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[Workload in software development work. A consideration based on work-characteristics and analysis on workload factors of each working group].

To clarify workload factors in software developing work, we designed questionnaires composed of questions of work-content based on the interview survey. For the analysis of workload, Cumulative Fatigue Symptom Index (CFSI) and the stress-rating-method by 7-likert-scale were used. With the cooperation of the Japanese Software Engineers' Association (SEA) responses were obtained from 270 out of 1,100 members and from 553 non-member software engineers in 18 companies in Japan. The CFSI score obtained was higher than those of other groups of other industries obtained in our previous studies. The stress-rating showed that "time-pressure," "too much amount of work, and "ambiguity in job specification" were the highest stressors. The work groups were categorized by the results of CFSI profile into 4 types. The results of stress-ratings were significantly different between the 4 type groups. Based on the multiple comparison analysis, the workload factors of each group could be specified. Out of the foregoing 4 types, the work groups which showed the deviation in F1B (depression) in CFSI and the work groups which showed high scores in every category in CFSI were higher in "ambiguity of specification" in stress-ratings. This result indicates that "ambiguity in specification" is a significant stressor in software engineers. This stressor is caused by the complicated communication process between users and engineers and by the shortage of tools or rules in this process. This stressor is considered to be the most typical workload which characterizes the software developing work.

Adult

Influence of workload on the antihypertensive effect of exercise.

1. The relation between workload and the antihypertensive effect of exercise therapy in hypertensive patients, and the mechanism of that effect, were investigated. 2. Twenty-six patients participated in the study and were randomly assigned to 10 weeks of either low or high workload exercise. In the low workload group, 16 mild hypertensive patients were treated with bicycle ergometer exercise at approximately 50% of their maximum oxygen consumption (VO2max) for 60 min three times a week for 10 weeks. In the high workload group, 10 mild hypertensive patients exercised on the same schedule, but at approximately 75% of VO2max. 3. After 10 weeks of exercise, the low workload group had significantly lower systolic (9 mmHg), mean (6 mmHg) and diastolic (6 mmHg) blood pressures. In the high workload group, decreases in systolic (3 mmHg), mean (4 mmHg) and diastolic (5 mmHg) blood pressure were not statistically significant. 4. In the low workload group, changes in haemodynamic and humoral variables were not significant, except for a reduction in plasma norepinephrine at week 7. Cardiac index and plasma norepinephrine tended to decrease. In the high workload group, plasma norepinephrine and the renin-angiotensin system were transiently stimulated after 4 weeks of exercise. Stroke volume significantly increased (+26.4%) after 10 weeks of high workload exercise. 5. Based on these results and better patient compliance with the exercise programme in the low workload group than in the high workload group, low workload exercise therapy was recommended to mild hypertensive patients.

Adult

[Participation of mental workload in circulatory system reaction to occupational work].

The aim of the study was to determine the degree to which the heart rate during and after work of variable physical and mental load was affected by the mental workload of moderate intensity. The subjects were 150 women aged 17-57. 24-hour recordings of their heart rates during work, leisure and sleep were taken using the Medilog recording-analysing system. Mental workload was determined in two ways: by the AET method, which enabled objective evaluation of the load, and by a method which involved subjective evaluation of work requirements and the ability to cope with them. Using the multiple regression analysis, the degree to which concurrent elements of mental and physical workload an serve as predictors of heart rate during work, leisure and sleep. The results show that physical workload is the more essential factor affecting the reaction of the circulatory system under the circumstances of concurrent mental and physical workload. By extending the measurements to involve off-duty hours, it was possible to determine that the consequences of mental workload manifested also after the work. The prolonged effect of mental workload on the heart rate was evident only when the subjective method of workload estimation was used. This points to the individual character of mental workload. The findings indicate on one hand that the share of mental workload should not be neglected during evaluation of the effects of occupational workload on the physiological reactions and, on the other, that the heart rate measurement is a useful tool for indicating essential elements of workload.

Adolescent

Therapeutic intervention scoring system (TISS)--a method for measuring workload and calculating costs in the ICU.

The Therapeutic Intervention Scoring System (TISS) is an easily applicable method for measurement of workload in the intensive care unit (ICU). In the present study a modified TISS-scoring (mTISS) was performed daily during 1988-1989 on 2693 patients in a general ICU. Of these, 900 could be classified as 'true' ICU-patients (ICU-stay > or = 24 h or TISS > or = 20 points), whereas the rest were postoperative. In ICU-patients the average length of stay was 4.5 +/- 8.9 days and the average workload 114 +/- 218 mTISS-points. The workload was not significantly related to age or type of admission (scheduled vs unscheduled). Hospital non-survivors (13.6%) showed a significantly increased mean total mTISS-score (239 +/- 364, P < 0.001). Critically ill (TISS Class IV) patients (14% of the sample), with an average workload of 437 +/- 401 mTISS-points, consumed 53% of the total resources. Patients categorized (ICD-9) to respiratory and infectious diseases showed the greatest average workload (207 +/- 315 and 208 +/- 355 mTISS-points, respectively). A workload-index was also developed relating the actual workload to the ICU personnel. The cost of each mTISS-point was calculated. In conclusion, the present study showed that mTISS is a valuable tool when evaluating resource utilization in the ICU. Together with the proposed workload-index and calculation of costs, mTISS could be used for ICU management control.

