Failure Modes and Mechanisms

The frequency and severity of obstetric lawsuits make the perinatal area a risk management priority. Risk management deals with the probability that a given risk will result in an adverse outcome and attempts to mitigate the consequences of adverse events. Perinatal care providers cannot escape risk in their everyday work environment. The article explores perinatal risk issues and offers recommendations and risk management strategies that may help minimize perinatal liability in the antepartum, intrapartum, and postpartum areas.

Desktop environments represent a powerful user interface and have been used as the de facto standard human-computer interaction paradigm for over 20 years. But the rising demand of 3D applications dealing with complex datasets exceeds the capabilities of traditional interaction devices and two-dimensional displays. Such applications need more immersive and intuitive interfaces. In order to be accepted by the users, technology-driven solutions that require inconvenient instrumentation, e.g., stereo glasses or tracked gloves, should be avoided. Autostereoscopic display environments equipped with tracking systems enable humans to experience virtual 3D environments more naturally, for instance via gestures, without having to use annoying devices. However, currently these approaches are used only for specially designed or adapted applications. In this paper we introduce new 3D user interface concepts for such setups which require minimal instrumentation of the user and can be integrated easily in everyday working environments. We propose an interaction framework which supports simultaneous display of and simultaneous interaction with both monoscopic as well as stereoscopic contents. We identify the challenges for combined mouse-, keyboard- and gesture-based input paradigms in such an environment and introduce novel interaction strategies.KeywordsHCIautostereoscopic display environments3D user interfaces

Until recently the vocational rehabilitation of chronic mentally ill often resulted in employment in the framework of sheltered workshops. There are an increased number of workshops and day clinics but in this context the patient does not come in contact with the everyday working environment. However, several multicenter studies demonstrated that "Individual Placement Support" (IPS) is more effective than vocational services. The aim of our project is to show that this concept is applicable even to patients with chronic and severe psychiatric diseases. We created "One-Euro-Jobs" for patients with chronic mental illnesses within regular employments in the confinements of our clinic. The choice of workplace was carried out according to the individual experience and knowledge and included the library, central buying and post office. Until now 15 mentally ill patients with an average disease duration of 11 years were included in the project. 1 patient discontinued within the first 3 weeks. The others were occupied on average for 9 months. Our project shows that integration of chronically mental ill patients in regular employment environments is possible. Concerns that the pressure and stress would be too extreme were proved to be unfounded.

ObjectivesIn-situ simulation (ISS) is widely recognised to improve team working and to identify patient safety threats.1 2 Anecdotally, the greatest barrier to overcome in delivery of ISS is workload and...

Healthcare providers in hospital emergency departments (EDs) work under high uncertainty and pressure to manage a variety of patients efficiently. Whereas much existing research has examined communicative implications of uncertainty from patients’ perspectives, we explored ED physicians’ experiences of uncertainty in their everyday work environment. Through an ethnographic fieldwork in an ED, we identified three main sources of uncertainty routinely faced by physicians: (a) patients’ incorrect expectation about the role of ED; (b); patient variability and ED physicians’ breadth of expertise; and (c) emerging and unexpected changes in patient cases after handoffs. We also found how ED physicians managed these uncertainties, including: (1) direct admission of scientific uncertainty to patients; (2) lowering epistemic uncertainty through swift Internet searches; and (3) maintenance of situational uncertainty. We discuss implications of these findings for researchers, providers, and hospital organizations.

<p>This paper explores the perceptions of Serbian IT professionals regarding the impact of artificial intelligence (AI) tools on individual productivity in the context of IT business. As AI technologies become increasingly integrated into everyday work environments, particularly in knowledge-intensive industries, understanding user attitudes and experiences is essential. The research is based on a quantitative study conducted through an online questionnaire, which gathered responses from IT professionals working in various roles across Serbia. The questionnaire assessed the frequency of AI tool usage, perceived benefits and challenges, and self-reported changes in work efficiency. The results indicate a generally positive perception of AI tools, especially in relation to time-saving and task automation. This study contributes to a better understanding of how AI adoption is shaping modern IT workflows and provides insights relevant to business leaders and digital entrepreneurs in the tech industry.</p>

