Levels Of Work Intensity Research Articles

Predictive Factors and the Duration to Pre-Injury Work Status Following Biceps Tenodesis

To determine when patients return to work after biceps tenodesis stratified by the preinjury level of work-intensity and to identify predictive measures of return to work. Patients undergoing biceps tenodesis between 2014 and 2017 were reviewed. Patients receiving concomitant rotator cuff repair or arthroplasty, revision biceps tenodesis, or unemployment before the procedure were excluded. Patient-acceptable symptom state (PASS), substantial clinical benefit, and minimal clinically important difference were calculated for the American Shoulder Elbow Society (ASES) score, subjective Constant-Murley score (CMS), and Single Assessment Numerical Evaluation (SANE) using the anchor-based and distribution-based approach. Preoperative outcome scores were analyzed to determine their predictive power of return to work using receiver operator curve area under the curve (AUC) analysis. Multivariate logistical analysis assessed predictive variables of return to work. Seventy-nine percent of patients were able to return to work without permanent restrictions at an average of 5.4 ± 2.8months after biceps tenodesis. Return to work status for sedentary, light, moderate, and heavy duties were 100%, 85%, 71%, and 69%, respectively. Return to work was associated with achieving PASS for the ASES and SANE questionnaires (P= .006, .003, respectively) but not for the CMS (P= .768). On multivariate analysis, there were no preoperative or intraoperative variables that were predictive of return to work in full capacity. The preoperative Short Form-12 mental component score (>59.4, AUC= 71.2%) was predictive of returning to work. After biceps tenodesis, most patients were able to return to work at an average of 5.4± 2.8months. Furthermore, there were no demographic or intraoperative variables that were predictive of return to work. Work intensity was not correlated with an increased duration of return to work. Achieving PASS on the ASES and SANE questionnaires was predictive of return to work. Level IV, case series.

Uncertainty-based prediction of work zone capacity using a Bayesian approach

The uncertainty-based work zone capacity model is formulated as a mixed linear regression function of explanatory variables where capacity is a random variable following a lognormal distribution. Model parameters are calibrated using a Bayesian approach. Results show that the proposed work zone capacity distribution model can accurately predict the mean and prediction interval of work zone capacity at any given confidence level. It is found that work zones located in urban roads, with a larger number of open lanes or with long-term work duration have a larger mean work zone capacity. A short prediction interval (i.e. low uncertainty) for work zone capacity is found to be associated with the following situations: (a) a bigger number of open lanes; (b) rural work zone; (c) short-term work duration; (d) left lane closure; (e) daytime work and (f) a smaller percentage of heavy vehicles. The predicted interval length for the medium level of work intensity is increased, although the corresponding mean work zone capacity is reduced, as compared with the light level of work intensity. There will be a bigger measured work zone capacity on average if the measurement method is adopted in which work zone capacity is taken as the mean queue-discharge rate.

Clinical work intensity among medical oncologists.

118 Background: Oncology faces workforce shortages and increasing stress. Oncology provider well-being and resilience are mediated by organizational factors through clinical work intensity. Clinical work intensity (CWI) is the level of requisite technical skill, physical and mental effort and clinical judgement necessary, plus care provision-associated stress. Suboptimal clinical work intensity may result from unfavorable practice organizational factors preceding burnout. This pilot study assess CWI experienced by medical oncologists and oncologic advanced practice registered nurses (APRNs)/nurse practitioners as a prelude to a study of provider resilience. Methods: Investigators solicited seventeen medical oncologists-12 physicians and 5 nurse practitioners-from five oncology clinics in the Northwest, Midwest, and Southern regions of the United States Providers reported on level of work intensity associated with 339 patient visits occurring over an 8 week period where for each provider 5 visits were randomly selected from each of 4 randomly selected clinic days. Intensity was measured by the NASA-Task Load Index that assesses 6 dimensions (subscales) with additional questions measuring stress and visit satisfaction. Results: Compared to medical oncologists, APRNs reported a higher work intensity score on average (38.6 vs. 32.9; p < 0.0064), and higher scores on the frustration subscale (36.5 vs. 21.5; p < 0.0001). APRNs also scored higher on stress (27.8 vs. 22.2; p < 0.048), and scored lower on provider-perceived satisfaction with the visit (73.0 vs. 81.1; p < 0.0001). There was no difference between oncologists and nurse practitioners on the other dimensions, including mental, time, and physical demand, and effort. Conclusions: Oncologic APRNs may experience greater work intensity than medical oncologists. Future research will consider whether APRN work intensity scores reflect different or disproportionate challenges owing to scope of practice, workload, or administrative responsibilities, and determine those dimensions of higher work intensity that portend provider burnout. The goal is to identify strategies optimizing work intensity among oncology providers, mitigating provider burnout and enhancing the practice environment.

