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PubMed1978

Workload and fatigue--in-flight EEG changes.

Continuous recordings were made of the EEG and ECG of one pilot during a series of instrument flights in a feeder-type transport aircraft. The flights were arranged to contain epochs of distinctly differing levels of workload. In addition, some flights were made after a night of sleep deprivation and others were made as the second and third flights of the day. Subjectively, there appeared to be marked differences in performance between the two types of tired flight. The EEG analyses showed changes that correlated well with differences in workload. In the highest workload areas during fresh flights, EEG activity increased by approximately a factor of 4 over that of the preflight resting values. This large increase did not occur in the tired flights. Further experiments are planned using flights in aircraft and in simulators using several subjects.

Aerospace Medicine↗
PubMed1991

Time oriented score system (TOSS): a method for direct and quantitative assessment of nursing workload for ICU patients. Italian Multicenter Group of ICU research (GIRTI).

A method for direct quantitation of nurses' workload required by ICU patients is described. Each nursing activity has been timed in 14 different ICUs participating in the multicentre study, and the results averaged. Nursing acts were grouped in different homology lists, complied according to operative similarities. Some lists include general nursing acts, which are common to all patients admitted to ICU, others include acts peculiar to different organ system abnormalities or acts ancillary to the general group, finally one list includes emergency or occasional acts which are not encountered in every patient. The TOSS is a simple and rapid method for ICU nurses' workload assessment, can be computed both at admission and during the stay in ICU, and can provide factual information on the nurse/patient ratio necessary in a specific environment. TOSS validation was conducted with a yearly prospective study collecting 2710 patients. TOSS values varied according to diagnosis, severity of illness (SAPS) and intensity of processes (TISS), and TOSS specificity was demonstrated by the possibility of selecting a wide combination of nurse/patient ratios from 1:4 to 1:1 not possible with TISS.

Adult↗
PubMed1992

Low back and neck/shoulder pain in construction workers: occupational workload and psychosocial risk factors. Part 2: Relationship to neck and shoulder pain.

The prevalence rate of neck and shoulder trouble and considerable neck and shoulder pain in a randomly selected sample of 1773 construction workers were studied. The relationship to physical and psychosocial factors was analyzed. The workers answered a postal questionnaire. Workload was measured by means of eight manual materials handling indices and ten psychosocial indices, based on results from factor analyses. The 1-year prevalence rate of considerable neck and shoulder trouble was 56% and of neck and shoulder pain 12%. To work with hands above shoulder level showed a dose-response relationship to both neck and shoulder trouble and neck and shoulder pain. The psychosocial factors were more prominently associated with neck and shoulder trouble and neck and shoulder pain than the physical workload factors. The psychosocial indices; psychosomatic and psychic symptoms, stress and job satisfaction showed the highest age-standardized prevalence rate ratios for both neck and shoulder trouble and neck and shoulder pain.

Adult↗
PubMed1992

Workload of general practitioners before and after the new contract.

OBJECTIVE: To assess changes in general practitioners' workload associated with the new contract introduced in April 1990. DESIGN: Weekly workload diary completed during four weeks in February-March 1990 and during the same period in 1991. SETTING: Sheffield, United Kingdom. SUBJECTS: All 300 general practitioners on Sheffield Family Health Services Authority list as principals in 1990 and 1991. MAIN OUTCOME MEASURES: Mean number of hours worked per week, number of patients seen each week, and mean time spent per patient. RESULTS: 181 (60%) general practitioners responded in 1990 and 163 (54%) in 1991. Of these, 18 (10%) were not working in 1990 and 14 (7%) in 1991. General medical service work increased during a "normal working week" from a mean of 38.6 hours a week in 1990 to 40.6 hours in 1991, and non-general medical service work decreased from 5.4 hours a week to 4.5 hours. Hours spent on call were similar before and after the contract. For the 99 general practitioners who responded in both years, time spent on general medical service duties increased significantly (40.5 h in 1990 v 42.5 h [corrected] in 1991; p = 0.033), mainly due to more time being spent in clinics. Significantly more patients were being seen in clinics (9 v 14; p = 0.001); the average time spent per patient remained at about 8 1/2 minutes during surgeries and 16 minutes for a home visit, and rose from 13 to 14 minutes for patients seen in clinics. The time spent on practice administration fell but not significantly. CONCLUSION: Since the new contract there has been a significant increase in general medical services work, mainly due to more patients being seen in clinics, with no reduction in the time spent per patient.

