve my statistical quota of 15 more years of life, that means about 15 times 365, or 5,475, more showers. But if I were so careless that my risk of slipping in the shower each time were as high as 1 in 1,000, I’d die or become crippled about five times before reaching my life expectancy. I have to reduce my risk of shower accidents to much, much less than 1 in 5,475.

This calculation illustrates the biggest single lesson that I’ve learned from 50 years of field work on the island of New Guinea: the importance of being attentive to hazards that carry a low risk each time but are encountered frequently.

I first became aware of the New Guineans’ attitude toward risk on a trip into a forest when I proposed pitching our tents under a tall and beautiful tree. To my surprise, my New Guinea friends absolutely refused. They explained that the tree was dead and might fall on us.

Yes, I had to agree, it was indeed dead. But I objected that it was so solid that it would be standing for many years. The New Guineans were unswayed, opting instead to sleep in the open without a tent.

I thought that their fears were greatly exaggerated, verging on paranoia. In the following years, though, I came to realize that every night that I camped in a New Guinea forest, I heard a tree falling. And when I did a frequency/risk calculation, I understood their point of view.

Consider: If you’re a New Guinean living in the forest, and if you adopt the bad habit of sleeping under dead trees whose odds of falling on you that particular night are only 1 in 1,000, you’ll be dead within a few years. In fact, my wife was nearly killed by a falling tree last year, and I’ve survived numerous nearly fatal situations in New Guinea.

I now think of New Guineans’ hypervigilant attitude toward repeated low risks as “constructive paranoia”: a seeming paranoia that actually makes good sense. Now that I’ve adopted that attitude, it exasperates many of my American and European friends. But three of them who practice constructive paranoia themselves — a pilot of small planes, a river-raft guide and a London bobby who patrols the streets unarmed — learned the attitude, as I did, by witnessing the deaths of careless people.

Traditional New Guineans have to think clearly about dangers because they have no doctors, police officers or 911 dispatchers to bail them out. In contrast, Americans’ thinking about dangers is confused. We obsess about the wrong things, and we fail to watch for real dangers.

Studies have compared Americans’ perceived ranking of dangers with the rankings of real dangers, measured either by actual accident figures or by estimated numbers of averted accidents. It turns out that we exaggerate the risks of events that are beyond our control, that cause many deaths at once or that kill in spectacular ways — crazy gunmen, terrorists, plane crashes, nuclear radiation, genetically modified crops. At the same time, we underestimate the risks of events that we can control (“That would never happen to me — I’m careful”) and of events that kill just one person in a mundane way.

Having learned both from those studies and from my New Guinea friends, I’ve become as constructively paranoid about showers, stepladders, staircases and wet or uneven sidewalks as my New Guinea friends are about dead trees. As I drive, I remain alert to my own possible mistakes (especially at night), and to what incautious other drivers might do.

My hypervigilance doesn’t paralyze me or limit my life: I don’t skip my daily shower, I keep driving, and I keep going back to New Guinea. I enjoy all those dangerous things. But I try to think constantly like a New Guinean, and to keep the risks of accidents far below 1 in 1,000 each time.

Jared Diamond, a professor of geography at the University of California, Los Angeles, is the author of the new book “The World Until Yesterday: What Can We Learn From Traditional Societies?"

The New York Times 28 January 2013 by Jared Diamond

Wednesday, January 23, 2013

Ergonomics in the workplace

SSI Schafer 23 January 2013 by Dr Max Winkler

Article is actually titled "Why ergonomics makes a difference in warehouse logistics." The interesting part to me is the underlying process described.

There are 3 principles of ergonomics@work!® that are combined here to improve the quality:
  1. removing physical loads from the employee and thus reducing errors caused by fatigue
  2. simple and clearly structured processes to reduce the number of possible errors right from the start
  3. intelligent workplaces that recognize mistakes before the process is completed
 Good ergonomics is self-explanatory and simple. Ergonomics is certainly more than just going easy on joints and muscles. It is also about logic, easy to follow work steps and stress-free processes. In relation to a distribution centre, this means for example optimizing search and orientation tasks. Either there is just one removal position (which means there’s no need for orientation), as in a pick-to-tote workstation, or the error-prone study of picking lists is replaced by light pointers and pick-by-light displays. On top of that, a good workplace is also intelligent. It “knows” which step is possible next or which processes are not permitted at that particular moment. For instance, an order cannot be completed if the article is dropped into the wrong chute.

Thursday, January 10, 2013

Few Savings From Digital Health Records

The New York Times 10 January 2013 by Reed Abelson and Julie Creswsell

The conversion to electronic health records has failed so far to produce the hoped-for savings in health care costs and has had mixed results, at best, in improving efficiency and patient care, according to a new analysis by the influential RAND Corporation.

Optimistic predictions by RAND in 2005 helped drive explosive growth in the electronic records industry and encouraged the federal government to give billions of dollars in financial incentives to hospitals and doctors that put the systems in place. 

“We’ve not achieved the productivity and quality benefits that are unquestionably there for the taking,” said Dr. Arthur L. Kellermann, one of the authors of a reassessment by RAND that was published in this month’s edition of Health Affairs, an academic journal.

RAND’s 2005 report was paid for by a group of companies, including General Electric and Cerner Corporation, that have profited by developing and selling electronic records systems to hospitals and physician practices. Cerner’s revenue has nearly tripled since the report was released, to a projected $3 billion in 2013, from $1 billion in 2005.

The report predicted that widespread use of electronic records could save the United States health care system at least $81 billion a year, a figure RAND now says was overstated. The study was widely praised within the technology industry and helped persuade Congress and the Obama administration to authorize billions of dollars in federal stimulus money in 2009 to help hospitals and doctors pay for the installation of electronic records systems.

