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At least 1,711 records · Page 95Linked to original sources

PubMed2000

Productivity of radiologists in 1997: estimates based on analysis of resource-based relative value units.

OBJECTIVE: Productivity of radiologists was quantified using the resource-based relative value scale for examining trends in workload. MATERIALS AND METHODS: Staffing and workload data for 1997 were collected in a survey of radiology departments in multispecialty clinics. Workload ratios were calculated and were compared with prior surveys of the same clinics and with published data. RESULTS: Fifteen clinics reported 3,234,730 examinations and 1,860,729 resource-based relative value units (RBRVUs) performed by 284 radiologists and 28 fellows serving 6305 providers. Productivity ratios were as follows: physician index, 19 physicians per radiologist; provider index, 23 providers per radiologist; availability index, 0.78; difficulty index, 0.54 RBRVUs per examination; examination index, 11,559 examinations per year per radiologist; RBRVU index, 6090 RBRVUs per year per radiologist. Each index had roughly a twofold range of variation from lowest to highest ratio observed. Among diagnostic and interventional procedures, 37% of the supervision and interpretation RBRVUs were in general radiography, 41% in sectional imaging, and 22% in special procedures. Since 1973, the percentages of sectional imaging and special procedure examinations and RBRVUs have increased, and the difficulty index has increased. The physician index has been relatively stable. Non-supervision and interpretation codes constitute approximately 18% of the reported RBRVUs. RBRVU valuation of total radiology services has held steady or slightly increased between 1993 and 1997. CONCLUSION: RBRVU workload of radiologists in the clinics appears to be increasing primarily because of an increase in the percentages of highly valued sectional imaging and interventional and angiographic studies, which constituted 63% of the diagnostic imaging RBRVU workload. The ranges of the indexes among the clinics varies greatly.

Efficiency↗

PubMed1999

The effects of slow- and fast-rhythm classical music on progressive cycling to voluntary physical exhaustion.

BACKGROUND: To investigate, based on the parallel information processing model and arousal hypothesis, whether musical tempo and its manipulation during exercise affect the maximal workload (watts) achieved during progressive cycling. METHODS DESIGN: repeated measures experiment that involved one control and four treatment conditions. SETTINGS: the experiment was performed in a controlled laboratory environment. PARTICIPANTS: twenty-four male and female volunteers, recruited from among a University population, were tested. INTERVENTION: the data collection proceeded in five counterbalanced test-sessions that included control (C), slow music (SM), fast music (FM) slow to fast music (SFM) and fast to slow music (FSM) interventions. In the last two conditions, musical tempo was changed when the participant's maximal HR reserve has reached 70%. In all test-sessions, participants started to cycle at 50 watts and then the workload was increased in increments of 25 watts every minute until self-declared exhaustion. Maximal ergometer cycling was defined as the workload at the last completed minute of exercise. MEASURES: workload, HR, and postexperimental ratings of test-session preferences were the dependent measures. RESULTS: Significantly higher workload was accomplished in the SFM condition. No between-session differences were seen in HR. The results also yielded significantly better "efficiency", in terms of workload/HR reserve ratio, in the SFM session. PARTICIPANTS preferred the FM and SFM sessions more than the other sessions. CONCLUSIONS: Switching to FM during progressive exercise results in the accomplishment of more work without proportional changes in HR. These effects may be due to distraction from fatigue and are, apparently, dependent on the attention capturing strength of the distracting stimulus.

Adult↗

PubMed2006

[Heart sound recognition algorithm based on PNN for evaluating cardiac contractility change trend].

This paper discusses the recognition of heart sound for evaluating the cardiac contractility change trend, which includes heart sound samples recorded at different exercise condition. Especially, focused on the recognition of heart sound recorded after high intensity exercise workload. The algorithm proposed consisted of two correlative methods. The first was to recognize heart sound recorded at rest and after low intensity exercise workloads by probabilistic neural network and the second was to recognize heart sound recorded after high intensity exercise workloads based on the characteristic of heart sound. Both methods have two consecutive phases. Firstly, all peaks, including the peaks of both heart sounds and noise, are marked by a repetitive threshold detecting algorithm. Secondly, probabilistic neural network is employed to classify the peaks detected in the first phase into Si, S2, and noise. Finally, the performance of the algorithm was evaluated using 45 digital heart sound recordings including normal and abnormal heart sound, which were recorded at rest and after low intensity exercise workloads, and 28 digital heart sound recordings recorded after high intensity exercise workloads. The results showed that over 94% of heart sound samples were classified and recognized correctly. Moreover, the reasons for the wrong classification, of which omitting and misdetection are two main problems, are also discussed and solutions are proposed. So this method can be improved and refined in following studies. In conclusion, this algorithm is a reliable approach to detect and classify heart sounds, providing a solid basis for further heart sound analysis.

