Uma das atividades pouco estudadas no âmbito da Saúde do Trabalhador no Brasil é a dos profissionais de Institutos de Beleza, função historicamente vinculada ao gênero feminino e que foi sujeita a grandes mudanças no processo de trabalho ao longo dos últimos anos. Nesse estudo, optou-se por analisar o trabalho das cabeleireiras, pois estas profissionais estão sujeitas a diferentes agravos à saúde devido aos fatores de risco inerentes às suas atividades. Os objetivos do estudo foram verificar a prevalência dos Distúrbios Osteomusculares Relacionados ao Trabalho (LER/DORT) em cabeleireiras por meio de relatos de sintomas, caracterizar as regiões anatômicas mais acometidas e identificar e analisar os fatores de risco para LER/DORT existentes no trabalho dessas profissionais. Foi utilizado um estudo epidemiológico transversal e também o embasamento teórico do método de avaliação da situação de trabalho e repercussões na saúde, desenvolvido pela teoria da Ergonomia Francesa, para se discutir determinadas associações entre condições de trabalho e morbidade referida. Foram estudadas, no período de abril de 2002 a fevereiro de 2004, 220 cabeleireiras e auxiliares que trabalhavam em Institutos de Beleza localizados nos distritos de Pinheiros e Jardim Paulista da cidade de São Paulo. Identificou-se, a partir de relato de sintomas, uma prevalência de LER/DORT de 70,5%. A localização corporal mais freqüente de relato de sintomas para LER/DORT foi ombro (48,6%), seguida pelo pescoço (47,3%) e coluna (38,6%). Verificou-se que os fatores de risco associados à ocorrência dos Distúrbios Osteomusculares Relacionados ao Trabalho (LER/DORT) em cabeleireiras estavam relacionados com: a) Fatores de Incômodo e Fadiga no Trabalho (referentes à organização do trabalho e aos aspectos psicossociais do trabalho) sendo que, após análise fatorial, o único dos fatores resultantes que teve significância estatística foi o que agrupava as variáveis Falta de reconhecimento no trabalho e Postura desconfortável no trabalho (ORaj=3,54; p=0,004); b) Posturas assumidas durante a realização das atividades - Não sentir conforto no corpo/pescoço/ombros enquanto trabalha (ORaj=2,78; p=0,004); c) Tempo de profissão acima de 15 anos(ORaj=3,04; p=0,022). Identificou-se, por meio de relato de sintomas e da análise ergonômica do trabalho, que os fatores de riscos ocupacionais associados ao desenvolvimento de LER/DORT em cabeleireiras, confirmam os riscos já descritos na literatura referentes a outras atividades, ou seja, aqueles relacionados aos fatores biomecânicos, organizacionais e psicossociais do trabalho. / An activity poorly studied in Occupational Health in Brazil is the work of professionals in Beauty Parlours. This occupation is historically linked to the female gender and in the past years has been through huge changes in its operational process. In this study it was decided to analyze the job of airdressers since these professionals are under different health hazards due to risk factors related to their activity. The objectives of the study were to assess the prevalence of WRMD among hairdressers through reported symptoms, to characterize the most injured anatomic regions, and to identify and analyze the risk factors for WRMD present in the activities of these professionals. A cross-sectional study was employed together with the theories of the method for evaluation of the work situation and its consequence on health developed by the French Ergonomics, in order to discuss certain associations between working conditions and reported morbidity. Between April 2002 and February 2004 a total of 220 hairdressers who worked in Beauty Parlors in the districts of Pinheiros and Jardim Paulista were studied. A prevalence of WRMD of 70,5% was found. The body region most reported with symptoms of WRMD was shoulder (48,6%), followed by neck (47,3%) and spinal column (38,6%). It was noted that the risk factors for WRMD in hairdressers were related to: a) Annoying Factors and Fatigue at Work (connected to the work organization and the psychosocial aspects of the work) that after factorial analysis the only remaining factor statistically significant was the one that contains the variables lack of recognition at work and uncomfortable position at work (ORaj=3,54; p=0,004); b) Postures during attainment of activities - not feeling comfortable in the body/neck/shoulder while working (ORaj=2,78; p=0,004); c) Time at this occupation above 15 years (ORaj=3,04; p=0,022). Through reported symptoms and ergonomic analysis it was identified that the occupational risk factors associated with the development of WRMD in hairdressers corroborate the risks already described in the literature for other occupations, that is, those related to biomechanical, organizational and psychosocial factors.

