5-day Work Week Research Articles

Seven-day services in surgery and the \u201cweekend effect\u201d at a Japanese teaching hospital: a retrospective cohort study

BackgroundHospitals deliver 24-h, 7-day care on a 5-day workweek model, as fewer resources are available on weekends. In prior studies, poorer outcomes have been observed with weekend admission or surgery. The purpose of this study was to investigate the effect of 7-day service at a hospital, including outpatient consultations, diagnostic examinations and elective surgeries, on the likelihood of the “weekend effect” in surgery.MethodsThis was a retrospective cohort study of patients who underwent surgery between April 2014 and October 2016 at an academic medical centre in Tokyo, Japan. The main outcome measure was 30-day in-hospital mortality from the index surgery. The characteristics of the participants were compared using the Mann–Whitney U test or the chi-squared test as appropriate. Logistic regression was used to test for differences in the mortality rate between the two groups, and propensity score adjustments were made.ResultsA total of 7442 surgeries were identified, of which, 1386 (19%) took place on the weekend. Of the 947 emergency surgeries, 25% (235) were performed on the weekend. The mortality following emergency weekday surgery was 21‰ (15/712), compared with 55‰ (13/235) following weekend surgery. Of the 6495 elective surgeries, 18% (1151) were performed on the weekend. The mortality following elective weekday surgery was 2.3‰ (12/5344), compared with 0.87‰ (1/1151) following weekend surgery. After adjustment, weekend surgeries were associated with an increased risk of death, especially in the emergency setting (emergency odds ratio: 2.7, 95% confidence interval: 1.2–6.5 vs. elective odds ratio: 0.4, 95% confidence interval: 0.05–3.2).ConclusionsPatients undergoing emergency surgery on the weekend had higher 30-day mortality, but showed no difference in elective surgery mortality. These findings have potential implications for health administrators and policy makers who may try to restructure the hospital workweek or consider weekend elective surgery.

빅데이터를 활용한 주5일제 및 주52시간제 시행전후 여가 인식 분석

Purpose: The purpose of this study is to examine the leisure Awareness before and after 5-day and 52-hour work week by applying the semantic network analysis method usign big data. The research questions set up for this are as follows. First, did leisure awareness change after 5-day work week? Second, did leisure awareness change after 52-hour work week?BR Method: In this study, data were collected before system enforcement (Jul. 1, 2003~Jun. 30, 2004) and after (Jul. 1, 2004~Jun. 30, 2005). The 52-hour week was implementedfr om July 1, 2018, and in this study, it was divided into pre-enforcement (Jul. 1, 2017~Jun. 30, 2018) and fater post-enforcement (Jul. 1, 2018~Jun. 30, 2019). The collected data were analyzed by semantic network through NetMiner program.BR Result: First, keywords related to leisure before 5-day work week weer in the order of product, travel, tourism, event, family, weekend, golf course, customer, Seoul, and experience. After 5-day work week, leisure-related keywords were goods, travel, tourism, time, family, events, experiences, weekends, Seoul, and business. Before 5-day work week, the co-word pairs appeared in the following order: product-package, product-travel, condo-hotel, construction-golf course, culture-experience, experience-program etc. After 5-day work week, the co-word pairs appear in the following order: reclaimed land-Seosan, commodity-travel, tourism-complex, city-complex, tourism-culture, experience-event, commodity-package etc. Before 5 day work week, keyword centrality was followed by travel, goods, condos, tourism, golf, events, experiences, weekends, Jeju, family, etc., and After 5- day work week, keyword centrality was travel, tourism, experiences, goods, events, culture, golf course etc. Second, leisure relatde keywords before 52-hour work week were in the order of business, sports, awards, tourism, experience, reigons, facilities. After fifty two- work week, leisure-relatedkeywords were in the order of culture, region, saefty, industry, tourism and facilities. Before 52-hour system, co-word pairs appear in the following order: corporate-friendly, tourism-activated, experienceprogramme, tourism-ocean, sports-experience etc. After 52-hour system, the co-word pairs were in the order of industry-sports, safety-equipment, experience-program etc. Before 52-hour system, keyword centrality was in the order of tourism, experience, sports, cultrue, industry, business etc. After 52-hour system, keyword centrality was in the order of sports, tourism, experiences, culture etc.BR Conclusion: Semantic network analysis is a very useful method for explonrig the research trends of sport for all. It is meaningful in that it identifies the changes related to leisure in Korean society through the semantic network analysis.