Work Intensity in Slovakia in Relationship with Socio-Economic Characteristics of Households

Objective: The aim of this article is to evaluate the relationship between work intensity and educational attainment of the household head and household type in Slovakia. Research Design & Methods: Statistical analyses were carried out in analytics software SAS Base and SAS Enterprise Guide by means of contingency, correspondence analysis and multinomial logistic regression. Empirical analyses are based on data from the survey EU-SILC 2015. Findings: The article provides estimates of the probabilities of individual degrees of households’ work intensity depending on the household type and educational attainment level of the household head, while simultaneously in both cases households are broken down by economic activity of the household head. The presented analysis revealed categories of households which are the most and the least threatened by labour market exclusion from the point of view of the considered factors. Implications & Recommendations: While the social inclusion monitor in Europe says that in 2012 (quasi-) joblessness was typical for households with three or more children, our analysis for 2014 did not confirm this. The exclusion from the labour market in 2014 was the most typical in Slovakia for households without dependent children, where there is no more than one person in productive age. Contribution & Value Added: The article is not limited only to the very low work intensity which is used to assess the progress in the reduction of (quasi-) joblessness, but focuses on all the levels of work intensity (very low, low, medium, high and very high).

Which workers are more vulnerable to work intensification? An analysis of two national surveys

Purpose – The purpose of this paper is to identify whether there are particular employee groups that are more vulnerable to work intensification and its outcomes for well-being. Design/methodology/approach – This paper utilises data collected in two representative national surveys in 2005 (n=1,004) and 2009 (n=1,016), first to determine which employee groups are most vulnerable to work intensification and, second, to identify who is more vulnerable to the impacts of high work intensity on well-being, in terms of job (dis)satisfaction, stress, fatigue, and work-life imbalance. Findings – Professionals reported significantly higher levels of work intensity than all other occupational groups, and higher levels of stress and work-life imbalance. In addition, full-time employees experienced greater work intensity than part-timers, and union members than non-union members. Public-sector employees reported greater stress and work-life imbalance than those in the private sector. There was also a small, but significant and consistent, interaction effect that identified women as more negatively impacted by high work intensity than men. Research limitations/implications – Professionals have become vulnerable workers, in the sense of high levels of work demand, and the notion of worker vulnerability needs to recognise this. Future research on vulnerable employees would benefit from a broader conception of what constitutes vulnerability, exploring a wider range of employee groups who might be considered vulnerable, and including a wider range of potential outcomes for the lives and well-being of the individuals concerned. In particular, a more finely grained examination of the working conditions of professionals would be desirable, as would a more detailed examination of the reasons for the higher negative impact of work intensity on women. Practical implications – One way of improving the sustainability of professional working is to foster higher rates of part-time working, which brings better outcomes in terms of stress and work-life balance. This, however, is hardly a societal remedy and the question of how to reverse deteriorating job quality among professionals, particularly those struggling to balance work and family demands, is something that needs much greater attention. Originality/value – The paper expands the notion of “vulnerable workers” to recognise those groups most at risk of work intensification, and the outcomes of that intensification for satisfaction, stress, fatigue, and work-life balance. The authors add to the small group of studies highlighting the degradation of professional work, as well as identifying other types of employee who are more vulnerable to work intensification. The use of two large-scale surveys, with a four-year gap, has allowed a high degree of consistency in the patterns of vulnerability to be revealed.