I am an author, the Chief Editor of Books at Harvard Health Publications, and the director of an annual Harvard CME publishing course. Much of my work as an editor and writing instructor is about helping healthcare professionals translate their knowledge into a powerful consumer health message. With increasingly shorter office visits, a growing trend towards prevention and self-help, and a public that is being encouraged by the availability of electronic media to do research to educate themselves health articles and books fill an important need and the public can't get enough. Despite a difficult national economic situation and the decline of print publishing, there are still plenty of wonderful opportunities for writers to publish, especially healthcare professionals who have much to offer readers. Whether you are a nurse writer, editor or reviewer, there are still plenty of excellent ways to bring healthcare information to consumers and others. Writers don't plan to fail, but they often fail to plan. Succeeding as a writer is easier if you have a plan. Many writers wait for the right mood to hit them before they'll commit words to paper. But most successful writers will tell you they write regularly – even when they are tired, sick, cranky and overwhelmed. Whether it's 1000 words a day or finishing one article for a deadline, successful writers produce-whether they feel like it or not. Think of your goals as a means to achieving success. Don't be discouraged if at first you don't reach your goals; understand that just as with an article or book manuscript, revising them is part of the process. Most writers need fantastic stories—whether they write fiction or nonfiction. I have talked to many young writers who have gone off on wonderful adventures seeking material for their great American novel. But most of us cannot drop everything we are currently doing to live among tribes in Africa or Afghanistan. And the truth is, there are many golden stories waiting to be sifted out of even the most seemingly mundane of life's experiences. Jill Grimes, M.D., a family physician, realized this about one of the routine procedures she performs during the course of her day in the office: the Pap smear. Pap smears are commonplace, a normal part of every female patient's yearly visit. What Jill became fascinated by were the stories her patients shared with her during these visits. Often these were well-educated, middle-aged women concerned about sexually transmitted diseases. When Jill attended my publishing course, she participated in “Shameless Pitches,” a session during which participants are given one minute to pitch their book ideas. When it was Jill's turn she strode up to the podium and after a quick introduction described her book, “Stirrup Tales,” about sexually transmitted diseases (her title had everyone smiling at the get-go). It was a fascinating proposal and she finished right on time, just as the buzzer sounded. One editor, who was part of the panel of judges, was so impressed with Jill's book idea, that she offered her a contract – then and there! (Stirrup Tales is now a new release from Johns Hopkins University Press, re-titled Seductive Delusions: How Everyday People Catch STDs – check out the provocative cover on Amazon.com). Jill turned her ordinary life experience into an important self-help book for the public. In preparation for “Shameless Pitches” I offer participants the opportunity to attend a workshop on how to give a great book pitch. A lot of editors refer to this pitch as an “elevator conversation” in which you have a very short time, perhaps the length of an elevator ride, to convince someone that your idea is worthwhile. This is an important skill to learn because in this busy industry, most editors don't have a lot of time to listen to new ideas. Those of you who are nurse editors understand this. You likely receive pitches all the time, and you know that pitches can get old fast, especially if they are long winded and unfocused. Many writers who speak at my course are published book authors, but not all. One graduate, Suzanne Koven, M.D., asked if she could come back to the course to speak. Suzanne had been writing online for an interfaith e-zine and was taking literature and publishing courses at the Harvard Extension School. One year had passed since she took my publishing course and she was still honing her book proposal. In her inspiring talk Suzanne pointed out that like her, most people don't find instant success in publishing. She used a football analogy; she thought of her writing goals as a way of “just moving the chain” – which is what happens in football when the offense tries for a first down. Along the sidelines, the chain is moved and marks the progress. I often think of Suzanne's great analogy, and I share it with my students at my course every year. It's important for them to know that publishing is a process. Success usually comes in the form of “moving the chain” rather than scoring a touchdown right away. A great book idea, combined with your education, training and clinical experience, add up to what publishers call platform, your entrée to becoming a book author. However, going from the idea phase to the published book phase takes knowledge and contacts. It is important to understand publishing protocols and how editors expect prospective authors to present their work for consideration. In nonfiction book publishing the author presents an idea in the form of a book proposal that includes an overview or summary of the book, a competition section describing similar books that have been published, a markets section that details the book's audience, and finally an about the author section that highlights the author's expertise. Many authors are inclined to write their books before approaching a publisher, but editors don't have the time to read entire manuscripts before deciding on their merit. Also, most editors at publishing houses are quite skilled at helping authors to shape books and often prefer to be included in the creative process. As with medicine, which has many protocols of its own, the publishing industry has accepted ways of doing things that make for a smoother process—and ultimately a better book. Imagine the chaos that would occur if an ICU physician wrote an order that read, “Give the patient something for his blood pressure—it's sky high.” No matter how highly skilled the ICU nurse might be, he or she depends on orders that follow a certain protocol. In the same way, writers must submit their work to editors appropriately. If you fail to do this, it may mean a rejection – even before the work gets reviewed. Every successful writer needs to have a long list of contacts in the publishing industry. This can be a challenge for nurses and other healthcare professionals to develop, because publishing professionals are often not part of our everyday work environment. However, if you are trying to get a book published, the next step after packaging your writing into a proposal is to get a literary agent or an acquisitions editor at a press to read it. A literary agent is a broker between the seller (you) and the buyer (the editor at a press). In the bigger publishing houses, editors usually only respond to proposals that are submitted by literary agents, because they assume the proposals will be in the correct format and ready for review. Editors at university and smaller trade presses will often read a proposal that is submitted by an author directly. It is not unusual for a literary agent or acquisitions editor to receive between 50–100 proposals a day. This makes it impossible for them to take more than just a few seconds to review each of them. Here is where establishing a personal connection with an agent or editor can make all the difference in the world. The best way for most prospective authors to do this is to attend a publishing course that offers networking opportunities with publishing professionals. Debbie Carvalko is a senior acquisitions editor in psychology and health for Praeger Publishers. She has been a faculty member at the publishing course that I direct and has made connections there with many of the authors whose books she has represented. Debbie says, “There are authors that come to the course with book proposals that are already gems, and others who have ideas that could easily shine, with a touch of editorial polish or reshaping…this is a great opportunity for me to spend quality time with budding writers.” Janice Bell Meisenhelder, DNSc, RN jump started her publishing career by taking a publishing course. As an associate professor at the Massachusetts General Hospital's Institute of Health Professions, she had a lot of ideas about what she wanted to write. However, honing those ideas and then pitching them to editors is something she focused on at the course. Janice advises others to do the same, “Taking a course will save you significant frustration as you attempt to make a dent in this highly competitive field.” Whether you take a course or network some other way, contacts are an essential part of a successful publishing career. Julie Silver, MD is an assistant professor at Harvard Medical School and an award-winning author of more than a dozen books including Super Healing (Rodale) and What Helped Get Me Through (American Cancer Society). She is founder and director of the popular Harvard CME course, Publishing Books, Memoirs and Other Creative Nonfiction (www.HarvardWriters.com), coming up on March 25–27, 2010.