The present study adopted a “field-laboratory-field” approach in the assessment of the efficacy of ergonomics interventions specific to two selected tasks evaluated in a South African automotive industry. Initial field testing was conducted in an Eastern Cape (South Africa) automotive plant where high risk areas were identified during walkthrough ergonomics surveys in conjunction with interaction with operators. Temporal factors and working postures of 12 industrial workers were recorded and observed, while physiological and perceptual responses were assessed. Two priority areas were focused upon for analysis, namely the Paintshop and Bodyshop with the former identified as being the more taxing of the two tasks. Responses of 30 students participating in rigourously controlled laboratory simulations were subsequently collected while completing the two tasks, namely the Paintshop Trolley Transfer (PTT) and Car Door Carriage (CDC) for participants. Working postures, kinematic, physiological and perceptual responses were assessed pre- and post-intervention. Following the laboratory experimentation a basic re-evaluation was conducted at the plant to assess whether the proposed changes had a positive effect on working postures, physiological and perceptual responses. The results of the preliminary field investigation revealed a prevalence of awkward working postures and excessive manual work in both areas. Laboratory experimentation revealed a notable reduction in task demands pre- versus post-intervention. The PTT mean lean angle for two-handed pre-intervention pulling observations of 23.7° (±3.51) was reduced to 13.9° (±2.21) post-intervention. Low back disorder (LBD) risk was reduced during the two-handed pull intervention (from 36.8% ±8.03 to 21.7% ±5.31). A significant decrement in heart rate responses from 103 bt.min-1 (±11.62) to 93 bt.min[superscript -1] (±11.77) was recorded during the two-handed symmetrical pushing intervention. The electromyography (EMG) responses for one-handed pushing and pulling pre-intervention showed the highest levels of muscular activity in the right medial deltoid due to an awkward and asymmetrical posture. CDC responses demonstrated that minor changes in the storage height of the door resulted in a significant reduction in sagittal flexion from 28.0° (±4.78) to 20.7° (±5.65). Predictions of average probability of LBD risk were significantly reduced from 50.3% (±5.91) to 39.8% (±5.10) for post-intervention car door lifting. In addition, the greatest reduction in EMG activity as a %MVC was achieved during sub-task ii (reduced from 35.1 to 13.7% and 30.5 to 13.9% for left and right erector spinae respectively) which was associated with the introduction of the transfer trolley for the door transfer phase of the CDC. Re-evaluation in the automotive plant revealed that the most notable change has been the implementation of automated ride on trolleys in the Paintshop. The Bodyshop area has also been modified to allow more effective job rotation and the step into the storage bin has been reduced via a “low-cost” stepping platform. Mean heart rate recordings were reduced from 94 (±9.77) bt.min[superscript -1] to 81 (±3.72) bt.min[superscript -1] in the Paintshop. Overall the results demonstrate the effect of “low-cost” interventions in reducing the physical stresses placed on workers in the automotive industry where much of the work is still done manually.

