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Work production and work absorption in muscle strips from vertebrate cardiac and insect flight muscle fibers.

Stretch activation, which underlies the ability of all striated muscles to do oscillatory work, is a prominent feature of both insect flight and vertebrate cardiac muscle. We have examined and compared work-producing and work-absorbing processes in skinned fibers of Drosophila flight muscle, mouse papillary muscle, and human ventricular strips. Using small amplitude sinusoidal length perturbation analysis, we distinguished viscoelastic properties attributable to crossbridge processes from those attributable to other structures of the sarcomere. Work-producing and work-absorbing processes were identified in Ca(2+)-activated fibers by deconvolving complex stiffness data. An 'active' work-producing process ("B"), attributed to crossbridge action, was identified, as were two work-absorbing processes, one attributable to crossbridge action ("C") and the other primarily to viscoelastic properties of parallel passive structures ("A"). At maximal Ca(2+)-activation (pCa 5, 27 degrees C), maximum net power output (processes A, B and C combined) occurs at a frequency of: 1.3 +/- 0.1 Hz for human, 10.9 +/- 2.2 Hz for mouse, and 226 +/- 9 Hz for fly, comparable to the resting heart rate of the human (1 Hz, 37 degrees C) and mouse (10 Hz, 37 degrees C) and to the wing beat frequency of the fruit fly (200 Hz, 22 degrees C). Process B maximal work production per myosin head is 7-11 x 10(-21) J per perturbation cycle, equivalent to approximately 2 kT of energy. Process C maximal work absorption is about the same magnitude. The equivalence suggests the possibility that a thermal ratchet type mechanism operates during small amplitude length perturbations. We speculate that there may be a survival advantage in having a mechanical energy dissipater (i.e., the C process) at work in muscles if they can be injuriously stretched by the system in which they operate.

Animals↗

Work Hours Assessment and Monitoring Initiative (WHAMI) under resident direction: a strategy for working within limitations.

PURPOSE: A review of surgical residents' duty-hours prompted a Work Hours Assessment and Monitoring Initiative (WHAMI) that preemptively limits residents from violating "duty-hours rules." METHODS: Work hours data for the Department of Surgery were reviewed over 8-months at New York Presbyterian Hospital-Columbia Campus. This ongoing review is performed by a work-hours monitoring team, which supervises residents' hours for the initial 5-days of each week. As residents approach work-hours limits for the week, they are dismissed from duty for appropriate time periods in the remaining 2 days of the week. RESULTS: The work-hours data entry compliance for 52 residents was increased from 93% to 99% after creation of the WHAMI. Before the new system, a mean of 9.5 residents per month (19%) worked an average of 7.3 +/- 6.4 hours over the 80-hour limit. Averaged monthly compliance with the 80-hour work limit was increased to 98% with introduction of the WHAMI. A review of on-call duty hours revealed a mean of 7 (14%) residents per month who worked an average of 2.4 hours beyond 24-hour call limitations including "sign-out" time imposed by the ACGME. New monitoring procedures have improved compliance to 100% with 24-hour call limitations imposed by the ACGME. Compliance with the more stringent New York State (NYS) guidelines has approached 94% with noncompliant residents extending on-call hours by an average of 1.5 hours over the 24-hour limitations, most on "off General Surgery" rotations or out-of-state rotations. Review of mandatory rest periods contributed to an increase in mean "time off" between work periods, thereby increasing compliance with ACGME guidelines and NYS regulations from 75% to 88%, and 90% to 98%, respectively. Residents reporting less than 10 hours rest reported increased "time off" from 6.2 +/- 2.0 to 7.9 +/- 1.3 hours (p < 0.001). CONCLUSIONS: Internal review of surgical resident's duty-hours at a large university hospital revealed that despite strict scheduling and the requirement of mandatory duty-hours entry, achieving the goals of meeting the duty-hours requirements and of ongoing data entry required the creation of a resident enforced, real-time Work Hours Assessment and Monitoring Initiative.