Age-Conditional Effects of Political Skill and Empathy on Emotional Labor: An Experience Sampling Study

AbstractGrounded in lifespan development theories that posit a positive influence of aging on emotion regulation, we examine how chronological age and political skill (i.e., a work-related interpersonal competency that functions as an emotion-relevant resource) jointly moderate the relationships between within-person levels of empathy and the use of emotional labor strategies across a workweek. Participants were n = 118 full-time university employees (Mage = 42.85 years; SD = 12.18; range = 20–70), who completed momentary surveys 3 times a day, over a single 5-day workweek. Results show that age and within-person levels of empathy were positively related to momentary levels of deep acting. Considering further the interaction of age, political skill, and empathy, results suggest that the positive relationship between empathy and deep acting is conditional upon age and individual differences in political skill, with differential relationships observed for relatively older versus relatively younger participants. Overall, the findings of this study contribute to a better understanding of the role of age and political skill for daily emotional regulation in the work context.

The role of job demands and negative work reflection in employees' trajectory of sleep quality over the workweek.

This study investigated interindividual differences in employees' trajectory of sleep quality over a 5-day workweek. We hypothesized that sleep quality is entrained to the rhythm of the workweek showing a linear increase from Monday to Friday. Moreover, we proposed that employees' chronic job demands (time pressure and social stress) and their negative work reflection on Sunday night moderated the sleep quality trajectory. In this study, 132 employees completed a baseline questionnaire assessing chronic job demands and age, and daily morning surveys from Monday to Friday assessing sleep quality and negative work reflection on Sunday. On average, sleep quality did not significantly change from Monday to Friday. However, negative work reflection moderated the sleep quality trajectory: When negative work reflection was high, the start level of sleep quality on Monday was lower and sleep quality displayed a linear increase over the workweek. When negative work reflection was low, employees' sleep quality remained stable throughout the week. Chronic social stress, but not time pressure, indirectly affected employees' sleep quality trajectory via negative work reflection on Sunday. Further, results revealed age differences in the effects of social stress on employees' sleep quality trajectory: The start level of sleep quality was lower and its increase over the workweek was stronger for older employees high on social stress. This study contributes to research on the dynamics of employee sleep and extends findings on age-differential effects of workplace characteristics. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A Case Report of Cognitive Processing Therapy Delivered Over a Single Week

Although evidence-based treatments for posttraumatic stress disorder (PTSD), such as Cognitive Processing Therapy (CPT), have been developed and widely disseminated, the rate of veterans engaging in and completing these therapies is low. Alternative methods of delivery may be needed to help overcome key barriers to treatment. Delivering evidence-based therapies intensively may address practical barriers to treatment attendance as well as problems with avoidance. This report details the case of a combat veteran who received 10 sessions of Cognitive Processing Therapy delivered twice per day over a single, 5-day workweek (CPT-5). Posttreatment, the veteran reported large and clinically meaningful decreases in PTSD and depression symptom severity as well as in guilt cognitions, which is a purported mechanism of successful treatment. These effects persisted 6 weeks after treatment ended. Despite the intensive nature of the treatment, the veteran found CPT-5 tolerable and could cite many benefits to completing therapy in 1 workweek. In conclusion, CPT-5 holds promise as a way to efficiently deliver an evidence-based therapy that is both clinically effective and acceptable to patients, although more rigorous clinical trials are needed to test this treatment delivery format.