Contract Services↗
PubMed1992

[Changes in mental workload and fatigue during performance of a mental task. 1. An experiment in 8-h self-paced transcribing task].

The changes in mental workload and fatigue during a one-day transcribing task were examined by determining some subjective and physiological measures which reflect mental activity. With an interval of one week between the three test days, 12 male students rested and performed self-paced transcribing task with moderate and maximum effort for 8 h each. The subjects transcribed more characters in the task with maximum effort than with moderate effort. In both the morning and afternoon, adrenaline excretion increased and heart rate decreased with the lapse of time. In linear proportion to the total working hours, occipital midline beta-2 amplitude, subjective rating of tiredness and subjective symptoms of fatigue rose, but critical flicker values fell slightly in the task with maximum effort. It was inferred from these results that with lapse of working hours intellectual activity and feeling of fatigue increase and the level of arousal slightly declines. Hence, it was considered that mental workload becomes heavier and subjective feeling of fatigue increases as the working hours become longer.

Adult↗
PubMed1992

[Evaluation of mental workload of short-term memory task by secondary task performance and frontal midline theta rhythm].

The purpose of the present study was to evaluate the mental workload of short-term memory task by two objective measures, the secondary task performance and the frontal midline theta rhythm (Fm theta) of the electroencephalogram (EEG). First, to choose Fm theta appearance subjects EEGs were recorded for 18 male students during performing additional task. On Fm theta appearance subjects (8 males) a series of short-term memory task with changed number of memorable figures was imposed as the primary task, and tracking task as the secondary task. The task that presents seven numbers will be over the subjects' limits of short-term memory, and it was the threshold that the subjects' mental workload will be increased.

Adult↗
PubMed1992

A comparison of workloads of physician-gastroenterologists and other consultant physicians. Prepared on behalf of the Clinical Services Committee, British Society of Gastroenterology.

In response to a workload questionnaire, carried out as part of an enquiry into manpower needs in gastroenterology, replies were received from 17 health regions, relating to 86 hospitals and 135 consultant gastroenterologists. The average yearly number of deaths and discharges of patients under the care of gastroenterologists was 992, while that of patients cared for by consultant physicians in other specialties was 679. When daycase admissions were also included, there were 1,553 annual discharges per gastroenterologist as compared with 871 for other physicians. These 682 extra cases per gastroenterologist largely represent the additional workload of gastrointestinal endoscopy.

Endoscopy↗
PubMed1991

Secondary-task assessment of workload: neuropsychological considerations for applied psychology.

The secondary-task paradigm has enjoyed considerable success as an assessment technique for operators' workload. However, during the past several years experimental neuropsychologists have employed an almost identical paradigm in their research investigating cerebral lateralization of function. To date, these areas of literature have existed as relatively isolated bodies of work, largely due to the differences between the disciplines. In the present manuscript is a brief review of the results from neuropsychological secondary-task studies and a consideration of these results in terms of their implications for the measurement of operators' workload.

Attention↗
PubMed1990

The relationship between psychic workload and cardiovascular response in industrial men managers.