In 2008, there were more than 5,200 workplace fatalities in the United States (BLS, 2010b). During the same time period, U.S. employees missed almost 1.1 million days from work (BLS, 2010c). Accidents are unexpected outcomes that result not only from individuals' behaviors, but from contextual factors (Krause, 1997; Reason, 1990). Therefore, unsafe behaviors have to be interpreted according to a combination of what is occurring in the environment and what the individual is doing in that environment. The present study sought to create a more comprehensive model of safety by means of macroergonomics. Macroergonomics utilizes sociotechnical systems theory to posit that a work system is composed of a personnel subsystem (i.e., ways individuals perform tasks), a technological subsystem (i.e., tasks to be performed), and external factors (Hendrick, 2002a). Perceived control over work hours, an aspect of the technological subsystem, was examined as an antecedent of work-family conflict. Supervisor instrumental support, an aspect of the personnel subsystem, was examined as a moderator of the relationships between perceived control over work hours and work-family conflict. Supervisors have an imperative role in employees' perception of control over their work hours (Kelly & Moen, 2007). Supervisor instrumental support was also hypothesized to moderate the relationships between work-family conflict and safety performance. Supervisors who support their employees in their work-family matters exceed mandatory requirements set forth to protect workers' safety and health (Mearns, Hope, Ford, & Tetrick, 2010). A majority of the 360 participants in the present study were grocery store employees who worked in the front end of the store as cashiers. Job tenure in this particular grocery store chain was an average of 7 years (SD = 5.96) and the average number of hours worked per week was 31 (SD = 8.55). The employees were an average age of 38 years old (SD = 15.25). Two hundred and sixty-two (73%) of the participants were female, 330 (92%) were White, 196 (55%) employees were married or living as married, 146 (41%) employees identified themselves as parents with children living at home, and 58 (16%) employees provided elder care. The data were analyzed using a moderated mediation model. An employee's perceived control over his/her work hours was negatively associated with work-to-family and family-to-work conflict. Work-to-family conflict was not significantly associated with either safety compliance or participation. In contrast, family-to-work conflict was significantly associated with both safety compliance and participation. These findings replicate Cullen and Hammer's (2007) findings that family-to-work conflict, but not work-to-family conflict, is negatively associated with safety compliance and participation. The replication of these significant findings gives support to macroergonomics' assertion that external forces (i.e., family) can affect the safety of employees. All of the meditating and moderating relationships proposed in this dissertation were not significant. I conducted post hoc analyses to determine other possible significant paths in the model examined. The FSSB dimension of supervisor instrumental support was found to positively affect both safety compliance and participation. Supervisor instrumental support was also found to directly affect work-to-family conflict. Overall FSSB and its subdimensions demonstrated similar patterns in the hypothesized relationships and in additional relationships examined. Numerous implications can be recognized from this dissertation. First, interdisciplinary approaches to safety research are emerging and important in the pursuit of safer work environments. Macroergonomics and I/O psychology have commonalities that lend themselves to a good partnership where researchers can learn from each other and collaborate to advance the study of safety. Second, organizations need to focus on the stressors their employees experience as part of their safety programs, and numerous studies, including this dissertation, have found that family-to-work conflict impacts safety compliance and participation. Future safety research may incorporate macroergonomics, which emphasizes that focusing on one adverse aspect of the system may not be enough to create valuable change if there are other adverse factors still creating demands elsewhere in the system. This will allow for a more comprehensive model that ensures certain aspects of the system are not neglected, which can reduce effectiveness of constructs used to create positive changes.

Indiana University-Purdue University Indianapolis (IUPUI) / Human-looking computer interfaces, including humanoid robots and animated humans, may elicit in their users eerie feelings. This effect, often called the uncanny valley, emphasizes our heightened ability to distinguish between the human and merely humanlike using both perceptual and cognitive approaches. Although reactions to uncanny characters are captured more accurately with emotional descriptors (e.g., eerie and creepy) than with cognitive descriptors (e.g., strange), and although previous studies suggest the psychological processes underlying the uncanny valley are more perceptual and emotional than cognitive, the deep roots of the concept of humanness imply the application of category boundaries and cognitive dissonance in distinguishing among robots, androids, and humans. First, laddering interviews (N = 30) revealed firm boundaries among participants’ concepts of animated, robotic, and human. Participants associated human traits like soul, imperfect, or intended exclusively with humans, and they simultaneously devalued the autonomous accomplishments of robots (e.g., simple task, limited ability, or controlled). Jerky movement and humanlike appearance were associated with robots, even though the presented robotic stimuli were humanlike. The facial expressions perceived in robots as improper were perceived in animated characters as mismatched. Second, association model testing indicated that the independent evaluation based on the developed indices is a viable quantitative technique for the laddering interview. Third, from the interviews several candidate items for the eeriness index were validated in a large representative survey (N = 1,311). The improved eeriness index is nearly orthogonal to perceived humanness (r = .04). The improved indices facilitate plotting relations among rated characters of varying human likeness, enhancing perspectives on humanlike robot design and animation creation.