How do German medical students perceive role models during clinical placements (\u201cFamulatur\u201d)? An empirical study

BackgroundStudies have demonstrated the importance of role models in medical education. Medical students in Germany participate in clinical placements (“Famulatur”) that last 4 months in total and represent the first real-world setting where students encounter possible role models in their clinical education. These placements are an extracurricular activity, however, and regarded as the “black box” of medical education. This study aimed to evaluate whether and how students experience role models during clinical placements, the qualities associated with potential role models and whether role model-related learning gains are relevant.MethodsWe recruited 96 students (mean age: 23.83 years; 75% female) in their 5th to 9th semesters at the Faculty of Medicine at the University of Ulm, Germany, who were participating in a clinical placement between July and October 2015. Participants completed a questionnaire at the beginning of a 5-day working week to record sociodemographic and other information and another one at the end of the week to assess various aspects of their experiences. On each of the 5 days, they completed a structured questionnaire to record their perceived role models and self-assessed learning gains.ResultsRole models and role modelling play an important role in clinical placements. The positive function of medical staff as role models predominated (88.4%) across all specialties. Junior doctors were the most frequently perceived role models (28.5%), followed by consultants (25.1%) and nursing staff (22.4%). The most commonly perceived positive quality was the interaction with students (16.5%), followed by team behaviour (13.6%), interaction with patients (13.6%) and professional expertise (13.4%). Students also had various kinds of learning gains such as knowledge or skills.ConclusionsAlthough these clinical placements are extracurricular activities in Germany and their content is not regulated, they are home to a relevant amount of role modelling. Students experience the various medical professions in different roles and in a range of tasks and interactions. Defining basic learning objectives could help to increase the relevance of these placements for the medical curriculum in Germany and transfer the associated learning gains from the hidden to the open curriculum.

Ad libitum Weekend Recovery Sleep Fails to Prevent Metabolic Dysregulation during a Repeating Pattern of Insufficient Sleep and Weekend Recovery Sleep

People commonly increase sleep duration on the weekend to recover from sleep loss incurred during the workweek. Whether ad libitum weekend recovery sleep prevents metabolic dysregulation caused by recurrent insufficient sleep is unknown. Here, we assessed sleep, circadian timing, energy intake, weight gain, and insulin sensitivity during sustained insufficient sleep (9 nights) and during recurrent insufficient sleep following ad libitum weekend recovery sleep. Healthy, young adults were randomly assigned to one of three groups: (1) control (CON; 9-h sleep opportunities, n= 8), (2) sleep restriction without weekend recovery sleep (SR; 5-h sleep opportunities, n= 14), and (3) sleep restriction with weekend recovery sleep (WR; insufficient sleep for 5-day workweek, then 2days of weekend recovery, then 2 nights of insufficient sleep, n= 14). For SR and WR groups, insufficient sleep increased after-dinner energy intake and body weight versus baseline. During ad libitum weekend recovery sleep, participants cumulatively slept ∼1.1h more than baseline, and after-dinner energy intake decreased versus insufficient sleep. However, during recurrent insufficient sleep following the weekend, the circadian phase was delayed, and after-dinner energy intake and body weight increased versus baseline. In SR, whole-body insulin sensitivity decreased ∼13% during insufficient sleep versus baseline, and in WR, whole-body, hepatic, and muscle insulin sensitivity decreased ∼9%-27% during recurrent insufficient sleep versus baseline. Furthermore, during the weekend, total sleep duration was lower in women versus men, and energy intake decreased to baseline levels in women but not in men. Our findings suggest that weekend recovery sleep is not an effective strategy to prevent metabolic dysregulation associated with recurrent insufficient sleep.

Prime and Performance: Can a CEO Motivate Employees Without Their Awareness?

