Average Workload Research Articles

Personnel resources as a component of ensuring the quality and availability of dental care for the population of Ukraine

Annotation. Providing high-quality and affordable dental care to the population requires monitoring the medical staff of the dental service. Purpose: to analyze the state and problems of human resources of the dental service of the system of the Ministry of Health of Ukraine in 2010-2020. Using the medical-statistical method, the statistical data of the Center for Medical Statistics of the Ministry of Health of Ukraine were analyzed. It is established that during 2010-2020 in Ukraine the process of restructuring the network of dental institutions continues. As a result, the number of communal/state institutions in the system of the Ministry of Health of Ukraine has decreased and the number of private institutions has increased rapidly. This process causes the outflow of dentists from the communal to the private sector of dentistry. During the observation period, the number of dentists in the institutions of the system of the Ministry of Health of Ukraine decreased by 40.9% (from 21,313 in 2010 to 12,601 individuals in 2020). The number of dentists per 10 000 population in the system of the Ministry of Health decreased by 34.9% (from 4.67 in 2010 to 3.04 in 2020). The staffing of full-time positions of dentists in the institutions of the Ministry of Health decreased over the observation period from 93.3% to 86.9%. Dentists of the system of the Ministry of Health of Ukraine are highly qualified to provide the population with quality dental care: 73.3% of them are certified (67.2% among doctors of all specialties), among the certified half (49.7%) have the highest, and a third (32.9%) – the first qualification category. Dentists in the institutions of the Ministry of Health of Ukraine continue to provide the bulk of dental care to the population of the country, serving the vast majority (63.1%) of all dental visits and have 2.2-2.9 times higher average annual workload than their counterparts in private sector of dental care. Solving the problem of providing the population of Ukraine with affordable and high-quality dental care requires the development of an effective personnel policy in the field of dental health, aimed at maintaining the human resources of the communal/state sector of dentistry.

Telenutrition: Changes in Professional Practice and in the Nutritional Assessments of Italian Dietitian Nutritionists in the COVID-19 Era.

The COVID-19 pandemic has brought about various restrictions around the world, and its impact on healthcare has been enormous: RDNs have had to shift from in-person interactions with clients to telenutrition consultations, encountering obstacles. We designed the first survey to investigate the changes in RDN practices related to telenutrition provision after the onset of the pandemic through an online survey in Italy. Four hundred and thirty-six responses were analyzed. Before the pandemic, only 16% of Italian RDNs provided telenutrition; this percentage increased significantly up to 63% (p < 0.001). Among patients, the lack of interest in accessing telenutrition (30.9%) and the Internet (16.7%) were the most frequently reported barriers. Among RDNs, one of the main obstacles was their inability to conduct nutritional evaluation or monitoring activities (24.4%). Our survey indicated that increased adoption of telenutrition can be a valid, safe alternative to face-to-face visits. Telenutrition was mainly used by young RDNs (20–39 years) with fewer years of professional experience (0–20 years) and master’s degrees. Remote nutrition can enable RDNs to maintain normal workloads and provide patients with uninterrupted access to nutritional healthcare. It is important that RDNs using telemedicine resources possess the ability to provide high-quality, efficient, and secure services using evidence-based guidance.

Perancangan Model Penjadwalan Teknisi pada Perawatan BD Check Pesawat Airbus dengan Memperhitungkan Beban Kerja

