Amount Of Workload Research Articles

A CASE STUDY: OBSTRUCTIONS ENCUMBERING THE TEACHER’S INCORPORATION OF ICT IN ENGLISH CLASSROOMS

The government has declared that all Malaysians that no one; both in rural and urban areas; would be divested from the Information and Communication Technology (ICT) development. This calls for a need for teachers nationwide to make essential adjustments to the teaching and learning process. This paper takes a closer gaze on the obstructions faced by teachers in integrating ICT tools in teaching English language in the classrooms. This study aspires at determining why the teachers do not use ICT in the classrooms even they were utterly encouraged by sufficient technical supports.10 English teachers from a Secondary School were interviewed and their views and thoughts were discussed. The findings exposed that even the school is highly resourced with ICT tools and facilities, obstructions such as lack of time, amount of workload, lack of ICT skills and teachers’ negative attitudes towards ICT were hindering the teachers to incorporate ICT in their teaching. However, the teachers should be competent to shape and systematize their learning environment in non-traditional ways by merging the ICT with new pedagogy.

Return to work and sporting activities after high tibial osteotomy.

High tibial osteotomy (HTO) is a commonly used treatment to correct varus malalignment of the knee. The purpose of this study was, first, to determine, whether HTO allows return to pre-operative work, depending on the amount of work load. Second, the restoration of sports ability and a difference in sports activities pre- to postoperative should be analyzed. Fifty-one patients were included in this study. Patients were divided into three groups dependent on work intensity. Sporting activity was evaluated by an activity score (Naal). Clinical examination includes Tegner-score, Lysholm-score and visual analog pain scale. General health was assessed using the 36-Item Short Form Survey questionnaire. On an average of 16.7 ± 15.6 weeks after surgery patients returned to work, and 93.8 % of the patients returned to pre-operative work load. The Tegner activity score did not show significant changes pre- and postoperatively. At the time of survey Lysholm score reached a value of 68.7 ± 23.9 points on average. Postoperatively, patients remarked on decreased pain by VAS by an average of 2.6 ± 2.3 points. In total, 92.3 % returned to pre-operative sports activities after surgery. A shift away from high impact activities to lower impact activities, a significant decrease of the duration of sports activities and number of sports disciplines was detected. In summary, HTO allows the young, active patient with medial osteoarthritis of the knee to return to work with the same work intensity and to return to sports.

Coping During Public Service Delivery: A Conceptualization and Systematic Review of the Literature

Frontline workers, such as teachers and social workers, often experience stress when delivering public services to clients, for instance because of high workloads. They adapt by coping, using such practices as breaking or bending rules for clients, or rationing services. Although coping is recognized as an important response to the problems of frontline work, the public administration field lacks a comprehensive view of coping. The first contribution of this article is therefore theoretical: conceptualizing coping during public service delivery and developing a coherent classification of coping. This is done via a systematic review of the literature from 1981 to 2014. The second contribution is empirical: via a systematic review of the literature from 1981–2014 this article provides a framework and analytical account of how coping during public service delivery has been studied since 1980. It highlights the importance of the type of profession (such as being a teacher or a police officer), the amount of workload, and the degree of discretion for understanding how frontline workers cope with stress. It also reveals that frontline workers often draw on the coping family “moving towards clients” revealing a strong tendency to provide meaningful public service to clients, even under stressful conditions. We conclude with an agenda for future studies, examining new theoretical, methodological and empirical opportunities to advance understanding of coping during public service delivery. Trabalhadores de linha de frente, tais como professores e assistentes sociais, frequentemente experimentam estresse no exercício de suas funções de entrega de serviços públicos para os clientes em função do acúmulo de trabalho. Eles se adaptam ao enfrentamento utilizando práticas tais como quebrar ou contornar regras para os clientes, ou racionamento de serviços. Apesar do enfrentamento ser reconhecido como uma importante resposta aos problemas de linha de frente, a administração pública se ressente de uma visão totalizadora do mesmo. A primeira contribuição do artigo é, desta forma, teórica: conceituando o enfrentamento durante a prestação de serviços públicos e o desenvolvimento de uma classificação coerente de enfrentamento. Isto é realizado via revisão sistemática da literatura de 1981 a 2014. A segunda contribuição é empírica: através de uma revisão sistemática da literatura de 1981-2014, o artigo apresenta um quadro e uma narrativa analítica de como o enfrentamento durante a prestação de serviços públicos tem sido estudada desde 1980. O texto realça a importância dos tipos de profissão (tal como ser um professor ou um agente policial), a quantidade de carga de trabalho e o grau de discernimento para o entendimento de como trabalhadores de linha de frente lidam com o estresse. Ele também revela que trabalhadores de linha de frente frequentemente recorrem à famílias de “clientes proativos” revelando uma forte tendência a entregar serviços públicos significativos para os clientes mesmo que em condições de estresse. Nós concluímos com uma agenda para estudos futuros, examinando novas teorias, métodos e oportunidades empíricas para avançar o entendimento do enfrentamento durante prestação de serviços públicos. Translated by Ricardo Gomes, University of Brasília