Age Factors

[Effect of workload on physicians' drug prescribing].

The possible effect of workload on the prescribing of drugs by physicians was studied in 10 primary care pediatricians during a 1-month period. The intraphysician variability revealed a positive correlation (p less than 0.05) between workload and prescription of antibiotics in the case of 2 of the physicians and a negative correlation (p less than 0.05) between workload and prescription of all drug items in another physician. The prescribing of the other 7 was not affected by changes in daily workload. The interphysician variability study revealed a significantly increased rate of prescription of analgesics/antipyretics by physicians with increased monthly workload (r = 0.91, p less than 0.001). These results suggest that although the prescribing habits of a minority of physicians may be affected by their workloads, prescription rates remain stable for the individual physician on most occasions. However, physicians with high workloads tend to prescribe more analgesics/antipyretics than those with low workloads.

Analgesics

Prediction of general practice workload from census based social deprivation scores.

STUDY OBJECTIVE: The aim was to compare the ability of census based social deprivation scores devised by Jarman, Carstairs, and Townsend to predict workload in general practice. DESIGN: This was a prospective study of 140,050 patients registered with general practices over one year from 1 July 1981 (Third National Morbidity Survey). Main outcome measures were workload score for each patient, defined as a weighted sum of consultations at the surgery and consultations elsewhere, excluding preventive procedures. SETTING: 25 general practices in England and Wales. MAIN RESULTS: In multivariate analyses the Jarman, Carstairs, and Townsend indices all predicted workload, but the Townsend index was the best predictor, with both housing tenure and car ownership being strong predictors of workload. The overcrowding and geographical mobility variables used in the Jarman index did not predict increased workload. The weighting assigned to children under five by the Jarman index underestimated the additional workload this group generated. CONCLUSIONS: For identifying social pressures on general practice workload the Jarman index is less valid than other census based scores because it fails to include car ownership and housing tenure. A more rational scheme for compensating general practitioners would directly weight the capitation fee for children aged under five years and allocate current deprivation payments according to the Townsend index or a similar score. This would redistribute resources from London to deprived areas in northern England.

Adolescent

Effect of different workloads varying in intensity and duration on resolution acuity.

An experiment was conducted to determine the effect of participation in physical activity on resolution acuity. In the experiment, 21 undergraduate males participated in exercise sessions with work loads of 300, 700, and 1100 kmp for durations of 3 and 6 min. and a non-exercise control session. Resolution acuity was then determined by finding thresholds of a 20-cpd sinusoid-wave grating using the method of adjustment. A repeated-measures analysis of variance compared the effects of different workloads, intensities, and durations of workloads, and the interaction of intensity and duration on resolution acuity. Significant improvement of resolution acuity was found for all workloads relative to the non-exercise control session, for all other workloads relative to the 300 kpm/3 min. workload, and for the 1100 kpm/6 min. workload relative to the 300 kpm/6 min. and the 700/3 min. workloads. Increases in duration or intensity of exercise significantly improved resolution acuity. There was no significant interaction of the variables of intensity and duration of work on resolution acuity.

Humans

Measuring physician mental workload: reliability and validity assessment of a brief instrument.

This study examined the reliability and validity of a brief six-item instrument to measure the mental workload experienced by residents for specific patient visits to an ambulatory care clinic. Participating in the study were twenty-two residents in postgraduate years 1 through 3 who were working in the general outpatient clinic of an inner city, private, nonprofit community hospital. Cronbach's alpha coefficient for the instrument was 0.80. Findings supported several theory-based hypotheses on determinants and performance consequences of mental workload. Mental workload was positively correlated with fatigue (r = 0.42, P = 0.03) and inversely correlated with residents' self-rated experience with patients' problems (r = -0.65, P less than 0.001). Residents' performance was measured through self-ratings and faculty physicians' ratings. Mental workload was inversely correlated with self-rated performance (r = -0.67, P less than 0.001). The correlation of mental workload with faculty physician ratings that reflected the technical dimension of patient care (physician examination, medications, and procedures) was r = -0.38 (P = 0.04). With mental workload squared, the correlation was r = -0.45 (P = 0.02) and the form of the relationship, consistent with the hypothesis, was a slightly downward sloping curve. Limitations of this research are discussed as well as suggestions for further research.