Algorithms↗

PubMed1991

[Estimation of physical exertion by the AET ergonomic job description].

The study has been aimed at showing the advantages of using the AET ergonomic job description for estimation of physical workload, as compared to the traditional methods in which the estimates are made on the basis of the value of energy expenditure, static load and motion monotypicity. From tests on employees at 28 workposts it has been found that by analysing 17 factors involved in the overall estimate of physical workload according to AET, it is possible to characterize the work more precisely. The results of the tests indicate that AET estimates of heavy dynamic work are strongly correlated with the size of energy expenditure, whereas the estimation of body position--with the estimate of static load and the frequency estimate--with the estimate of motion monotypicity. New possibilities, with regard to the traditional method of physical workload estimation, are opened up by the AET method in relation to light dynamic work and static effort. The physical workload rate, calculated according to the AET method as the total of 17 elements estimated, does not differentiate the values of the workloads at individual workposts and, therefore, requires physiological verification.

Energy Metabolism↗

PubMed1989

Ancillary service consumption by Military Health Service System special programs: implications for diagnosis related group resource allocation.

An analysis was conducted of consumption of ancillary services by medical treatment facility special programs within the Military Health Service System (MHSS). This workload would not receive explicit credit under the new weighted ambulatory visit/inpatient disposition workload credit system mandated by the National Defense Authorization Act for Fiscal Year 1987. Results indicated that ancillary workload consumption by facility special programs was substantial. When the weighted visit/disposition workload credit system is implemented throughout MHSS, appropriate adjustments must be made to reflect ancillary workload generated by MHSS facilities in support of direct patient care missions but lost under this type of credit system.

Ancillary Services, Hospital↗

PubMed1989

Cognitive demands in automation.

As the nature of a task changes with increasing automation, so do the cognitive demands on the human operator. The present study examines the implications of such changes on subjective workload and automation design issues. A variety of tasks (continuous flight control, discrete target acquisition, and decision making) was used to tax the different cognitive systems. Each task could be performed alone or in combination with other tasks. Performance and subjective workload ratings, obtained by three workload scales, were examined as a function of the level of automation. Results demonstrated the usefulness of the multiple resource approach to task analysis. All three workload scales were found to be sensitive to the task demands. The Bedford scale was particularly impressive in distinguishing the different types of resources in demand. Both the multiple resource model's performance predictions and the subjective workload ratings were shown to be invaluable for decisions on how and what to automate.

Adolescent↗

PubMed1998

[Low back pain syndrome in coal miners: preliminary results of an epidemiological study].

The objective of the study was to determine the occurrence of low-back-pain syndrome in coal-miners and to compare the results obtained in the study and control groups. In two groups of subjects (624 employees of the 'Staszic' and 598 employees of the 'Sośnica' mines) the survey and medical assessment were performed and available medical records reviewed. Two groups were similar in terms of age and employment duration, however, working conditions in the 'Sośnica' mine were more difficult, and associated with a larger physical burden. All workers were divided into three groups according to the workload: workers with 'heavy workload' (35.9%), 'medium workload' (37.6%), and 'light workload'. The control group consisted of 449 policemen matched by age and the number of years preceding their retirement. The study revealed that low-back-pain syndrome occurred in 66.4% and 62.2% of the 'Sośnica' and 'Staszic' miners, respectively, while in policemen this figure accounted for only 7.5%. Among miners and policemen, a group with the employment ranging from 10 to 20 years was identified. The group comprised 730 miners, including 179 persons with light workload, and 142 policemen. Law-back-pain occurred in 61.6% of miners and in 14.1% of policemen. In miners the syndrome was associated mainly with lifting heavy objects or with an inappropriate forced position of the body at work. The preliminary results of the epidemiological study indicated that low-back-pain syndrome occurred more frequently in coal-miners than in policemen.

Adult↗

PubMed1995

Reduced ambulatory heart rate response to physical work and complaints of fatigue among hypertensive males treated with beta-blockers.

Treatment with beta-blockers affects oxygen metabolism and lipolysis during physical exertion. Together with possible central nervous system effects, this may impair the work capacity of treated hypertensive subjects. In a study of 1619 male employees, aged 45-64 years, mean resting and ambulatory heart rate (HR) and complaints of fatigue were compared between hypertensive workers treated with beta-blockers and untreated hypertensives and normotensives under low and high workload conditions. Treated hypertensives had lower mean resting HRs compared with normotensives and untreated hypertensives. Their change from resting to ambulatory HR during low and high workload was also lower than normotensives and untreated hypertensives, and they had higher fatigue scores than their untreated counterparts at both workload levels. The highest fatigue score was reported by treated subjects under high workload. These findings demonstrate a reduced HR response to physical work accompanied by more symptoms of fatigue during treatment with beta-blockers. When hypertensives are engaged in physically demanding work, other classes of antihypertensive therapy should be considered.