SUMMARY & CONCLUSIONSIn the realm of reliability testing, one of the fundamental challenges lies in the identification and selection of the most critical failure modes and corresponding performance parameters. With a vast array of potential failure mechanisms and performance metrics, engineers often struggle to pinpoint those that truly reflect real-world degradation and field performance. Traditionally, this selection process is guided by expert judgment and established references such as the NSWC Mechanical Handbook, and other well-defined handbooks. However, practical constraints including limited time, budget, and test resources make exhaustive testing for all potential failure modes unfeasible.This paper introduces the Critical Failure Mode Prioritization (CFMP) methodology for reliability test design. Unlike traditional approaches that rely heavily on expert opinion and static reference standards, CFMP integrates real-world operating conditions and focuses on prioritizing the most significant and probable failure modes. By leveraging tools such as Parameter Diagram (P-Diagram), Design Failure Mode and Effects Analysis (DFMEA), actual field usage data, and historical field failure data, this methodology moves beyond subjective biases. It identifies and models failure modes based on their occurrences, Mean Time to Failure (MTTF), and percentage of contributions, thereby enhancing the relevance and accuracy of the testing process.The key distinction of the CFMP approach lies in its ability to handle products with multiple failure modes and mechanisms. It emphasizes identifying the critical failure mode or mechanism that could lead to system failure as early as possible. This method is more comprehensive, focusing on end-to-end processes and prioritizing sub-assembly and system-level testing from the end user's perspective, rather than primarily from an engineer’s point of view.This paper addresses the highly relevant topic of prioritizing different failure modes in reliability testing. It mentions relevant exemplary data, especially on the side of requirements.Moreover, the CFMP methodology is grounded in core reliability engineering principles. By incorporating physics-of-failure (POF) analysis to explore optimal failure mechanisms, degradation modeling to forecast failure progression, and preventive maintenance strategies for proactive decision-making, CFMP ensures that test conditions are aligned with actual usage profiles. This results in more accurate, relevant, and efficient testing, directly supporting the prediction of field performance and facilitating better-informed decisions.