“RAND got a lot of attention and a lot of buzz with the original analysis,” said Dr. Kellermann, who was not involved in the 2005 study. “The industry quickly embraced it.”

But evidence of significant savings is scant, and there is increasing concern that electronic records have actually added to costs by making it easier to bill more for some services.

Health care spending has risen $800 billion since the first report was issued, according to federal figures. The reasons are many, from the aging of the baby boomer population, to the cost of medical advances, to higher usage of medical services over all.

Officials at RAND said their new analysis did not try to put a dollar figure on how much electronic record-keeping had helped or hurt efforts to reduce costs. But the firm’s acknowledgment that its earlier analysis was overly optimistic adds to a chorus of concern about the cost of the new systems and the haste with which they have been adopted.

The recent analysis was sharply critical of the commercial systems now in place, many of which are hard to use and do not allow doctors and patients to share medical information across systems. “We could be getting much more if we could take the time to do a little more planning and to set more standards,” said Marc Probst, chief information officer for Intermountain Healthcare, a large health system in Salt Lake City that developed its own electronic records system and is cited by RAND as an example of how the technology can help improve care and reduce costs.

The RAND researchers pointed to a number of other reasons the expected savings had not materialized. The rate of adoption has been slow, they said, and electronic records do not address the fact that doctors and hospitals reap the benefits of high volumes of care.

Many experts say the available systems seem to be aimed more at increasing billing by providers than at improving care or saving money. Federal regulators are investigating whether electronic records make it easier for hospitals and doctors to bill for services they did not provide and whether Medicare and other federal agencies are adequately monitoring the use of electronic records.

Technology “is only a tool,” said Dr. David Blumenthal, who helped oversee the federal push for the adoption of electronic records under President Obama and is now president of the Commonwealth Fund, a nonprofit health group. “Like any tool, it can be used well or poorly.” While there is strong evidence that electronic records can contribute to better care and more efficiency, Dr. Blumenthal said, the systems in place do not always work in ways that help achieve those benefits.

You Can't Achieve Six Sigma Without Ergonomics

ergoweb 10 January 2013 by Jeanie Croasman and Rachel Michael

“Incorporating ergonomics into Lean/Six Sigma creates a win-win situation for both production and safety,” says Ben Zavitz, an Ergonomist for Boeing's Manufacturing Research and Development in Auburn, Washington. “Employees experience less discomfort and fatigue which results in improved productivity and quality.  However, in the beginning stages, people may be hesitant to address ergonomic issues, as they believe ergonomics may slow the process down or cost too much money. [But] focusing on practical simple solutions early on can help gain acceptance and approval of the need and benefits of ergonomics in a Lean/Six Sigma System,” Zavitz says.

“Ergonomics parallels Lean/Six Sigma -- both have their origins in Industrial Engineering. One is concerned with manufacturing efficiency and the other with human efficiency,” says Zavitz who has first hand insight from his work at Boeing and through his presentations on the subject at conferences in the U.S. and Canada. “We should strive to make the employee’s job as easy as possible,” Zavitz says, “and get away from trying to define what is an acceptable or unacceptable magnitude and/or duration for a given ergonomic risk factor.  By addressing employee ergonomic concerns during Lean/Six Sigma activities, Boeing has been able to show a significant improvement in safety, productivity and quality.”

When a company implements a Six Sigma program, they want a systematic approach to address and correct quality issues. Often, poor quality or slow production can be linked to poor ergonomics. With a knowledge base in ergonomics, the team can successfully address the problem, and ultimately produce a better product that satisfies customers, but without adding more to anyone’s already-full plate.

In its strive for near-perfection, Six Sigma involves five components  -- Defining the goals, Measuring the process/problem, Analyzing the cause, Improving the process, Controlling the future process (note -- this is the DMAIC approach; a DMADV approach -- define, measure, analyze, design and verify, also exists). Mike Wynn, Vice President of Humantech, offers this case study where Six Sigma and ergonomics worked together to solve an office worker discomfort problem:

In 1999, a U.S. Federal agency discovered growing challenges related to ergonomics with their office-based population that was ultimately affecting their customers’ expectations. The agency's Occupational Safety and Health Manager submitted a proposal to conduct an ergonomics assessment of headquarter operations.

Define: The following goals were identified:
  • Respond in a timely manner to individual discomfort issues.
  • Provide rapid improvement to individuals as their workstations are assessed.
  • Define furniture and equipment needs for the next budget cycle.
Measure: The results of the detailed discomfort survey found that 15% of the population reported significant discomfort.  This data was further analyzed to identify the body parts that were most commonly cited for significant discomfort: 
  • Lower back (8.2% of the population)
  • Neck (6.7%)
  • Right shoulder (6.0%)
Analyze: A survey method was used to identify workstation conditions contributing to discomfort. Scores showed that 14% of the population were a high priority. Within this high priority group, inadequate keyboard supports and poor seating were identified as root causes.
Improve: The solution to poor seating involved procuring and providing seating that meets current guidelines for computer workstations. The solution to inadequate keyboard support was more complicated due to the variety of furniture systems.  After thorough investigation, two classes of workstations were derived with an appropriate improvement for each. The majority of high priority individuals were provided with new keyboard trays, while a number of individuals had their work surfaces retrofitted to provide adequate space and height adjustability.
Control: The agency used the information derived from the survey to establish workstation typicals for installation upon site relocation.  These workstation typicals address important elements including workstation layout, keyboard support, seating and lighting.