Adrenergic beta-Antagonists↗

PubMed2006

Human experimental exposure study on the uptake and urinary elimination of N-methyl-2-pyrrolidone (NMP) during simulated workplace conditions.

A human experimental study was carried out with 16 volunteers to examine the elimination of N-methyl-2-pyrrolidone (NMP) after exposure to the solvent under simulated workplace conditions. The NMP concentrations were 10, 40 and 80 mg/m(3) for 2 x 4 h with an exposure-free interval of 30 min. Additionally, a peak exposure scenario (25 mg/m(3) baseline, 160 mg/m(3) peaks for 4 x 15 min, time-weighted average: 72 mg/m(3)) was tested. The influence of physical activity on the uptake and elimination of NMP was studied under otherwise identical exposure conditions but involving moderate workload on a bicycle ergometer (75 W for 6 x 10 min). The peak times and biological half-lives of urinary NMP and its main metabolites 5-hydroxy-N-methyl-2-pyrrolidone (5-HNMP) and 2-hydroxy-N-methylsuccinimide (2-HMSI) in urine were analysed as well as the interrelationships between exposure and biomarkers. All analytes showed a close correlation between their post-shift peak concentrations and airborne NMP. An exposure to the current German workplace limit value of 80 mg/m(3) under resting conditions resulted in urinary peak concentrations of 2,400 microg/L NMP, 117 mg/g creatinine 5-HNMP and 32 mg/g creatinine 2-HMSI (workload conditions: 3,400 microg/L NMP, 150 mg/g creatinine 5-HNMP, 44 mg/g creatinine 2-HMSI). Moderate workload enhanced the total uptake of NMP by approximately one third. Differences between the estimated and the observed total amount of urinary metabolites point to a significant contribution of dermal absorption on the uptake of NMP. This aspect, together with the influence of physical workload, should be considered for the evaluation of a biological limit value for NMP.

Administration, Inhalation↗

PubMed1996

Profile of radiotherapy departments contributing to the Cooperative Group of Radiotherapy of the European Organization for Research and Treatment of Cancer.

PURPOSE: Since 1982, the Radiotherapy Group of the European Organization for Research and Treatment of Cancer (EORTC) is carrying out a Quality Assurance program that includes the evaluation of the structure and human resources of 50 centers actively participating in protocols of clinical research in radiotherapy. METHODS AND MATERIALS: One or two site visits were made by a team of radiation physicists and physicians. A detailed questionnaire was circulated to these radiotherapy centers to collect and update standardized figures on the status and activities of each center, to clarify some obscurities encountered during on-site visits, and to extend investigations to issues that were not addressed during local audits. RESULTS: This article reports on departmental infrastructure, staff and equipment workload, and quality control procedures carried out by single institutions. Large variations in equipment and staff are observed among participating centers. Comparisons between data collected in the early 1980s and during a recent update show no difference in workload per megavoltage equipment and per simulator. The number of cancer patients treated per year per radiotherapist seems to slightly diminish, especially in centers that experienced a considerable staff shortage a few years ago. The most significant improvement is observed for the number of cases treated per year per member of the radiation physics team. The radiographer's workload shows an opposite trend. CONCLUSIONS: Our database provides participating centers with strong comparative arguments to correct staff and equipment unbalances and to convince administrative authorities of priorities in decision making. The current analysis shows that the situation for equipment is unchanged in comparison with that observed 6 years ago. Efforts have to be put forth in some institutions to reduce the workload at simulators. A tentative profile and guidelines for minimum recommendations for European radiotherapy departments involved in clinical research are presented.

Cancer Care Facilities↗

PubMed2006

Is there a minimum caseload that achieves acceptable operative mortality in abdominal aortic aneurysm operations?