Work motivation research is at a crossroads with the discovery of the causal effects of primed subconscious goals in addition to those of consciously set goals on performance. Although social psychologists continue to demonstrate positive effects of primed goals on a multitude of dependent variables, priming research has been criticized for its lack of generalizability beyond tightly controlled laboratory experiments. Addressing this skepticism, a field experiment was conducted in a for-profit organization, where the CEO used goal priming to motivate job performance. A performance goal for achievement was primed with achievement-related words embedded in an email from the CEO to employees. The goal priming by the CEO necessitated little to no costs yet it increased objectively measured performance effectiveness by 15% and efficiency by 35% over a 5-day work-week. This field experiment illustrates a new alternative for increasing employee performance. In a second experiment, we conducted a conceptual replication of the field experiment in the laboratory with a larger sample size, and we extended theory by testing a measure of motivation level as a mediator of the primed goal-performance effect. The results affirmed the hypothesized motivational influence. These two experiments increase understanding of subconscious motivation processes.

Practical rat tickling: Determining an efficient and effective dosage of heterospecific play

Laboratory rats may experience stress during handling which can reduce their welfare. Rat tickling, a handling technique that mimics aspects of rat rough-and-tumble play, has been found to induce positive affect based on production of 50-kHz ultrasonic vocalizations (USVs). However, current protocols for rat tickling are time-intensive, making implementation difficult. Our objective was to determine a time-efficient and effective dosage of rat tickling that could be practically implemented in the laboratory. We hypothesized that affect and handling can be improved by short, daily doses of tickling within a 5-day work week. Long-Evans rats (N = 72) of both sexes, housed in pairs were sampled. Each pair was randomly assigned a tickling duration (15, 30 or 60 s per rat) and frequency (1, 3, or 5 days). After the final day of tickling, rats were tested for ease of, and reaction to, handling via an intraperitoneal injection of saline following a tickling session for their assigned duration. On test day, we measured production of USVs, home cage behavior (60 min before/after testing), approach behavior (30 s before/after testing), and fecal corticosterone. Periods before and after testing measured anticipatory and reactionary responses, respectively. In cage behaviors included social play, activity, and location. Approach behaviors included indicators of fear or anxiety such as rearing, location, and contact with the hand. Data were analyzed using general linear models. We found that 3-day rat tickling was most efficient and effective as it produced a higher rate of 50-kHz USVs before and during tickling (p < 0.0001), and rats played more and were less inactive in their cage for the hour before tickling and injection (p < 0.003) compared to 1-day of rat tickling, but there was no difference between 3- and 5-days of tickling. Only one outcome (play behavior after tickling) showed more positive results after 5- vs 3-days of tickling (p = 0.002). Tickling duration did not impact any outcome measures (p > 0.05). Neither tickling duration nor frequency impacted approach behavior, injection duration, or fecal corticosterone (p > 0.05). In conclusion, a time-efficient and effective rat tickling dosage was identified to be 15 s for 3-days before any potentially aversive procedures are applied. This conclusion is based on increased 50-kHz USVs (a measure of positive affect) and positive anticipatory behavior, including play. Overall, our results suggest that minimal rat tickling can effectively habituate rats to handling and prepare them for research procedures within a work week.