Decomposing Child Poverty Reduction

European countries vary in the extent to which they succeed in reducing poverty using social transfers. However, we do not have good ways of understanding how these different outcomes are achieved. It is therefore very difficult to learn lessons from abroad. This paper uses micro data from the EU Statistics on Income and Living Condition (SILC), and attempts to decompose reductions in child poverty rates and gaps into the contribution made by children, old age, social exclusion, housing and work-related benefits. The analysis is undertaken for all families with children under 16, lone parent families, couple families, and then for families with varying levels of work intensity. Transfers make a substantial contribution to reducing child poverty rates and closing poverty gaps. The contribution varies between countries in the European Union. There is no single model, no most successful exemplar. Some countries do better for their children in lone parent households and others do better for their children in couple households. The analysis has enabled some opening up of the how question, though what is going on is still something of a mystery in some countries. It is probable that analysis at the national level with greater knowledge of national benefits systems is necessary to further open the ‘black box’.

A Conceptual Model of Physician Work Intensity

Physician work intensity, although a major factor in determining the payment for medical services, may potentially affect patient health outcomes including quality of care and patient safety, and has implications for the redesign of medical practice to improve health care delivery. However, to date, there has been minimal research regarding the relationship between physician work intensity and either patient outcomes or the organization and management of medical practices. A theoretical model on physician work intensity will provide useful guidance to such inquiries. To describe an initial conceptual model to facilitate further investigations of physician work intensity. A conceptual model of physician work intensity is described using as its theoretical base human performance science relating to work intensity. For each of the theoretical components, we present relevant empirical evidence derived from a review of the current literature. The proposed model specifies that the level of work intensity experienced by a physician is a consequence of the physician performing the set of tasks (ie, demands) relating to a medical service. It is conceptualized that each medical service has an inherent level of intensity that is experienced by a physician as a function of factors relating to the physician, patient, and medical practice environment. The proposed conceptual model provides guidance to researchers as to the factors to consider in studies of how physician work intensity impacts patient health outcomes and how work intensity may be affected by proposed policies and approaches to health care delivery.

CPR compression depth and rate in relation to physical exertion in paramedic students

The International Liaison Committee on Resuscitation (ILCOR) guidelines suggest rescuers deliver cardiopulmonary resuscitation (CPR) in cycles of 30 chest compressions and 2 ventilations (30:2) at a rate of 100 compressions per minute with a compression depth of 4-5 cm. Given this increase from the previous CPR cycle of 15:2, there is now also greater emphasis on pushing faster and deeper with minimal interruption. This has led to speculation surrounding rescuer fatigue and compression inefficiency. The purpose of this pilot study was to assess the level of work intensity and fatigue among undergraduate students during simulated CPR, including the quality of chest compressions. Methods: this was an observational pilot study investigating second year undergraduate paramedic students’ fatigue levels and quality of chest compressions following 20 minutes of simulated CPR. Data were collected at baseline and after every 2 minutes until conclusion of twenty minutes. Measurements of work intensity and fatigue included heart rate, rating of perceived exertion (Borg), compression depth and compression frequency. Results: a total of 7 subjects participated (2 male, 5 female), with five students aged 21-25 years. Male subjects showed a significantly slower compression rate when compared to females (108.0 vs 125.6 chest compressions per minute, P=0.006). Heart rate was significantly higher than rest (prior to commencing CPR) after 14 minutes of CPR (P=0.045). Perceived exertion was significantly higher than at rest at 2, 6, 10, 14, and 18 minutes, (P<0.01). Conclusion: this pilot study suggests that high levels of fatigue and perceived exertion are present early when undertaking CPR in a controlled setting, with some fatigue attributed to the faster than recommended chest compression rates.