BACKGROUND: Studies have shown correlation between operative workload and mortality for major operations. Is there a threshold for case volume that predicts an acceptable mortality for abdominal aortic aneurysm surgery? METHODS: Hospital Episode Statistics (HES) Data for England between 1997-2002 was analysed using ICD-10 codes I71.x and OPCS-4 codes L16.x-L26.x. Mortality was identified by the method of discharge. RESULTS: 31,078 operations on abdominal aortic aneurysms were studied in 223 NHS Trusts. 6,007 in-hospital deaths were identified in both elective and emergency cases (overall mortality rates 7.7% and 40%, respectively). Trusts with large elective workloads had reduced mortality for both elective and emergency operations. Using parabolic regression and logarithmic transformation, 14 elective operations per Trust per year was identified as a cut-off point above which the decrease in mortality rate with increasing case volume was relatively small. A similar effect was not seen with increasing emergency workload alone. CONCLUSION: HES data analysis suggests increasing elective workload correlates with lower in-hospital mortality for elective and emergency operations on abdominal aortic aneurysm. Data suggests a range of hospital caseload that correlate with an acceptable elective and emergency mortality rate.

Aortic Aneurysm, Abdominal↗

PubMed1997

Health service indicators for radiology departments: how meaningful are they?

The Health Service Indicator (HSI) for Radiology Services in the UK is represented by a cost per case figure based on annual expenditure and workloads in individual departments. These show significant variations betweeen departments for a number of predictable reasons. Detailed analysis shows good correlation between population-based radiology costs and workloads and that departments with low cost per case values have above average workloads. The usefulness of the HSI cost per case is limited to identification of departments with unduly high or low values, thus allowing such departments to critically appraise their staffing and workload levels. Taken at face value, they can easily be misinterpreted as a measure of cost-effectiveness.

Hospital Costs↗

PubMed2003

Physician health, stress and gender at a university hospital.

OBJECTIVE: To determine personal and work related factors contributing to physician health and stress in men and women physicians in a university hospital. METHOD: Mail survey of 161 hospital-based Canadian academic physicians (51 women, 110 men). RESULTS: Women compared to men, physicians were younger (M = 43 years, S.D. = 7.4 vs. M = 48 years, S.D. = 8.64; P = .001) and fewer had spouses (76% vs. 90%; P = .01) and children (76% vs. 91%; P = .02). A five-item scale measured somatic symptoms, the dependent variable. Among physicians of both gender, the somatic symptoms scale was significantly correlated with satisfaction with amount of time spent working and scales of mental health (five items), work satisfaction (five items), workload (five items), healthy lifestyle (five items), coping abilities (three items) and support-in-stress (two items). On stepwise regression analysis, for women physicians, 70% of the variance in somatic symptoms was explained by support from colleagues when stressed, and workload. For men, 42% of the variance was explained by healthy lifestyle, mental health, support from colleagues when stressed, and workload. Regardless of gender, the majority of physicians reported an excessive workload but the sources of support when stressed varied by gender. CONCLUSION: Different strategies are needed for women and men physicians to reduce their stress levels.

Adult↗

PubMedDate not supplied

[Gender differences in the influence of housework on health].

OBJECTIVE: To analyze the influence of domestic workload on the health of the working population of Catalonia, taking into account its differential impact on males and females. SUBJECTS AND METHODS: The study population were the 2,164 men and 1,215 women interviewed in the Catalonian Health Survey (ESCA) of 1994, with a paid work who were the main responsible for the family unit. The dependent variable was the self-perceived health status that was dichotomized for the bivariate and multivariate analysis. The domestic workload was measured with the number of people living at home (2, 3, 4 or more than 4), living with children younger than 15 and living with older than 65. The adjusting variables were age and occupational social class. The analysis was separated for men and women and crude, adjusted for age, and for all the predictor variables odds ratios (OR) were calculated with their 95% confidence intervals (95%CI). RESULTS: There was no relation between domestic workload and health status among men. Among women the risk or poor health status increased with the number of people living at home with adjusted OR associated to living with more than four persons of 2.35 (95%CI = 1. 33-4.15), as compared with living only with the spouse. Living with older than 65 was protector for women (adjusted OR = 0.63; 95%CI = 0. 39-1.03). CONCLUSIONS: The risk of poor health status associated to the domestic workload among women with paid work, suggests the need of increasing community resources for caring children, as well as, increasing the participation of men in the domestic work. Future health surveys should collect information about the number of people of different age strata living at home.

Adolescent↗

PubMedDate not supplied

Mass gathering events: retrospective analysis of patient presentations over seven years.

