scholarly journals Guiding Principles For Determining Work Shift Duration And Addressing The Effects Of Work Shift Duration On Performance, Safety, And Health

SLEEP ◽  
2021 ◽  
Author(s):  
Indira Gurubhagavatula ◽  
Laura K Barger ◽  
Christopher M Barnes ◽  
Mathias Basner ◽  
Diane B Boivin ◽  
...  

Abstract Risks associated with fatigue that accumulates during work shifts have historically been managed through working time arrangements that specify fixed maximum durations of work shifts and minimum durations of time off. By themselves, such arrangements are not sufficient to curb risks to performance, safety, and health caused by misalignment between work schedules and the biological regulation of waking alertness and sleep. Science-based approaches for determining shift duration and mitigating associated risks, while addressing operational needs, require: 1) a recognition of the factors contributing to fatigue and fatigue-related risks; 2) an understanding of evidence-based countermeasures that may reduce fatigue and/or fatigue-related risks; and 3) an informed approach to selecting workplace-specific strategies for managing work hours. We propose a series of guiding principles to assist stakeholders with designing a shift duration decision-making process that effectively balances the need to meet operational demands with the need to manage fatigue-related risks.

2021 ◽  
Author(s):  
Adrian Ahne ◽  
Guy Fagherazzi ◽  
Xavier Tannier ◽  
Thomas Czernichow ◽  
Francisco Orchard

BACKGROUND The amount of available textual health data such as scientific and biomedical literature is constantly growing and it becomes more and more challenging for health professionals to properly summarise those data and in consequence to practice evidence-based clinical decision making. Moreover, the exploration of large unstructured health text data is very challenging for non experts due to limited time, resources and skills. Current tools to explore text data lack ease of use, need high computation efforts and have difficulties to incorporate domain knowledge and focus on topics of interest. OBJECTIVE We developed a methodology which is able to explore and target topics of interest via an interactive user interface for experts and non-experts. We aim to reach near state of the art performance, while reducing memory consumption, increasing scalability and minimizing user interaction effort to improve the clinical decision making process. The performance is evaluated on diabetes-related abstracts from Pubmed. METHODS The methodology consists of four parts: 1) A novel interpretable hierarchical clustering of documents where each node is defined by headwords (describe documents in this node the most); 2) An efficient classification system to target topics; 3) Minimized users interaction effort through active learning; 4) A visual user interface through which a user interacts. We evaluated our approach on 50,911 diabetes-related abstracts from Pubmed which provide a hierarchical Medical Subject Headings (MeSH) structure, a unique identifier for a topic. Hierarchical clustering performance was compared against the implementation in the machine learning library scikit-learn. On a subset of 2000 randomly chosen diabetes abstracts, our active learning strategy was compared against three other strategies: random selection of training instances, uncertainty sampling which chooses instances the model is most uncertain about and an expected gradient length strategy based on convolutional neural networks (CNN). RESULTS For the hierarchical clustering performance, we achieved a F1-Score of 0.73 compared to scikit-learn’s of 0.76. Concerning active learning performance, after 200 chosen training samples based on these strategies, the weighted F1-Score over all MeSH codes resulted in satisfying 0.62 F1-Score of our approach, compared to 0.61 of the uncertainty strategy, 0.61 the CNN and 0.45 the random strategy. Moreover, our methodology showed a constant low memory use with increased number of documents but increased execution time. CONCLUSIONS We proposed an easy to use tool for experts and non-experts being able to combine domain knowledge with topic exploration and target specific topics of interest while improving transparency. Furthermore our approach is very memory efficient and highly parallelizable making it interesting for large Big Data sets. This approach can be used by health professionals to rapidly get deep insights into biomedical literature to ultimately improve the evidence-based clinical decision making process.


2014 ◽  
pp. 137-147
Author(s):  
Judith Aufenthie

Creating optimal well being is a multifaceted, complex process. It involves many biological, psychological, physical, behavioral, emotional as well as neurobiological factors which all interact and effect the choices we make and changes that we are able to implement. Research has begun to connect with the decision making process to better understand how our decisions and choices are made. This research coupled with research and evidence based models provides integrative nurses and patients with validated tools to optimize change and wellness.


2018 ◽  
Vol 25 (1) ◽  
pp. 118-129 ◽  
Author(s):  
Tobias Nowak

The case of the Working Time Directive (WTD) is a prime example of a failed attempt by the Member States and the Commission to counter rulings of the European Court of Justice (CJEU) by legislative overrule. Outsourcing the decision making process to the social partners also did not deliver the desired results. After years of trying to reform the WTD, the Commission changed its strategy and issued an interpretive communication instead. However, it is doubtful that this communication will solve all that is wrong with the WTD. What were the obstacles to legislative overrule in this case? What other strategies in avoiding the consequences of CJEU rulings do the Member States apply? What will the future of WTD look like?