Follow-Up Studies↗

Private or public? An empirical analysis of the importance of work values for work sector choice among Norwegian medical specialists.

In the aftermath of the Norwegian hospital reform of 2002, the private supply of specialized healthcare has increased substantially. This article analyses the likelihood of medical specialists working in the private sector. Sector choice is operationalized in two ways: first, as the likelihood of medical specialists working in the private sector at all (at least 1% of the total work hours), and second, as the likelihood of working full-time (90-100%) privately. The theoretical framework is embedded in work values theory and the results suggest that work values are important predictors of sector choice. All analyses are based on a postal questionnaire survey of medical specialists working in private contract practices and for-profit hospitals and a control group of specialists selected from the Norwegian Medical Association's member register. The analyses revealed that while autonomy values impact positively on the propensity for allocating any time at all to the private sector, professional values have a negative effect. Given that the medical specialist already works in the private sector, a high valuation of professional values and payment and benefit values increases the likelihood of having a dual sector job rather than a full-time private position. However, due to the cross-sectional structure of the data and limitations in the dataset, causality questions cannot be fully settled on the basis of the analyses. The relationship between work values and sector choice should, therefore, be regarded as associations rather than causality links. Finally, the likelihood of working in the private sector varies significantly at the municipality level, suggesting that medical specialist's location is important for sector choice.

Adult↗

Work load and work hours in relation to disturbed sleep and fatigue in a large representative sample.

OBJECTIVE: To study the relation between work and background factors on the one hand and disturbed sleep and fatigue on the other. METHOD: A representative national sample of 58,115 individuals was selected at regular intervals over a period of 20 years and interviewed on issues related to work and health. The data were subjected to a multiple logistic regression analysis. RESULTS: The number of cases was 18,828 (32.8%) for fatigue and 7347 (12.8%) for disturbed sleep. For disturbed sleep, the significant predictors became: female gender, age above 49 years, present illness, hectic work, physically strenuous work, and shift work. For fatigue, the significant predictors became female gender, age below 49 years, high socioeconomic status, present illness, hectic work, overtime work, and physically strenuous work. CONCLUSION: Work stress, shift work, and physical workload interfere with sleep and are related to fatigue.

Adolescent↗

The Work Design Questionnaire (WDQ): developing and validating a comprehensive measure for assessing job design and the nature of work.

Although there are thousands of studies investigating work and job design, existing measures are incomplete. In an effort to address this gap, the authors reviewed the work design literature, identified and integrated previously described work characteristics, and developed a measure to tap those work characteristics. The resultant Work Design Questionnaire (WDQ) was validated with 540 incumbents holding 243 distinct jobs and demonstrated excellent reliability and convergent and discriminant validity. In addition, the authors found that, although both task and knowledge work characteristics predicted satisfaction, only knowledge characteristics were related to training and compensation requirements. Finally, the results showed that social support incrementally predicted satisfaction beyond motivational work characteristics but was not related to increased training and compensation requirements. These results provide new insight into how to avoid the trade-offs commonly observed in work design research. Taken together, the WDQ appears to hold promise as a general measure of work characteristics that can be used by scholars and practitioners to conduct basic research on the nature of work or to design and redesign jobs in organizations.

Employment↗

Expanding the psychosocial work environment: workplace norms and work-family conflict as correlates of stress and health.

This study examined the contributions of organizational level norms about work requirements and social relations, and work-family conflict, to job stress and subjective health symptoms, controlling for Karasek's job demand-control-support model of the psychosocial work environment, in a sample of 1,346 employees from 56 firms in the Norwegian food and beverage industry. Hierarchical linear modeling analyses showed that organizational norms governing work performance and social relations, and work-to-family and family-to-work conflict, explained significant amounts of variance for job stress. The cross-level interaction between work performance norms and work-to-family conflict was also significantly related to job stress. Work-to-family conflict was significantly related to health symptoms, but family-to-work conflict and organizational norms were not.