Prevalence of pediatric alopecia areata among 572,617 dermatology patients

To the Editor: The authors initiated this retrospective analysis to evaluate the prevalence, age, and sex of pediatric patients with alopecia areata (AA) and the impact that pediatric AA has on a typical dermatology practice. Billing data from Leavitt Medical Associates of Florida, doing business under the name Advanced Dermatology and Cosmetic Surgery, was collected from offices throughout Florida and Ohio, and 572,617 dermatology patients were identified. The study population included 71,951 pediatric patients (1-17 years of age): 33,800 boys and 37,791 girls. Of all 572,617 dermatology patients, 3633 had AA (0.63%). Of 71,951 pediatric patients, 656 had AA. Girls (n = 365) outnumbered boys (n = 291) (P = .004) with a ratio of 1.25:1. Overall, pediatric patients with AA were 18.1% (656/3633) of all patients with AA and 11.9% (656/5520) of all patients with any hair abnormality. Pediatric AA patients represented 0.1% (656/572,617) of all patients and 0.9% (656/71,591) of pediatric patients. The prevalence distribution of both sexes resembled a bell-shaped curve, with boys peaking at 12 years of age and girls peaking at 9 years of age (Fig 1). To compare the prevalence of AA among different age groups, the patients were divided into 3 broad groups: toddlers (1-5 years of age), children (6-11 years of age), and adolescents (12-17 years of age). Table I shows the prevalence of AA in these age groups.Table INumbers and rates of alopecia areata patients and patients with hair disorders by demographicAge, yearsSexPatients, NPatients with AA, NPatients with hair disorder, NAA patients, N/1000 patientsAA patients, N/1000 patients with hair disorder1-5Male4253142553.354.9Female4318283416.582.1Total8571425964.970.56-11Male12,3901239199.9133.8Female13,32516693612.5177.4Total25,715289188511.2155.812-17Male17,15715415369100.3Female20,14817115338.5111.5Total37,30532530698.7105.91-17Male33,80029127108.6107.4Female37,79136528109.7129.9Total71,59165655209.2118.81-80Total572,617363351,1936.371.0AA, Alopecia areata. Open table in a new tab AA, Alopecia areata. In 2004, Stern estimated that 9598 total US office-based dermatologists see 47,990,000 dermatology patients per year, with the average dermatologist seeing ∼5000 patients per year.1Stern R.S. Dermatologists and office-based care of dermatologic disease in the 21st century.J Investig Dermatol Symp Proc. 2004; 9: 126-130Abstract Full Text Full Text PDF PubMed Scopus (62) Google Scholar Given our prevalence of a diagnosis of AA in 0.63% (3633/572,617) of dermatology patients of all ages, we estimate that 302,337 patients with AA visit US dermatology practices each year. A 1992 study reported a similar nationwide prevalence of 306,000 AA patients.2Safavi K. Prevalence of alopecia areata in the First National Health and Nutrition Examination Survey.Arch Dermatol. 1992; 128: 702Crossref PubMed Scopus (176) Google Scholar Our study found that pediatric AA patients represented 18.1% of AA patients of all ages. Thus, we estimate that ∼54,000 pediatric AA patients visit dermatology offices per year. McMichael et al reported that 16% of total visits for AA involved patients 0-19 years of age,3McMichael A.J. Pearce D.J. Wasserman D. et al.Alopecia in the United States: outpatient utilization and common prescribing patterns.J Am Acad Dermatol. 2007; 57: S49-S51Abstract Full Text Full Text PDF PubMed Scopus (39) Google Scholar and Safavi et al found that 27.7% of 292 AA patients were 0-19 years of age.4Safavi K.H. Muller S.A. Suman V.J. Moshell A.N. Melton 3rd, L.J. Incidence of alopecia areata in Olmsted County, Minnesota, 1975 through 1989.Mayo Clin Proc. 1995; 70: 628-633Abstract Full Text Full Text PDF PubMed Scopus (449) Google Scholar The rate of 5000 dermatology patients per year per dermatologist noted above can be viewed as 21 patients per day (assuming a 5-day work week 52 weeks/year) or 1000 patients in ∼2.4 months.3McMichael A.J. Pearce D.J. Wasserman D. et al.Alopecia in the United States: outpatient utilization and common prescribing patterns.J Am Acad Dermatol. 2007; 57: S49-S51Abstract Full Text Full Text PDF PubMed Scopus (39) Google Scholar On the basis of our data, pediatric patients represent 126 of these 1000 patients; 10 of 126 will have a hair condition, and 1 of 126 will have AA. Thus, on average, 1 pediatric patient with AA will appear for treatment at a private dermatology office in the United States every 2.4 months; this single AA patient is 1.25 times more likely to be a girl than a boy.