The aim of this experimental study was to ascertain the fatigue failure modes of thermal spray coatings in rolling/sliding contact. These failure modes outline the design requirements of thermal spray coatings for high-stress tribological applications including impact and point or line contact loading. Recently, a number of scientific studies have addressed the fatigue performance and durability of thermal spray coatings in rolling/sliding contact, but investigations on the mechanisms of these failures are seldom reported. The understanding of such failure mechanisms is, however, critical in optimizing the generic design of these overlay coatings. This study takes a holistic approach to summarize the results of ongoing research on various cermet (WC-Co) and ceramic (Al2O3) coatings deposited by detonation gun (D-Gun), high-velocity oxyfuel (HVOF), and high-velocity plasma spraying (HVPS) techniques, in a range of coating thickness (20–250 µm) on various steel substrates to deliver an overview of the various competing failure modes. Results indicate four distinct modes of fatigue failure in thermal spray cermet and ceramic coatings: abrasion, delamination, bulk failure, and spalling. The influences of coating process, thickness, materials, properties of substrate materials, and prespray conditions on these fatigue failure modes are also discussed. A modified four-ball machine was used to investigate these failure modes under various tribological conditions of contact stress and lubrication regimes in conventional steel and hybrid ceramic contact configurations. Results are discussed in terms of pre- and post-test surface examination of rolling elements using scanning electron microscopy (SEM), electron probe microscopy analysis (EPMA), and surface interferometry, as well as subsurface observations using x-ray diffraction (XRD), residual stress analysis, and dye-penetrant investigations.

In the literature, little is known about the vagal response during exposure to a sit-stand workstation. This study measured the vagal response to exposure to a dynamic workstation that moved between sitting and standing heights for different regular durations and documented sex-related response. Fourteen workers (43.6 ± 4.0 years of age; 16.1 ± 4.1 years of experience) who work normally with computers (seven women, seven men of working age) were exposed to a dynamic workstation in their everyday office work environment. Heart rate variability (HRV) was used to measure the vagal activity with SD1, SD2 and MeanRR indicators, and questionnaires measured musculoskeletal health. Indicator of overall physiological response (HRV) to a dynamic workstation appears to be related to sex among a cohort of experienced office workers, where women showed a higher vagal response than men, and men had a decrease in body regions with musculoskeletal discomfort. More attention should provide to sex-specific responses to a dynamic workstation.