Adult↗

How does the severity of a learning disability affect working memory performance?

Working memory performance was examined in children aged 11-12 years who had borderline, mild, and moderate learning disabilities. Comparisons with children of average abilities were used to determine whether those with more severe learning disabilities had greater impairments in working memory. Seven measures of working memory span were used to assess temporary phonological short-term storage (digit span, word span), temporary visuo-spatial short-term storage (pattern span, spatial span), and temporary short-term storage with additional processing, or central executive, demands (listening span. odd one out span, reverse digit span). Children with mild and moderate learning disabilities were impaired on all measures of working memory compared to children of average abilities. Children with borderline learning disabilities were just as good as children with average abilities on visuo-spatial and complex span tasks, but showed an impairment on phonological span tasks. Children with moderate learning disabilities were indistinguishable from children with mild learning disabilities on simple span tasks, but were significantly poorer than the mild group on the more demanding complex span tasks. For the group as a whole, working memory was strongly related to mental age.

Case-Control Studies↗

Shift work, health, the working time regulations and health assessments.

Shift work and night work in particular have been associated with sleep difficulties, general malaise, fatigue, peptic ulceration, ischaemic heart disease, cigarette smoking and adverse pregnancy outcome. The medical conditions previously regarded as making individuals unsuitable for shift work show wide ranging patho-physiological activity and there is no published evidence for any such condition to be regarded an absolute reason to exclude an individual from shift work. The fulfilment of the legal obligations of the Working Time Regulations 1998 is neither prescribed nor constrained in any way. It is advisable therefore to build on existing health procedures where they are in effect. Periodic health questionnaires can offer health professionals an opportunity to detect any disorder likely to be aggravated by shift work or by a combination of shift work, job demands and workplace conditions. A further purpose of the questionnaire is the assessment of ability to undertake shift work duties. However, health questionnaires are neither sensitive nor specific enough to be used to select applicants or employees for shift work, since they do not consistently predict tolerance of shift work or subsequent health problems. Whether employers should offer anything more than a simple questionnaire will depend on the culture of the company and accessibility of health services. Screening programmes affect many people relative to the few who benefit and with existing knowledge, periodic general health examinations performed in asymptomatic subjects have limited predictive or preventive value.

Disease↗

Working with a chronic disorder--the development of the Work and Handicap Questionnaire.

The Work and Handicap Questionnaire (WHQ) was developed to improve the vocational perspectives of patients with a chronic disorder. The WHQ differs from similar instruments in its explicit linkage between disabilities in daily life and job demands. This is an important feature, which allows for the development of specific strategies to counter work problems of people with a chronic disorder. The WHQ makes an inventory of possibly harmful working conditions and of possible strategies to counter health-related work problems by means of the work adjustments. Results of the application of the WHQ are shown for three patient groups (neuromuscular disorders, multiple sclerosis and asthma) and a group of colleagues with no chronic disorder. Results show similarities and differences between labour conditions and labour experiences between the three patient groups. It also shows differences and similarities between those working with a chronic disorder and those without such a disorder. Acceptance of the consequences of a chronic disorder for the job performance and a focus on health-related work problems would prolong career opportunities for workers with a chronic disorder. The use of the Work and Handicap Questionnaire will hopefully further these aims in determining health-related work problems and offer solutions by means of adequate work adjustment.

Adult↗

Low-back pain in 40- to 47-year-old men: work history and work environment factors.

The relationship of low-back pain (LBP) to work history and work environment factors was studied in a randomized sample of 940 men from 40 to 47 years of age. The life-time incidence of LBP was 61%, the prevalence 31%. In a univariate analysis ten of the variables studied were found to be correlated to the occurrence of LBP: less overtime work, diminished work satisfaction, decreased potential to influence the work situation, lesser demand on concentration, monotonous work, physically heavy work, a high degree of lifting, to a lesser degree sitting, and to a greater standing and walking work posture. When a covariance analysis was applied to these variables, only three had a direct association to LBP. They were less overtime work, monotonous work, and a high degree of lifting.

