Flexible Shift Research Articles

Shift Pruning-Based SCL Decoding for Polar Codes

In the context of the high-speed development of 5G communications, high-performance decoding schemes for polar codes are a hot spot in channel coding research. Shift pruning successive cancellation list (SP-SCL) decoding aims to recover the correct path by shift pruning in the extra SCL decoding. However, the current SP-SCL decoding is inflexible in determining the shift positions. In this paper, a flexible shift pruning SCL (FSP-SCL) decoding is proposed. Firstly, the reasons for movement and the eliminated states of the correct path are analyzed in detail using the path metric range (PMR), and on this basis, the validity of the method adopted in this paper for determining the shift priority of the information bits is verified. Secondly, the FSP-SCL decoding proposes two methods for determining the shift positions. One is the log-likelihood ratio (LLR) threshold method, which compares the LLR values of the eliminated paths on the shift bit with the corresponding LLR threshold to determine the shift positions. The other is the path distance method. It combines the minimum distance between the eliminated paths and the received vector with the path metrics to determine the shift positions. Both methods are more flexible and practical, as they can calculate the corresponding shift positions online based on a specific shift bit, avoiding the high complexity caused by the simulation method. Finally, this paper designs various experimental schemes to verify the decoding performance of the FSP-SCL. The experimental results show that in terms of error-correction performance, the LLR threshold-based FSP-SCL (FSPL (LLR threshold)) decoding, the path distance-based FSP-SCL (FSPL (path distance)) decoding and the existing SP-SCL decoding are roughly equal overall. In terms of decoding complexity, FSPL (LLR threshold) decoding is slightly better than FSPL (path distance) decoding, and the decoding complexity of both is lower than that of SP-SCL decoding, with the difference being more pronounced in the medium to high SNR regions.

Organisational factors associated with healthcare workforce development, recruitment, and retention in the United Kingdom: a systematic review

AimsTo synthesise evidence regarding organisational practice environment factors affecting healthcare workforce development, recruitment, and retention in the UK.Methods/data sourcesA systematic search of PubMed, Web of Science, EMBASE, and PsycINFO yielded ten relevant studies published between 2018 and 2023 and conducted in the UK (the last search was conducted in March 2023). Adhering to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, two independent reviewers conducted screening, sifting, and data extraction, applying the quality assessment tool for risk of bias.ResultsResults highlight key factors associated with staff intention to leave/turnover/retention: workplace challenges, aggression, moral distress, on-the-job embeddedness, leadership involvement, organisational support, and flexible shift patterns. Notably, aggression from colleagues, including clinical staff but not interdisciplinary personnel, has a more detrimental impact on staff intention to leave than aggression from patients.ConclusionThe complex and context-dependent impacts of these organisational factors on the UK healthcare workforce underscore the need for tailored interventions. The review acknowledges limitations, including bias from excluding qualitative studies, a small pool of included studies, and nurse overrepresentation.

The risk of premature cardiac contractions (PAC/PVC) related to caffeine consumption among healthcare workers: A comprehensive review.

Premature atrial contractions (PACs) and premature ventricular contractions (PVCs) are ectopic heart rhythm disorders with implications for cardiovascular health. This study explores the relationship between caffeine consumption and the risk of PACs and PVCs, with a focus on healthcare workers, such as doctors, nurses, pharmacists, and midwives, who often rely on caffeine to combat fatigue, especially during night shifts. A thorough review was conducted through PubMed, Scopus, Google Scholar, and Web of Science, utilizing a combination of MeSH terms and keywords. Studies examining the link between caffeine consumption and PACs and PVCs, particularly in healthcare workers, were included. We found that caffeine shows various effects based on dosage and can impact arrhythmia risk. Individuals working long shifts, including healthcare professionals, are prone to increased caffeine intake, leading to higher cardiovascular risk. To mitigate these risks, tailored guidelines for caffeine consumption, flexible shift scheduling, and mental health support services are recommended. Promoting caffeine alternatives within healthcare institutions can be beneficial. Although caffeine may have potential benefits, its drawbacks, particularly concerning cardiovascular health, may surpass its advantages, especially when consumed in high doses. A multidisciplinary approach is crucial for healthcare workers' well-being and quality of patient care. Further research is required to refine and support these recommendations.

