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Most Cited International Journal of Industrial Ergonomics Articles
The most cited articles published since 2011, extracted from Scopus.
Learning curve models and applications: Literature review and research directionsMichel Jose Anzanello | Flavio Sanson Fogliatto
Volume 41, Issue 5, September 2011, Pages 573-583
Learning curves (LCs) are deemed effective tools for monitoring the performance of workers exposed to a new task. LCs provide a mathematical representation of the learning process that takes place as task repetition occurs. These curves were originally proposed by Wright in 1936 upon observing cost reduction due to repetitive procedures in production plants. Since then, LCs have been used to estimate the time required to complete production runs and the reduction in production costs as learning takes place, as well as to assign workers to tasks based on their performance profile. Further, effects of task interruption on workers' performance have also being modeled by modifications on the LCs. This wide variety of applications justifies the relevance of LCs in industrial applications. This paper presents the state of the art in the literature on learning and forgetting curves, describing the existing models, their limitations, and reported applications. Directions for future research on the subject are eventually proposed. Relevance to industry: The Learning Curve (LC) models described here can be used in a wide variety of industrial applications where workers endeavor new tasks. LC modeling enables better assignment of tasks to workers and more efficient production planning, and reduces production costs. © 2011 Elsevier B.V.
New methodological framework to improve productivity and ergonomics in assembly system designD. Battini | M. Faccio | A. Persona | F. Sgarbossa
Volume 41, Issue 1, January 2011, Pages 30-42
This work analyses how ergonomics and assembly system design techniques are intimately related. It also develops a new theoretical framework to assess a concurrent engineering approach to assembly systems design problems, in conjunction with an ergonomics optimization of the workplace. Its purpose is to provide professionals with a new and detailed approach to assembly system design procedures that includes ergonomics issues.The methodological framework offered takes into account technological variables (related to work times and methods), environmental variables (i.e. absenteeism, staff turnover, work force motivation) and ergonomics evaluations (i.e. human diversity) to create a comprehensive analysis.At conclusion of the study, the work reports data and insights from two real industrial cases, where an advanced simulation software is used, to validate the procedure and support methodology applicability. Relevance to industries: This work provides an extremely valuable methodological framework to companies who recognize the link between assembly and ergonomics. The methodology underlines the necessity to analyze and classify the assembly system layout configuration in relation to both technological and environmental parameters- as reported in the framework. © 2010 Elsevier B.V.
Prevalence of musculoskeletal symptoms in relation to gender, age, and occupational/industrial groupBaiduri Widanarko | Stephen Legg | Mark Stevenson | Jason Devereux | Amanda Eng | Andrea t. Mannetje | Soo Cheng | Jeroen Douwes | Lis Ellison-Loschmann | Dave McLean | Neil Pearce
Volume 41, Issue 5, September 2011, Pages 561-572
Although musculoskeletal symptoms (MSS) are common worldwide, little is known about its prevalence amongst the working population in relation to gender, age, and occupational/industrial group. This paper describes the prevalence of MSS in a sample of 3003 men and women aged 20-64 randomly selected from the New Zealand Electoral Roll. MSS experienced during the previous 12 months in 10 body regions was assessed in telephone interviews using a modified version of the Nordic Musculoskeletal Questionnaire (NMQ). MSS prevalence was 92% (for any body region). The highest prevalence was for low back (54%), neck (43%), and shoulders (42%). Females reported a statistically significantly higher prevalence of MSS in the neck, shoulders, wrist/hands, upper back and hips/thighs/buttocks regions compared to males while males reported more symptoms of the elbows, low back and knees. There were no statistically significant differences in prevalence among age groups. In general, participants with heavy physical workloads had significantly higher prevalence of symptoms in most body regions than those with light physical workloads although women with light physical workloads reported more neck symptoms. The study indicates that the New Zealand working population has a high prevalence of MSS and that exposure in the workplace plays a role. Relevance to industry: The findings of this study imply that efforts to reduce MSS in the workplace should focus on females and employees with high physical workloads. © 2011 Elsevier B.V.
Kano's model in Kansei Engineering to evaluate subjective real estate consumer preferencesCarmen Llinares | Alvaro F. Page
Volume 41, Issue 3, May 2011, Pages 233-246
Kansei Engineering is a product development tool used to identify users' perceptions and find quantitative relationships between their subjective responses and design features. This paper proposes the use of Kano's model in this process to analyse the impact of different subjective attributes on consumers' purchase decisions. A practical example of real estate promotions design is presented. In the first stage, semantic differential is used to measure the subjective component of the emotional state. In the second stage, regression analysis and Kano's model are used to define the relative weight of each emotional attribute in the purchase decision. Besides linear attributes, Kano's model identified two other kinds of attributes that present a non-linear performance: basic attributes and exciting attributes. Therefore linear models could underestimate the effect of such kind of attributes. Relevance to industry: This information is very relevant for architects and designers as it enables them to determine the extent to which they must direct their efforts at improving certain attributes with the object of improving the global evaluation. © 2011 Elsevier B.V.
Nordic Safety Climate Questionnaire (NOSACQ-50): A new tool for diagnosing occupational safety climatePete Kines | Jorma Lappalainen | Kim Lyngby Mikkelsen | Espen Olsen | Anders Pousette | Jorunn Tharaldsen | Kristinn Tómasson | Marianne Törner
Volume 41, Issue 6, November 2011, Pages 634-646
Although there is a plethora of questionnaire instruments for measuring safety climate or culture, very few have proven able to present a factor structure that is consistent in different contexts, and many have a vague theoretical grounding. The Nordic Safety Climate Questionnaire (NOSACQ-50) was developed by a team of Nordic occupational safety researchers based on organizational and safety climate theory, psychological theory, previous empirical research, empirical results acquired through international studies, and a continuous development process. Safety climate is defined as workgroup members' shared perceptions of management and workgroup safety related policies, procedures and practices. NOSACQ-50 consists of 50 items across seven dimensions, i.e. shared perceptions of: 1) management safety priority, commitment and competence; 2) management safety empowerment; and 3) management safety justice; as well as shared perceptions of 4) workers' safety commitment; 5) workers' safety priority and risk non-acceptance; 6) safety communication, learning, and trust in co-workers' safety competence; and 7) workers' trust in the efficacy of safety systems. Initial versions of the instrument were tested for validity and reliability in four separate Nordic studies using native language versions in each respective Nordic country. NOSACQ-50 was found to be a reliable instrument for measuring safety climate, and valid for predicting safety motivation, perceived safety level, and self-rated safety behavior. The validity of NOSACQ-50 was further confirmed by its ability to distinguish between organizational units through detecting significant differences in safety climate. Relevance to industry: NOSACQ-50 will enable comparative studies of safety climate between and within companies, industries and countries. It is suitable for research purposes as well as for practical use in evaluating safety climate status, as a diagnostic tool, and in evaluating the effect of safety climate interventions. © 2011 Elsevier B.V.
Comparing the results of eight methods used to evaluate risk factors associated with musculoskeletal disordersMarie ève Chiasson | Daniel Imbeau | Karine Aubry | Alain Delisle
Volume 42, Issue 5, September 2012, Pages 478-488
This paper presents a comparison between eight different methods for determining risk factors for work-related musculoskeletal disorders. The Quick Exposure Check (QEC), the Ergonomic Workplace Analysis developed by the Finnish Institute of Occupational Health (FIOH), ACGIH's Hand Activity Level threshold limit values method (HAL), the Job Strain Index (JSI), the OCRA index, the EN 1005-3 standard, the Rapid Upper Limb Assessment (RULA) and the Rapid Entire Body Assessment (REBA) methods were all used to assess 224 workstations involving 567 tasks in various industrial sectors. The results are compared using three risk categories (low, moderate, high). Data were gathered using video and measurements taken at the workstations. A questionnaire was also administered to employees participating in the study. The findings reveal that the various methods differ in their analyses of the same workstation. The EN 1005-3 standard assessing risk to the shoulder was the most conservative, identifying over 86% of the workstations as high risk. The HAL classified 37% of the workstations as low-risk to the hand and wrist compare to JSI with 9%. Correlation was highest between RULA and REBA, and between JSI and HAL. The FIOH, RULA and REBA methods did not identify any workstations as low risk. The QEC method proved to be the less stringent in assessing overall risk, classifying 35% of the workstations as high risk compare to RULA with 76%. The QEC Hand/wrist and OCRA Hand/wrist/elbow indices showed similar results for the number of workstations classified as high risk, but did not classify the same workstations in this category. OCRA and QEC were in agreement 57% of the time for all risk categories combined. Relevance to industry: These results provide a better understanding of the differences between various risk assessment methods. This information should be particularly useful for practitioners when choosing a method prior to an ergonomic intervention in industry. © 2012 Elsevier B.V.
Task complexity: A review and conceptualization frameworkPeng Liu | Zhizhong Li
Volume 42, Issue 6, November 2012, Pages 553-568