Job strain (demands and control model) as a predictor of cardiovascular risk factors among petrochemical personnel

Background:One of the practical models for the assessment of stressful working conditions due to job strain is job demand and control model, which explains how physical and psychological adverse consequences, including cardiovascular risk factors can be established due to high work demands (the amount of workload, in addition to time limitations to complete that work) and low control of the worker on his/her work (lack of decision making) in the workplace. The aim of this study was to investigate how certain cardiovascular risk factors (including body mass index [BMI], heart rate, blood pressure, cholesterol and smoking) and the job demand and job control are related to each other.Materials and Methods:This prospective cohort study was conducted on 500 workers of the petrochemical industry in south of Iran, 2009. The study population was selected using simple random statistical method. They completed job demand and control questionnaire. The cardiovascular risk factors data was extracted from the workers hygiene profiles. Chi-square (χ2) test and hypothesis test (η) were used to assess the possible relationship between different quantified variables, individual demographic and cardiovascular risk factors.Results:The results of this study revealed that a significant relationship can be found between job demand control model and cardiovascular risk factors. Chi-square test result for the heart rate showed the highest (χ2 = 145.078) relationship, the corresponding results for smoking and BMI were χ2 = 85.652 and χ2 = 30.941, respectively. Subsequently, hypothesis testing results for cholesterol and hypertension was 0.469 and 0.684, respectively.Discussion:Job strain is likely to be associated with an increased risk of cardiovascular risk factors among male staff in a petrochemical company in Iran. The parameters illustrated in the Job demands and control model can act as acceptable predictors for the probability of job stress occurrence followed by showing a high trend of CVD risk factors.

Interview to Questionnaire Comparison of Workload Measurement on Nuclear Power Plant Tasks

Nuclear Power Plant (NPP) Main Control Room (MCR) operators oversee proper functioning of the facilities, including the controls to maintain the nuclear reactor. At least three operators, two reactor operators (ROs) and one senior reactor operator (SROs), are required for safe operations. The level of detail involved in performing the duties required of a nuclear power plant operator can result in a considerable amount of workload. Given the responsibility for safe operations, it is critical that operator workload is understood to provide accurate information about potential errors. Workload is the perceived amount of demand associated with executing a given task [1]. In light of resource theory, workload is the amount of resources required to perform a task and generally, it is accepted that as workload increases, performance decreases, thus errors are more likely and safety can be jeopardized [2]. Systematic experimentation for identifying levels of workload associated with NPP MCR tasks has been limited and the studies conducted are not without their limitations [3–5]. To understand the level of workload experienced by NPP operators, an experiment was conducted using “experienced” participants. An experienced participant in the present discussion is one that completed a rigorous training curriculum for three common task types encountered during main control room operations. The task types as adapted from [6] were checking, response implementation, and detection [7]. Three experienced participants served in the role of an RO in the present experiment, participating in 27 sessions each, and completing the three task types during each session. Each task type consisted of a block of four tasks. The NASA-Task Load Index was administered after each task type block and interviews were conducted at a later time. Results indicated that the detection task was the most demanding. The implications of measurement fit for workload assessment in a nuclear power plant domain are discussed.