INTRODUCTION: St John Ambulance Operations Branch Volunteers have been providing first-aid services at the Royal Adelaide Show for 90 years. The project arose from a need to more accurately predict the workload for first-aid providers at mass gathering events. A formal analysis of workload patterns and the determinants of workload had not been performed. HYPOTHESIS: Casualty presentation workload would be predicted by factors including day of the week, weather, and crowd size. METHOD: Collated and analyzed casualty reports over a seven-year period representing >7,000 patients who presented for first-aid assistance for that period (63 show days) were reviewed retrospectively. RESULTS: Casualty presentations correlated significantly with crowd size, maximum daily temperature, humidity, and day of the week. Patient presentation rate had heterogeneous determinants. The most frequent presentation was minor medical problems with Wednesdays attracting higher casualty presentations and more major medical categories. CONCLUSION: Individual event analysis is a useful mechanism to assist in determining resource allocation at mass gathering events providing an evidence base upon which to make decisions about future needs. Subsequent analysis of other events will assist in supporting accurate predictor models.

Anniversaries and Special Events↗

PubMed2002

Organization, work and work reactions: a study of the relationship between organizational aspects of nursing and nurses' work characteristics and work reactions.

This article describes a quantitative, correlational study of the relationship between organizational aspects (such as the predictability of the care), work characteristics (autonomy and workload) and work reactions (work satisfaction and health complaints) in nursing work. The variables have been measured by questionnaires. Subjects were 155 nurses from nine units in two general hospitals in the Netherlands. Several organizational aspects seem to be correlated with work characteristics and work reactions. Organizational aspects particularly influence work characteristics and play, therefore, a mediating role in the relationship between organizational aspects and work reactions. Job satisfaction is not only correlated with the autonomy, but also with workload. Health complaints appeared to be mainly correlated with the workload. It is concluded that for an improvement of job satisfaction and reduction of health complaints, it is not only necessary to improve autonomy and reduce workload, but also to pay attention to organizational aspects because these may influence the work characteristics.

Cooperative Behavior↗

PubMed2004

Cervicobrachial muscle response to cognitive load in a dual-task scenario.

People working in an office environment often have to deal with significant cognitive workload due to the coordination of multiple, simultaneous tasks. The objective of this research was to examine the impact of cognitive load in office-type tasks on physical-stress response, using a dual-task paradigm involving a primary cognitive task and secondary typing task. The central hypothesis of this research was that altering the demands of the cognitive task would lead to a difference in physical stress-level and performance. Cognitive load was manipulated by presenting participants with three different types of cognitive tasks described in taxonomy, including skill-, rule-, and knowledge-based tasks. Dependent variables examined in the study included: (1) electromyographic activity of the upper trapezius (pars descendens) and cervical erector spinae muscles, (2) performance in a secondary typing task, and (3) subjective measures of stress and cognitive workload. The results of this study revealed that the primary task causing the highest level of perceived workload also produced 61% higher muscle activity in the right trapezius, and 6 and 11% higher activity in the left and right cervical erector spinae, respectively, in comparison to muscle activity associated with the cognitive task causing the lowest perceived workload. With respect to performance, a 23% decrease was observed in typing productivity when the rule-based task was completed simultaneously vs. typing in the absence of any additional cognitive task (the baseline condition). This information may be used to better organize work activities in office environments to increase performance and reduce stress.

Adaptation, Physiological↗

PubMed2005

Physiologically based modeling of n-hexane kinetics in humans following inhalation exposure at rest and under physical exertion: impact on free 2,5-hexanedione in urine and on n-hexane in alveolar air.

We used a modified physiologically based pharmacokinetic (PBPK) to describe/predict n-hexane (HEX) alveolar air concentrations and free 2,5-HD urinary concentrations in humans exposed to n-HEX by inhalation during a typical workweek. The effect of an increase in workload intensity on these two exposure indicators was assessed and, using Monte Carlo simulation, the impact of biological variability was investigated. The model predicted HEX alveolar air concentrations at rest of 19.0 ppm (25 ppm exposure) and 38.7 ppm (50 ppm exposure) at the end of the last working day (day 5), while free 2,5-HD urinary concentrations of 3.4 micromol/L (25 ppm) and 6.3 micromol/L (50 ppm) were predicted for the same period (last 4.5 hours of Day 5). Monte Carlo simulations showed that the range of values expected to occur in a group of 1000 individuals exposed to 50 ppm of HEX (95% confidence interval) for free 2,5-HD (1.7-14.7 micromol/L) is much higher compared with alveolar air HEX (33.4-46 ppm). Simulations of exposure at 50 ppm with different workloads predicted that an increase in workload intensity would not greatly affect both indicators studied. However, the alveolar air HEX concentration is more sensitive to modifications of workload intensity and time of sampling, after the end of exposure, compared with 2,5-HD. The PBPK model successfully described the HEX alveolar air concentrations and free 2,5-HD urinary concentrations measured in human volunteers and is the first, to our knowledge, to describe the excretion kinetics of free 2,5-HD in humans over a 5-day period.

Exercise↗