Task complexity has been recognized as an important task characteristic that influences and predicts human performance and behaviors. However, currently there is still limited consensus on how to understand this concept. This study aims at providing a clear, systematic understanding of task complexity. Task complexity definitions and models in the literature are reviewed from structuralist, resource requirement, and interaction viewpoints. Various existing task complexity definitions are summarized. Confusing terms related to task complexity are then clarified. From an objective and broad sense, task complexity is conceptualized following a task-component-factor-dimension framework. A six-component task model is proposed for identifying salient complexity contributory factors. Task complexity is then structured with ten dimensions. Finally, the proposed task complexity model was compared with other models. Relevance to industry: The review and conceptualization of task complexity are helpful for better understanding of task complexity, its measurement and management, and in-depth analysis of various tasks in industries. © 2012 Elsevier B.V.
Kansei clustering for emotional design using a combined design structure matrixYuexiang Huang | Chun Hsien Chen | Li Pheng Khoo
Volume 42, Issue 5, September 2012, Pages 416-427
Consumers' emotional requirements, or so-called Kansei needs, have become one of the most important concerns in designing a product. Conventionally, Kansei engineering has been widely used to co-relate these requirements with product parameters. However, a typical Kansei engineering approach relies heavily on the intuition of the person who uses the method in clustering the Kansei adjectives, who may be the engineer or designer. As a result, the selection of Kansei adjectives may not be consistent with the consumers' opinions. In order to obtain a consumer-consistent result, all of the collected Kansei adjectives (usually hundreds) need to be evaluated by every survey participant, which is impractical in most design cases. Therefore, a Kansei clustering method based on a design structure matrix (DSM) is proposed in this work. The method breaks the Kansei adjectives up into a number of subsets so that each participant deals with only a portion of the words collected. Pearson correlations are used to establish the distances among the Kansei adjectives. The subsets are then integrated by merging the identical correlation pairs for an overall Kansei clustering result. The details of the proposed approach are presented and illustrated using a case study on wireless battery drills. The case study reveals that the proposed method is promising in handling Kansei adjective clustering problems. Relevance to industry: This study presents a generic method to deal with consumers' Kansei requirements for emotional design in new product development. It appears that the proposed method can be utilized to capture and analyze consumers' Kansei needs as well as to facilitate decision making in practical industrial design cases. © 2012 Elsevier B.V.
Cognitive ergonomics, socio-technical systems, and the impact of healthcare information technologiesErin K. Lawler | Alan Hedge | Sonja Pavlovic-Veselinovic
Volume 41, Issue 4, July 2011, Pages 336-344
The United States healthcare system is transitioning from paper-based to computer-based systems. In this process, it is vitally important to focus on optimizing the role of human factors in systems design. This review examines a wide range of cognitive ergonomics and socio-technical systems issues that impact the successful implementation of healthcare information technologies (HIT). We review evidence on the impact of HIT on medication errors, electronic health records and clinical support, copying clinical exams and notes, computerized-provider order entry and clinical decision support system, and bar-code medication administration systems. We examine research on barriers to successful HIT implementation and also on user workarounds of systems' limitations. The review concludes by summarizing a series of important human factors design considerations that must be considered for successful systems implementation. This information is presented in a manner that should allow HIT system designers and implementers to readily incorporate these principles into their future developments.Relevance to industry: Evidence from a comprehensive review of the impact of HIT on a wide variety of important healthcare issues is presented and a series of human factors design considerations that are critical to successful HIT systems design is summarized. © 2011 Elsevier B.V.
Effects of different physical workload parameters on mental workload and performanceAngela DiDomenico | Maury A. Nussbaum
Volume 41, Issue 3, May 2011, Pages 255-260
The design and evaluation of an occupational task should include an assessment of mental workload, since excessive levels of mental workload can cause errors or delayed information processing. Physically demanding work that is performed concurrently with a cognitive task may impact mental workload by impairing mental processing or decreasing performance. The primary objective of this study was to determine whether there is a differential effect of various types of physical activity on both mental workload and cognitive performance. Objective and subjective assessment tools (heart rate variability and visual analog scale) were used as indicators of mental workload, while correct responses during an arithmetic task reflected levels of performance. Thirty participants (ages 18-24 years) performed a combination of tasks inducing both physical and mental workload. Type of physical effort, frequency of movement, and force exertion level were manipulated to alter the workload associated with the physical activity. Changes in subjective ratings generally corresponded to changes in both performance on the arithmetic task and objective mental workload assessment. Some discrepancies occurred at the highest physical force exertion level as participants perceived an increase in effort to maintain the same level of performance. Further research is needed to determine the force exertion threshold, beyond which the physical effort required interferes with mental workload and/or cognitive performance. Relevance to industry: Technological advancements have increased the requirement for many workers to execute cognitive tasks concurrently with physical activity. When designing and evaluating such situations it is important to determine the interactive effects of these activities. A simple, uni-dimensional tool is suggested as a screening tool to identify situations requiring excessive or increased mental workload that many degrade performance or place additional stress on the individual. © 2011 Elsevier B.V.
Investigation of musculoskeletal symptoms and ergonomic risk factors among female sewing machine operators in TurkeyNilüfer Öztürk | Melek Nihal Esin
Volume 41, Issue 6, November 2011, Pages 585-591
This cross-sectional study aimed to identify the prevalence of musculoskeletal symptoms and ergonomic risks in female sewing machine operators at a textile company. The study sample comprised all female sewing machine operators in the company. The sample included 283 sewing machine operators. Data were collected through the use of the adapted Nordic Musculoskeletal Questionnaire and by direct observations via the rapid upper limb assessment (RULA) to determine ergonomic risks. RULA is a validated tool for assessment of ergonomic risks. The mean age of the women was 30.2 (SD: 8.4) and the mean number of years of employment was 13.4 (SD: 5.5). The highest prevalence rates for the women's musculoskeletal symptoms were in the trunk (62.5%), neck (50.5%), and shoulder (50.2%). Of the women, 65% had experienced musculoskeletal pain or discomfort over the last 6 months. Pain intensity of these symptoms was assessed with a visual analogue scale. The average pain intensity of the women was found to be 3.5 (SD: 2.8). Results of the RULA scores were found to be quite high. There were no employees who received RULA scores of 1-2, which indicates acceptable postures (all scores >5). The final RULA scores of 6.9 indicate that the participants' postures at their work stations need to be investigated immediately. Relevance to industry: This study based on the RULA method allowed to perform a rapid and quite correct evaluation tolls for SMOs. For this research population, the research findings provided fundamental data on the prevalence of musculoskeletal symptoms and ergonomic risks among Turkish female SMOs. © 2011 Elsevier B.V.
Effects of concurrent physical and mental demands for a short duration static taskRanjana K. Mehta | Michael J. Agnew
Volume 41, Issue 5, September 2011, Pages 488-493
The purpose of this study was to quantify the effects of concurrent physical and mental demands on the upper extremity muscle activity during static exertions. Seventeen healthy participants performed isometric upper extremity exertions at five levels of physical intensity (5%, 25%, 45%, 65%, and 85% maximum voluntary contraction (MVC)) in the presence and absence of a mental task (Stroop color word test). Muscular responses were quantified using surface electromyography (EMG) and motor performance was measured through force fluctuations. Subjective assessments were obtained through the NASA-TLX tool and the Borg CR-10 Scale. In general, a decrease in mean anterior and posterior deltoid muscle activity and co-contraction index (CCI) of the shoulder was observed in the presence of the mental task. However, these changes were more prominent at higher physical exertion levels compared to the lower levels. Furthermore, the additional mental task resulted in decreased upper and lower arm muscle activity, specifically at the 45% MVC level. Motor performance improved at the middle exertion levels, but was adversely affected by the mental task at higher exertion levels. Decreased motor performance at higher loads may have been a result of decreased muscular effort to maintain the loads in a steady posture. Both mental and physical demand adversely affected the NASA-TLX ratings, however, ratings using the Borg CR-10 Scale were only sensitive to changes in physical demand. Relevance to industry: Workplace tasks, such as jobs performed by healthcare workers, assembly line workers, and computer operators, have become more multidimensional in the recent years; with workers experiencing combined physical and mental demands in their daily jobs, yet their effect on muscular responses is not clearly understood. Results from this study suggest that certain physical exertion levels are more susceptible to interference by mental demands than others. © 2011 Elsevier B.V.
Modeling user experience: A case study on a mobile deviceJaehyun Park | Sung H. Han | Hyun K. Kim | Seunghwan Oh | Heekyung Moon
Volume 43, Issue 2, March 2013, Pages 187-196
User experience (UX) consists of all aspects of interactions between a user and a product. Recently, many studies have been conducted to define the UX concept, but few studies have attempted to quantify UX. This paper proposed quantification models that integrate major elements of UX into a single index. A variety of models were proposed and evaluated including compensatory (i.e. simple linear, polynomial and S-shaped value) and non-compensatory (i.e. conjunctive and disjunctive) models. A case study with a commercial tablet PC was conducted in which a total of 26 subjects participated in a laboratory environment. Each participant performed a pretest ensuring the ability to make ratio judgments and then evaluated predefined dimensions with the modified magnitude estimation procedure. A total of 22 hierarchical dimensions were evaluated such as overall UX, its elements (i.e. usability, affect and user value) and sub-elements. Both compensatory and non-compensatory models had high performance in terms of goodness of fit. The results of this study are expected to help product or service designers develop indices representing an overall UX value. Relevance to industry: This study proposed quantification models that aggregate elements of UX. Although the UX index has been controversial, the single value developed by the models can be expected to help decision-makers understand about products or services intuitively. © 2013 Elsevier B.V.