Adult

Aerobic and anaerobic energy contribution during maximal work output in 90 s determined with various ergocycle workloads.

The aim of this experiment was to evaluate the effect of different workloads on the relative contribution of the various energy delivery systems during a 90-s ergocycle test. Nine male subjects, 22 +/- 1 (mean +/- SD) years of age and weighing 71.4 +/- 6.8 kg, were submitted to a VO2max test, as 10-s test (0.1 kp/kg) and three 90-s tests at different loads (LO: 0.05, ME: 0.075 and HI: 0.1 kp/kg) on an ergocycle. No difference was found between peak power output during the 10-s and HI tests. No differences were observed in the total work output performed during 90 s at different workloads (between 481 and 495 J/kg) as well as in the contribution of aerobic and anaerobic pathways to total energy production. However, VO2max was reached earlier during the ME and HI tests than during the LO test. These results indicate that variation in workload did not influence the total work output and the total contribution of aerobic and anaerobic systems during maximal 90-s ergocycle performances. However, variation in workload had an impact on the relative aerobic and anaerobic contribution at various time points. It is concluded that a 90-s ergocycle test with a resistance of at least 0.1 kp/kg is required to appropriately assess maximal anaerobic power while anaerobic capacity might be measured with workloads as low as 0.05 kp/kg.

Adult

Women's workload and its impact on their health and nutritional status.

This paper highlights various issues in relation to the workload of women in developing countries and its impact on health and nutritional status. The determining factors in women's workload and work-time and the methods employed for assessment are described. The drawbacks of the methods used and the resulting inconsistencies in the data are reviewed. How women are subjected to different health stresses owing to their productive and reproductive roles has been examined under three categories of work: economic, domestic and agricultural. The interaction of women's workload and health is complex and multifactorial owing to variations in the environment and socio-economic conditions within developing countries. There is a critical need to re-examine the assumptions existing about women's workload in programmes aimed at reducing work-time and workload of women in developing countries.

Developing Countries

Evaluation of Physical and Mental Workload and Transfusion Time in Trauma Resuscitation.

BACKGROUND: Trauma resuscitation is time sensitive and complex. Whole blood (WB) and blood components are standard treatments for trauma related hemorrhage, yet their nursing workload and transfusion time have not been well evaluated. PURPOSE: To assess feasibility of a simulation-based crossover trial and obtain preliminary estimates comparing nursing workload and transfusion completion time between WB and blood component administration. METHODS: A randomized crossover pilot study using in situ simulation was conducted with experienced trauma nurses. Time-motion analysis measured transfusion completion time, and the National Aeronautical and Space Administration Task Load Index assessed workload domains. RESULTS: Strong feasibility was demonstrated across recruitment, retention, adherence, and completion. WB was associated with significantly shorter transfusion time, lower overall workload and mental demand, less effort, and better perceived performance. CONCLUSIONS: These findings support the feasibility and justify a fully powered trial. WB may improve resuscitation efficiency and reduce cognitive burden, with potential implications for patient outcomes and nursing workflow.

Humans

List size, composition of practice and general practitioners' workload in The Netherlands.

Workload of general practitioners plays an important role in discussions about list size and remuneration in health care systems with fixed patient lists and capitation payments, such as in the Netherlands and in the United Kingdom. Against the background of the fairness of differences in income level between GPs the question is posed to what extent differences in list size reflect differences in workload and to what extent differences in patient characteristics influence workload. Both list size and practice composition relate to the demand led character of general practice. Data collected in the National Study of Morbidity and Interventions in General Practice are used. Central to this study is a three month recording of all contacts of 161 general practitioners (and their locums, assistant GPs and trainees) in the Netherlands. For each practice a patient register has been made to relate contacts to the practice population. The participating GPs kept a detailed diary covering 24 hr a day during one week. As indicators of workload several contact rates, hours worked in practice per week (in direct patient care and in other activities) and average length of office consultations are used. Demand related characteristics have the strongest relation to the number of hours worked by GPs, particularly the number of hours spent in patient-related activities. Rates of contacts, with the exception of the office contact rate, are not related to list size, but mainly to practice composition. The average length of consultations is negatively related to list size and some characteristics of the practice population.

Capitation Fee

[Evaluation of workload in middle-aged steel workers by measuring urinary excretion of catecholamines and cortisol].