Nurses’ Sleep Characteristics by Shift Type in a Tertiary Hospital With Flexible Working Arrangements

Objectives: To improve the adaptation of shift work, various flexible shift patterns for nurses have introduced in addition to the existing eight-hour-three-shift system. This study aimed to compare the differences in rotating nurses’ sleep characteristics according to shift patterns. Methods: A total of 62 rotating nurses (all females, mean age 29.79±4.30 years) participated in sleep monitoring for consecutive two weeks. Objective sleep was obtained using Readiband (Fatigue Science, Inc., Vancouver, BC, Canada), a wrist-worn device that uses an accelerometer to distinguish sleep and wakefulness. Subjective sleep characteristics were measured using the Morningness-Eveningness questionnaire (MEQ), Bedtime Procrastination Scale (BPS), Epworth Sleepiness Scale (ESS), and Insomnia Severity Index (ISI). Results: Mean BPS was 30.42±5.10, ESS was 10.42±4.27, and ISI was 11.58±4.16, and there were no statistical differences in sleep parameters except for total sleep time (TST). Although significant differences were not found in sleep parameters according to shift patterns, 27.4% of rotating nurses report subjective sleep problems. More than half (59.7%) suffer from excessive daytime sleepiness. ISI was negatively correlated with age (rho=-0.275, <i>p</i>=0.031) and shift work period (rho=-0.278, <i>p</i>=0.028), but it was positively correlated with ESS (rho=0.306, <i>p</i>=0.015). Furthermore, BPS was negatively correlated with MEQ (rho=-0.351, <i>p</i>=0.005) and TST (rho=-0.307, <i>p</i>=0.016). Conclusions: To improve the sleep of rotating nurses, more active interventions, such as sleep education to reduce bedtime procrastination and short naps during night shifts, are needed.

Medical education during the COVID-19 pandemic: lessons for the orthopedic departments

BackgroundAfter the Coronavirus pandemic, many educational routines were stopped for the safety of medical staff. To achieve educational goals, we have implemented new policies in our hospitals. In this study, we aimed to evaluate the effect of such strategies.MethodThis survey-based study uses questionnaires to assess newly implemented educational strategies. We surveyed 107 medical staff of the orthopedic department of Tehran University of Medical Sciences, including faculty members, residents, and students. The survey contained three series of questionnaires for these groups.ResultsThe maximum satisfaction for all three groups was observed in the platform and facilities for using e-classes, and the cost- and time-saving capabilities (Respectively, faculty members (FM): 81.8%, residents (R): 95.2%, students/interns (S/I): 87.0%; FM: 90.9%, R: 88.1%, S/I: 81.5%). The new policies have been shown to reduce the stress level of most trainees, increase the quality of knowledge-based education, increase the opportunity for reexamining educational content, expand discussion and research opportunities, and improve work conditions. There was a broad acceptance of the virtual journal clubs and morning reports. However, there were discrepancies between residents and faculty members on issues such as the evaluation of trainees, the new educational curriculum, and flexible shift schedules. Our strategies failed to improve skill-based education and patient treatment status. Most participants indicated that e-learning should be used with face-to-face training post-pandemic (FM: 81.8%, R: 83.3%, S/I: 75.9%).ConclusionOur efforts to optimize the educational system during this crisis have generally improved trainees’ work conditions and educational experience. Most participants believed that e-learning and virtual methods should be used alongside traditional training as a complementary component after the pandemic.

Strategies for Adaptation to Shift Work

More than 20% of the industrialized workforce includes shift workers. The misalignment between their work schedules and circadian clock-driven sleep-wake cycles can result in excessive sleepiness during work and disturbed sleep after work. Shift work is associated with various negative health consequences, and workers are at risk for shift work disorder. In this review, we focus on strategies to facilitate shift work adaptation, including medication, light therapy, scheduled sleep and naps, flexible shift schedules, sleep hygiene, and family and social support to promote sleep, wakefulness, and adaptation to the circadian clock. An integrated approach that combines multiple management strategies in contrast to a single approach, can enable more effective shift work adaptation.