The aim of the present study was to estimate the relationship between high-strain work and heart rate. The study was carried out in 23 managers from a big industrial plant. Evaluation of work demands and the ability to cope with them as regards mental difficulty, monotony, risk, responsibility, interpersonal conflicts and time pressure was regarded as an indicator of psychic workload. Heart rate (HR) was recorded according to the Holter method. Mean HRs were calculated for periods of work (HR work), outside work (HR home) and sleep (HR sleep). HR during work suggested the occurrence of substantial psychic load. This was supported by subjective evaluation, especially as regards responsibility, interpersonal conflicts, time pressure and mental difficulty. Work demands and the ability to cope with them could be regarded as the predictors of HR in all three periods of time considered, but especially during sleep. The prolonged influence of psychic workload on cardiovascular system reflects its intensity and may be the cause of the common occurrence of cardiovascular diseases in managerial staff.

Adult↗
PubMed1985

Nursing workload, medical diagnosis related groups, and nursing diagnoses.

Patient conditions associated with the relative amount of time nurses spent caring for patients were identified in this study. The patient conditions examined were: nursing condition using 37 nursing diagnoses, medical condition using diagnosis-related groups (DRGs), and demographic characteristics of age, sex, and race. Nursing time was estimated using the Rush-Medicus patient classification workload measurement tool. Data were gathered from checklists of nursing diagnoses and the discharge records of 2560 adult inpatients of an acute care community hospital. Using multiple regression analysis nursing condition explained twice the variation in daily nursing workload (52.4%) than medical condition (26.3%). The finding that nursing care time is predicted better by a patient's nursing condition than by either medical condition or demographic characteristics indicates that nursing care is not physician prescribed.

Adolescent↗
PubMed1988

Effects of pyruvate on post-ischemic myocardial recovery at various workloads.

In the present study the hemodynamic and metabolic effects of pyruvate (5 mM), added as cosubstrate to glucose (11 mM) perfused, transiently ischemic, isolated working rat hearts, were evaluated. During 2 h of normoxic perfusion pyruvate improved functional stability, prevented depletion of glycogen and triacylglycerol stores, and increased non-esterified fatty acid (NEFA) levels, even at relatively high workloads. The elevated NEFA levels are in line with the notion that pyruvate competes with endogenously produced fatty acids for oxidative energy production. After 45 min of global ischemia pyruvate was found (a) to affect markedly the relative contribution of ATP, ADP and AMP to the total adenine nucleotide content and (b) to stimulate the degradation of glycogen and to enhance the accumulation of lactate, suggesting enhanced anaerobic ATP production. After restoration of flow pyruvate reduced the incidence of fibrillation and markedly improved recovery of cardiac output at both normal and high workload. Pyruvate did neither attenuate the release of lactate dehydrogenase, a marker for cell death, nor improve the conservation of the total adenine nucleotide and ATP content of hearts reperfused for 30 min. The latter findings indicate that hemodynamic recovery during reperfusion in the presence of pyruvate is neither related to the absolute tissue content of ATP nor to a reduction of irreversible cell damage, and suggest that pyruvate exerts its advantageous hemodynamic effects rather by improving the condition of reversibly damaged cells during reperfusion.

Animals↗
PubMed1989

Effects of daily workload on subsequent behavior during marital interaction: the roles of social withdrawal and spouse support.

This article examines daily variability in 2 marital behaviors, social withdrawal and the expression of anger, as a function of daily taskload at work. Thirty-three air traffic controllers (ATCs) and 27 wives completed surveys on 3 consecutive days. Subjective and objective indicators of daily workload (air traffic volume and visibility at the airport) were related to the couples' descriptions of the ATCs' behavior after work. Despite a positive association between withdrawal and anger, workload seemed to influence these 2 behaviors in opposite ways. On high spouse-support evenings, work overload was associated with increased social withdrawal and less expression of anger. Social withdrawal may help an aroused individual return to a baseline emotional and physiological state. By facilitating their stressed partner's social withdrawal, supportive spouses may buffer the effects of minor daily stressors.

Anger↗
PubMed1976

[Assessment of radiologists workload in Scandinavia(author's transl)].

Experience in Sweden, Norway and Finland (University Clinic, Oulu) indicates that the points system instituted by the Scandinavian Association of Radiologists provides a satisfactory means of measuring radiologists' workload. A similar system for assessing radiographic technicians' workload is desirable.