A novel approach for determining fatigue resistances of different muscle groups in static casesLiang Ma | Damien Chablat | Fouad Bennis | Wei Zhang | Bo Hu | François Guillaume
Volume 41, Issue 1, January 2011, Pages 10-18
In ergonomics and biomechanics, muscle fatigue models based on maximum endurance time (MET) models are often used to integrate fatigue effect into ergonomic and biomechanical application. However, due to the empirical principle of those MET models, the disadvantages of this method are: 1) the MET models cannot reveal the muscle physiology background very well; 2) there is no general formation for those MET models to predict MET. In this paper, a theoretical MET model is extended from a simple muscle fatigue model with consideration of the external load and maximum voluntary contraction in passive static exertion cases. The universal availability of the extended MET model is analyzed in comparison to 24 existing empirical MET models. Using mathematical regression method, 21 of the 24 MET models have intraclass correlations over 0.9, which means the extended MET model could replace the existing MET models in a general and computationally efficient way. In addition, an important parameter, fatigability (or fatigue resistance) of different muscle groups, could be calculated via the mathematical regression approach. Its mean value and its standard deviation are useful for predicting MET values of a given population during static operations. The possible reasons influencing the fatigue resistance were classified and discussed, and it is still a very challenging work to find out the quantitative relationship between the fatigue resistance and the influencing factors. Relevance to industry: MSD risks can be reduced by correct evaluation of static muscular work. Different muscle groups have different properties, and a generalized MET model is useful to simplify the fatigue analysis and fatigue modeling, especially for digital human techniques and virtual human simulation tools. © 2010 Elsevier B.V.
Ergonomic design knowledge built in the intelligent decision support systemJasmin Kaljun | Bojan Dolšak
Volume 42, Issue 1, January 2012, Pages 162-171
Existing computer tools for ergonomic design are unable to assist designers with higher level advice within design processes. Thus, design engineers need to rely on their own knowledge and experience when making crucial decisions relating to products' ergonomic parameters. An intelligent decision support system has been developed in order to overcome this bottleneck. This paper presents a knowledge base, containing ergonomic design knowledge specific for hand tool design. A pneumatic hammer handle design is used as a case study in order to show how ergonomic design knowledge built within this system is used to improve the ergonomic value of a product. Relevance to industry: Engineers in small and medium-size enterprises (SME's) or young designers are in an unenviable position as their knowledge domains and experiences are minimal. When applying decision support system discussed here, even SME's could appear on the market with optimal designed products with relatively minor influence on development budget. Consequently their role on the market will be aggrandised. © 2011 Elsevier B.V.
A neuroergonomic approach to evaluating mental workload in hypermedia interactionsLeandro L. Di Stasi | Adoración Antolí | Miguel Gea | José J. Cañas
Volume 41, Issue 3, May 2011, Pages 298-304
Neuroergonomics could provide on-line methods for measuring mental effort while the operator interacts with hypermedia. We present an experimental study in which 28 participants interacted with a modified version of an existing Spanish e-commerce website in two searching tasks (Goal oriented shopping and Experiential shopping) that demand different amounts of cognitive resources. Mental workload was evaluated multidimensionally, using subjective rating, an interaction index, and eye-related indices. Eye movements and pupil diameter were recorded. The results showed visual scanning behaviour coincided with subjective test scores and performance data in showing a higher information processing load in Goal oriented shopping. However, pupil diameter was able to detect only the variation in user activation during the interaction task, a finding that replicates previous results on the validity of pupil size as an index of arousal. We conclude that a neuroergonomics approach could be a useful method for detecting variations in operators' attentional states. Relevance to industry: These results could provide important information for the development of a new attentional screening tool for the prevention of accidents in several application domains. © 2011 Elsevier B.V.
What are the obstacles and needs of proactive ergonomics measures at early product development stages? - An interview study in five Swedish companiesAnn Christine Falck | Mikael Rosenqvist
Volume 42, Issue 5, September 2012, Pages 406-415
Despite health and safety legislation and ergonomics regulations for several years many Swedish companies are still unable to effectively prevent the consequences of poor ergonomics. Corrective measures are often made (too) late when employees complain and work-related disorders have already occurred. Besides, several studies have shown that poor ergonomics result in deteriorated assembly quality and reduced productivity and that late measures are often costly. Other studies have proven that design engineers are often unaware of design consequences and do not know how to apply ergonomics principles in new product and production design. Therefore, the purpose of this study was to explore what is required to improve the situation. One way to find out was to ask engineers involved in product and production development. Thus, 64 engineers in design and manufacturing engineering in five Swedish companies were interviewed about ergonomics conditions related to quality and productivity issues. In general, their answers unexpectedly demonstrated a fairly good awareness of the implications of poor assembly ergonomics but also that appropriate product and production design methods and tools to prevent these are missing. 58 of the respondents thought that poor ergonomics could result in reduced product quality. 47 stated that profitability calculations are necessary for changes of poor ergonomic solutions. 37 said that ergonomics risks are accepted due to lack of appropriate calculation methods. Altogether, many suggestions emerged for how to improve product and production design methods and tools in order to achieve more complete and sustainable manufacturing solutions. Relevance to industry: The relationship between ergonomics and assembly quality deserves more attention in order to achieve both good working conditions and sustainable and cost-efficient manufacturing solutions. Assembly ergonomics and quality relationships must therefore be proactively considered already in early design phases of new product and assembly concepts. © 2012 Elsevier B.V.
The impact of ergonomics intervention on psychosocial factors and musculoskeletal symptoms among office workersAlireza Choobineh | Majid Motamedzade | Maryam Kazemi | Abbas Moghimbeigi | Ahmad Heidari Pahlavian
Volume 41, Issue 6, November 2011, Pages 671-676
Musculoskeletal disorders have a multi factorial etiology that includes not only physical risk factors but also psychosocial factors. This study aimed to investigate psychosocial risk factors and musculoskeletal symptoms among office workers of an Iranian oil refinery and also to examine the subsequent effects of ergonomics intervention on musculoskeletal discomfort and psychosocial risk factors.In this study, 73 office workers as a case group and 61 office workers as a control group from an Iranian oil refinery plant were randomly selected and examined. The Nordic Musculoskeletal Disorders Questionnaire and the Persian version of the Job Content Questionnaire (P-JCQ) were used as collecting data tools before and after the interventional program.Low back problem (28.8%) was found to be the most common problem among the office workers. Significant differences found between prevalence rates of reported musculoskeletal in upper back, lower back and feet/ankle regions before and after intervention. Our findings showed that psychosocial variables were not affected by the intervention. The only variables on the P-JCQ that were significantly different pre/post intervention are the physical variables: physical job demands, physical exertion and physical isometric load. None of the other psychosocial variables were found to be significant. With the top management support, improvements in all office workstation components were made successfully. Relevance to industry: Recently, changes in the nature of work draw increased attention to the relation between psychosocial factors and musculoskeletal disorders. The results of the current study indicate that a well conducted implementation of an interventional program can lead to a decrease in musculoskeletal symptoms and to some extent in the psychosocial factors at work. © 2011 Elsevier B.V.
That's nice, but what does IT do? Evaluating the impact of bar coded medication administration by measuring changes in the process of careRichard J. Holden | Roger L. Brown | Samuel J. Alper | Matthew C. Scanlon | Neal R. Patel | Ben Tzion Karsh
Volume 41, Issue 4, July 2011, Pages 370-379
Health information technology (IT) is widely endorsed as a way to improve key health care outcomes, particularly patient safety. Applying a human factors approach, this paper models more explicitly how health IT might improve or worsen outcomes. The human factors model specifies that health IT transforms the work system, which transforms the process of care, which in turn transforms the outcome of care. This study reports on transformations of the medication administration process that resulted from the implementation of one type of IT: bar coded medication administration (BCMA). Registered nurses at two large pediatric hospitals in the US participated in a survey administered before and after one of the hospitals implemented BCMA. Nurses' perceptions of the administration process changed at the hospital that implemented BCMA, whereas perceptions of nurses at the control hospital did not. BCMA appeared to improve the safety of the processes of matching medications to the medication administration record and checking patient identification. The accuracy, usefulness, and consistency of checking patient identification improved as well. In contrast, nurses' perceptions of the usefulness, time efficiency, and ease of the documentation process decreased post-BCMA. Discussion of survey findings is supplemented by observations and interviews at the hospital that implemented BCMA. Relevance to industry: By considering the way that IT transforms the work system and the work process a practitioner can better predict the kind of outcomes that the IT might produce. More importantly, the practitioner can achieve or prevent outcomes of interest by using design and redesign aimed at controlling work system and process transformations. © 2011 Elsevier B.V.