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hossein Azarpanah ◽  
Mohsen Farhadloo ◽  
Rustam Vahidov ◽  
Louise Pilote

Abstract Background Vaccine hesitancy has been a growing challenge for public health in recent decades. Among factors contributing to vaccine hesitancy, concerns regarding vaccine safety and Adverse Events (AEs) play the leading role. Moreover, cognitive biases are critical in connecting such concerns to vaccine hesitancy behaviors, but their role has not been comprehensively studied. In this study, our first objective is to address concerns regarding vaccine AEs to increase vaccine acceptance. Our second objective is to identify the potential cognitive biases connecting vaccine hesitancy concerns to vaccine-hesitant behaviors and identify the mechanism they get triggered in the vaccine decision-making process. Methods First, to mitigate concerns regarding AEs, we quantitatively analyzed the U.S. Vaccine Adverse Event Reporting System (VAERS) from 2011 to 2018 and provided evidence regarding the non-severity of the AEs that can be used as a communicable summary to increase vaccine acceptance. Second, we focused on the vaccination decision-making process. We reviewed cognitive biases and vaccine hesitancy literature to identify the most potential cognitive biases that affect vaccine hesitancy and categorized them adopting the Precaution Adoption Process Model (PAPM). Results Our results show that the top frequent AEs are expected mild reactions like injection site erythema (4.29%), pyrexia (3.66%), and injection site swelling (3.21%). 94.5% of the reports are not serious and the average population-based serious reporting rate over the 8 years was 25.3 reports per 1 million population. We also identified 15 potential cognitive biases that might affect people’s vaccination decision-making and nudge them toward vaccine hesitancy. We categorized these biases based on the factors that trigger them and discussed how they contribute to vaccine hesitancy. Conclusions This paper provided an evidence-based communicable summary of VAERS. As the most trusted sources of vaccine information, health practitioners can use this summary to provide evidence-based vaccine information to vaccine decision-makers (patients/parents) and mitigate concerns over vaccine safety and AEs. In addition, we identified 15 potential cognitive biases that might affect the vaccination decision-making process and nudge people toward vaccine hesitancy. Any plan, intervention, and message to increase vaccination uptake should be modified to decrease the effect of these potential cognitive biases.


1997 ◽  
Vol 170 (S32) ◽  
pp. 35-36 ◽  
Author(s):  
Michael Harris

Risk assessment has always been an essential part of all medical practice, and doctors have always been trained to make rapid assessment of risk. Much of the early training of doctors in both medicine and surgery centres on risk assessment. However, the method of acquiring that knowledge is predominantly through the apprenticeship model with observation by the trainee of the trainer's decision-making process. Those decisions, however, are often skewed and biased by a whole variety of influences, rather than always being based on scientific evidence. Clearly the increasing influence of evidence-based medicine will help this. At one extreme, however, there are heroic surgeons taking unnecessary risk or taking on cases which might more appropriately have been left without treatment, and at the other extreme, consultants who may feel demoralised or depressed might well become nihilistic about medicine and therefore might not attempt to treat cases that are treatable.


2016 ◽  
Vol 82 (3) ◽  
pp. 259-265 ◽  
Author(s):  
Victoria Serpico ◽  
Amy E. Liepert ◽  
Kenneth Boucher ◽  
Diane L. Fouts ◽  
Layla Anderson ◽  
...  

To enhance shared decision-making for patients with breast cancer, we developed an evidence-based educational breast cancer video (BCV) providing an overview of breast cancer biology, prognostic indicators, and surgical treatment options while introducing health care choice. By providing patients access to a BCV with information necessary to make informed surgical decisions before seeing a surgeon, we aimed to increase patient participation in the decision-making process, while decreasing distress. Patients with a new diagnosis of breast cancer were provided a link to the BCV. Group 1 participated in online pre- and postvideo questionnaires, with the BCV embedded in between. The questionnaires evaluated self-reported baseline knowledge of breast cancer and perceived distress related to the diagnosis. Changes in self-reported responses were analyzed using the Wilcoxon matched pairs test. Group 2 received a survey collecting demographics, decision-making information, and perceptions of the BCV at the time of clinic visit before meeting the surgeon. Group 1 included 69 subjects with 62 per cent reporting improved knowledge and 30 per cent reporting reduced distress in regard to their breast cancer diagnosis. Group 2 included 87 subjects; 94 to 98 per cent felt the BCV provided information and stimulated thoughts and questions to assist in breast cancer treatment decision-making. The BCV was positively received by participants and feasible to implement into clinical practice. Evidence-based media tools improve knowledge and reduce distress in patients with a new diagnosis of breast cancer as well as contributing to the shared decision-making process.


Affilia ◽  
2018 ◽  
Vol 34 (2) ◽  
pp. 219-236
Author(s):  
Bincy Wilson

Involvement of women in commercial sexual activity (CSA) has always been viewed from a moralistic point of view in India, with legislations attempting to rescue and rehabilitate them. Some, however, look at this involvement as legitimate work. Agencies engaged in service provision align themselves to these differing ideologies. This article examines the organizational frameworks and ideologies of agencies engaged in service provision to women in or exiting from CSA, along with assessing women’s level of satisfaction and the duration of services received from these agencies. In doing so, 40 service providers from nine agencies across five major cities in India were interviewed, and 163 women receiving services from these agencies participated in a survey. The findings revealed that agencies differed based on their guiding principles, factors determining services, structure, involvement of peers/survivors, and decision-making process. The level of satisfaction with services, and duration of services received, was the highest for those in women-centric agencies and the lowest in government state protective homes. Agencies assisting women in CSA must consider adopting non-institutional-based and women-centric service approaches, as this would make a real difference to those being assisted.


2015 ◽  
Vol 16 (1) ◽  
pp. 28-33
Author(s):  
Sally Gibson

Purpose – The purpose of this paper is to show the value of benchmarking organizational performance in order to enable conversations about workflow analysis and potential changes. Design/methodology/approach – Data from a time-to-shelf study are compared to literature describing similar studies at other academic libraries which enable the decision-making process for a new workflow. Findings – The results of a time-to-shelf study necessitated a change in workflow. This paper examines how the data enabled staff to agree to changes and supported the decision-making process. Originality/value – This paper examines the impact of evidence-based decision making on the performance and workflow of a technical services department.


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