&lt;p&gt;&lt;strong&gt;PT GMF AeroAsia is engaged in the maintenance, repair, and overhaul (MRO) of aircraft. It is known that GMF is the largest domestic MRO company at 30% while 70% is owned by foreign MRO companies. Based on the company's vision to make the company a world-class MRO, it is necessary to develop a business scheme in terms of capability, quantity, and quality. However, the scheduling of technicians in carrying out aircraft maintenance is currently unable to meet the demand every hour due to the uncertain flight schedule of the aircraft every day so that the workload of each technician exceeds the normal workload. The calculation of the workload using the full-time equivalent method showed that the workload of technicians was overloaded so that an additional number of technicians was needed, as well as analyzing the causes and consequences of the excessive workload of technicians using the fishbone diagram method and modeling the formulation of the technician scheduling problem that works in maintenance before departure check Airbus aircraft in the form of integer linear programming with decision variables such as the number of technicians, the number of shifts and the number of working days, then the constraint function is the constraints to be achieved in modeling, and the objective function is to minimize the number of technicians employed. Furthermore, the model is implemented using the LINGO 19.0 software so that it is found that the model can produce an optimal technician schedule in scheduling.&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Keywords&lt;/em&gt;&lt;/strong&gt; - &lt;em&gt;Fishbone Diagram, Full Time Equivalent, Integer Linear Programming, Lingo Software, Matchematical Modeling, Scheduling, Workload&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;

Exploiting Renewable Energy and UPS Systems to Reduce Power Consumption in Data Centers

Leveraging on-site renewable sources like solar and wind provides ample opportunities on developing environmental friendly and energy-efficient data centers. Due to intermittent nature of renewable energy and fluctuating grid energy price, advanced data centers often deploy distributed UPS systems with high efficiency, scalability, and reliability. In this study, we investigate the problem of energy management for data centers with renewable resources and energy storages. We propose an interface-backbone layer framework designed unified energy efficiency management system called REDUX, which properly allocate fluctuating renewable energy, UPS battery energy storage or grid power with dynamic price aiming to minimize the long-term electricity bill for the data center. With prediction of renewable energy supply, categorization of grid power price level and energy storage in the UPS devices, REDUX orchestrates workload distribution with heuristic algorithms which act as renewable energy smoothing, UPS device control, and high level control strategies, and make back-fills or defer decisions for the non-urgent jobs. Compared with the existing strategies, REDUX provides a comprehensive view for the energy efficiency data center and demonstrates a prominent capability of mitigating average peak workload and boosting renewable-energy utilization.

The effect of medical material management system app on nursing workload and stress

AimsTo develop a clinical medical material management App for nurses, in order to reduce their workload and improve the efficacy of medical material management.DesignThe single-group pre- and post-test experimental design was adopted.MethodsThe subjects were nurses in the intensive care units of a regional hospital in Hsinchu City enrolled by purposive sampling. Single-group pre-tests and post-tests were conducted. The research period was from November 2019 to March 2020. The workload, stress, and information acceptance of 57 nurses before and after the intervention of the Medical Equipment App were collected. The research tools included a structured questionnaire, which includes open questions that cover the aspects of workload, stress, and information acceptance intention of nurses, as well as a demographic questionnaire, which collects the basic personal data, including gender, age, years of service, educational level, nursing ability level, use ability of IT products, and unit type. The results were analyzed and compared using SPSS, APP Inventor, and data mining modeling to determine the effects of the App.ResultsAfter employing the Shift Check App, the average workload of nurses was effectively reduced, in particular, the workload reduction of the N1 level nursing ability was greater than that of N2. In addition to satisfaction, the scores of information acceptance intention in all aspects, including behavioral intention, technology use intention, and contributing factors, all increased.ConclusionThe use of information technology products to assist medical material management in clinical practice has a significant effect on the load reduction of nurses and improvement of satisfaction.Clinical relevanceThe App developed in this study can improve nurses’ work satisfaction, quality of care and workload reduction.

Characterizing Patient-Clinician Communication in Secure Medical Messages: Retrospective Study.