Estimated energy expenditure of nursing assistants in long term care

Ergonomic research on nursing work has focused primarily on the biomechanical analysis of patient handling tasks. Few studies have addressed the intensity of a full day of nursing work as measured by changes in heart rate and energy expenditure. A pilot study was conducted between August 2009 and May 2010 to examine the intensity of performing nursing assistant work in long term care settings and to assess the usefulness of heart rate monitoring as a measure of work intensity. The residents of the facilities were physically dependent adults. The settings had floor-based mechanical lifting devices available and no-lift policies that restricted workers from lifting. Eight women between the ages of 19 and 54 from two facilities participated in this study. A wearable recorder allowed unobtrusive heart rate monitoring while nursing assistants worked their usual shift. Continuous heart rate monitoring for a full shift provided an estimation of energy expenditure. The data suggest that the nursing assistants worked at a moderate level yet were within the safe work intensity level recommended by NIOSH [32]. The information provides preliminary baseline data for nursing assistants who work with physically dependent adults using floor-based lifts in a no-lift environment.

Clinical Work Intensity Among Physician Specialties: How Might We Assess It?

The level of work intensity associated with patient encounters has implications for quality of care, patient safety, practice management, and reimbursement. The utility of available instruments for clinical work intensity assessment is unknown. We assessed, in the clinical setting, the performance of existing measures of work intensity that are valid for nonclinical contexts. A cross-sectional, multimeasure design involving work intensity assessments for the last patient encounter and for an entire half-day clinic session. A convenience sample of 14 providers from the following 4 specialties: family medicine, general internal medicine, neurology, and surgery. Perceived clinical work intensity was measured by the following 3 instruments: National Aeronautic and Space Administration-Task Load Index, Subjective Workload Assessment Technique, and Multiple Resources Questionnaire; stress was measured by the Dundee Stress State Questionnaire. Convergent validity was assessed by correlation among the instruments. For the last patient encounter, there was a moderate to high correlation between the work intensity instruments' scores (Pearson's r ranged from 0.41 to 0.73) and low to moderate correlation with the distress subscale of the Dundee Stress State Questionnaire (Pearson's r ranged from -0.11 to 0.46), reflecting their stress dimension. Provider personality was associated with reported levels of work intensity and stress. Similar results were obtained when the entire clinic session was the unit of reference. Existing measures of work intensity and stress appear to be valid for use in the clinical setting to generate evidence on perceived intensity and stress experienced by providers in the performance of medical services.

Precarious employment, working hours, work-life conflict and health in hotel work

Precarious or temporary work is associated with adverse outcomes including low control over working hours, work-life conflict and stress. The rise in precarious employment is most marked in the service sector but little research has been done on its health effects in this sector. This study compares permanent and temporary workers in the hotel industry, where working hours are highly variable. Survey data from 150 workers from eight 3-Star hotels in urban and regional areas around Sydney were analyzed. Forty-five per cent were male and 52 per cent were female. Fifty four per cent were permanent full-time and 46 per cent were temporary workers. The effects of employment status on perceived job security, control over working hours, and work-life conflict are investigated using PLS-Graph 3.0. The effects of control over working hours, on work-life conflict and subsequent health outcomes are also explored. Temporary workers perceived themselves as less in control of their working hours, than permanent workers ( β = .27). However, they also reported lower levels of work intensity ( β = .25) and working hours ( β = .38). The effects of low hours control ( β = .20), work intensity ( β = .29), and excessive hours ( β = .39) on work-life conflict ( r 2 = .50), and subsequent health effects ( r 2 = .30), are illustrated in the final structural equation model.

Heavy Episodic Alcohol Use in Emerging Adulthood: The Role of Early Risk Factors and Young Adult Social Roles

In this paper we examine the potential interdependence between early adolescent alcohol use and later role occupancy of such social roles as higher education attendance, parenthood, level of work intensity, and marriage. Data from a ten-year prospective study (1990–1993 & 2000–2003) were employed to examine these relationships among a sample of 523 young adult males who had previously attended a Miami-Dade County (Florida) middle or high school. Among the adult social roles considered, only being currently married was shown to be a significant predictor of having an inverse association with heavy alcohol use. However, an important conditional relationship was also observed: among those respondents who have a history of high early alcohol use, there is an association between work intensity and heavy alcohol use such that work intensity has a social amplification effect on young adult heavy alcohol use. The results presented here demonstrate that early risk factors need to be considered in conjunction with later social role occupancy when examining young problem drinking. The implications and limitations of these findings are discussed.

