Occupational Demands Research Articles

A Lifespan Perspective on Emotion Regulation Repertoires at the Workplace

Emotion regulation at work has received considerable attention in recent years. According to lifespan-psychological theory and research, aging is associated with improvements in emotion regulation. Nevertheless, results regarding better emotion regulation strategy use with age in the organizational aging literature have been inconsistent. In the present study, we aim to reconcile some of these divergent results by studying emotion regulation strategies at the repertoire level as opposed to investigating the use of single strategies, and by investigating the role of work conditions as contextual affordances of these emotion regulation strategies. Using a sample of 980 participants, we first identified five work-related emotion regulation latent profiles and examined their associations with well-being outcomes. Second, using configural frequency analysis, we found that overall, emotion regulation profiles that were positively associated with well-being were more (less) likely to be afforded in favorable (unfavorable) working conditions, which calls into question the hypothesis of emotion regulation as a buffer to occupational demands. Third, older workers were more likely to be members of emotion regulation profiles that were positively associated with well-being, thereby replicating the older-age advantage in emotion regulation in the work context. Interestingly, older workers’ emotion regulation strategy use seemed more stable across all work contexts than younger workers’ strategy use, which points to the need for more research regarding younger workers’ responses to work conditions. Keywords: Emotion regulation; age; latent profile analysis; well-being; job design

The Accommodation Response and Facility between Children and Young Adults

Tonic accommodation decreased with age among children. In young adults, late-onset myopia will develop due to occupational near vision demands. This study aims to investigate the accommodation response and facility between children and young adults, in emmetrope (non-myopic) and myope group. The accommodation response and facility of young adults and children were measured using monocular estimation method (MEM), monocular accommodative facility (MAF) and binocular accommodative facility (BAF) with an exposure of near task for 15 minutes. Near task has significantly increased the lag of accommodation in all groups (p<0.05). However, the accommodation facility was not affected by near work in all groups (p>0.05). Keywords: accommodation response, accommodation facility, myopes, emmetropes. eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v5i14.2168

Seasonal Changes In Cardiovascular Function, Risk Factors, And Oxidative Stress Of Wildland Firefighters

Wildland firefighters (WLFF) experience extreme physiological strain throughout a typical season due to intense occupational demands and consistent woodsmoke exposure. There is a rationale to indicate that accumulated physiological strain, and oxidative stress, throughout a WLFF season has the potential to negatively alter cardiovascular function and risk factors. PURPOSE: The purpose of the study was to examine the effects of a season on cardiovascular function, risk factors, and markers of oxidative stress in WLFF. METHODS: Fourteen members of a Type I interagency hotshot crew participated in the study (males: n=13, females: n=1, age: 30.1 years ± 4.8). Pre- and post-seasonal resting measurements (May, October) were obtained for heart rate variability (lnRMSSD, lnHF, lnHF, LF:HF), pulse wave velocity (PWV), blood lipid panels (TC, TG, LDL, HDL), metabolic biomarkers (blood glucose, HbA1c), blood pressure (SBP, DBP) and blood oxidative stress (3-nitrotyrosine, 8-isoprostane). Paired samples t-tests were used to identify differences among pre- and post- seasonal values. RESULTS: There were no seasonal effects observed on resting heart rate variability, PWV, 3-nitrotyrosine, 8-isoprostane, TC, TG, LDL, blood glucose, SBP, or DBP (p>0.05). A significant reduction occurred in HDL (Pre: 53 mg/dL ± 14, Post: 45 mg/dL ± 18, p=0.043) and HbA1c increased (Pre: 5.2% ± 0.2, Post: 5.3% ± 0.2, p=0.034) from pre- to post-season. CONCLUSION: These data suggest a WLFF season did not impact resting markers of heart rate variability, pulse wave velocity, and oxidative stress. Alterations in metabolic biomarkers of cardiovascular risk factors (HDL and HbA1c) demonstrate unfavorable seasonal changes, suggesting that the WLFF season may increase cardiovascular risk.

Outcomes of a 2-year, 5 cohort faculty development program.