Academy of Management Annual Meeting Proceedings includes abstracts of all papers and symposia presented at the annual conference, plus 6-page abridged versions of the “Best Papers” accepted for inclusion in the program (approximately 10%). Papers published in the Proceedings are abridged because presenting papers at their full length could preclude subsequent journal publication. Please contact the author(s) directly for the full papers. ArticlesLEARNING TO AVOID LEARNING: THE PARADOXES OF RESIDENCY TRAINING AROUND MEDICAL ERRORS.TIMOTHY J. HOFFTIMOTHY J. HOFFPublished Online:13 Dec 2017https://doi.org/10.5465/ambpp.2004.13857704AboutSectionsPDF/EPUB ToolsDownload CitationsAdd to favoritesTrack Citations ShareShare onFacebookTwitterLinkedInRedditEmail AbstractErrors and safety are important issues in organizations. Within the health care industry, current debate around them stresses the need to create "learning cultures" to promote systems-thinking, error reporting, and develop more physician leaders in patient safety. Sociologically, medical residency is seen as the primary training and socialization point for physicians as professionals. Thus, the present study explores the reality and potential of the everyday medical residency work environment to function as a learning culture around mistakes and failure. Extended observations and interviews of attending and resident physicians working in surgical and medical intensive care unit settings revealed over 20 medical errors within each setting, most of which had few learning-oriented attitudes and behaviors associated with them. The study finds inherent paradoxes in the nature of how residents are trained presently that negatively affect the ability of the medical profession and hospitals to foster learning environments with respect medical errors. Through a competing value lens, the paradoxes are viewed as resulting from the need for residency programs to pursue a diverse array of effectiveness goals in order to turn residents into independently practicing physicians, above and beyond the singular focus on minimizing error. The findings highlight the difficulty of attempting to create and maintain "cultures of safety" in organizations which must respond to safety imperatives. They also point to a view of organizational safety management that involves developing reliable ways of simultaneously maintaining divergent cultural practices that allow pursuit of the widest range of effectiveness goals possible.FiguresReferencesRelatedDetails Vol. 2004, No. 1 Permissions Metrics in the past 12 months History Published online 13 December 2017 Published in print 1 August 2004 InformationCopyright of Academy of Management Journal is the property of Academy of Management and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder’s express written permission. However, users may print, download, or email articles for individual use.KeywordsMEDICAL errorsMEDICINE -- PracticeRESIDENTS (Medicine)MEDICAL careSAFETYORGANIZATIONAL learningPHYSICIAN & patientWORK environmentHOSPITALS -- ManagementLEARNINGDownload PDF

The uplift failure mechanism of buried pipe and its linked soil resistance are key concerns in pipe design. Although the uplift responses of pipe buried in remolded backfill have been discussed extensively, little effort has been spent on pipes buried in cemented ground, a situation that could emerge in practical engineering. This paper aims to eliminate this deficiency through a comprehensive, two-dimensional distinct element method (DEM) study on the failure mechanisms of uplifting pipe buried in loose cemented sand ground with respect to soil bond strength and pipe cover ratio. Two forms of failure mode are identified, namely the global slide failure mechanism and the local flow failure mechanism. Three stages are identified for the global failure mechanism: (1) full mobilization of uplift resistance, (2) postpeak softening with full development of the crack zone, and (3) continual growth of the trapezoid zone with further softening. The local failure mechanism presents with the opposite flow of soils around the pipe, with soils above and below the pipe flowing upward and soils from the two lateral sides of the pipe to the far field flowing downward. With the soil bond strength decreasing or the pipe cover ratio increasing, the failure mechanism gradually changes from the global failure mode found in relatively strongly cemented cases to the local failure mode commonly found in weakly cemented or uncemented cases. A new dimensionless parameter r incorporating both the effects of bond strength and the cover ratio is proposed to identify the uplifting failure modes.

Since traditional failure mode and effect analysis (FMEA) methods could not identify failure mechanism, and are weak to analysis failure cause, to identify potential failure mode, and to reason failure effect, a novel failure mechanisms, modes and effects analysis (FMMEA) method is presented in this paper. Firstly, a function model based on function basis is created, in accordance with system structure, function and internal material flow, energy flow, signal flow and other information. Then, component failure information is added to compose the system function flow model. Based on the model, the failure mode propagated tables are obtained using fuzzy cognitive map theory. Finally, a fuel supply system is analyzed to verify the feasibility and effectiveness of this method.

Experimental study, finite element simulation and theoretical analysis on failure mechanism of steel–concrete-steel (SCS) composite deep beams with UHPC

A PHM (prognostics and health management) scheme for electronic product is proposed on the basis of physics-of-failure. This method can help online reliability evaluation under real environmental condition by the identification of potential failure mechanism and failure position for devices, products and systems, so as to establish the foundation of reliability assessment for new material, new structure and new product. Under the analysis of failure mechanism for electronic product, the FMMEA (Failure Modes, Mechanisms and Effects Analysis) is used to get the failure mode, mechanism and failure physics model for the potential fault site. Based on the simulation model derived from the parameters of product material, structure, processing technology and the analysis of stress, the life distribution for the potential fault can be got through damage analysis with physics-of-failure model. The PHM information derived can be used to maintain, prognostic and decision-making for electronic product to reduce the life cycle cost and enhance the availability.