Validity of long-term and short-term recall of occupational sitting time in Finnish and Chinese office workers

BackgroundAs sedentary behavior is a global health issue, there is a need for methods of self-reported sitting assessment. The accuracy and reliability of these methods should also be tested in various populations and different cultural contexts. This study examined the validity of long-term and short-term recall of occupational sitting time in Finnish and Chinese subgroups. MethodsTwo cohort groups of office-based workers (58.6% female, age range 22–67 years) participated: a Finnish group (FIN, n = 34) and a Chinese group (CHI, n = 36). Long-term (past 3-month sitting) and short-term (daily sitting assessed on 5 consecutive days) single-item measures were used to assess self-reported occupational sitting time. Values from each participant were compared to objectively measured occupational sitting time assessed via thigh-mounted accelerometers, with Spearman's rho (ρ) used to assess validity and the Bland-Altman method used to evaluate agreement. Coefficients of variation depicted day-to-day variability of time spent on sitting at work. ResultsIn the total study sample, the results showed that both long-term and short-term recall correlated with accelerometer-derived sitting time (ρ = 0.532, 95% confidence intervals (CI): 0.336–0.684, p< 0.001; ρ = 0.533, 95%CI: 0.449–0.607, p< 0.001, respectively). Compared to objectively measured sitting time, self-reported occupational sitting time was 2.4% (95%CI: −0.5% to 5.3%, p = 0.091) and 2.2% (95%CI: 0.7%–3.6%, p = 0.005) greater for long-term and short-term recall, respectively. The agreement level was within the range −21.2% to 25.9% for long-term recall, and −24.2% to 28.5% for short-term recall. During a 5-day work week, day-to-day variation of sitting time was 9.4% ± 11.4% according to short-term recall and 10.4% ± 8.4% according to accelerometry-derived occupational sitting time. ConclusionOverall, both long-term and short-term self-reported instruments provide acceptable measures of occupational sitting time in an office-based workplace, but their utility at the individual level is limited due to large variability.

History Is Not Boring: Using Social Media to Bring Labor History Alive

This article features an innovative and engaging assignment to help students learn about labor history events. Labor history is more than just a collection of dates, facts, and figures. Rather, it is the study of the men, women, and children who fought for a workplace that many of today’s employees take for granted: paid leave, a 5-day workweek, potential legal representation of a union, and pensions. By imagining the key stakeholders with access to social media during the time of their chosen historical event, students develop a deeper understanding of the event’s impact and relationship to current practices. Educators seeking an alternate way of tasking students to examine stakeholder theory may also find this assignment useful. We leverage social media to counter the perception among some management students that history is boring with little to no connection to their lives.

Variability in 2-year training programs in vascular surgery based on results of an Association of Program Directors in Vascular Surgery survey

ObjectiveAlthough a great deal of attention has recently focused on 5-year integrated (0+5) training programs in vascular surgery, a paucity of data exists concerning variability of daily assignments in 2-year (5+2) vascular fellowships. MethodsWe polled Association of Program Directors in Vascular Surgery members with 2-year vascular fellowships to determine the number of days in a 5-day work week that first- and second-year fellows were assigned to open vascular operations, endovascular procedures (hospital vs nonhospital facility), arterial clinic, venous clinic, noninvasive vascular laboratory (NIVL), and research. ResultsOf the 103 program directors from 5+2 vascular training programs, 102 (99%) responded. The most common schedule for both first- and second-year fellows was performing both open and endovascular procedures in the hospital on the same day 4 days of the week and spending time in combined artery and vein clinic 1 day of the week. Program directors developed different schedules for each year of the 2-year fellowship in about half (55% [56]) of the programs. A small minority of programs devoted days to only open surgical cases (13% [13]), a separate venous clinic (17% [17]), or a separate arterial clinic (11% [11]) and performed endovascular procedures in a nonhospital facility (15% [15]). All but three programs had mandatory time in clinic both years. Approximately one-third (30% [31]) of programs designated time devoted to research, whereas the others expected fellows to find time on their own. Although passing the Registered Physician in Vascular Interpretation examination is required, there was devoted time in the NIVL in only 60% (61) of programs. ConclusionsTraining assignments in terms of time spent performing open and endovascular procedures and participating in clinic, the NIVL, and research varied widely among Accreditation Council for Graduate Medical Education-accredited 5+2 vascular fellowships and did not always fulfill Accreditation Council for Graduate Medical Education guidelines. In the current era of emphasis on endovascular-based interventions, few programs devoted days to purely open surgical procedures. Endovascular experience in a nonhospital facility (where these procedures will likely become more common in the future), outpatient venous procedures, and designated time devoted to the NIVL and research were lacking in many programs. These results provide a valid data set for the Association of Program Directors in Vascular Surgery to consider establishing guidelines for training assignments in 5+2 vascular training programs.