Assessment of sick building syndrome and its associating factors among nurses in the educational hospitals of Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Background:Sick Building Syndrome is a diseases associated with indoor air quality accompanied with symptoms such as headache, dizziness, nausea, coughing and sneezing, irritation of eyes, throat and nose mucous membrane, and skin itching and inflammation. The purpose of this study was to investigate the symptoms of the syndrome and its related factors among nurses in teaching hospitals of Shahid Sadoughi University of Medical Sciences, Yazd, Iran.Methods:The study was conducted amongst nurses of three teaching hospitals of Shahid Sadoughi University of Medical Sciences, in Yazd. In this study the MM040EA questionnaire of sick building syndrome and indoor air quality was used and data extracted from the questionnaires were analyzed using the chi-square test and t-test.Results:The prevalence of sick building syndrome was 86.4%. The prevalence of the syndrome was in no association with age, gender, employment history and type of shift work. The most common symptoms reported by nurses included headache, fatigue and dry hands. Lack of sense of airflow, unpleasant odor in workplace (P<0.05), and also the amount of workload (P<0.001) were in relation with sick building syndrome.Conclusion:The high prevalence of sick building syndrome symptoms in the nursing environment was associated with factors of unpleasant odor and high workload of environment. So improvement of environmental conditions such as increasing the efficiency of the HVAC system, increasing fresh air flow in the sector, reducing the nurses workload as well as enhancing the quality of working life, will motivate the nurses and increase productivity in the workplace.

JJ Stent Removal under Ultrasound Guidance in Women: It is Simple and Safe.

With the increase in number of patients treated for urological problems with endoscopic procedures, the number of patients with JJ stent is also increasing. The amount of workload thus incurred multiplies, even to the point that, sometimes we waste more time in the operating room removing JJ stents than the actual endourological procedures. Here in our institute, we have devised a very simple and effective way of removing JJ stents in women and also determined the efficacy, safety and cost of JJ stent removal under ultrasound guidance in women in comparison to cystoscopic removal. Two hundred women attending the Department of Urology from July 2012 to July 2013 at RIMS hospital were randomly divided into two arms. One hundred women had their JJ stent removed with cystoscope and another 100 women had their JJ stent removed under ultrasound guidance using simple surgical tools available at the hospital. The primary comparative points were waiting time for operating room appointment date, cost of the procedure, time taken for the procedure, discomfort or pain felt by the patient and urethral injuries. In all the parameters, stent removal under ultrasound guidance was significantly better except for urethral injuries where both the procedures had similar outcomes. We concluded that JJ stent removal under ultrasound guidance in women was simple, effective and safe.

Pre-placement examination: A strategy to ensure benefit to the employees and employers

Ergonomics is the “science of work” that encompasses different measures to ensure fitting the workplace to the worker. Among all the strategies implemented to safeguard the interests of both workers and employers, pre-placement examination, has been acknowledged as the foundation element. A comprehensive pre-placement examination assists in careful selection of workers, developing systematic plans to help workers to get acclimatized to their job, minimizing health risks to the workers, improving the quality of life of workers, reducing burden on the health care delivery system / insurance companies, maintaining good relations between employee & employer, building a healthy environment at workplace, and eventually augments the outcome of the industry. The pre-placement examination for a given job position is difficult to standardize worldwide, and thus should be tailor-made based on the characteristics of the employee; the type of equipment / process utilized to perform a specific job; routine policy of the industry; and amount of workload. To conclude, pre-placement examination is an integral component of the ergonomics and thus there is an immense need to implement it effectively in all settings to ensure benefit to both employees and employers, and eventually augment the productivity of the industry or economic growth of the nation.