Most organizations today understand the valuable contribution employees as people (rather than simply bodies) provide to their overall performance. Although efforts are made to make the most of the human in organizations, there is still much room for improvement. Focus in the reduction of employee injuries such as cumulative trauma disorders rose in the 80 s. Attempts at increasing performance by addressing employee satisfaction through various methods have also been ongoing for several years now. Knowledge Management is one of the most recent attempts at controlling and making the best use of employees knowledge. All of these efforts and more towards that same goal of making the most of people s performance at work are encompassed within the domain of the Human Factors Engineering/Ergonomics field. HFE/E provides still untapped potential for organizational performance as the human and its optimal performance are the reason for this discipline s being. Although Human Factors programs have been generated and implemented, there is still the need for a method to help organizations fully integrate this discipline into the enterprise as a whole. The purpose of this research is to develop a method to help organizations integrate HFE/E into it business processes. This research begun with a review of the ways in which the HFE/E discipline is currently used by organizations. The need and desire to integrate HFE/E into organizations was identified, and a method to accomplish this integration was conceptualized. This method consisted on the generation of two domain-specific ontologies (a Human Factors Engineering/Ergonomics ontology, and a Business ontology), and mapping the two creating a concept map that can be used to integrate HFE/E into businesses. The HFE/E ontology was built by generating two concept maps that were merged and then joined with a HFE/E discipline taxonomy. A total of four concept maps, two ontologies and a taxonomy were created, all of which are contributions to the HFE/E, and the business- and management-related fields.

Thesis (MScPhysio)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Aims: To assess the effect of a vertical height adjustment of the chair and visual display unit (VDU) on work related upper quadrant musculoskeletal pain (WRUQMP) and sitting comfort in computer users. The upper quadrant refers to the occiput, cervical and upper thoracic spine including the clavicles and scapulae. Methods: An N=1 study was conducted using the ABC design whereby an ergonomic workstation adjustment, of VDU and chair height, was compared to the subject’s usual workstation settings. Pain and sitting comfort were measured using visual analogue scales (VAS). The subject was assessed over the four week phases as she performed her typical VDU work. The results were compiled and tabulated. Results: Both the mean and variance in pain intensity decreased after the workstation intervention. A deterioration was noted in sitting comfort. Conclusion: The vertical height adjustment of the chair and VDU may have contributed to a decrease in WRUQMP in this subject. This safe, economical workstation intervention may be a practical management option for the computer user suffering from WRUQMP. Further research into the measurement of comfort whilst sitting at a computer workstation, is recommended. / AFRIKAANSE OPSOMMING: Doelwitte: Om die effek te bepaal van n vertikale aanpassing van die stoel en beeldskerm van rekenaargebruikers op werksverwandte boonste kwadrant muskuloskeletale pyn en sitgemak. Die boonste kwadrant verwys na die oksiput, servikale en boonste torakale werwelkolom en sluit ook die klavikel en skapula in. Methode: Die N=1 studie is onderneem met gebruik van die ABC ontwerp in terme waarvan n ergonomiese aanpassing van stoel en beeldskerm vergelyk is met die normale gebruik van die deelnemer. Pyn en sitgemak is gemeet deur die gebruik van die Visueel analoogskaal. Die interwensies is ge-evalueer oor vierweekfases tydens normale rekenaar gebruik van die deelnemer. Die resultate is saamgestel en getabuleer. Uitkoms: Beide die gemiddelde en veranderlike pynintensiteit het verminder nadat die werkstasie aangepas is. Geen verbetering in sitgemak is opgemerk nie. Gevolgtrekking: Die vertikale hoogte-aanpassing van die stoel en beeldskerm het moontlik bygedra tot die verminderde pynvlakke in hierdie deelnemer. Hierdie veilige, ekonomiese verstelling is moontlik n praktiese beheeropsie vir rekenaargebruikers wat werksverwandte boonste kwadrant muskuloskeletale pyn verduur. Verder studie in die meet en waarneming van sitgemak tydens rekenaarwerk is nodig.