Event-related (De)synchronization (ERD/ERS) during motor imagery tasks: Implications for brain-computer interfacesYongwoong Jeon | Chang S. Nam | Young Joo Kim | Min Cheol Whang
Volume 41, Issue 5, September 2011, Pages 428-436
The primary aims of this research were to examine (1) mu and beta event-related desynchronization/synchronization (ERD/ERS) during motor imagery tasks with varying movement duration and (2) the potential impacts of movement duration on ERD/ERS patterns. Motor imagery tasks included brief and continuous imagined hand movements. During an imagery task, participants imagined an indicated movement for 1 s (i.e., brief movement imagery) or 5 s (i.e., continuous movement imagery). The results of the study support (1) that mu and beta ERD/ERS patterns are elicited during imagined hand movements and (2) that movement duration affects ERS and does not affect ERD patterns, during motor movement imagery. Additionally, brief movement imagery had a greater impact on mu and beta ERD; continuous movement imagery had a greater impact on mu and beta ERS. This research will be useful for designing future brain-computer interfaces as it provides valuable insight into the dynamics of electroencephalographic (EEG) oscillatory changes during motor imagery tasks with varying movement duration. Relevance to industry:: Brain-computer interfaces (BCIs) have gained considerable interests by both research and industry communities who want to improve the quality of life for those who suffer from severe motor disabilities, such as amyotrophic lateral sclerosis (ALS), brainstem stroke, and cerebral palsy (CP). The results of this study should be applied to EEG-based BCI system design in order to enhance accuracy and classification performance for BCI system control. © 2011 Elsevier B.V.
Perceptual matching of shape design style between wheel hub and car typeShi Jian Luo | Ye Tao Fu | Yu Xiao Zhou
Volume 42, Issue 1, January 2012, Pages 90-102
The current automobile industry lacks matching rules between wheel hubs and car types; given the multitude of potential combinations between these two vehicle components, it is often difficult for manufacturers to confirm that their selected design is truly the most appropriate for and harmonious with a given car. For the purpose of providing guidelines for wheel hubs selection, this paper, therefore, presented a case study on 6 typical types of cars and 20 wheel hubs, examined their shape design styles and accordingly proposed a methodology for evaluating the perceptual matching quality between the two through a participatory experiment, including (1) identification of Kansei attributes, (2) matching evaluation by ranking method, and (3) semantic differential (SD) evaluation of wheels and car bodies separately. Based on computing the correlations of SD evaluation value vectors between bodies and wheels, the matching quality was verified to have a strong relationship with the similarity of the components' design style. With a subsequent correspondence analysis of ranking data, the obtained projection value explicitly reflected the strength of the association between wheel hubs and corresponding car types. As a result, 6 positive and 3 negative representative design samples of wheel hubs were obtained for each type of car. Accordingly, design solutions were recommended, and the achievements can be readily employed by companies to propose appropriate designs that precisely meet market demands. Relevance to industry: This paper suggests that automobile product developers consider a matching relationship among the components within their cars. The matching quality of one component has been verified to be strongly related to the similarity between its shape design style and holistic car image. This paper's findings can be readily employed by automobile manufactures for predicting appropriate wheel hub designs according to the specific requirements of vehicle development. These well-founded design solutions will meet the market demands precisely. © 2011 Elsevier Ltd.
Neck loads and posture exposure of helicopter pilots during simulated day and night flightsKelsey A. Forde | Wayne J. Albert | Michael F. Harrison | J. Patrick Neary | James Croll | Jack P. Callaghan
Volume 41, Issue 2, March 2011, Pages 128-135
This study investigated neck loads and neck postures experienced by Canadian Forces (CF) helicopter pilots during routine simulator day and night flights. During the night flights pilots' helmets were equipped with night vision goggles (NVG) which have been implicated in the increase of neck pain amongst pilots. Pilot's postures were determined from video recordings of their flight missions to: (1) identify the neck postures assumed during day and night flight missions, and (2) determine the amount of biomechanical cervical spine loading experienced during these flights. Neck postures and peak and cumulative cervical kinetic loading were significant different (P<0.05) between day and night. During night flights the percentage of work cycle spent in mildly flexed posture increased significantly from 43% during day flights to 74% during night flights. As well, cumulative reaction compression values significantly increased from 583. kN. s to 694. kN. s. The biomechanical results lend support to previous physiological investigations of NVG use and further justify the need for guidelines associated with NVG use. Relevance to industry: The research highlights the biomechanical demands on the neck resulting from wearing a helmet with added weight from night vision equipment. The results have direct implication to military and commercial operators required to wear night vision equipment or added weight to the head. © 2011 Elsevier B.V.
Endurance time of grip-force as a function of grip-span, posture and anthropometric variablesMahmut Eksioglu
Volume 41, Issue 5, September 2011, Pages 401-409
The time to volitional exhaustion (endurance time) for sustained contractions is considered as a valid parameter to quantify fatigue and to determine the required rest pauses between two successive contractions. In this study, the effects of grip-span, shoulder posture and anthropometric characteristics on endurance time of grip-force during sustained 30% of maximal voluntary grip-force were investigated. Both subjective and objective measures of fatigue were used in determining the endurance times. Twelve male subjects performed sustained isometric handgrip contractions using a handgrip dynamometer at the combinations of three different grip span settings and two shoulder postures. The investigated three grip spans were the optimal, 2 cm narrower than the optimal, and 2 cm wider than the optimal. The investigated two shoulder postures were neutral and 25° flexion. The outcome measures were: endurance time, surface electromyography of related forearm muscles, heart rate, blood pressure, and ratings of perceived discomfort/pain. The results indicate that the endurance time decreases significantly as the grip span deviates from the optimal in both directions. On the other hand, the considered shoulder postures did not have a significant effect on the endurance time. Further analysis indicated a significant negative correlation between endurance time and rest pause and a marginal positive correlation between maximum voluntary grip-force and rest pause. Body mass index, and volume of forearm and hand had also significant negative correlation with endurance time. The comparisons are made with a number of existing endurance models and the impact of findings are discussed. Relevance to industry: In accurate establishment of the time standards, muscular fatigue allowances need to be taken into account. The endurance time for sustained isometric contractions is correlated with the required rest allowances (pauses) for intermittent static contractions; and therefore, required muscular fatigue allowances can be estimated from the endurance times. © 2011 Elsevier B.V.
Development of a web-based survey system for evaluating affective satisfactionYoungseok Cho | Jaehyun Park | Sung H. Han | Sungjin Kang
Volume 41, Issue 3, May 2011, Pages 247-254
The concept of affective satisfaction is used to measure subjective feelings or impressions toward a product and to provide designers with knowledge about how well users are affectively satisfied. Numerous studies of affective satisfaction toward mobile devices have been conducted in laboratory environments. However, evaluating affective satisfaction whenever a new product is designed can be expensive. Therefore, this study proposes a method to develop a web-based survey system for evaluating affective satisfaction. A case study evaluating the affective satisfaction of thirty mobile phones was conducted by more than three hundred participants. The multiple linear regression technique was applied to build the relationship models between affective satisfaction and design features of the mobile phones. The proposed method can be used for a guideline to evaluate the affective satisfaction over the internet. Moreover, designers can use this method in product families other than mobile phones. Relevance to industry: The results of this study can be used to evaluate affective satisfaction of consumer electronic products efficiently. Moreover, designers can get feedback on their prototypes of products through analyzing the evaluation results. © 2011 Elsevier B.V.
Applying Kansei engineering to industrial machinery trade show booth designMing Shyan Huang | Hung Cheng Tsai | Tzu Hua Huang
Volume 41, Issue 1, January 2011, Pages 72-78
Trade shows are considered an important marketing channel for companies since they provide manufacturers and purchasers with a vital commercial platform. Traditionally, plastics and rubber industry trade shows have been ineffective due to poor booth planning. Nevertheless, few studies have examined trade show booth design and planning. Actually, most companies lack distinct goals, and their decisions regarding trade show participation may influence decisions regarding which products should be demonstrated, size of trade booth, and level of advertising. Such a decision-making is a problem involving multi-criteria decisions, and requires a logical and objective operating procedure. This work thus devises an objective procedure for trade show. This investigation focuses on booth design for plastics and rubber industry trade shows and comprises three parts: (1) selecting appropriate assessment criteria for trade show design using the Delphi method and Kansei engineering. (2) Establishing suitable booth design principles and procedures for plastics and rubber industry trade show using fuzzy product positioning. (3) Further employing the proposed method to design trade show booths and verify their performance. The results demonstrate the feasibility of the proposed method. Relevance to industry: This study was conducted to support machinery vendors as a systematic design flow chart and related criteria to provide an objective approach to trade show booth planning. © 2010 Elsevier B.V.