BackgroundPatient-clinician secure messaging is an important function in patient portals and enables patients and clinicians to communicate on a wide spectrum of issues in a timely manner. With its growing adoption and patient engagement, it is time to comprehensively study the secure messages and user behaviors in order to improve patient-centered care.ObjectiveThe aim of this paper was to analyze the secure messages sent by patients and clinicians in a large multispecialty health system at Mayo Clinic, Rochester.MethodsWe performed message-based, sender-based, and thread-based analyses of more than 5 million secure messages between 2010 and 2017. We summarized the message volumes, patient and clinician population sizes, message counts per patient or clinician, as well as the trends of message volumes and user counts over the years. In addition, we calculated the time distribution of clinician-sent messages to understand their workloads at different times of a day. We also analyzed the time delay in clinician responses to patient messages to assess their communication efficiency and the back-and-forth rounds to estimate the communication complexity.ResultsDuring 2010-2017, the patient portal at Mayo Clinic, Rochester experienced a significant growth in terms of the count of patient users and the total number of secure messages sent by patients and clinicians. Three clinician categories, namely “physician—primary care,” “registered nurse—specialty,” and “physician—specialty,” bore the majority of message volume increase. The patient portal also demonstrated growing trends in message counts per patient and clinician. The “nurse practitioner or physician assistant—primary care” and “physician—primary care” categories had the heaviest per-clinician workload each year. Most messages by the clinicians were sent from 7 AM to 5 PM during a day. Yet, between 5 PM and 7 PM, the physicians sent 7.0% (95,785/1,377,006) of their daily messages, and the nurse practitioner or physician assistant sent 5.4% (22,121/408,526) of their daily messages. The clinicians replied to 72.2% (1,272,069/1,761,739) patient messages within 1 day and 90.6% (1,595,702/1,761,739) within 3 days. In 95.1% (1,499,316/1,576,205) of the message threads, the patients communicated with their clinicians back and forth for no more than 4 rounds.ConclusionsOur study found steady increases in patient adoption of the secure messaging system and the average workload per clinician over 8 years. However, most clinicians responded timely to meet the patients’ needs. Our study also revealed differential patient-clinician communication patterns across different practice roles and care settings. These findings suggest opportunities for care teams to optimize messaging tasks and to balance the workload for optimal efficiency.

Time-Constrained Service Handoff for Mobile Edge Computing in 5G

Many mobile device applications require low end-to-end latency to edge computing infrastructure when offloading their computation tasks in order to achieve real-time perception and cognition for users. User mobility brings significant challenges in providing low-latency offloading due to the limited coverage area of cloudlets. Virtual machine (VM)/container handoff is a promising solution to seamlessly transfer services from one cloudlet to another to maintain low latency as users move. However, an inefficient path planning for the handoff can result in system congestion and consequently poor quality of service (QoS). The situation can even worsen by selfish users who intentionally lie about their true parameters to achieve better service at the cost of degrading the whole system's performance. To fill this research gap, we propose an Online Service Handoff Mechanism (OSHM) to provide an efficient path dynamically for transferring VM/container from the current serving cloudlet to a nearby cloudlet at the destination of a mobile user. Our proposed path planning algorithm is based on a label correction methodology, leading to polynomial time complexity. OSHM is accompanied by our proposed payment determination function to discourage misreporting of unknown parameters. We discuss the theoretical properties of our proposed mechanism in implementing a system equilibrium and ensuring truthfulness. We also perform a comprehensive assessment through extensive experiments which show the efficiency of OSHM in terms of workload, handoff time, consumed energy, and other metrics compared to several benchmarks. Experimental results show that OSHM outperforms other algorithms, reducing at least 61% in average workload, 33% in average handoff time, and 29% in average energy consumption.

Workload, Emotional Intelligence and Professional Stress Level among Employees of Private Commercial Companies in Abidjan

This study allows us to assess the stress level of employees in private commercial enterprises in Abidjan, based on workload and emotional intelligence. To this end, a sample of sixty employees selected by the onsite sampling method was subjected to a questionnaire. Processing the results using the student "t" technique for independent samples indicates that employees with a high workload have a high level of stress compared to their counterparts with a normal workload. Also, employees who do not have the ability to use their emotional intelligence have a high level of stress compared to their emotionally intelligent colleagues. 'This study will enable managers of these private commercial companies to best manage the stress of their employees by taking into account the workloads entrusted to them and the implementation of their emotional intelligence.