신체능력향상프로그램이 다운증후군 성인의 작업강도에 미치는 영향

The purpose of this study was to examine the effect of physical fitness improvement program on work intensity of persons with Down syndrome. For this, 8 adults with Down syndrome participated in program and were evaluated. The physical fitness improvement program consisted of grasp, lifting, carrying exercise for 12 weeks, 1 day a week for 2 hours per session. Compared with pre-program conditions, participants in program improved significantly in right grasp power, lifting ability but there was not significant improvement in carrying ability. In view of work intensity, work intensity level of two subjects was changed from average to hard in lifting. One subject was changed from very light to average and two subjects was changed from light to average in carrying. This results suggested that physical fitness improvement program was helpful for promotion the intensity of adults with Down syndrome.

Do social policy reforms have different impacts on employment and welfare use as economic conditions change?

AbstractThis paper uses March Current Population Survey data from 1985 to 2004 to explore whether social policy reforms implemented throughout the 1990s have different impacts on employment and welfare use depending on economic conditions, a topic with important policy implications but which has received little attention from researchers. I find evidence that many reforms operate differently as labor market conditions fluctuate. Although social policies increase employment during economic slowdowns, the largest effects are generated in favorable labor market conditions. The impact of time limits, mandatory job search, and cash diversion programs are particularly sensitive to the macroeconomy, while the earned income tax credit is associated with similar employment effects in most environments. The results vary substantially across policy “carrots” and “sticks,” levels of work intensity, and subsamples of single mothers, but a tentative conclusion is that a strong economy reinforces the positive incentives created by social policy reforms. © 2008 by the Association for Public Policy Analysis and Management.

Why is work intensity associated with heavy alcohol use among adolescents?

Purpose To examine and explain the relationship between work intensity (number of hours worked per week) and heavy alcohol use among adolescents. Methods Analyses were conducted with two waves of in-home interview data provided by a representative sample of adolescents who participated in the National Longitudinal Study of Adolescent Health. Multinomial logistic regression analyses were conducted to determine whether a higher level of work intensity at Wave 1 predicted a higher level of past-year heavy drinking approximately 1 year later at Wave 2, and the degree to which the relationship between work intensity and heavy drinking persisted after adjusting for demographic characteristics, alcohol use before Wave 1, and psychosocial risk and protective factors in family, school, and peer-individual domains. Results Higher levels of work intensity at Wave 1 (11–20 or more than 20 hours/week) were predictive of heavy drinking at Wave 2. However, these effects were substantially attenuated after adjusting for demographic characteristics and prior alcohol use. Risk and protective factors such as school commitment, friends' drinking, and delinquency also partially explained the effects of work intensity and background variables on heavy drinking, suggesting that these factors may act as confounders and/or mediators. Conclusions This study suggests that working more than 10 h/week increases the likelihood of heavy alcohol use among adolescents, and that the effect of work intensity is largely, but not completely attributable to demographic characteristics (e.g., age, race/ethnicity, personal income), prior alcohol use, and family, school, and peer-individual factors.

My field of dreams

J Emerg Nurs 2001;27:319-20.

Wages and the Intensity of Labor Effort: Efficiency Wages versus Compensating Payments

The distinction between efficiency wages and compensating payments is, at best, rather vague in both the theoretical and empirical literatures positing a relationship between wages and the intensity of labor effort.' While efficiency wages and compensating payments are both related to work intensity, the mechanisms that generate these relationships are in each case quite distinct. Compensating payments exist in competitive labor markets to equalize overall compensation across identical workers with dissimilar working conditions. Workers who expend more labor effort must be paid more or they will seek employment elsewhere. Efficiency wages are employment rents paid by firms in order to ensure adequate labor effort. These rents vary with the costs firms face in monitoring labor effort. They cannot be competed away because without employment rents, profit-maximizing levels of work intensity would not be forthcoming. In this paper we distinguish between the efficiency wage and compensating payments components in wage differences across workers and firms. In the first section of the paper, we use a theoretical model of optimal labor effort choice by workers and firms to make these two com-

Evaluation of the Colin STBP-680 at rest and during exercise: an automated blood pressure monitor using R-wave gating.