text:
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Living donation is a way for people to receive a particular organ and/or tissue for transplants.
It can offer an alternative to waiting on the national transplant waiting list for an organ from a deceased donor.
Like retrieving organs from a deceased donor, it does mean carrying out major surgery. However results are successful.
Before you can become a living donor, we will carefully assess you to make sure
What you can donate
Kidneys are the most common organ donated by a living person. About a third of all kidney transplants carried out in the UK are from living donors. A healthy person can lead a normal life with one working kidney.
Further information on kidney donation.
Could I be a living kidney donor? FAQs
Could I give my kidney to someone I don't know?
The UK Living Kidney Sharing Schemes
You can also donate part of your liver as a living person, although this is less common than living kidney donation.
As a living donor you can donate your bone and amniotic membrane.
To become a living kidney or liver donor:
To become a tissue donor:
Read Chris' story
Read Katie's story

subset: commoncrawl


text:
Size matters...no wait size doesn't matter. Such blanket statements of (not necessarily true) fact are a part of everyday life. One of the great things about football is there is very little room for such a black and white mentality.
While other team sports quite naturally need to place an emphasis on height or strength, the nature of football allows it to embrace creativity and technical ability more than others might.
This has meant players who aren't six foot tall or bigger to both comfortably make a living in the sport, and in many cases flourish successfully. The shining example of this today is Barcelona and Argentina's Lionel Messi.
Messi utilises his comparatively slight stature in the way he, at times, unfathomably weaves his way through what seems the tightest of spaces with a mixture of tremendous trickery and speed. Yet while this is one element of his game, his size does not wholly characterise who he is as a player.
As is the case with the following list of 25 of the best small players in the world right now. The only criteria being they come in under 5'9'', like Messi, these players are some of the most talented in the world right now.
If there is anyone you think is missing out or if someone on the list isn't worth their place please feel free to comment and discuss.


text:
Best Kids Parties: Alice in Wonderland
Read Between the Limes and, for fun, read Carri's post on the party aftermath! (Images: Carri Stokes)
We love a good party! If you'd like to share the good ideas and photos from your child's celebration with the Ohdeedoh community please submit through the "My Party" submission form.


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Donburi Kitchen misses the concept
Heart set on donburi. Is there something besides ramen or sushi?
Ian Anderson 3 p.m., Sept. 25
Cowboy Jack Band
Sycuan Casino
|Wednesday, September 28, 5 p.m. to 9:30 p.m.
Dave Scott & His Latin Jazz Trio
Hacienda Casa Blanca
|Wednesday, September 28, 5:30 p.m.
Chet & the Committee
Nicolosi's Italian Restaurant
|Thursday, September 29, 6:30 p.m.
Oktoberfest in El Cajon
German American Societies
|Friday, September 30, 4 p.m. to 10 p.m.
World oil prices decline following Brexit vote
San Diego area gas prices jumped 10 to 15 cents per gallon last week, with many stations pushing their cash price for regular gas over the $3.00 threshold. Surprisingly, the oil companies are not offering ...
"You should come back any night during this Ramadan season. We have a special feast."
I arrived too early. For Ramadan, that is. This was before last Sunday, when Ramadan began. I came because I was curious about what you eat if you are Muslim and fasting for the month. ...
New bill would apply same rules for weed and ciggies in apartments
There are several places in San Diego where local laws ban smoking, such as beaches and parks. But for the 46 percent of residents who are renters, unless they live in public housing, landlords make ...
At a young age I knew I would be a pastor, even as a child....
Membership: "less than 100" Pastor: Kurt Bergquam Age: 54 Born: Grand Forks, ND Formation: Berean Bible College, San Diego; Christian Bible College and Seminary, Blue Springs, MO Years Ordained: 25 San Diego Reader: What's your ...
East County Middle Easterns
Speaking English is eighth on their priority list.
Can anyone explain why El Cajon lost most of it's old town?
El cajon is a nice discrete city during the day but at night the weirdos come out to play. Keep El cajon discrete not wound up like the crack heads in the night. Go El cajon P.D.
The "HUB" of East County!!! Let's give it up for El Cajon Valley!!!
When the 52 freeway opened in 2012, did nobody look down the road and think "Hey, we might need to change the 67 south interchange to Interstate 8 to accommodate all this additional traffic."
Get off the freeway, change lanes, underpass, clover leaf, merge, merge again, merge a third time to get back on the freeway.
How many deaths before a flyover is built?
The El Cajon City Council has sent property owners notifications of a proposed change in sewer billing, designed to save the City $100,000 a year. The new billing system will be incorporated with the County of San Diego's property tax collection, due for payment in November and February.
A public hearing will be held at Council Chambers on 9 July 2013 for those that object to the change in assessment. There is no indication given that there is any rate rise associated with the billing method.
Only those property owners who object in writing PRIOR to the meeting will be heard at the meeting.
This family wants to give a big shout out to the area firefighters. We were at Camino Canada last week when fire broke out on the mountain behind VONS. Once again we witnessed a fire across Highway 8 this week. Coming from an area where there is always a debate of which fire department will respond to an unincorporated area we were pleasantly surprised and amazed of the teamwork exhibited by several fire departments that responded to the call. Thank you so much for all you do!
"Supermoon" rising over El Cajon.


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2 Step chords by Dave Matthews Band, added: October 31st, 2001
Profile History
+ --------------------------------------------------------------------- +
| Ultimate Guitar Tabs Archive - your #1 source for tabs! |
| http://www.ultimate-guitar.com/ |
| |
| Over 1,000,000 guitar, guitar pro and bass tabs! Also lessons |
| news and guitar forums! |
+ --------------------------------------------------------------------- +
name: Tony Mack
artist: Dave Matthews Band
SongTitle: 2 Step
Tabs: OK guys here is my version of 2 Step. I took it from Listener
On LS the violin plays this part but you can play it on guitar.
Then at the :15 mark, Dave plays this.
For later use we'll call this Intro 2.
Dave begins to play this at the 2:20 mark
We'll call this Intro 3.
After this, he begins to play the first intro at the 2:37 mark and he
plays that until the verse starts. Now for the lyrics and chords.
At the end of this are the chord definitions.
Dm Bb C F Bb Am Gm
Hey my love I came to you with best intentions
Dm Bb C F
You laid down and gave to me just what
Bb Am Gm F
I'm seeking I say
Bb Am Gm F
Love you drive me to distraction
Now Boyd begins to pluck the violin. I don't have that down so Dave
plays Intro 3 over the solo.
Dm Bb C F
Oh my love do you believe that we
Bb Am Gm Dm Bb C F
Might last a thou sand years or more if not for this
Bb Am Gm F
Our flesh and blood it ties
Bb Am Gm F
You and me right up time we celebrate oh
C Gm Bb Am F
Celebrate we will
F C Gm Bb Am
Cuz life is short but sweet for certain
F C Gm Bb Am F
Hey we climb on two by two
F C Gm Bb Am
To be sure these days continue
F Bb Am Gm Dm
Things we can not change
Once again Boyd plucks a solo so play Intro 3 over top of it.
Dm Bb C F
Oh my love you came to me like wine
Bb Am Gm Dm
Comes to that mouth
Bb C F
Grown tired of water all the time
Bb Am Gm F
You quench my heart and love
Bb Am Gm F
You quench my mind and celebrate oh
The chorus is then played twice the same way as above.
Dave then sings verse 1 again. He plays the same rhythm but he messes
around with the words a little bit and makes it kind of complicated so
sorry about that. Just play it the same way as verse 1.
He then plays the chorus 2 more times before they go into the piano
Once the piano jam starts you play the third intro the entire way
through it.
Now here are the chords:
Dm C Bb F Am Gm
Well that is pretty much all of it. I hope this works out for you
guys. Let me know if you have any questions or problems. Have fun!!
@NiRvanAcobain....he might suck (not really) at least he didn't end up with "brains in his corn flakes" So what is it you do, go around and randomly put your well thought of signature taglines on well written tabs because you hate life? Seeing that your post was made 9 years ago you are probably in a box spitting in a camera for all eternity just like your hero.