The impact of emergency department crowding on admission decisions and patient outcomes.

The objective of this study is to evaluate the impact of emergency department (ED) crowding levels on patient admission decisions and outcomes. A retrospective study was performed based on 2-year electronic health record data from a tertiary care hospital ED in Alberta, Canada. Using modified Poisson regression models, we studied the association of patient admission decisions and 7-day revisit probability with ED crowding levels measured by: 1) the total number of patients waiting and in treatment (ED census), 2) the number of boarding patients (boarder census), and 3) the average physician workload, calculated by the total number of ED patients divided by the number of physicians on duty (physician workload census). The control variables included age, gender, treatment area, triage level, and chief complaint. A subgroup analysis was performed to evaluate the heterogeneous effects among patients of different acuity levels. Our dataset included 141,035 patient visit records after cleaning from August 2013 to July 2015. The patient admission probability was positively correlated with ED census (relative risk [RR]=1.006, 95% confidence interval [CI]=1.005 to 1.007) and physician workload census (RR=1.029, 95% CI=1.027 to 1.032), but inversely correlated with boarder census (RR=0.991, 95% CI=0.989 to 0.993). We further found that the 7-day revisit probability of discharged patients was positively associated with boarder census (RR=1.009, 95% CI=1.004 to 1.014). Patient admission probability was found to be directly associated with ED census and physician workload census, but inversely associated with the boarder census. The effects of boarder census and physician workload census were stronger for patients of triage levels 3-5. Our results suggested that (i) insufficient physician staffing may lead to unnecessary patient admissions; (ii) too many boarding patients in ED leads to an increase in unsafe discharges, and as a result, an increase in 7-day revisit probability.

ANALISIS BEBAN KERJA PEGAWAI NEGERI SIPIL PADA SEKRETARIAT DINAS PEKERJAAN UMUM PERUMAHAN DAN ENERGI SUMBER DAYA MINERAL PROVINSI DIY (STUDI KASUS JABATAN FUNGSIONAL UMUM)

This research on the workload problem of Civil Servants is based on the number of Civil Servants who exceeds the number of public functional positions (JFU) at the Secretariat of the Office of Public Works, Housing and Energy of Mineral Resources of DIY Province, namely 13 general functional positions and with 29 employees Civil Affairs.&#x0D; The purpose of this study was to determine the suitability between workloads for existing job assignments and to find out the needs of Civil Servants needed to handle 13 general functional positions that have been established. This study uses a descriptive qualitative research design, using the Full-Time Equivalent (FTE) method. This method compares the amount of time the task is multiplied by the workload compared with the amount of effective work time.&#x0D; The results of this study indicate that there is a mismatch between workload on office duties and a shortage of employees in the general functional position of the Secretariat of the Office of Public Works, Housing and Energy of Mineral Resources of DIY Province. This is indicated by the normal workload in general functional positions as much as 13 employees or 45% of the normal amount of 100% but there are still general functional positions where the workload is underloaded by 9 employees or 31% of the normal amount and 7 employees are overloaded or 21% of the total normal. While the number of employees to handle 13 general functional positions is 29 Civil Servants, according to the results of the analysis for future staffing planning, it is necessary to optimize employee performance by changing the composition of the workforce by adding 4 Civil Servants to 33 Civil Servants.

The dominance of English

Abstract The unprecedented spread of English and its growing dominance in the translation and interpreting industry have implications on the market behaviour of translators and interpreters depending on the combination of their working languages. This paper investigates the extent to which market signals (e.g. average rates and workloads) can be reflected in the motivation of students to enter the translation profession in respect to the combination of their working languages and the inclusion of English within that combination. Two surveys were used to obtain data for our analysis: one focused on the market behaviour of professional translators, whereas the other assessed the plans and motivations of T&amp;I students at the end of their studies. Respondents in both surveys were divided according to the role of English in their language combination. As this paper demonstrates, professionals working only with English (or with English and at least one other foreign language) had a better position in the market in terms of overall workload. These groups of professionals also had a more positive outlook in terms of demand for their services. On the contrary, professionals working with languages other than English had a lower workload and a more pessimistic outlook in terms of demand for their services. As our data suggest, students in the same category of working language combinations (without English) were more hesitant to pursue a career in the industry. Our findings underline a degree of sensitivity among students to market signals depending on the combination of their working languages. Importantly, they present relevant information for T&amp;I programme administrators and university management when designing curricula and planning future study programmes.