Sleep disturbances and depressive symptoms of shift workers: Effects of shift schedules

This study explored sleep disturbances and depression among various types of shift workers (SWs) and non-SWs, focusing on work schedule diversity. We enrolled 6,654 adults (4,561 SWs, 2,093 non-SWs). Based on self-report questionnaires on work schedules, the participants were classified according to shift work type: non-shift work; and fixed evening, fixed night, regularly rotating, irregularly rotating, casual, and flexible shift work. All completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and short-term Center for Epidemiologic Studies-Depression scale (CES-D). SWs reported higher PSQI, ESS, ISI, and CES-D than non-SWs. Fixed SWs (fixed evenings and fixed nights) and true SWs (regularly and irregularly rotating SWs) scored higher on the PSQI, ISI, and CES-D than non-SWs. True SWs scored higher on the ESS than fixed SWs and non-SWs. Among fixed SWs, fixed night SWs scored higher on the PSQI and ISI than fixed evening SWs. Among true SWs, irregular SWs (irregularly rotating and casual SWs) scored higher on the PSQI, ISI, and CES-D compared to regularly rotating SWs. The PSQI, ESS, and ISI independently were associated with the CES-D of all SWs. We found an interaction between the ESS and the work schedule on the one hand, and the CES-D on the other, which was stronger in SWs than non-SWs. Fixed night and irregular shifts were linked with sleep disturbances. The depressive symptoms of SWs are associated with sleep problems. The effects of sleepiness on depression were more prominent in SWs than non-SWs.

Factors related to career interruption and Re-employment of women in human health and social work activities sector: Comparison with other industry sectors.

This study aims to examine the factors related to career interruption and re-employment of women who had worked or were working in the human health sector and to compare them with those in other industrial sectors. Secondary data analysis study. Data from the 2019 economic activities survey of career-interrupted women of South Korea was used, and 2570 participants were included in the analysis. Women who had majored in health care and had worked, or were working, in the human health and social work activities sector showed a higher tendency to work more than 40 h per week, compared to the mean of all participants. Moreover, parental leave and flexible working time were related to career interruption and re-employment. Policies that encourage the use of parental leave and flexible shift work systems should be developed and implemented to prevent career interruption of women in the health sector.

A study on employee experience with shift work

Shift work has become necessary for many industries operating 24 hours a day, 7 days a week, affecting individual workers and their overall well-being. Based on a survey of 1049 shift workers of various industries, ages, and genders from all fourteen regions of the Czech Republic, the paper analyzes their experience with different shift work rosters to determine individually perceived advantages and disadvantages of shift work and discuss perspective ways of improving shift workers' well-being. The findings confirm the importance of effective and efficient shift work planning and organizing to achieve demanded work productivity, desired work-life balance and overall well-being of shift workers. The analysis confirmed a hypothesis that the preference for work shifts depends on the age of shift workers. Individually perceived negative impacts of shift work included physical fatigue, sleep disorders, or depression. These could be limited by more flexible shift work scheduling to harmonize work shifts with personal matters whenever possible and thus support shift workers' work-life balance and well-being.

Влияние добывающего сектора на развитие территории: где концентрируются эффекты

The review of the extensive methodological apparatus developed for assessing the socio-economic effects of investment projects, state policy or the activities of companies is carried out. By the example of the Severo-Enisejskij district of the Krasnoyarsk region, the dynamics of the influence of gold mining industry on the socio-economic development of the territory in comparison with other municipalities of the region is considered. It is shown that in the 2000s the district was significantly different in comparison with the region by many indicators, then in the mid-2010s there was a decrease in its separation. It was caused by the dependence of its socio-economic situation on the situation in the world market, and by a decrease in the influence of the industry on the territory. The differences in the effects of activities in the district of two companies — “Polyus” and “Sovrudnik” — are analyzed. These companies are different in its scale and history of development. It is shown that the size of a company affects the hierarchical administrative level at which the maximum effects from its activities are concentrated. On the territory of the district, large effects, including attracting permanent residents to the territory, have been retained until recently by “Sovrudnik”, while “Polyus” is more evident at the regional level. Its administrative resource allows to implement infrastructure projects that are interesting to the company, but can indirectly have positive effects for the local population. However, the future development of both companies is most likely to be associated with maximizing the use of a more flexible shift mode of work, and the effects of their activities in this regard will continue to decrease.