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Alaska Glacier Sled Dog Tours
Fly in a helicopter, see amazing scenery, land on the glacier and mush your own dog-team - all in one awesome adventure! We offer private tours for small groups of 2 – 8 people, so you'll have plenty of quality time with the dogs. Watch the Today Show video with Al Roker having a blast on our dogsled tour. No time to stay in one of our super cozy cabins? No problem, anybody can join our helicopter tours. Our transfer service can pick you up in Anchorage. See you on the glacier!
Photo's (c) Jeff Schultz - www.schultzphoto.com
Choose from three different dogsled tours
Classic Dogsled Tour
- 35 minute helicopter tour
- 1 hour glacier dogsled tour
- from $499 per person
Extended Dogsled Tour
- 35 minute helicopter tour
- 2 hour glacier dogsled tour
- help harness the team
- from $570 per person
Overnight Dogsled Tour
- 35 minute helicopter tour
- 2 glacier dogsled rides
- help harness the team and feed the dogs
- camp on the glacier with the dogs and the mushers
- the most in-depth experience
- From $975 per person
No longer available for 2016 season


text:
item(s) in cart
My Account X
Guy Harvey Men's Redfish Seagrass Short-Sleeve Tee
Item # 757987
Key Features
100% pre-shrunk cotton
Tagless design reduces irritation
Large Redfish graphic across the back
Guy Harvey logo on front left chest
Our Price $24.00
Sale Price $14.96
Availability:Sold Out
Prices, promotions, styles and availability may vary by store and online.
detailsback to top
Product DescriptionMade of 100% pre-shrunk cotton, and featuring a tagless design, the Guy Harvey Redfish Seagrass Short-Sleeve Tee is redefining comfort. A large Redfish graphic is displayed on the back, and is sure to draw interest. On a more subtle note, a small Guy Harvey logo is located on the front chest, adding a nice touch to the Redfish Seagrass tee. Imported.


text:
Telephone & Addresses
(1 - 4 from 11
Rachel Haig
66047 Lawrence KS
Rachel B Haig (Age: 30)
75220 Dallas TX
Rachel J Haig (Age: 32)
46226 Indianapolis IN
canada411.ca: M & R Haig
(905) 852-6865, 42 Cedar St N, Uxbridge, ON, L9P 1B2
Network Profiles
(1 - 4 from 8
Twitter Profile: rachel haig (rachyhaig81)
Married. Full time mummy to my two amazing kids xx
classmates: Rachel Haig
Pike High School, Indianapolis, IN, 1996-2000
(1 - 4 from 7
Rachel Mackerras Haig (Veitch) (1820 - 1879) - Genealogy
... Haig, Henrietta Frances Haig, Janet Stein Haig. View the Record. Rachel Haig (born Veitch) in MyHeritage family trees (Meyer Web Site) ...
Rachel Dorothea Wolseley Haig (deceased) - Genealogy
Records for Rachel Haig. 72,841 Records. Share your family tree and photos with the people you know and love. Build your family tree online ...
Douglas Haig, 1st Earl Haig - Geni
Victoria Doris Rachel Haig (7 November 1908—1993); Lady Victoria Haig from 1919; Lady Victoria Montagu-Douglas-Scott from marriage in ...
Rachel Haig 1832-1907 - Ancestry.ca
Research genealogy for Rachel Haig, as well as other members of the Haig family, on Ancestry.ca.
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text:
Company Overview
First healthcare advisors partner with our clients to derive value from investments in technology initiatives with the understanding that people will have the most significant impact on cost and quality advances.
First understands what providers are facing today. Providers turn to First for guidance as they navigate regulatory mandates, technological and cultural shift, decreased margins and the emphasis on quality care delivery.
First develops and sustains relationships by delivering dependable Clinical, Revenue Cycle, Technical, and Advisory solutions.
First works extremely hard to provide our clients with the right advisor for the program, project or role requested. The time we invest in vetting and preparing our personnel save our clients valuable time and dollars while building trust that we have, and will, provide the ideal resource. The manner in which First addresses and supports our clients interests and concerns is a key discriminator of our organization.
The People of First
- Accomplished healthcare IT professionals that have demonstrated their problem solving expertise with healthcare information technology systems.
- Provide benefit and value throughout the life of the engagement.
- Solve and support complex IT initiatives, allowing our clients to concentrate their resources on core priorities and business objectives.
- Deliver complete and fully documented solutions.
The Clients of First:
- Value our ability to deliver highly vetted and specialized advisors and a management team that has served on every side of the healthcare delivery spectrum.
- Value our ability to deliver the "right" solutions regardless of the complexity of the problem.
- Value our flexibility in addressing the challenges in utilizing and managing consultative personnel, acting as long term partner.
The Management Team at First:
- Includes some of the most experienced and talented healthcare business and technology leaders in the industry, who consistently demonstrate the vision necessary for leading a national healthcare advisory organization.
- Separates itself by leveraging a wide network of Federal and commercial relationships in areas that strengthen our core expertise to the ultimate benefit of our clients.
- Focuses solely on the healthcare IT industry and government agencies with healthcare related missions, attracting the top experts in the field.
Working at First:
First knows that prosperous employees create successful client experiences and we believe that technology can only be made meaningful through people. Our people have a superb support structure at First, creating enriched skill sets, engagements and careers. Our company is equally focused on ensuring that our employees maintain a balance with their career and family or personal lives. Our compensation, vacation policy, non-billable and bench time plans, and overall culture encourages pursuits outside of the consulting world. Our compensation package is HIGHLY competitive and there is no relocation necessary. In addition, First has a long history of working with experienced independent consultants and paying above market rates. First is committed to our employees while on billable engagements or not and we are constantly investing in our employees finding new ways to function and collaborate as a one team even though we serve many clients in multiple locations.
Leadership Team
The Management team at First includes some of the most experienced and talented healthcare business and technology leaders in the industry, who consistently demonstrate the vision necessary for leading a national healthcare advisory organization. Our team separates itself by by leveraging a wide network of relationships in areas that strengthen our core expertise to the ultimate benefit of our clients. Each First manager is solely focused on the healthcare IT industry, providing our clients focused expertise in the field and issues driving healthcare transformation.
+ Randy Bailey - Chairman
Randy BaileyChairman
Randy is a Founder and the Chairman of First. Most recently Randy served as CEO of First. Prior to founding First, Randy was Senior VP and member of the Executive Management Team of Park City Solutions. As a member of the Executive Management Team he participated in all aspects of the operations of the company.
Along with Randy's duties on the Executive Management Team at Park City Solutions, he served as Senior Vice President of Consulting Services and Senior Vice President of Marketing and Public Relations. Actively involved in the information technology industry for more than 26 years, Randy's experience includes operational and leadership roles in the consulting and information technology industry both as a vendor and private consulting firm. Having received his educational training in accounting and advanced public speaking, he has spent his entire career in information technology.
Linked In Profile
+ Carter Groome - Chief Executive Officer
Carter GroomeChief Executive Officer
Carter is a Founder and the Chief Executive Officer of First. He brings 19 years of healthcare information technology management, consulting, and sales leadership experience to the company.
As Chief Executive Officer, Carter is able to draw upon his hospital, consulting, and vendor leadership background to benefit First's commercial and Federal clients and partners. Before becoming CEO of First in 2010, Carter was Executive Vice President responsible for sales, marketing and strategic direction. Prior to founding First, he was the Director of Business Development at Park City Solutions.
Carter spent 5 years as an applications and integration Program Manager and consultant in the healthcare information technology arena with First Choice Consulting.Prior to his consulting career, Carter held various IT management positions with Adventist HealthCare.
Carter holds a B.S. in Health Science from the University of Arizona and a M.B.A. from Johns Hopkins University.Linked In Profile
+ Jack Wagner - VP - Advisory Services
Jack WagnerVP - Advisory Services
Jack brings 27 years of Information Technology experience to First's VP of Advisory role, with the past 11 in the healthcare industry. Jack brings an extensive background in technology, program/project management, and hospital IT management to the organization. His broad experience allows him to focus on the macro-level while tracing the inner workings of the organizations for which he works to assist them perform tight integration of technologies, processes and governmental regulations within complex environments.