The lingering curvilinear effect of workload on employee rumination and negative emotions: A diary study

ABSTRACT A high workload has long been considered a harmful stressor that adversely affects employees. In the current study, we propose that work underload also has negative implications for employees, and that there is a curvilinear relationship between daily workload and rumination. These negative consequences can carry over to the next day. We collected data from a sample of 137 employees over the course of 9 days to examine how deviations from employees’ average workload impacts their negative rumination at the conclusion of the workday and their negative emotions the following morning. Results of the multilevel analyses indicated that daily workload had a significant curvilinear, J-shaped association with subsequent evening negative rumination that carries over into the following day in the form of higher negative emotions. These effects were stronger for employees with high levels of trait negative affectivity. Our findings suggest that while the effect of upward deviation from the typical workload is worse for employee rumination and subsequent negative emotions than the effect of downward deviation, deviations in either direction have negative effects on employees, especially for individuals with high levels of trait negative affectivity. In conclusion, this study highlights the importance of examining daily fluctuation in workload.

An interactive decision support system for real-time ambulance relocation with priority guidelines

Changes in demand patterns and unexpected events are the two primary sources of delays in healthcare emergency operations. To mitigate such delays, researchers proposed the movement of idle ambulances between emergency bases as one of the effective ways to improve the areal coverage of future demands. In this study, we have developed a model-driven decision support system that simultaneously seeks to maximize demand coverage while minimizing travel time by optimally relocating emergency response vehicles. The developed mathematical model partitions and prioritizes demand into four categories and continuously updates them over time. Furthermore, it dynamically calculates the number of coverages in different regions based on the current location of idle ambulances. Also, we developed a real-time risk assessment DSS for recommended relocations, which could be utilized as a reference by the EMS user while implementing suggested relocation decisions. A real case study is used to validate the proposed DSS, and its final output is compared to the existing operational policy. The findings show that the average workload added to each ambulance due to relocations has significantly improved the response time and coverage ratio. Compared to the existing operational policy, the developed decision support system decreased the time to respond to calls, which was deemed to be more than to offsets the increase in travel time due to relocation. Furthermore, the system also reduced the total working time of all ambulances by about 9% per shift.

A Dynamic Scaling Approach in Hadoop YARN

In Cloud based Big Data applications, Hadoop has been widely adopted for distributed processing large scale data sets. However, the wastage of energy consumption of data centers still constitutes an important axis of research due to overuse of resources and extra overhead costs. As a solution to overcome this challenge, a dynamic scaling of resources in Hadoop YARN Cluster is a practical solution. This paper proposes a dynamic scaling approach in Hadoop YARN (DSHYARN) to add or remove nodes automatically based on workload. It is based on two algorithms (scaling up/down) which are implemented to automate the scaling process in the cluster. This article aims to assure energy efficiency and performance of Hadoop YARN’ clusters. To validate the effectiveness of DSHYARN, a case study with sentiment analysis on tweets about covid-19 vaccine is provided. the goal is to analyze tweets of the people posted on Twitter application. The results showed improvement in CPU utilization, RAM utilization and Job Completion time. In addition, the energy has been reduced of 16% under average workload.

National Survey Regarding Motivation and Conditions of Physicians Working in a Pediatric Cardiac Intensive Care Unit.