The application of automated blood pressure measurement during exercise has been limited by inaccuracies introduced by the effects of accompanying motion and noise. We evaluated a newly developed automated blood pressure monitor for measuring exercise blood pressure (Colin STBP-680; Colin, San Antonio, Texas, USA). The STBP-680 uses acoustic transduction with the assistance of the electrocardiogram R-wave to trigger the sampling period for blood pressure measurement. The automated monitor readings were compared with simultaneous technician mercury sphygmomanometric readings in the same arm. Blood pressure was measured in 18 men at rest and during exercise at 40% VO2 peak, (low intensity), 70% VO2 peak (moderate intensity) and VO2 peak (high intensity) on the cycle ergometer. Mean(s.d.) systolic blood pressure difference between the automated monitor and mercury manometer readings at rest and during exercise at low, moderate and high work intensities were 3(0) mmHg, 3(2) mmHg, 1(1) mmHg, and 0(11) mmHg respectively (analysis of variance; P > 0.05). Resting diastolic blood pressure obtained with the STBP-680 was similar to the mercury manometer readings (78(10) versus 81(7) mmHg (P > 0.05). Exercise diastolic pressure at the low level of work intensity was almost identical between the automated monitor and mercury manometer readings (64(8) versus 65(10) mmHg (not significant)). Diastolic blood pressure readings between the STBP-680 and mercury manometer showed a greater difference at the moderate and high workloads (11 mmHg and 9 mmHg, respectively), but this difference was not significant (P > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

THE PHYSIOLOGICAL COST OF WEARING A DISPOSABLE RESPIRATOR

In order to gain an understanding of the physiological stresses imposed by the wearing of a single-use disposable respirator, a series of experiments was done to measure the cardiopulmonary effects of wearing the respirator (heart rate, respiratory rate, and blood pressure); resistance to breathing while wearing a respirator; and heat stress imposed by the use of a respirator (changes in inspired and expired air temperature). Ten men, ages 24 to 35, of varying fitness levels, served as volunteers in the studies. All the men exercised on a treadmill both with and without 3M Model 8715 disposable respirators. Workloads corresponding to light, moderate, and heavy levels were calculated for each volunteer based on his maximal oxygen uptake. As work intensity increased, an increase in breathing resistance was found. Peak resistances were in the range of +/- 2 cm water. Work-intensity level increases in respiratory rates were found with and without the respirators, but the respirator use trial had a significantly increased respiratory rate. Heart rate also showed a dose-related increase as work intensity increased and was significantly greater in the respirator trials at heavy levels of work and during recovery. Systolic blood pressure showed a biphasic response to respirator use, being significantly lower at rest and higher at high levels of work. Diastolic blood pressure changes were less dramatic but were elevated in the respirator trials. Clinically important increases in blood pressure were found in two volunteers when respirators were worn. Air temperatures immediately anterior to the face were, on average, 7.5 degrees C higher in the respirator trials.(ABSTRACT TRUNCATED AT 250 WORDS)

A review of blood lactate and ventilatory methods of detecting transition thresholds.

As far back as the 1930s exercise physiologists recognised the existence of critical levels of work intensity above which lactate accumulation increased drastically and energy production was affected. Investigation of these transition points (thresholds) both invasively and non-invasively has led to much recent controversy. Respiratory exchange variables such as Ve, Ve/VO2, VCO2, excess CO2 and blood lactate have been monitored for simple, double and exponential breakaway points to elucidate these critical work intensities. A number of studies have produced high correlations between endurance performance and anaerobic threshold calculations, further demonstrating the potential existence of critical work intensities. Much of the controversy surrounding these phenomena has centered on mechanisms and nomenclature. The term 'anaerobic threshold' has been severely criticised because in addition to the tissues being oxygen insufficient, an imbalance in the energy systems may have resulted. The anaerobic condition or lactate accumulation may be due to changes in lactate production and removal. Muscle fibre type and the fibre type recruitment patterns may also be important factors in threshold transitions. Further examination is made in this review of non-invasive measures for determining transition thresholds and protocols for elucidating the critical points.