Prior to joining First, Jack was the Area Vice President of Consulting Services (South Central US) for maxIT-VCS and the Technical Services Manager for St. Vincent Health System in Little Rock, AR. Previous to these positions, Jack was on active duty in the United States Marine Corps.
Jack is a certified Project Management Professional (PMP) and has worked on various IT leadership roles and large projects during his career to include Epic Inpatient and Ambulatory projects at Mount Sinai in New York, and multiple system selection projects to identify and procure services from vendors in the Health Information Exchange (HIE), Population Management, and Data Framework technology space. He has in-depth knowledge in large challenges facing organizations today, to include the various stages of Meaningful Use for both the Eligible Hospital and Eligible Professional.
Linked In Profile
+ Carol Selvey - VP - Advocacy
Carol SelveyVP - Advocacy
As First's VP of Advocacy, Carol brings over 27 years of experience in leadership and operational management, for both consulting and information system vendors. First clients benefit from Carol's deep vendor, services, and advisory capability, in addition to strong IDN, acute care, academic, long term care, commercial lab, and physician practice knowledge. Having spent time with PwC, SoftMed, ACS, the Revere Group and Iatric Systems she is also extremely well versed in healthcare information technology.
Carol's advocacy reach is broad, serving in many industry group roles and linking First with legislators to better understand the regulatory landscape and how it impacts our field. Carol served on the HIMSS Board of Directors from 2008-2011 and is an active Board Member of the Central and North Florida HIMSS Chapter.
Carol is a Fellow with the American College of Healthcare Executives (FACHE) and holds a BA from Vassar College and an Master of Health Services Administration from University of Kansas. Carol also completed the Health Care Certificate Program in Leadership Strategies for IT at Harvard School of Public Health.
Linked In Profile
+ Bob Hooper - VP of Sales
Bob HooperVP of Sales
Bob is the Vice President of Sales for First. He brings 22 years of healthcare information technology management, implementation, support, consulting, and sales experience to the company.
As VP of Sales, Bob is able to draw upon his technical and applications background from working at hospitals as a Network Engineer, Project Manager, and an Applications Director, to ensure that he is bringing the right resources to his customers. He has been on the other side of the table, using resources for his project teams and to augment his own staff. He knows what to look for in consultant or new hire, and uses that experience to properly vet candidates for his customers that will have the right skillset and personality to work well with their existing teams.
Bob has worked with SMS, MEDITECH, McKesson Horizon Clinicals, and Epic in his years of working at hospitals. He knows what it is like to be in his customers' position, and therefore works tirelessly to provide the right resources to them, so that his customers can focus on other priorities.
Bob holds a B.S. in Physical Science from the United States Naval Academy, and was commissioned as a US Naval Officer. He served as a Surface Warfare Officer in the US Navy before finding his calling in the healthcare arena.
https://www.linkedin.com/in/bob-hooper-bb771037Linked In Profile
+ Kerri Gallagher - Chief People Officer
Kerri GallagherChief People Officer
Kerri is the Chief People Officer at First Healthcare Advisory Solutions, providing our advisors the support needed to be successful while managing the recruiting organization for the company.
Kerri has extensive experience within healthcare information technology sales, marketing, recruiting and client services. With her dedication to First's clients and consultants, Kerri continually commits to positioning First as a trusted partner for clients and a trusted manager for our advisors. Prior to joining First, Kerri spent 4 years with Vitalize Consulting Solutions.
Kerri holds a BS in Psychology and Marketing from Arizona State University.Linked In Profile
+ Patti Donoghue - Chief Financial Officer
Patti DonoghueChief Financial Officer
As Chief Financial Officer at First, Patti brings extensive services and retail experience to her role in managing the fiscal activities and relationships. Patti has extensive payroll, benefits, financial reporting, tax preparation and banking relations experience and has positioned First as a well respected partner to our clients and a trusted employer to our advisors. Patti's commitment to timeliness and accuracy has proven invaluable to the engine of the company and industry reputation.
As a CPA and prior to joining First, Patti spent 11 years with Prince Manufacturing. Responsible for implementation and ongoing IRS compliance, GAAP reporting, pension planning, and other benefit planning. Prior to Prince, Patti spent time at KPMG focused on audits and preparation of financial statements.
Patti holds a BS in Business Administration/Accounting from LaSalle University
Linked In Profile
Vision & Approach
Today's health tech initiatives go far beyond the CIO's world. CMIO's, CNO's, CFO's, clinicians more are invested in and navigating a massive shift in how healthcare must be delivered, in how information flows and how involved patients are in their well being.
Clients are asking questions like:
- "How do we realize the value from our technology investments?"
- "How do we use our technology to compete and win?"
- "How do we maintain the culture of change once the technology is implemented?"
- "How do we get our arms around the new documentation requirements?"
- "How do we get our physicians to adopt our new systems?"
- "How do we avoid lapses in training?"
- "What can be done about our technical bottlenecks?"
- "Cookbook medicine will not work in our organization, how can change management succeed in our unique environment?"
- "Our consulting budget has been drastically cut, how can we still get the help we need?"
Our Vision
Consensus best practices and methodologies for healthcare, at best, will have minimal impact on bending the cost curve in our organization. Time and time again, we see that the answers to these questions involve the alignment of an organization's financial, clinical and technical processes with culture as a major influencer. This alignment must occur in small steps on a customized basis, as no two organizations are the same. Small success will allow for larger initiatives and capability for marked progress. First provides the experts to quickly identify efficiency issues, improve performance, and transfer knowledge to your organization.
Our Client Approach "Dynamic Maximization"
First developed and honed and approach and methodology called FirstTRAK that measures and accelerates process efficiency to optimize clinical, revenue cycle, and technical components of your organization. The dynamic part of our approach refers to an understanding that no two health delivery organizations are alike and we must take socio-cultural factors into each engagement. Maximization refers to an ideal state of harmony between the value influencers and the personnel side of lasting change management. FirstTRAK is built to provide value in diverse implementation, optimization, regulatory deployment, project management, training or even analysis efforts.
Our Advisor Approach cultivates and supports experts that are dedicated to improving the delivery of healthcare
Voted the best places to work in 2014 by Modern Healthcare magazine, employees and consultants choose to work with First. All of our advisors are experienced professionals in the healthcare industry in addition to their deep knowledge of the latest technology and practices. First diligently matches our advisors experience with engagements that are poised to take advantage of their background and personalities. Our people are located throughout the US, often times allowing our clients to take advantage of regional resources for smaller targeted engagements while lowering any expenses related to consultant travel. In addition, First is capable of leveraging the combined experience of our four business units (Clinical, Revenue, Technical, and Advisory Solutions) to meet large scale deliverables with deep resource needs.
Case Studies
EHR Value Realization
Client: Community Health Systems Assignment: Cerner Clinical Workflow Optimization Results: Multi-hospital core measure improvements
Client: Veterans Affairs Assignment: VistA Workflow Integration Results: Development and testing efficiency gains
Meaningful Use
Client: Mt. Sinai Health System, NYC Assignment: MU Program Management Results: Attestation strategy, execution and new entity
Revenue Cycle
Client: Renown Health Assignment: Epic Revenue Cycle Implementation and Workflow Design Results: Charge review training and metric improvement
Client: Bon Secours Health System Assignment: Epic Revenue Cycle Optimization Results: Reporting and Integration Streamlining
Client: Mt. Sinai Health System, NYC Assignment: ICD-10 Program Management Results: Testing and training program implementation and readiness
Legacy Support
Client: Swedish Medical Center (Providence Health) Assignment: Support of legacy systems while Epic installed Results: Single sourcing for all support needs over 3 years