Task-dependent reversal learning dynamics challenge the reversal paradigm of measuring cognitive flexibility

Cognitive flexibility may be necessary for animals facing changing conditions and has long been tested by the reversal learning paradigm. However, while this paradigm is typically based on training animals to discriminate between a rewarding and nonrewarding stimulus and then reversing their roles, under natural conditions animals usually face more than one set of two stimuli. Here, we addressed these potential intricacies by studying the reversal learning of house sparrows, Passer domesticus , in a two-set task. Sparrows previously trained as either colour or shape specialists exhibited different reversal dynamics: While colour discrimination was acquired faster than shape discrimination, shape specialists, including those reaching perfect preference of the rewarding shape, reversed faster than colour specialists. The reversal success of shape specialists was also less variable than that of colour specialists. Additionally, despite being slower, during the reversal, colour specialists sampled shapes more than shape specialists sampled colours. These results suggest that (1) when comparing different reversal tests, significant differences in reversal behaviour may be explained by the type of learned stimulus (e.g. shape versus colour) rather than by differences in cognitive flexibility and (2) under realistic conditions of multiple foraging options, preferences that are difficult to reverse (and typically viewed as indicating low cognitive flexibility) may nevertheless facilitate an ecologically flexible shift to novel food types. Finally, our results also demonstrate that a two-set (multiple-cue) experimental design may help to tease apart some of the different processes underlying reversal behaviour and cognitive flexibility. • The results of reversal learning tests differed depending on stimulus type. • Differences were independent of the discrimination level reached before reversal. • Associations that were difficult to reverse induced flexible shift to novel cues. • Reversal scores may not reflect ecological flexibility in multiple-cue environments. • A multiple-cue set-up helps tease apart the subcomponents of the reversal process.

Analysis and Countermeasures of 101 Inpatients with Falls in Internal Medicine Department

Falling of inpatients can cause serious injuries to patients, family members and caregivers. It damages patients’ physical and mental health, increases the remedy cost of medical institution, and affects the quality of nursing service in hospital. The aim of this study is to analyze the current situation of falls of inpatients in internal medicine department, so as to provide reference information for improving patient safety management and hospital quality control. With the help of the method of retrospective investigation, the number of inpatients with falls in the First Affiliated Hospital of Jinan University from January to December 2019 was reviewed, and the incidence, causes, time and nurse patient ratio were analyzed. There were total 101 falls of inpatients in internal medicine department in year 2019, accounting for 58% of the fall patients in the hospital, the fall rate of internal medicine department inpatients was 0.5‰. The injury rate of grade1 and above was 54.45%. The incidence of falls has three epidemiological characteristics, mainly for the elderly over 60 years old, accounting for 71.3%, the most commonplace to fall is the toilet, the high incidence period is 22:01-07:00. Drugs are one of the main factors leading to falls, with sedative-hypnoticdrugs (benzodiazepines) being the most common, followed by antidiabetic drugs, antihypertensive drugs and diuretics. Patients at high risk of falling, despite the presence of caregivers is 69.3%, had a higher incidence of falls. A nurse on duty attended to 10 to 50 patients in the falling event. From the above outcome, it is illustrated that the incidence of fall injury in medical inpatients is higher. The main population is the elderly and patients taking sedatives, sleeping pills or hypoglycemic drugs. Nurses need to keep an eye out for patients who take medications that can easily lead to falls. Hospital management departments should strengthen the training of nursing staff and new nurses, establish safety culture and improve nurses’ consciousness of fall prevention. Head nurses should take flexible shift system to effectively reduce the incidence of falls.