Adult↗

Association between recovery outcomes for work-related low back disorders and personal, family, and work factors.

STUDY DESIGN: Incident cases of work-related low back disorders were identified in an automotive metal stamping plant. Individuals were asked to recall health and work habits at the time of diagnosis of the work-related disorder and to report their current low back pain and physical functioning. OBJECTIVES: To evaluate five measures of health outcomes for work-related low back disorders in an industrial population and to determine potentially modifiable correlates of recovery. SUMMARY OF BACKGROUND DATA: The factors that influence recovery in actively working adults and how to best measure recovery outcome in this population are not well known. METHODS: Eighty-eight hourly employees of a metal stamping plant who experienced a work-related low back disorder were interviewed. Health status, health habits, and family and work relations were assessed with a structured interview to determine their association with various recovery outcomes (low back pain, low back pain disability, physical functioning, general physical health, and lost workdays). Interview information was supplemented with data from the plant's Occupational Safety and Health Administration Form 200 log. RESULTS: The clinical measures of recovery from the work-related low back disorders examined had similar overall predictive ability. However, in multivariate analyses, different potentially modifiable prognostic variables emerged as significant among them. Poorer self-rated health status and high personal stress were correlated with low back pain disability. Higher levels of cigarette smoking were correlated with higher levels of low back pain disability, lower physical functioning, and more severe low back pain at follow-up. CONCLUSION: The choice of measure of recovery from work-related low back disorders should be made in the context of the rehabilitation intervention goal. Interventions designed to modify and promote healthful personal behavior should be given more emphasis in rehabilitation efforts for work-related low back disorders.

Adult↗

Work sampling: the way in which physiotherapists utilise their working hours.

A time budget study was performed in order to assess how all physiotherapists working in Västerbotten County, northern Sweden, utilise their work-time and to identify factors influencing their allocation of working hours. The study, carried out in the autumn of 1985 and spring 1986, comprised 149 subjects, requiring one week each. Their activities were recorded at randomly selected 30-min intervals over the working week and distributed into predefined task categories. The treatment of patients took on average 33% of the physiotherapists' gross working time. Continuing education and development work on average amounted to 6% and the remaining occupational tasks to 38%. Transport, breaks and occasional days or hours off work took up 23% on average. Occupational area was the most important of the factors studied for the utilisation of working hours. Work sampling affords a better insight into the elements and structure of the professional work of physiotherapists.

Education, Continuing↗

The effect of polycythemia on blood flow in working and non-working skeletal muscle.

The effect of acutely induced polycythemia on blood flow and viscosity in the vasodilated vascular bed of working and non-working skeletal muscle was studied. In 12 mongrel dogs anesthetized with thiopental sodium the calf muscle of one hind limb was isolated. Vasodilation was induced either by sciatic stimulation setting the muscle at maximal work or by i.a. infusion of papaverine. Blood flow was measured at different perfusion pressure before and after infusion of 300 ml packed homologous red cells. Blood viscosity in vitro was determined in a coneplate viscometer. Apparent viscosity in vivo was analyzed by comparing pressure-flow relationships for blood and a reference solution. Polycythemia decreased blood flow by 35% in the non-working muscle but less than 10% in the working muscle at comparable perfusion pressures. Blood viscosity in vitro increased by 35% at low shear rates. Apparent viscosity in vivo increased by 35% in the non-working muscle but less than 10% in the working muscle. The flow impairment induced by polycythemia was far more pronounced in the non-working skeletal muscle indicating a flow facilitation by the rhythmic muscle contractions. Erythrocyte flow in fact increased in the working muscle after induced polycythemia while decreased in the non-working muscle.

Animals↗

Work centrality and post-award work behavior of lottery winners.