Thesis (MScPhysio)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Aims: To assess the effect of a chair and computer screen height adjustment on the neck and upper back musculoskeletal symptoms in an office worker. Methods: An N=1 study was conducted using the ABC design. Ethics approval was obtained for the study and the participant provided informed written consent. The participant was assessed over three four week phases as she performed her habitual computer work. The outcome measures assessed during the three phases were the pain intensity and perceived sitting comfort. The three phases were named the baseline, intervention and wash-out phases. During the baseline phase, the outcome measures were obtained at the participant‟s habitual work station. The intervention phase involved a vertical adjustment of the chair and computer screen height. The wash-out phase allowed the participant to adjust the chair and computer screen height to their choice. A follow-up interview was conducted with the participant three months after completion of the study. The mean values and the ranges of the pain intensity and perceived comfort were obtained and compared. The data collected was captured on a Microsoft Excel 2010 spread sheet, where after the data was tabulated and presented graphically. Results: The mean pain intensity of the participant increased slightly during the intervention phase in comparison to the baseline phase, but remained stable during the wash-out phase. The mean perceived sitting comfort deteriorated initially during the intervention phase, but improved later during the intervention phase and showed greater improvement during the wash out phase. The perceived sitting comfort showed more improvement than the pain intensity during the washout phase. Both the pain intensity and perceived sitting comfort showed improvement at the three months follow up assessment, post completion of the study. Conclusion: The vertical height adjustment of the chair and the VDT did not improve the participant‟s pain intensity and perceived sitting comfort when compared to the participant‟s habitual workstation parameters. The findings do not favour the horizontal viewing angle. The findings of this study however support the use of „slightly below horizontal‟ viewing angle as being conducive to reduce the pain intensity and improve the sitting comfort of an office worker. / AFRIKAANSE OPSOMMING: Doelstelling: Om die effek te bepaal van die hoogte aanpassing van die stoel en rekenaarskerm op die nek en bo-rug muskuloskeletale simptome van 'n kantoorwerker. Metodes: „n N=1 studie was uitgevoer deur gebruik te maak van die ABC ontwerp. Etiese goedkeuring was verkry vir die studie en die deelnemer het ingeligte skriftelike toestemming verleen. Die deelnemer was ge-evalueer oor drie vier week-lange fases terwyl sy haar gewone rekenaarwerk verrig het. Die uitkomsmetings ge-evalueer tydens die drie fases was pyn intensiteit en waargenome sitgemak. Die drie fases was genoem die basislyn, intervensie en uitwas fases. Gedurende die basislyn fase was die uitkomsmetings by die deelnemer se gewone werkstasie ingevorder. Die intervensie fase het 'n vertikale aanpassing van die stoel en rekenaarskerm behels. Die uitwas fase het die deelnemer toegelaat om haar stoel en rekenaarskerm se hoogte aan te pas volgens haar keuse. 'n Opvolg onderhoud was gevoer met die deelnemer drie maande na die voltooiing van die studie. Die resultate was vasgelê op 'n Microsoft Excel 2010 data bladsy, waarna die data getabuleer en grafies uitgebeeld is. Resultate: Die gemiddelde pyn intensiteit van die deelnermer het effens toegeneem tydens die intervensie fase in vergelyking met die basislyn fase, maar het stabiel gebly tydens die uitwas fase. Die gemiddelde waargenome sitgemak het aanvanklik verswak tydens die intervensie fase, maar het later verbeter tydens die intervensie fase en het aangehou verbeter tydens die uitwas fase. Die waargenome sitgemak het groter verbetering getoon as die pyn intensiteit tydens die uitwas fase. Beide pyn intensiteit en waargenome sitgemak het verbetering getoon by die drie maande opvolg evaluasie, na voltooiing van die studie. Gevolgtrekking. Die vertikale hoogte aanpassing van die stoel en rekenaarskerm het nie die deelnemer se pyn intensiteit en waargenome sitgemak in vergelyking met die deelnemer se gewone werkstasie parameters verbeter nie. Hierdie bevindinge is nie ten voordeel van die horisontale kykhoek nie. Nietemin, ondersteun die bevindinge van hierdie studie die gebruik van die "effens onder die horisontale" kykhoek as bevorderend om die pyn intensiteit te verminder en die sitgemak van 'n kantoorwerker te verbeter.