Performance modeling of hybrid MPI/OpenMP scientific applications on large-scale multicore supercomputers

In this paper, we present a performance modeling framework based on memory bandwidth contention time and a parameterized communication model to predict the performance of OpenMP, MPI and hybrid applications with weak scaling on three large-scale multicore supercomputers: IBM POWER4, POWER5+ and BlueGene/P, and analyze the performance of these MPI, OpenMP and hybrid applications. We use STREAM memory benchmarks and Intelʼs MPI benchmarks to provide initial performance analysis and model validation of MPI and OpenMP applications on these multicore supercomputers because the measured sustained memory bandwidth can provide insight into the memory bandwidth that a system should sustain on scientific applications with the same amount of workload per core. In addition to using these benchmarks, we also use a weak-scaling hybrid MPI/OpenMP large-scale scientific application: Gyrokinetic Toroidal Code (GTC) in magnetic fusion to validate our performance model of the hybrid application on these multicore supercomputers. The validation results for our performance modeling method show less than 7.77% error rate in predicting the performance of hybrid MPI/OpenMP GTC on up to 512 cores on these multicore supercomputers.

To write alone or not to write alone, that is the question

Correspondence: David E Vance Center for Nursing Research, School of Nursing, 1701 University Boulevard, University of Alabama at Birmingham, Birmingham, AL 35294-1210, USA Tel +1 20 59347589 Fax +1 20 5996 7183 Email devance@uab.edu Over the past 20 years, I have written and published over 150 book chapters and journal articles, with others and alone. Despite such collaborative efforts in generating articles, writing itself is a solitary act, requiring a great deal of concentration, knowledge, and dedication, along with a keen eye for detail. And it is that solitary approach that I would like to address. Since writing is such a solitary exercise, why do we write in groups? Clearly, fantastic advantages (eg, insights in conceptualization, help with interpretation and analysis of data, valuable feedback in revising the article) as well as dismal disadvantages (eg, personality clashes, extra time needed) exist for doing so. In fact, viewing scientific writing as a continuum ranging from a single/solo author to a team of multiple coauthors, a few of the pros and cons can be observed along both ends of this framework as is outlined in Figure 1; these include authorship determination, amount of workload, coordination of others, production speed, and quality checks. Starting at the solo author end of this continuum, let me begin by saying, I prefer to work on articles alone, at least initially as I’m developing the ideas, pulling the reference materials together, developing the outline, and putting pen to paper. Although I handle most of the workload when I draft the article, one reason I prefer writing alone is because when I complete a draft of the article there is no doubt that I am the first author because most of the article reflects my original thoughts and insights. Another reason I prefer to write alone is that I can be as creative and unorthodox in my reasoning as I like; likewise, I can focus on the topics that appeal to me. From a “going for promotion” perspective, I also like writing alone because I am in control of how fast the article will be written; if it does not get done, I have no one to blame but myself. But if I am writing with others, many times the production of the article is delayed as I wait on my coauthors to finish their substantial contributions which in some instances can linger for months (or in rare cases years). Yet there are several disadvantages to writing alone, such as lacking a specific skill set or knowledge base needed to improve the article. Also, let us not discount the value of balancing one’s point of view with the professional perspective of someone from another discipline; such intellectual feedback certainly can contribute to the enhancement of the article. Given these compelling reasons, I try to balance the advantages and disadvantages of both sides of the solo – team writing continuum by adopting a middle path. Once the article is drafted, I frequently invite colleagues with expertise in certain areas, to substantially contribute to the conception and interpretation of the findings of the Dovepress

Multi-Threading and Suffix Grouping on Massive Multiple Pattern Matching Algorithm

The widely used multiple pattern matching algorithms experience severe performance degradation when the number of patterns to match increases. In light of this fact, this paper presents a multi-threaded multiple pattern matching algorithm to overcome the performance degradation; this algorithm presents two additional improvements on the original Wu–Manber algorithm. First, the proposed algorithm employs a multi-threaded execution model to parallelize the pattern matching operation on multi-core processors. Second, the patterns to be searched are distributed over multiple threads according to the pattern similarity. For this purpose, the proposed algorithm groups the target patterns on the basis of their suffixes and distributes the patterns over multiple threads. Through experiments and performance analysis, our algorithm shows a significant performance gain as compared with the original Wu–Manber algorithm and the previously proposed multi-threaded pattern matching on massive pattern sets of size exceeding 5000. The results obtained from the pattern matching operation using eight cores show much improved execution time, which is nearly 14.9 times faster on average than that of the conventional Wu–Manber algorithm. It is demonstrated that the proposed idea improves the overall performance by reducing the amount of workload on a single thread through multi-threading and an efficient data distribution policy.