Individuals who had won the lottery responded to a survey concerning whether they had continued to work after winning. They were also asked to indicate how important work was in their life using items and scales commonly used to measure work centrality. The authors predicted that whether lottery winners would continue to work would be related to their level of work centrality as well as to the amount of their winnings. Individuals who won large amounts in the lottery would be less likely to quit work if they had relatively greater degrees of work centrality. After controlling for a number of variables (i.e., age, gender, education, occupation, and job satisfaction), results indicated that work centrality and the amount won were significantly related to whether individuals continued to work and, as predicted, the interaction between the two was also significantly related to work continuance.

Achievement↗

Disability beneficiaries who work and their experience under program work incentives.

This research examines the return to work by Disability Insurance beneficiaries who were first entitled to benefits in 1980-81 and who were originally selected to be interviewed in the New Beneficiary Survey. To facilitate an examination of actual labor-force participation by beneficiaries, information on work and participation in program work incentives was collected from their claims folders. The analysis shows that approximately 10 percent of disability beneficiaries work during their initial period of benefit entitlement. About 80 percent are granted a trial work period, and over 70 percent of those granted trial work successfully complete it. More than half of them, however, were not successful in leaving the rolls through their work effort. In fact, benefit terminations due to work occurred for fewer than 3 percent of all beneficiaries in the cohort; approximately one-third of them had returned to the rolls by the end of the period under study. Beneficiaries most likely to make a work attempt were young and had a high level of education. Those with a high Social Security benefit amount were less likely to make a work attempt.

Adult↗

Working part-time: achieving a successful 'work-life' balance?

The role of part-time employment in the balancing of women's employment and family lives has generated an immense literature. Using data on women working part-time and full-time in different level occupations in the British Household Panel Survey, this paper argues that it is now vital to move these balancing debates on from their location within work-family rhetoric and to re-position the study of women's working time in broader work-life discussions. Work-family debates tend to neglect a number of key domains that women balance in their lives, in addition to family and employment, including their financial security and their leisure. The paper shows that examining the financial situations and the leisure lives of female part-timers in lower level jobs reveals a less positive picture of their 'life balancing' than is portrayed in much work-family literature. Instead, they emerged as the least financially secure employees and, linked to this, less satisfied with their social lives too. It is concluded that since the work-life system is multi- and not just two-dimensional, it is important to examine how all life domains interrelate with each other. In this way, we would be in a better position to begin to assess all the benefits and disadvantages associated with working part-time and with other work-life balancing strategies.

Adolescent↗

Employment status and ability to work among working-age chronic dialysis patients.

283 patients, age 18-59 years on chronic dialysis were interviewed about their current work status and their ability to work if currently not employed. Only 11% of the total sample was currently employed. However, one third of the nonemployed patients said they were able to work, and most of these patients had made an effort to be employed. Age, race, educational level, health status, and physical ability to perform job tasks, recent work experience, and interest in working were related to the reported ability to work. Patients who said they were able to work were also likely to be rated able to work by the medical director of their dialysis facility. The data indicate the importance of helping work-interested patients maintain their jobs when they start chronic dialysis treatment.

Adult↗

[Perception of work load among female workers as an indicator of work stress and chronic fatigue].

The aim of the present paper was to determine the trends and extent of the effect of primary parameters of female workers' workload on the feeling of fatigue caused by a day's work and on chronic fatigue. The study comprised female workers 138 of whom performed fynamic-static work and 117 were busy with static work only. Methods used for measuring both the workload and fatigue were subjective. The experiments demonstrated that the extent of different types of workload was, according to workers, not always related to an increased fatigue caused by day's work and chronic fatigue. The effect of workload parameters is modified by the type of work performed and characteristics of workers groups. Time pressure turned out to be a negative factor affecting an increased fatigue caused by a work's day. Physical workload is an important indicator of an intensified fatigue resulting from a day's work as well as of chronic fatigue of female workers performing dynamic work. Physical workload has not the same effect on the other group of workers. Negative influence of workload parameters revealed itself mainly in relation to day's work fatigue, and to a lesser degree, in relation to chronic fatigue.

Chronic Disease↗