To evaluate physical and mental workload in middle-aged workers, urinary excretion of catecholamines and cortisol and self-reported scores of fatigue, stress and arousal in middle-aged steel workers were compared with those in young steel workers. Noradrenaline excretion in daytime of the day-off was higher in middle-aged workers than that in young workers. In the work days, noradrenaline excretion during working hours increased in both age groups when compared with that in the day-off. The work-related increase in noradrenaline excretion was more evident in the middle-aged group than in the young group. Adrenaline excretion during working hours was greater in the middle-aged group than that in the young group, whereas the adrenaline value in the day-off was almost the same in the two age-groups. Age-difference was hardly observed in dopamine and cortisol excretion. These findings suggest that the workload in middle-aged workers was greater than that in young workers. However, self-reported scores of fatigue and stress in middle-aged workers were less than those in young workers, suggesting inconsistency between subjective score of workload and urinary levels of catecholamines. These age-related differences in urinary levels of noradrenaline and adrenaline were not so obvious in workers engaged in automated and mechanized work (vigilance task) when compared to workers engaged in less automated and less mechanized work. It is considered that factory automation might reduce the workload in middle-aged workers.

Adult

Assessing pilot workload. Why measure heart rate, HRV and respiration?

The application of heart rate and respiratory measures to the human factors of flight is discussed. The concept of pilot workload is related to the concept of arousal and distinguished from physical workload. Finds from studies of pilot workload using heart rate measures are reviewed for flight, simulated flight and related real-life challenges. Measurement techniques and transducers are discussed from the perspective of field measurement. Recommended procedures are presented as are directions for future work.

Aircraft

Emergency department workload--a transatlantic comparison.

This paper compares the workload of the emergency department of a Level One trauma center in the United States and a large city hospital in the United Kingdom. The referral pattern and diagnostic classification of 5,000 patients presenting to both departments were compared, as were the transportation systems at the two sites. It was shown that similarities existed in many areas. Major trauma formed only a small proportion of the overall workload of both departments. The conclusion is that although the two emergency care systems have fundamental differences in terms of organization and finance, the workloads are remarkably similar. Interesting differences arose in areas such as use of helicopter transport, psychiatric and drug and alcohol related admissions, and in the number of patients brought to hospital under police escort.

Aircraft

An epidemiological profile of in-patient workload in dermatology.

Trends in admission rates, patterns of readmission, lengths of stay and clinical caseload for in-patient dermatology from 1976 to 1985 are described using data from the Oxford record-linkage study. Age-specific admission rates were considerably higher in people aged 50 years and over than in younger people. Admission rates declined over time in most age-sex groups below the age of 70 years, but increased over time for the over 70s. In dermatology, unlike most other specialties, the length of patients' stay did not decrease substantially over the 10 years. In-patient workload consisted predominantly of leg ulcers, psoriasis, and eczema. This did not change appreciably over time. New out-patients at dermatology clinics rose by 41% from 1976 to 1985, and all out-patient visits rose by 20% during the 10-year period. Because the profile of in-patient workload changed relatively little over time, we speculate that the impact of innovations in dermatological practice has been much greater in the ambulatory setting than in the management of those patients requiring prolonged in-patient care. Future routine measures of workload in dermatology should include demographic and clinical data on out-patients.

Adult

Choosing the preventive workload in general practice: practical application of the Coronary Prevention Group guidelines and Dundee coronary risk-disk.

OBJECTIVE: To determine the workload implications for general practice of the Coronary Prevention Group and British Heart Foundation action plan for preventing heart disease. DESIGN: Computer simulation of plan, including calculation of Dundee risk scores, with data from OXCHECK trial. SUBJECTS: 4759 patients aged 35-64 who had health checks during 1989-91. MAIN OUTCOME MEASURE: Effect of using different risk scores as thresholds on workload and coverage of patients at known risk. Thresholds of 6-20 were used for cholesterol screening (nearset) and 4-16 for special care (preset). RESULTS: On the basis of workload a nearset of 8 and preset of 12 would be reasonable. This implies cholesterol measurement in 1794 (37.7%) patients and special care in 1074 (22.6%). However, many patients with single risk factors were not allocated to special care at these thresholds: 11 (37.9%) patients with cholesterol concentrations > or = 10 mmol/l, 21 (33.9%) with systolic pressure > or = 180 mm Hg, and 213 (40.7%) heavy smokers (> 20 cigarettes/day) were missed. The distribution of scores was similar in those at established clinical risk, those with family history of heart disease, and others. CONCLUSION: The guidelines may help to make best use of resources within specific age-sex groups but sound protocols for unifactorial risk assessment and modification remain essential.

Adolescent

Perceived workload and performance of shift workers.

The present paper is based on the results of a study conducted to investigate whether the relationship between perceived workload and quality of performance, if any, holds true if controlled for shift system, type of task, age, and skill level of the workers. The sample of the study comprised 279 blue-collar workers of a jute industry operating under fixed three-shift system. The subjects were all males selected by random sampling method. The method of data collection was a field study through questionnaire. The collected data were analyzed by employing zero-order and partial correlation coefficients. The results indicate that workload and performance were negatively correlated but the strength of the relationship reduced substantially when the effects of the control variables were partialled out simultaneously. It was concluded that the control variables had joint effect on the relationship between workload and performance but skill level of the employees appeared to be the variable having the greatest contaminating effect.

Adolescent