(A178) Evaluating the Feasibility of Verbal Analogue Scale among Emergency Care Providers in Assessment and Management of Acute Pain in Trauma Victims

BackgroundAcute pain assessment and management in trauma victims is often overlooked in emergency department (ED). Visual analogue scale is the preferred scale for assessment and management of pain however, its role in a busy ED is limited. The objective of this study was to evaluate the feasibility of verbal and visual analogue scale among emergency care providers.MethodsEmergency caregivers were instructed to use both pain scales wherever feasible for assessment, management, and monitoring of pain in 100 non-consecutive alert patients. A separate, pre-tested survey questionnaire addressing the feasibility of each pain scales was surveyed among emergency care providers (emergency physicians, nursing staff). A Likert scale (1 to 5) was assessed for cooperativeness, availability of time for assessment, the format, the peak period feasibility, the monitoring ease and the amount of work load. Binary scale (yes and no) was used to measure the overall utility in assessment and management of pain.ResultsOut of 100 patients enrolled, the verbal analogue score was used in all patients and visual analogue score was used in 30 patients. The average Likert scale score for verbal analogue score questionnaire was 1.7 and the average Likert scale score for visual analogue score questionnaire was 3.9. On the overall utility both scales were found to be useful in all patients.ConclusionsBoth the scales were found to be useful in overall assessment and management of pain. However, there was a favorable trend towards using verbal analogue scale among emergency care providers.

Distributed framework for yard planning in container terminals

This study discusses a yard planning system, which considers various resources such as storage space, yard cranes, and traffic areas in container terminals. The system is based on the function for estimating resource requirements of yard plans. For a given yard plan, the proposed system allows planners to check the feasibility of the plan which requires a certain amount of workload of resources in related blocks during a planning horizon. The yard planning system in this study is aimed at balancing workloads among the blocks and providing the ability to modify current yard plans by detecting blocks and periods with overloaded workloads. The system implements its planning function in a distributed manner in which planners construct yard plans under their individual control and send and receive only limited necessary information for the negotiation.

Social Network Based P2P Multicast Reducing Psychological Forwarding Cost in Mobile Networks

The demand for data/audio streaming/video streaming multicast services in large scale networks has been increasing. Moreover, the improved transmission speed and mobile-device capability in wireless access networks enable people to use such services via their personal mobile devices. Peer-to-peer (P2P) architecture ensures scalability and robustness more easily and more economically than server-client architecture; as the number of nodes in a P2P network increases, the amount of workload per node decreases and lessens the impact of node failure. However, mobile users feel much larger psychological cost due to strict limitations on bandwidth, processing power, memory capacity, and battery life, and they want to minimize their contributions to these services. Therefore, the issue of how we can reduce this psychological cost remains. In this paper, we consider how effective a social networking service is as a platform for mobile P2P multicast. We model users' cooperative behaviors in mobile P2P multicast streaming, and propose a social-network based P2P streaming architecture for mobile networks. We also measured the psychological forwarding cost of real users in mobile P2P multicast streaming through an emulation experiment, and verify that our social-network based mobile P2P multicast streaming improves service quality by reducing the psychological forwarding cost using multi-agent simulation.

