No abstract

No abstract

BackgroundThere is currently conflicting evidence surrounding the effects of obesity on postoperative outcomes. Previous studies have found obesity to be associated with adverse events, but others have found no association. The aim of this study was to determine whether increasing body mass index (BMI) is an independent risk factor for development of major postoperative complications.MethodsThis was a multicentre prospective cohort study across the UK and Republic of Ireland. Consecutive patients undergoing elective or emergency gastrointestinal surgery over a 4‐month interval (October–December 2014) were eligible for inclusion. The primary outcome was the 30‐day major complication rate (Clavien–Dindo grade III–V). BMI was grouped according to the World Health Organization classification. Multilevel logistic regression models were used to adjust for patient, operative and hospital‐level effects, creating odds ratios (ORs) and 95 per cent confidence intervals (c.i.).ResultsOf 7965 patients, 2545 (32·0 per cent) were of normal weight, 2673 (33·6 per cent) were overweight and 2747 (34·5 per cent) were obese. Overall, 4925 (61·8 per cent) underwent elective and 3038 (38·1 per cent) emergency operations. The 30‐day major complication rate was 11·4 per cent (908 of 7965). In adjusted models, a significant interaction was found between BMI and diagnosis, with an association seen between BMI and major complications for patients with malignancy (overweight: OR 1·59, 95 per cent c.i. 1·12 to 2·29, P = 0·008; obese: OR 1·91, 1·31 to 2·83, P = 0·002; compared with normal weight) but not benign disease (overweight: OR 0·89, 0·71 to 1·12, P = 0·329; obese: OR 0·84, 0·66 to 1·06, P = 0·147).ConclusionOverweight and obese patients undergoing surgery for gastrointestinal malignancy are at increased risk of major postoperative complications compared with those of normal weight.

The concept of industrial human-robot collaboration (HRC) is becoming increasingly attractive as a means for enhancing manufacturing productivity and product. However, due to traditional preventive health and safety standards, there have been few operational examples of true HRC, so it has not been possible to explore the organisational human factors that need to be considered by manufacturing organisations to realise the benefits of industrial HRC until recently. Charalambous, Fletcher and Webb (2015) made the first attempt to identify the key organisational human factors for the successful implementation of industrial HRC through an industrial exploratory case study. This work enabled (i) development of a theoretical framework of key organisational human factors relevant to industrial HRC and (ii) identification of these factors as enablers or barriers. Although identifying the key organisational human factors (HF) was an important step, it presented a crucial question: when should practitioners involved in HRC design and implementation consider these factors? New industrial processes are typically designed and implemented using a maturity or readiness evaluation system, but these do not incorporate of or link to any formal considerations of HF. The aim of this paper is to expand on the previous findings and link the key human factors in the theoretical framework directly to a recognised industrial maturity readiness level system to develop a new Human Factors Readiness Level (HFRL) tool for system design practitioners to optimise successful implementation of industrial HRC.

No abstract