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-09-28T12:25:54Z No. of bitstreams: 1 Juliana Somekh.pdf: 1105964 bytes, checksum: e95f09685cf91805d123f838a61a6076 (MD5) / Made available in DSpace on 2018-09-28T12:25:54Z (GMT). No. of bitstreams: 1 Juliana Somekh.pdf: 1105964 bytes, checksum: e95f09685cf91805d123f838a61a6076 (MD5) Previous issue date: 2017-08-31 / This study presents and questions an experiment carried out in the discipline of Ergonomics, which I teach in a Course of Design at a São Paulo university. The concern of the experiment is to awaken in the youngsters - the future designers -, the responsibility to create a design which is more inclusive and more affectionate towards old people. The project selected with this aim consists of the production of an user friendly guide, which teaches the elderly how to use, by themselves, the APP to watch films Netflix. The work investigates whether there is a gain in the quality of the produced guide and in the learning process of ergonomics when the teaching method includes a more humane view on aging, based in great part on the philosophy of encounter of Martin Buber and on exercises experiencing empathy with aging. The general aim of the research is to elaborate a proposal for a teaching method based on the principles of the science of Ergonomics allied with a theoretical analysis of empathy, and guiding the student of design to adopt a posture of respect with the aged and to seek more inclusive and user friendly solutions for products. The evaluation method of the project consisted of reports elaborated by the students after tests of their user guides with the aged people, as well as questionnaires answered by them in class about their impressions on their work and experiences. The result of the experiment shows that, although a more lasting more positive view of the aged by the young had not been achieved, when the latter would see the former as an active, eager to achieve individual it was possible to witness moments of true empathy during the tests of the guides. With the support of humanist thinkers like Buber, we conclude that it is necessary to continue the fight against prejudices ingrained in human beings and that the educator has nowadays a great responsibility to promote in the teaching environment activities originating more humane, more affectionate and more inclusive view on human diversity / Esta investigação apresenta e problematiza uma experiência da disciplina de Ergonomia que leciono em um curso de Design em uma universidade paulistana, cuja preocupação é despertar nos jovens, futuros designers, a responsabilidade por um design mais inclusivo e afetuoso aos idosos. O projeto escolhido com esta finalidade é a criação de um Manual ergonômico, que ensina o velho a usar sozinho o aplicativo de filmes NETFLIX. Investiga-se neste trabalho se há um ganho na qualidade do Manual produzido e no aprendizado de Ergonomia, ao incluir, na didática de ensino, um olhar mais humano da velhice, baseado em grande parte na filosofia de encontro de Martin Buber e em vivências de empatia com o envelhecimento. O objetivo geral da pesquisa é elaborar a proposta de uma metodologia de ensino fundada nos princípios da ciência da Ergonomia, do design inclusivo, aliada a uma análise teórica da empatia, orientando o aluno de design para uma postura de respeito com o usuário-idoso, de busca por soluções de maior afeto e usabilidade. O método de avaliação empregado consistiu em relatórios elaborados pelos alunos após o teste do manual com os idosos, bem como em questionários respondidos por eles em classe sobre suas impressões dos trabalhos e das vivências. O resultado das experiências mostra, na finalização deste trabalho, que - embora não se tenha conseguido uma mudança mais duradoura de olhar na relação jovem-velho, quando o primeiro veria o segundo como um ser produtivo e desejoso de realizações -, foi possível atestar que ocorreram momentos verdadeiramente empáticos durante o teste final do manual. Concluímos, com apoio em pensadores humanistas como Buber, que é preciso continuar a luta contra os preconceitos arraigados no ser humano e que é muito grande a responsabilidade social que deve ter hoje o educador em propiciar, no ambiente de ensino, atividades práticas, que gerem um olhar mais humano, mais afetuoso e inclusivo à diversidade humana

INTRODUÇÃO: A curarização residual está associada a maior risco de morte após anestesia. Erros diagnósticos após o uso de bloqueador neuromuscular (BNM) estão relacionados com prevalência de 65-88% de curarização residual pré-extubação traqueal (CRPE). Esse estudo analisou a decisão clínica intuitiva de usar antagonista de BNM antes da extubação traqueal. MÉTODOS: Após aprovação do Comitê de Ética em Pesquisa, a decisão clínica dos anestesiologistas da nossa instituição foi auditada em 150 pacientes. A participação foi voluntária e anônima. As decisões, como se fossem resultados de um teste diagnóstico, foram comparadas à aceleromiografia, com TOF < 0,9 definido como CRPE. Uma árvore de decisão foi estruturada para comparar as diferentes estratégias e uma pesquisa sequencial (Delphi), realizada entre 108 anestesiologistas, extraiu as heurísticas (regras simplificadoras) mais usadas. RESULTADOS: A prevalência de CRPE foi de 77%. A intuição clínica apresentou sensibilidade de 0,35 (0,23-0,49) e