Work–Family Balance and Alternative Work Schedules

In 2008, the State of Utah implemented a 4-day workweek for their employees. This article examines the impact on employees using a postimplementation survey. For employees on the 4-day schedule, there were no significant differences by gender on work–family balance or on the impact of the schedule. However, women did demonstrate slightly more positive attitudes toward the 4-day schedule. Employees with children at home reported lower work–family balance and greater impact of the 4-day schedule. In contrast, no difference in attitudes toward the 4-day schedule was found by age, although work–family balance differed among age groups. There were differences in work–family balance between employees on the 4-day schedule and those on traditional schedules; however, the more substantial factor was whether an employee selected his or her schedule. The current study highlights the importance of engaging employees when making significant organizational changes, such as transitioning from traditional work schedules to alternative schedules.

Smart Tourism Information System using Location-based Technology

With the broader application of 5-day work week scheme and expanding wellbeing trend of South Korea, increasing number of people are looking for tourism leisure activities. And the demand for tourism information has surged as well. In this situation, the internet, SNS, broadcasting and many other medial channels have been providing exponentially growing number of tourism information. In this study, smart tourism information system was produced by applying the location-based service (LBS) to provide customized information in line with user characteristics and push function on open platform with a view to activate information, culture and transactional exchanges between local entities and tourists. The system proposed herein enabled tourists to gain the information on their surroundings through a smart phone in major tour destinations and local commercial districts. The system provided more sophisticated customized smart tourism guide service via hybrid BLS method combining GPS location determination method and beacon-using micro location determination method. With the application of IoT technologies, tourism and culture contents have become utilized to the maximum extent, enabling smart tourism service. And with smart devices, tourists are expected gain great help in searching information or making decisions on destination and surrounding places, etc.

The physical sacrifice of thinking: Investigating the relationship between thinking and physical activity in everyday life.

Physical activity level is an important contributor to overall human health and obesity. Research has shown that humans possess a number of traits that influence their physical activity level including social cognition. We examined whether the trait of "need for cognition" was associated with daily physical activity levels. We recruited individuals who were high or low in need for cognition and measured their physical activity level in 30-second epochs over a 1-week period. The overall findings showed that low-need-for-cognition individuals were more physically active, but this difference was most pronounced during the 5-day work week and lessened during the weekend.

Morning Circadian Misalignment during Short Sleep Duration Impacts Insulin Sensitivity