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2bulbs is founded by a pair of great friends who come from different countries, speak different languages, at quite different ages, grow up under different cultures and educations. But we have one thing in common - The natural enthusiasm in electronics.
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2bulbs knows that there must be a lot of people same like us around the world. We are willing to provide cutting-edge information of electronics to those and help them to be part of it.


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Protecting machine gears from wear and corrosion is important for prolonging asset life and preventing breakdowns. The Shell Omala range of gear oils offers protection across a wide range of applications. It includes Shell's latest synthetic oils such as Shell Omala S4 GX, which offers exceptional long-life performance under extreme loads and temperatures.
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UC Berkeley,
Bancroft Library
Ashburner (William) Collection of Photographs from the Geological Exploration of the Fortieth Parallel
> Pyramid Lake. [Pyramid Island]
We recommend you include the following information in your citation. Look below the item for additional data you may want to include.
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RE: Calisphere: Request high-resolution copy of item for Pyramid Lake. [Pyramid Island]


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Cadence Creek Cowboys (Book 2)With his break-your-heart smile, rodeo star and rebel Ty Diamond has a reputation that should have Clara Ferguson running scared-not straight into his arms!Ty knows he needs to take it easy with Clara-her past has left her with a bruised heart and she's determined never to rely on a man again. But Ty isn't all he seems and his gentle side shakes Clara's resolute independence to its breaking point.
The Last Real Cowboy & The Rancher's Runaway Princess: The Last Real Cowboy\The Rancher's Runaway Princess
Cadence Creek Cowboys (Book 1)From the moment he turned up late to her charity's meeting, placating everyone with a tip of his Stetson and a lazy smile, Angela Beck knew that Sam Diamond was going to be Trouble with a capital T.Angela is the prickliest woman Sam's ever met-let alone had to work with! He'd love to still her sharp tongue with a kiss, but first he has to get close enough to awaken the complex woman beneath the
Little Cowgirl on His Doorstep
Cadence Creek Cowboys (Book 4368)Little cowgirl makes threeFor Avery Spencer, the sight of rugged, sullen and dangerously sexy Callum Shepard is enough to set her pulse racing. Too bad she's only on his ranch to tell him that her adorable baby niece is his daughter!Reclusive rancher Callum is shocked to discover he's a father. But now Callum must learn to believe he does have what it takes to become a dad, and convince Avery that
Cadence Creek Cowboys (Book 4383)Friendship?Melissa Stone has done a fine job of avoiding her former best friend Cooper Ford. She was devastated when she discovered her husband was cheating on her, and felt doubly betrayed that Cooper had known all along. Forgiveness But she can't ignore him forever-especially now that they're working together on a charity project! And as she and Cooper get closer again, she confides in him her
Cadence Creek Cowboys (Book 4401)It's Christmas in Donna Alward's Cadence Creek Taylor Shepard has come to Cadence Creek to organize her brother's Christmas wedding. Organizing such a special event might be a little bit stressful-but she can't deny she's swept away by the town's holiday charm and by brooding rancher Rhys Bullock.Loner Rhys has been burned far too many times in the past. He's sure he has city girl Taylor all
Harlequin Romance November 2013 Bundle
Proposal at the Lazy S Ranch\A Little Bit of Holiday Magic\A Cadence Creek Christmas\Marry Me under the MistletoeHarlequin Romance brings you four new titles for one great price, available now for a limited time only from November 1 to November 30! Experience the rush of falling in love! This Harlequin Romance bundle includes Proposal at the Lazy S Ranch by Patricia Thayer, A Little Bit of Holiday Magic by Melissa McClone, A Cadence Creek Christmas by Donna Alward and Marry Me Under the Mistletoe by Rebecca
$1.99From USA Today Bestselling Author Leigh Greenwood comes a historical Western romance filled with gritty cowboy heroes, strong-willed heroines, and a whole lot of heart in the Wild West.A STRANGER TO THE RESCUEColby Blaine has been a loner his whole life. And he isn't about to change now. But that doesn't mean he can ignore people in trouble. When he rides up to an inexperienced wagon train under
Montana Mavericks: Rust Creek Cowboys (Book 2275)USA TODAY bestselling author Christyne Butler visits Rust Creek Falls, the setting for the popular Montana Mavericks: Rust Creek Cowboys continuity, in a sexy and emotional romance that is sure to capture readers' hearts!Rust Creek Ramblings The Great Montana Flood has brought all sorts of interesting menfolk to Rust Creek Falls. At the Ace in the Hole, they're all talking about hunky out-of
$7.99"Found love, lost treasure and ever-present danger. R.C. Ryan delivers it all with page-turning romance." ---NORA ROBERTS, New York Times bestselling author.A COPPER CREEK COWBOYS NOVELFirst love always burns hotter . . .Ash MacKenzie broke his share of hearts when he left Copper Creek all those years ago and struck out on his own. Tall, tough, and proud. That's how Brenna always remembered him,
$7.99A COPPER CREEK COWBOYS NOVELA love worth fighting for . . .The last thing widow Juliet Grayson needs is a man in her life. Between caring for her two young sons and maintaining her husband's ranch, her hands are more than full. Then she meets Griff Warren. With his quiet strength and his easy way with her boys, she's tempted to trust him. But if there's anything she's learned, it's that love only
$7.99When Love Walks Through the Door . . .Like all MacKenzie men, Whit respects three things: hard work, his family, and the wild beauty of the Montana land he calls home. The solitude of the high country is a welcome respite to a loner like Whit. So when a powerful spring snowstorm hits as he's tending the herd, Whit heads to one of the family's isolated cabins. The cold winds don't trouble him. The
Montana Mavericks: Rust Creek Cowboys (Book 2269)Rust Creek RamblingsSeducing the Schoolteacher?We apologize, dear readers, for our brief hiatus in publication. The offices of the Rust Creek Rambler were damaged in the Great Flood, but we are now filing our reports from a bar stool at the Ace in the Hole. And do we have scandalous news for you!We have it on good authority that during the storm, gorgeous rapscallion Collin Traub was stranded with


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NEW ORLEANS -- Certain issues resonate better in consumer education programs related to using technology in the food industry, and those approaches are more effective in improving the chances for concepts like biotechnology and irradiation to succeed in the marketplace, according to a pair of industry experts who spoke at the Produce Marketing Association's Fresh Summit 2002. Christine Bruhn, Ph.D., director, Center for Consumer Research at the University of California, Davis, said consumer ...
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Shoei J-Cruise 13mm Center Pad
Write Review | Q & A | Ask a Question
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Claude Fischer: Today, Americans are the least likely, among the citizens of affluent nations, to support price controls or generally any interference in the market.
L.A. Denies Chalk Walk Permit, Occupy LA Proceeds with Plans
Cheryl Aichele: "If you have money or power or permits you can get away with activities otherwise deemed illegal by the City for Occupiers".
LA's Downtown Business Leaders Give ArtWalk Protesters the Brush-Off
Dan Bluemel: Rampant hooliganism will not be tolerated in downtown Los Angeles; it could interfere with commerce.
Rodney King Dead at 47
Rodney King, the man whose video taped beating by Los Angeles police twenty years ago shocked the nation, was found dead this morning, Sunday June 17, 2012 in Southern California. According to Reuter's King's body was found at the bottom of his swimming pool in Rialto a suburb of Los Angeles. Cynthia Kelly, King's fiancee […]
20 Years After the LA Riots: What Have We Learned?
Dick Price & Sharon Kyle: What has changed in South LA — then South Central — where the flames shot to the sky 20 years ago, after an all-white jury exonerated the gang of police officers who had beaten a black motorist half to death, captured on video for all to see?
Crown Heights Riots 20 Years Later
David Love: Crown Heights was imminently important from a political perspective, as it altered the course of New York's political history and ended the brief stint that was Black Power in the Big Apple.
Mehserle-Grant Verdict Aftermath: Oakland Lives Another Day
H. Scott Prosterman: Regardless of the verdict, some element of violent protest was inevitable. Ironically, most of those arrested were white, suburban anarchist, rather than black activists.


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Penn State Behrend men defeat LaRoche, advance to the AMCC championship
Jimmy Belack scored a pair of first-half goals and Penn State Behrend shut out LaRoche 3-0 Wednesday at Behrend Field to advance to the AMCC championship for the 15th time in the past 17 years.
Belack found the back left corner of the net at the 13-minute mark and scored again minutes later when he beat LaRoch goalie Zach Schindhette. Anthony Crivelli completed the scoring less than 2 minutes later by lobbing in a shot.
Eric Vunovic assisted on all three goals for Behrend (15-4-1), which will play Medaille at 6 p.m. on Saturday for the AMCC title. Medaille defeated Mt. Aloysius 1-0 Wednesday in the other semifinal.
Jarrod Wassell need to make just one save to earn his seventh shutout of the year for the Lions, who outshot LaRoche 16-6.
LaRoche completed its season at 11-9.


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The last BYU football fans might have seen of defensive lineman Eathyn Manumaleuna and safety/cornerback Mike Hague could have been seeing them leave the field due to injury. Both Hague and Manumaleuna only played in four games in 2012 with neither taking the field following the loss to Boise State. Hague had a calf injury, while Manumaleuna hurt his knee...
Return of Manumaleuna, Hague Could Provide Needed Experience and Depth
From HeraldExtra.com
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Paul Gayler's Thai Inspired Risotto With Pumpkin
Total Time
Prep 20 mins
Cook 1 hr
Paul Gayler makes wonderful vegetarian and vegan food. Great recipe for when you have a bit of time to cook.
Ingredients Nutrition
- 40 g margarine
- 1 onion, chopped
- 1 garlic, clove crushed
- 1 stalk lemongrass, thinly sliced
- 1 red chile, deseeded and chopped
- 2.46 ml curry powder
- 3 cm fresh gingerroot, chopped
- 350 g pumpkin, peeled and cut in 1 cm pieces
- 350 g arborio rice
- 100 ml dry white wine
- 700 ml vegetable stock
- 150 ml coconut milk
- 14.79 ml chopped of fresh mint
- 14.79 ml chopped fresh coriander
- salt & freshly ground black pepper
- grated coconut, to serve
- Melt the margarine in a large heavy bottomed pan.
- Add the onion, garlic, lemongrass, chili, curry powder and ginger and cook,stirring over a low heat for 5 minutes.
- Add the pumpkin and rice and cook for 1 minute more.
- Pour in the wine and a ladle full of stock and cook, stirring, until the liquid is absorbed.
- Keep adding the stock, a ladle full at a time, stirring continuously, until the rice is tender, but al dente, about 25 minutes.
- Towards the end of cooking, add the stock in smaller quantities and check frequently to see if the rice is cooked.
- Add the coconut milk, mint, and coriander.
- Remove from the heat, season and sprinkle with grated coconut to serve.
Most Helpful
Just wonderful. My whole family loved it (especially me and vegan beau) but even my dad (carny of the century who doesn't like pumpkin) polished off his big bowl. My boyfriend and I added some cashew nuts to our meal for the extra protien - it was really yummy. Also I baked the pumpkin and stired it through at the end of cooking just before the coconut milk - i love roast pumpkin - great flavor! I have a rice maker so for me this meal didn't take long. After stirfrying the onion, marg etc I just added the rice all vege stock and let it do it's thing - stiring every now and then. It was fine.
I used a butternut squash because pumpkin was out of season - great substitution! Make sure you have some extra broth on hand - can't really say how much, but I had an extra litre at my disposal and I am glad I did because not only does the risotto have to cook, but the pumpkin/squash needs lots of broth to cook too! I also doubled the amount of coconut milk for an extra coconutty dish and I would recommend you do the same as it is an excellent counterpoint to the curry and lemongrass flavour. An outstanding recipe combining two of my favorite things in the world - risotto and Thai food. My boyfriend said that this was one of the best things I have ever cooked. Will make again! Thanks for posting, Missy Wombat!
A lovely unique blend of flavours. A nice creamy risotto (the coconut milk makes it really creamy) with just the right amount of Thai spices. It did take a lot more stock (I used powdered vegetable stock in water) than the recipe suggests though. A definite make again recipe.


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To order a printed copy of the Ramblers Worldwide Holidays brochure, simply click the Request button below.Request Printed Brochure
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