especificidade de 0,80 (0,54- 0,94) para CRPE (P= 0,0001). Em uma escala de 0-10 a utilidade esperada da intuição foi menor do que sempre antagonizar (4,1 + 4,4 vs. 8,4 + 3,0, P< 0,05). As heurísticas mais proeminentes foram O intervalo desde a última dose de BNM foi curto e O padrão respiratório está inadequado, citadas por 73% e 71% dos anestesiologistas, respectivamente. Uma hora após dose única de atracúrio comparada ao rocurônio, 69,3% vs. 47,1% (P= 0,0035) dos anestesiologistas não usam antagonista antes da extubação traqueal. Os anestesiologistas têm a percepção de que a prevalência de curarização residual clinicamente significativa é maior na prática dos seus colegas do que na sua própria prática clínica (razão de chances 7,8 (3,8-16,2) P< 0,0001). CONCLUSÕES: A intuição clínica não deve ser usada para descartar a presença de curarização residual. Sempre usar o antagonista é uma estratégia melhor do que usar a intuição clínica para decidir. Os anestesiologistas tomam a decisão intuitiva baseados em uma previsão da duração dos efeitos do BNM e no julgamento qualitativo da adequação do padrão respiratório do paciente. Eles se consideram mais capacitados para evitar a curarização residual do que os colegas. Demonstram confiança excessiva na própria capacidade de prever a duração de ação do BNM e de descartar intuitivamente a presença de CRPE / BACKGROUND: Residual curarization is associated with a higher risk of death after anesthesia. Diagnostic errors after the use of neuromuscular blocking agents (NMBA) are related to 65-88% prevalence of preextubation residual curarization (PERC). This study analyzed the clinical intuitive decision of antagonizing NMBA before tracheal extubation. METHODS: After IRB approval, this clinical decision was audited in 150 patients. Participation in the study was voluntary and anonymous. Decisions, as if a diagnostic test, were compared to acceleromyography, with TOF<0.9 defined as PERC. A decision tree was structured to compare different decision strategies. A sequential survey (Delphi) was conducted among 108 anaesthesiologists to elicit the most frequently used heuristics (rules of thumb). RESULTS: PERC prevalence was 77%. Clinical intuition presented sensitivity of 0.35 (0.23-0.49) and specificity of 0.80 (0.54-0.94) (P=0.0001). In a 0-10 rating scale, expected utility of intuition was lower than always antagonize all patients (4.1 + 4.4 vs. 8.4 + 3.0, P<0.05). The most salient heuristics were Short interval since the last NMBA dose and Breathing pattern is inadequate stated by 73% and 71% of the anesthesiologists, respectively. One hour after a single dose of atracurium compared with rocuronium, 69.3% vs. 47.1% (P= 0.0035) of the anesthesiologists do not use antagonist before tracheal extubation. They perceive that prevalence of clinically significant residual curarization is higher in their colleagues practice than in their own clinical practice (odds ratio 7.8 (3.8- 16.2), P< 0.0001). CONCLUSIONS: Clinical intuition should not be used to rule out residual curarization. Routine antagonism is a better strategy than the use of clinical intuition to make this decision. Clinicians make this intuitive decision based on a forecast of the duration of the effects of NMBA and on a qualitative judgement about the adequacy of the patients breathing pattern. They consider themselves more capable of avoiding residual curarization than their colleagues. They are overconfident in their own capacity to predict NMBA duration and intuitively rule PERC out

Within the design of any building, there is a requirement for designers to understand the intended purposes of the building and the elements that influence performance. These elements can be as tangible as providing a lecture hall within a university or relatively intangible such as the environmental temperatures of the rooms. The elements involved are generally recognised within the design industry and a combined force of engineers, architects, and specialist advisors work together to ensure all of the elements are in place for each new design. However, one element affecting performance that has not yet been comprehensively covered (at least for many building types) is that relating to occupant movement and the influence this has on experience and hence performance. For example, the number of times people have to negotiate cross-flow environments in a train station before becoming agitated is unknown. Also, the average distance people will walk through a shopping centre before becoming tired and ending the activity is unknown. Even so, they will both be impacted upon by the design and they will both reflect back on the performance of the design. Before starting this research, it was realised by the research engineer that there was only a limited understanding and application of people flow analyses within industry and, where it existed, it was solely related to transport terminals, pedestrian walkways/crossings, sports stadia arrivals/egress, and evacuation analyses.