Short sleep duration and circadian misalignment are hypothesized to causally contribute to health problems including obesity, diabetes, metabolic syndrome, heart disease, mood disorders, cognitive impairment, and accidents. Here, we investigated the influence of morning circadian misalignment induced by an imposed short nighttime sleep schedule on impaired insulin sensitivity, a precursor to diabetes. Imposed short sleep duration resulted in morning wakefulness occurring during the biological night (i.e., circadian misalignment)-a time when endogenous melatonin levels were still high indicating the internal circadian clock was still promoting sleep and related functions. We show the longer melatonin levels remained high after wake time, insulin sensitivity worsened. Overall, we find a simulated 5-day work week of 5-hr-per-night sleep opportunities and ad libitum food intake resulted in ∼20% reduced oral and intravenous insulin sensitivity in otherwise healthy men and women. Reduced insulin sensitivity was compensated by an increased insulin response to glucose, which may reflect an initial physiological adaptation to maintain normal blood sugar levels during sleep loss. Furthermore, we find that transitioning from the imposed short sleep schedule to 9-hr sleep opportunities for 3 days restored oral insulin sensitivity to baseline, but 5 days with 9-hr sleep opportunities was insufficient to restore intravenous insulin sensitivity to baseline. These findings indicate morning wakefulness and eating during the biological night is a novel mechanism by which short sleep duration contributes to metabolic dysregulation and suggests food intake during the biological night may contribute to other health problems associated with short sleep duration.

Weekends as social distancing and their effect on the spread of influenza

Many published influenza models treat each simulation day as a weekday and do not distinguish weekend days. Consequently, the weekend effect on influenza transmission has not been fully explored. To assess whether distinguishing between weekday and weekend transmissions in simulation models of flu-like infectious disease models matters, this study uses an agent-based model of the Chicago, Illinois metropolitan area. Our study assesses whether including weekend effects is offset by increases in weekend contact patterns and if implementing 3-day weekends dampens disease transmission enough to warrant its use as a containment strategy. Results indicate that ignoring weekend behaviors without incorporating increases in community-based non-school contacts (i.e., compensatory behaviors) causes the peak case incidence day to occur 7 days earlier and can reduce the peak attack rate by as much as 60 %. These results are sensitive to the proportion of symptomatic cases that are assumed to remain at home until they recover. The 3-day weekend intervention has interesting possibilities, but the benefits may only be effective for mild epidemics. However, a 3-day weekend for schools would be less detrimental to the educational process than sustained permanent closing because student and teacher contact is maintained throughout the epidemic period. Also, a 4-day school and work week may be more easily accommodated by many types of schools and businesses. On the other hand, an additional day per week of school closure could result in substantial societal costs, with lost productivity and child care costs outweighing the savings of preventing influenza cases.

Current status of intensive care units registered as critical care subspecialty training hospitals in Korea.

There is a lack of information on critical care in Korea. The aim of this study was to determine the current status of Korean intensive care units (ICUs), focusing on the organization, characteristics of admitted patients, and nurse and physician staffing. Critical care specialists in charge of all 105 critical care specialty training hospitals nationwide completed a questionnaire survey. Among the ICUs, 56.4% were located in or near the capital city. Only 38 ICUs (17.3%) had intensive care specialists with a 5-day work week. The average daytime nurse-to-patient ratio was 1:2.7. Elderly people ≥ 65 yr of age comprised 53% of the adult patients. The most common reasons for admission to adult ICUs were respiratory insufficiency and postoperative management. Nurse and physician staffing was insufficient for the appropriate critical care in many ICUs. Staffing was worse in areas outside the capital city. Much effort, including enhanced reimbursement of critical care costs, must be made to improve the quality of critical care at the national level.

The era of the 24-hour society?: assessing changes in work timing using a Japanese time use survey

Using data from a Japanese time use survey, we show a noteworthy increase in the share of employees working at unusual hours (late night and early morning) over a period of a decade since the mid-1990s. When controlling for changes in hours worked, however, we find that the notable increase in the fraction of people at work at unusual hours was for low-income nonregular employees (part-time, temporary and contract workers) while relatively higher income regular employees' work timing remains stable. These observations imply that there is a trend of diversification of work timing in Japan between regular and nonregular employees. A possible explanation is that the increase in the average hours worked per weekday by regular employees, possibly because of the spread of the 5-day workweek since the 1990s, increased services and goods demand at unusual hours as they returned home. An Oaxaca–Blinder type decomposition suggests that such an increase in the average hours worked by regular employees explains partially the rise in the employment rate of nonregular employees at unusual times.