Teaching and Teacher Education for Health Professionals: Perspectives on Quality and Outlook of Health Professionals Education in Zambia

Purpos: To measure students’ perspectives on the teaching quality of the school of medicine at University of Zambia and concurrently measure health professionals educators perspectives on the need for teaching courses for health professionals educators (educational skills training). The results are discussed as indications for educational skills training for educators in health professionals’ education. Method: 250 medical students from the MB ChB programme were surveyed, in an evaluation exercise, to rate the teaching contribution of all the full-time and honorary lecturers (n=88). The students were requested to rate each lecturer out of 10 on eight scales: a) attendance, b) punctuality, c) clarity, d) interest in the subject, e) supportiveness to students, f) ability as a lecturer, g) appropriate use of audiovisual aids, and h) amount of workload done in the academic year. Additionally, a multi-site study surveyed 426 health professionals educators, defined as persons who considered themselves as continually participating in teaching students in a training institutions for health professions in the Country on the necessity for and their willingness to enroll into a teaching programme for health educators. Results: Two hundred students of the eligible 250 completed the evaluation giving a response rate of 80%. The scores for teaching quality ranged from 8/ 40 to 40/40. The mean score was 32.2. The results showed that about 27.2% (n=24) did not meet the merit standard which was set at 30/40 as the quality assurance benchmark by the School. This result suggests that a large proportion of teaching staff could benefit from teacher education. Four hundred and four questionnaires were completed and returned out of the 426 that had been distributed, yielding a response rate of 94.8 %. The Cronbach’s alpha for reliability test was 0.62 – 0.70 on the teaching skills sub-scale and 0.76 – 0.78 on the Educational skills sub-scale. The majority, over 85%, acknowledged they lacked expertise in educational skills and that they would enrol in a programme to improve their educational skills. There was overwhelming (>90%) agreement in topics to be covered. Limitations: Quality of teaching contributions only measured at school of medicine; Large proportion of educators’ survey were not full-time teaching staff. Implications: The belief that professional qualifications are sufficient for preparation for teaching health professionals is now being confronted. Formal systems of teacher education in the health professions have emerged worldwide and are now also available in Zambia.

Least-cost planning sequence estimation in labelled Petri nets

This paper develops a recursive algorithm for estimating the least-cost planning sequence in a manufacturing system that is modelled by a labelled Petri net. We consider a setting where we are given a sequence of labels that represents a sequence of tasks that need to be executed during a manufacturing process, and we assume that each label (task) can potentially be accomplished by a number of different transitions, which represent alternative ways of accomplishing a specific task. The processes via which individual tasks can be accomplished and the interactions among these processes in the given manufacturing system are captured by the structure of the labelled Petri net. Moreover, each transition in this net is associated with a non-negative cost that captures its execution cost (eg, in terms of the amount of workload or power required to execute the transition). Given the sequence of labels (ie, the sequence of tasks that has to be accomplished), we need to identify the transition firing sequence(s) (ie, the sequence(s) of activities) that has (have) the least total cost and accomplishes (accomplish) the desired sequence of tasks while, of course, obeying the constraints imposed by the manufacturing system (ie, the dynamics and structure of the Petri net). We develop a recursive algorithm that finds the least-cost transition firing sequence(s) with complexity that is polynomial in the length of the given sequence of labels (tasks). An example of two parallel working machines is also provided to illustrate how the algorithm can be used to estimate least-cost planning sequences.

Twenty‐four‐hour shift work, depressive symptoms, and job dissatisfaction among Japanese firefighters

The influence of a 24-hr shift-work burden on firefighters' mental health has not been fully investigated. The purpose of this study is to clarify the relationships between specific workload items among firefighters engaged in 24-hr shift work and job stress as estimated by the generic job-stress questionnaire on depressive symptoms and job dissatisfaction from the National Institute for Occupational Safety and Health (NIOSH). The subjects were 1,301 firefighters. The questionnaire covered age, gender, job type, job class, marital status, smoking and drinking habits, number of attendances, turnout time, extra work hours, average nap-time, the Center for Epidemiologic Studies Depression Scale (CES-D), and questions from the NIOSH generic job-stress questionnaire, including those on job satisfaction. In multivariate logistic regression analyses, a model that included all variables except the measures from the NIOSH generic job-stress questionnaire showed that shorter nap-time had significant higher odds ratios (ORs) for depressive symptoms and job dissatisfaction, but the significances disappeared in a fully adjusted model. In fully adjusted logistic regression analyses, low quantitative workload, low variance in workload, high intra- and intergroup conflict, low social support from a supervisor, high role conflict and ambiguity, and low self-esteem had significant higher ORs for depressive symptoms and/or job dissatisfaction. Amount of workload, variance in workload, intra- and intergroup conflict, social support from a supervisor, role conflict and ambiguity, and self-esteem were significantly related to depressive symptoms and/or job dissatisfaction among Japanese firefighters. Moreover, inadequate nap-time may affect their mental health.