Humans↗
PubMed1990

The ergonomic evaluation of eye movement and mental workload in aircraft pilots.

This paper presents an experiment which examines characteristics of pilots' scanning behaviour when using integrated CRT displays, and the changes in characteristics when pilots face abnormal situations. The subjects were five experienced pilots. They performed two modes of flight tasks, under normal and abnormal situations, in flight simulators with standard settings. The flight simulators were for a Boeing 747-300 (B747), which made use of electromechanical displays, and for a Boeing 767 (B767), equipped with integrated CRT displays. The results showed that the B767 pilots tended to gaze at the attitude director indicator which was displayed in the integrated CRT display. It was assumed that 'gaze-type scanning' might be one of the characteristics of pilots' scanning behaviour in cockpits which use the integrated display. By employing subjective ratings and heart rate variability to measure mental workload, no differences in mental workload between the B767 pilots and the B747 pilots were observed. However, in abnormal situations, the changes in scanning pattern for B767 pilots were found to be smaller than those of the B747 pilots. It is concluded that the application of integrated displays helps pilots to obtain sufficient information more easily than electromechanical displays do, even under abnormal situations.

Adult↗
PubMed1987

Variable threshold of exertional ischaemia in patients with positive exercise test at low workload.

In order to determine individual variability of ischaemic threshold on different days, 18 patients with exertional ischaemia at low workload were studied. All patients performed two exercise tests during different days in the morning and three on the same day at 9 am, 2 pm and 5 pm. The test performed in the morning on different days resulted in a significant difference in the mean values of rate pressure product at the ischaemic threshold as a consequence of individual variability observed in 10 patients. In 8 of these patients the differences were greater than 4000 mmHg beats min-1. Two patients showed respectively, 1 and 5 negative exercise tests despite the greater values of rate pressure product reached. Only 3 patients showed circadian variation of the ischaemic threshold; in these 3 patients variations of rate pressure product at the ischaemic threshold were also observed between different days. These data indicate that in patients with exertional ischaemia at low workload the rate pressure product at the ischaemic threshold shows considerable variability between tests performed on different days.

Angina Pectoris↗
PubMedDate not supplied

Workload management system for nurses: application to the burn unit.

A patient acuity classification is required by the Joint Commission on Accreditation of Healthcare Organizations, and this is vital in providing safe, cost-effective nursing care. The Workload Management System for Nurses (WMSN), which is based on direct and indirect nursing care research, prospectively classifies patients on the basis of direct care requirements and then establishes staffing levels on the basis of both direct care and indirect care workloads. Application of the Department of Defense WMSN to the military burn research center is feasible and has provided data for objective staffing adjustments and validated staffing requirements. In addition, several other quality assurance implications have been realized as a result of implementation of the system.

Burn Units↗
PubMed1989

The impact of a manufacturer's revision of pacemaker service life on the workload of a large pacing center.

In certain batches of a manufacturer's pacemakers, inadequate insulation of the battery cell feed-through mechanism led to internal short-circuiting and premature battery depletion. We describe the impact of the consequent reduction in service life and recommended close supervision of these generators on the follow-up clinics and inpatient workload at a large pacing center. One-hundred and ninety patients had Cordis Gamma series pacemakers implanted between September 1981 and July 1985; 135 have had to undergo premature generator replacement. Eleven of these pacemakers had developed early depletion of rate and 12 no-output failure. Within 3 months of their generator change, 12 patients developed wound sepsis, three of them requiring further system replacement. We calculate that at least 540 extra outpatient appointments, 400 in-hospital patient days and 12 full working days in one of our catheterization laboratories were required to deal with the problems. The pacemaker industry, as well as doctors and technicians involved in pacemaker purchase and implantation, should be aware of the consequences of a major recall not only on workload but also on patient morbidity and anxiety.

Electric Power Supplies↗