Quality oriented multimode processes monitoring based on a novel hierarchical common and specific structure with different order information

Abstract Due to higher demands on product diversity, flexible shift between productions of different products in one equipment becomes a popular solution, resulting in existence of multiple operation modes in a single process. In order to handle such multi-mode process, a novel double-layer structure is proposed and the original data are decomposed into common and specific characteristics according to the relationship between variables among each mode. In addition, both low and high order information are considered in each layer. The common and specific information within each mode can be captured and separated into several subspaces according to the different order information. The performance of the proposed method is further validated through a numerical example and the Tennessee Eastman (TE) benchmark. Compared with previous methods, superiority of the proposed method is validated by the better monitoring results.

What makes them happy? Professional care-givers' job satisfaction.

Nurses' job dissatisfaction can be seen as an early warning indicator of occupational change and (early) termination intentions. Abetter understanding of job satisfaction and its determinants can help to prevent nurses from leaving their profession. We assessed the impact of nurses' perception of job characteristics on their overall job satisfaction in order to identify the most relevant factors. We also investigated the potential mechanisms through which the most relevant factor influences job satisfaction. We used multiple regression analysis based on astandardized survey of about 800 registered nurses (in long-term care facilities) in both inpatient care and outpatient care in Germany as well as qualitative content analysis of about 50 semi-structured interviews with nurses. We found that collaboration with the team and supervisor to be the most relevant factor associated with job satisfaction. Agood team can create professional support and ideational support for professional caregivers and enhance their professional development and the quality of care. Our results point to the importance of leadership training, team building methods and other measures for establishing and cultivating apleasant working atmosphere with flexible shift handovers and team meetings.

Altered activation and connectivity of the supplementary motor cortex at motor initiation in Parkinson’s disease patients with freezing

ObjectiveMotor initiation failure is a key feature of freezing of gait (FOG) due to Parkinson’s disease (PD). The supplementary motor cortex (SMC) plays a central role in its pathophysiology. We aimed at investigating SMC activation, connectivity and plasticity with regard to motor initiation in FOG. MethodsTwelve patients with FOG and eleven without FOG underwent a multimodal electrophysiological evaluation of SMC functioning including the Bereitschaftspotential and movement-related desynchronisation of cortical beta oscillations. SMC plasticity was modulated by intermittent theta burst stimulation (iTBS) and its impact on gait initiation was assessed by a three-dimensional gait analysis. ResultsPrior to volitional movements the Bereitschaftspotential was smaller and beta power was less strongly attenuated over the SMC in patients with FOG compared to those without. Pre-motor coherence between the SMC and the primary motor cortex in the beta frequency range was also stronger in patients with FOG. iTBS resulted in a relative deterioration of gait initiation. ConclusionsReduced activation of the SMC along with increased SMC connectivity in the beta frequency range hinder a flexible shift of the motor set as it is required for gait initiation. SignificanceAltered SMC functioning plays an important role for motor initiation failure in PD-related FOG.

Resilience in new nurses: a qualitative study

Abstract Objectives To explore the resilience experience of new nurses and how new nurses develop and apply resilience strategies to cope with the difficulties during the transition period. Methods A descriptive qualitative research method was on data acquired using data semi-structured interviews with 12 new nurses aged 20–26 years whose working time was more than 12 months but less than 24 months. Results Analysis of the data could determine participants adopting resilience strategies to withstand difficulties and challenges in transition period. This period consisted of three main phases: “self-protection,” “undertaking challenges,” and “planning future.” The first-line nurse managers’ feedback and flexible shift scheduling paid a vital part in promoting the resilience development of new nurses. Conclusions Recognizing the importance of understanding and developing the resilience of new nurses in the transition period could greatly reduce the turnover rate and alleviate the shortage of nurses in global nursing workforce.