Background The professional demands on the expertise in pediatric intensive care have continuously increased in recent years. Due to a lack of applicants, the staffing of a continuous shift service with qualified medical staff poses major challenges to the hospitals. Methods A web-based questionnaire with 27 predominantly matrix questions on working conditions and motivation for working in this area was sent to pediatric hospitals throughout Germany. Results 165 doctors responded to the survey. The average age of the participants was 35.2 years. The average weekend work load reported by 79% of the respondents was 2 weekends per month, 70% of the study participants performed five to seven night shifts per month. 92% of the respondents stated that they basically enjoyed working in the intensive care unit (ICU). When asked to prioritize the working conditions, an appreciative working atmosphere in the team was named as priority 1 by 57%, followed by good guidance in the independent performance of interventions (25%) and good working conditions (19%). Discussion The survey result shows that neither aspects of work–life balance nor payments are the key issues selecting the interesting, but physically and emotionally demanding job in pediatric ICU. Conclusion When evaluating vocational training in pediatric intensive care medicine, the immediate working atmosphere in the team with mutual respect and understanding and the guidance in training are more important than the general conditions.

Determination of Conventional Transportation for ADL Pathway in Malang City

The number of conventional microbus transports with passengers can be seen from the comparison between capacity in a trip t.hat is far from the capacity standard. This study uses the Work Sampling and Work Load Analysis theory to determine the optimal needs of the microbus ADL (Arjosari - Dinoyo - Landungsari) route. The study was conducted by observation and interview. The study was conducted by taking samples of microbus and microbus drivers as many as 38 unit of the total number of drivers and minibus available is 42 unit. Data collection by following the driver's activities for 5 days commuting. Record the number of passengers and the productive and non-productive time of the driver by taking into account the Performance Rating and Allowance factors and calculating the driver's workload. The results showed an average driver workload only 49 % with the current active microbus condition with total of 42 units. The researcher recommends that each minibus driver has an ideal workload of 90%, so the need for ADL line microbuses is 23 units in the hope that the number of passengers will increase.

The Efficacy of Pyogenic Cavity Aerobic Therapy with Negative Pressure Drainage in the Treatment of Deep Neck Space Infections.

ObjectiveTo determine the effectiveness of pyogenic cavity aerobic therapy with negative pressure drainage in the treatment of deep neck space infections (DNSI).MethodsThe study was a prospective, observational analysis of 36 cases of DNSI at a tertiary care center. The patients were divided into two groups according to the treatment method. Group A was treated with pyogenic cavity aerobic therapy with negative pressure drainage and included 13 patients (6 males and 7 females), while group B was treated with traditional incision debridement drainage and included 23 patients (12 males and 11 females). The average hospitalization days and doctors’ workload (ie, average days of postoperative dressing changes) were analyzed and compared between the two groups.ResultsThe mean hospitalization days in the traditional dressing group were 26.74 ± 3.39 days, while the average days of postoperative dressing change were 25.91 ± 3.43 days. In contrast, the averages for hospitalization days and days of postoperative dressing changes in the pyogenic cavity aerobic therapy plus negative pressure drainage were 11.08 ± 2.11 and 3.69 ± 0.21 days, respectively. All 36 patients were cured. Compared with the group B, group A had a shorter hospital stays and lower doctor workloads (P < 0.001).ConclusionPyogenic cavity aerobic therapy is an effective and simple method for changing dressings after DNSI. This therapy, when combined with negative pressure drainage, shortens hospitalization days and days that require a dressing change. This has reduced the workload of clinical doctors and pain experienced by patients. This therapy also has a high degree of safety and a very satisfactory curative effect.