Understanding changes in mental workload during execution of goal-directed tasks and its application for interruption management

Notifications can have reduced interruption cost if delivered at moments of lower mental workload during task execution. Cognitive theorists have speculated that these moments occur at subtask boundaries. In this article, we empirically test this speculation by examining how workload changes during execution of goal-directed tasks, focusing on regions between adjacent chunks within the tasks, that is, the subtask boundaries. In a controlled experiment, users performed several interactive tasks while their pupil dilation, a reliable measure of workload, was continuously measured using an eye tracking system. The workload data was extracted from the pupil data, precisely aligned to the corresponding task models, and analyzed. Our principal findings include (i) workload changes throughout the execution of goal-directed tasks; (ii) workload exhibits transient decreases at subtask boundaries relative to the preceding subtasks; (iii) the amount of decrease tends to be greater at boundaries corresponding to the completion of larger chunks of the task; and (iv) different types of subtasks induce different amounts of workload. We situate these findings within resource theories of attention and discuss important implications for interruption management systems.

Strategies To Improve Scheduling and Completion of Screening Colonoscopy in a VA Setting

Purpose: Veterans Health Administration (VHA) directive mandates that screening colonoscopy must be completed < 60 days from referral. Aim: To determine the best scheduling strategy for implementation. Methods: Three strategies were tested: primary care provider (PCP) generated an electronic (e-) consult to GI to schedule the patient (Group 1); or after discussion with patient, PCP generated an e-consult to GI AND each patient was given written information about screening colonoscopy and instructed to CALL GI “today” (Group 2); or COME TO GI “today” (Group 3) to schedule colonoscopy. One week after the e-consult, GI called the patients who did not initiate contact to schedule colonoscopy. Study period: 4/4/07–4/30/07. The following time intervals (days) were tabulated: e-consult to 1st GI contact, 1st GI contact to completed colonoscopy and e-consult to completed colonoscopy. Number of calls made by GI was recorded. Results: 184 patients (37, 101 and 46 in Groups 1, 2 and 3) were referred. We excluded 10 who did not return phone calls after 3 messages; 12 who declined colonoscopy; 5 who had inappropriate referrals and 22 who were scheduled for colonoscopy after 6/4/07. The data of 135 patients were analyzed. Table 1 shows that when the scheduling was patient-driven (same day come to GI) time intervals were significantly shorter. Conclusion: The strategy of having patients come to GI personally on the same day after PCP clinic visit resulted in significantly shorter time intervals compared to e-consult only and patient-initiated phone scheduling. This strategy also imposes the least amount of work load (initiating contact with patients) on GI as seen by the significantly smaller number of calls needed to schedule the patients. Patient-initiated same day personal scheduling with GI appears to be the most efficient and effective to ensure timely completion of screening colonoscopy.

Application of Notch Strain Approach to Evaluate Fatigue Life of Construction Equipment

The technical development of construction equipment such as wheel loader leads to an increase of not only amount of workload per hour, but also magnitude of allowable stress range. Since welded structures of the wheel loader occupy approximately 40-60% of its total weight and are subjected to incessant fatigue loads, fatal fatigue failures occur occasionally around the welded zone during its practical operation in the field. To reasonably evaluate the fatigue life, the effect of these geometries and welding residual stress on the fatigue life should be taken into account. In this paper, the modified notch strain approach developed previously by the authors is applied practically to assess the fatigue life of welded joints in boom and front frame structures of the wheel loader.