The flexible break assignment problem for large tour scheduling problems with an application to airport ground handlers

The paper examines the complexity of assigning multiple breaks to shifts in the context of large-scale tour scheduling. A mixed-integer programming (MIP) model is presented that includes shift and days-off scheduling along with break assignments for a multi-skilled workforce. To achieve tractability, a two-stage decomposition procedure is proposed that separates the tour scheduling problem (TShP) from the break assignment problem (BAP). The former MIP is first solved to determine the shifts and days off for the workforce that minimize labor and shortages costs over the planning horizon. The results are used as input to a second MIP that optimally places the breaks to minimize the costs of working hours and uncovered periods. Three implicit BAP formulations are investigated. To better understand the literature and the models previously developed, a 3-field break classification scheme is introduced. The first field characterizes the number of breaks permitted per shift, the second specifies whether the length of the breaks is fixed or variable, and the third limits their position in a shift. A complexity analysis of the resulting 12 BAPs along with a few special cases is also included. Most problems are shown to be strongly NP-hard. Computations are presented for a wide variety of scenarios for both the TShP and the BAP using data provided by a European airport ground handler company. In all, over 500 instances were investigated using high and low demand fluctuation curves and the various break and shift flexibility options. The results indicate that increasing flexibility in break regulations can make a significant difference in coverage, but the degree depends on the underlying structure of the demand curve as well as on the types of shifts permitted. Formulations with the most flexible shift and break regulations reduced undercoverage by up to 16.68% compared to the most common scenarios in which shifts are limited to a single lunch break.

A Shifting Strategy That Reduces the Number of Shifts for Urban Conditions

Nowadays, urban conditions have become the main operating conditions for vehicles. Urban traffic congestion leads to a higher rate of vehicle idle speed and frequent shifts. This paper proposes a new shifting strategy in order to effectively improve the problem of frequent shifting, which is called flexible shift. In view of the fact that the electric vehicle cancels the clutch, shifting is completed directly by the control of the motor during the shifting process. Reducing the number of shifts can effectively reduce wear and increase the life of the transmission, which can be realized by the flexible shift. This paper uses MATLAB to simulate the shifting times of this shift strategy under FTP conditions. The simulation results show that electric vehicles with flexible shifting control strategy can significantly reduce the number of shifts, improve comfort, reduce hardware loss, and do not reduce economic efficiency.

DWMAcc

PIM (processing-in-memory) based hardware accelerators have shown great potentials in addressing the computation and memory access intensity of modern CNNs (convolutional neural networks). While adopting NVM (non-volatile memory) helps to further mitigate the storage and energy consumption overhead, adopting quantization, e.g., shift-based quantization, helps to tradeoff the computation overhead and the accuracy loss, integrating both NVM and quantization in hardware accelerators leads to sub-optimal acceleration. In this paper, we exploit the natural shift property of DWM (domain wall memory) to devise DWMAcc, a DWM-based accelerator with asymmetrical storage of weight and input data, to speed up the inference phase of shift-based CNNs. DWMAcc supports flexible shift operations to enable fast processing with low performance and area overhead. We then optimize it with zero-sharing , input-reuse , and weight-share schemes. Our experimental results show that, on average, DWMAcc achieves 16.6× performance improvement and 85.6× energy consumption reduction over a state-of-the-art SRAM based design.

Planning for Overtime: The Value of Shift Extensions in Physician Scheduling

Scheduling physicians is a key success factor in hospitals. Heterogeneous demand and 24/7 service make the problem challenging. Approaches in the literature use flexible shift patterns to match demand with scarce resources. In these approaches, demand is usually assumed to be deterministic. However, surgery durations and emergency arrivals are both uncertain, leading to massive staff overtime. We introduce stochastic demand for physicians using a scenario-based approach. To incorporate this in scheduling, we allow variable shift extensions. If a variable shift extension is scheduled, the physician knows that with a given probability he or she may have to work a few periods longer. Thus, we ensure a matching of supply with demand, and at the same time we increase predictability of working hours. We propose a mixed-integer model and a column generation heuristic to solve our problem and provide experimental data from a German university hospital. Our approach reduces unplanned overtime by more than 80%, given a constant workforce. In cases of similar levels of unplanned overtime, the required workforce level can be decreased by 20%. Our approach aims at improving physicians’ work–life balance and provides insights for hospitals’ contract design processes.