Dimensioning of nursing team at neonatal intensive care unit: real versus ideal / Dimensionamento de enfermagem em unidade de terapia intensiva neonatal: real versus ideal

Objective: to compare the workload at a neonatal unit, according to Nursing Activities Score, and the dimensioning of nursing staff. Methods: cross-sectional study at a teaching unit with 30 beds. Data collection took place from October 6 to December 6, 2017, and data were analyzed according to descriptive statistics. Results: the sample of 115 neonates, totaling 1944 measurements. The average workload score was 73%. The unit has 107 nursing professionals, while should has 137. The proportion of registered nurses was lower than recommended (34%), whereas the proportion of nursing technicians was higher than recommended (66%). Conclusion: there was an imbalance between workload and number of professionals in nursing staff. Tools as Nursing Activities Score should be applied for supporting the staff dimensioning, since workload can impact the health outcomes and patient safety.

Primary Care Physician Workforce 2020 to 2025 - a cross-sectional study for the Canton of Bern.

The Swiss primary care sector faces a lack in its workforce and the Canton of Bern - the second largest canton (i.e. federal state)- is believed to be more affected than others. To be able to predict a shortage in the overall workforce, reliable numbers for the workforce of all generalpractitioners (GPs) and paediatricians (primary care physicians, PCPs) actively working in the Canton of Bern are needed. Switzerland has no registry of active PCPs; therefore, our goal was to (1) define the number and characteristics of all PCPs in the Canton of Bern, (2) to establish the workforce density for the whole canton and its administrative districts, and (3) to forecast the next five years with respect to the PCP workforce development. In this cross-sectional study, we contacted all potential PCPs of the Canton of Bern. We included all board-certified physicians in general internal medicine, paediatrics and physicians with the title "Praktischer Arzt (practical doctor)" with a professional license from the available registers (MedReg and the FMHregister). All potential PCPs received a questionnaire to assess their involvement in the primary care setting, their personal characteristics including workload (current and in 5 years to allowus to estimate the projected workforce per projected population size in 2025), type of practice, administrative district, and additional questions on their acceptance of new patients and their perception of a shortage in their region. The data from non-responders were collected via follow-up letters, emails and phone calls. The density was calculated as full-time equivalent PCPs per 1000 inhabitants in total and per district. From all potential PCPs (n = 2217), we identified 972 working in the Canton of Bern, 851 as GPs (88%) and 121 as paediatricians (12%). From these physicians, we had a response rate of 95%. The mean age was 53 years for GPs and 50 years for paediatricians. Thirteenpercentof all PCPswere aged 65 or older. The average workload was 7.6 half-days (GPs) and 6.9 half-days (paediatricians). We found a density of 0.75 (95% confidence interval [CI] 0.69-0.81) full-time equivalents per 1000 inhabitants for the total of the Canton of Bern, and a regional variability withdensities between 0.59 to 0.93. Without new PCPs, the workforce density of PCPs will drop to 0.56 (95% CI 0.49-0.62) within the next 5years. This is the first study in which 95% of active PCPs participated and it demonstrated that within the next 5 years there will be a shortage in the workforce of PCPs that can only be improved by higher numbers of new domestic PCPs - even after accounting for the current inflow of foreign PCPs.

Hand weeding tools in vegetable production systems: an agronomic, ergonomic and economic evaluation

ABSTRACT Hand weeding is a common method of weed control on vegetable farms, especially in developing countries. It requires considerable physical labour and is a significant economic burden, yet comparative studies on hand weeding tools are rare. We evaluated the agronomic, ergonomic and economic performance of four hand weeding tools (and unweeded control) at two sites and two weed ages. Agronomic efficiency was evaluated based on the reduction in weed load from pre-weeding to post-weeding, economic efficiency based on the time taken to weed, and ergonomic efficiency based on heart rate and energy expenditure of the tool operator. Among the tools, the chipping hoe provided higher weed control efficiency than the rotating hoe and combined tool, and showed a lower average heart rate and workload than the combined tool. Ergonomic performance was superior in loam soil compared with clay. The light-weight chipping hoe provided better weed control than heavier tools while also reducing the workload of the weeder. Tools did not differ in economic performance, but the cost was 50% higher with late weeding. Viable hand weeding strategies require the optimization of tools for ergonomic performance and careful attention to timing of operations, thus benefiting economic performance.