A grant-funded faculty development program, From Practice to Preceptor (FP2P), sought to recruit and train diverse general and pediatric dentists to become dental faculty from 2012-2018. This study is an evaluation of this completed initiative and offers an initial review of long-term outcomes of the program. Over 5 entering cohorts, 133 practitioners applied to the program and 45 were accepted. A 2-year training program used classroom and hands-on training to prepare practitioners for the occupational demands of academia. Program participants were offered pre- and post-surveys to evaluate their perceived preparedness in faculty competencies identified by the program. Participants were also sent an alumni survey, and employment was tracked by the host institution. Most (43 of 45) participants completed the program. Pre- and post-survey results were received from 24 of 30 (80%) participants in Cohorts 2, 3, and 5, and used for this analysis. The results suggest the program participants' perception of their ability to work effectively as faculty members in administrative, teaching, and clinical arenas increased. Over half of the program completers obtained employment as dental faculty. A majority of (19/26, 73%) program completers who responded to the alumni survey indicated the skills and knowledge gained in the program were useful to their current employment. The FP2P program evaluation results indicate a long-term faculty training program may be a useful methodology for recruiting and training current dentists to work in academic dentistry.

Predictors of Voice Therapy Initiation: A Cross-Sectional Cohort Study

To determine predictors of voice therapy initiation. Cross-sectional cohort study. All patients were evaluated in an interdisciplinary model at the University of Wisconsin Voice and Swallow Clinics between June 2016 and October 2017. Patients were eligible if they were diagnosed with a voice disorder and recommended for voice therapy as the only treatment. The dependent variable was attendance in at least once voice therapy session. Independent variables included therapeutic alliance, measured using the Session Rating Scale, and patient- and disease-related factors. These factors included gender, age, distance to the clinic, education level, household composition, occupational voice demand, Voice Handicap Index score, auditory-perceptual dysphonia severity (Grade, Roughness, Breathiness, Asthenia, Strain), and medical voice diagnosis. Ninety-five patients were enrolled in the study. Voice therapy initiation rate was 70%. Having fewer school-aged children (5-18 years) in the household was significantly different between the group that initiated voice therapy and the group that did not (P=0.048). There was no difference between groups for all other factors. This investigation suggests that household composition, specifically having fewer school-aged children in the household, may predict initiation of voice therapy. This study confirms in a prospective fashion the absence of relationship between voice therapy initiation and most patient- and disease-related factors. Therapeutic alliance should be further investigated for its ability to predict voice therapy initiation using a measure that is validated for the population of patients with dysphonia.

Caritas Education: Theory to Practice

Increasingly complex occupational demands along with varied educational and personal examples of caring, may impact the ability to deeply connect with patients. Literature has identified that nurses and patients have differing perceptions of caring behaviors. Jean Watson's Theory of Human Caring provides a framework for care delivery that focuses on the caring nurse–patient relationship and the experience through the patients' lens.Caring healing relationships are at the core of professional nursing. The purpose of this project was to design and deliver an educational seminar based on Jean Watson's Theory of Human Caring to newly graduated nurses to examine the impact on self-efficacy in caring behaviors.The project participants (N = 56) consisted of a nonprobability convenience sample of newly graduated nurses at a local faith-based community hospital. The educational intervention consisted of experiential learning activities to facilitate translating theory to practice. The study utilized the Caring Efficacy Scale (CES), which is an instrument based on Watson's caring theory and Albert Bandura's self-efficacy theory. Results demonstrated a significant improvement in caring efficacy between the preintervention (M = 5.1, SD = .47), and immediate post intervention (M = 5.5, SD = .38); t (52) = −9.09, p = .000.The knowledge from this study could provide insights for the development of effective teaching strategies to facilitate translating nursing theory to practice. Establishing and developing skills to facilitate nurturing, caring nurse–patient relationships may enhance both the patient and caregiver experience.

Sources and impact of occupational demands for autistic employees

BackgroundOccupational demands are well documented for the general population. Social relationships are one such demand, according to job demands-resources theory. When demands exceed an individual’s available resources, stress results; in turn impacting well-being. Little research has investigated the potential differences between social demands, the impact of demands and relationships that buffer these comparing autistic and non-autistic (i.e., neuro-typical; NT) individuals. MethodUsing an online survey, the present exploratory study gathered 140 responses. Thematic analysis was applied. ResultsDifferent facets of social relationships were described by autistic (n = 81) and NT individuals (n = 31) as an occupational demand. Together, demands appear to have a greater impact on well-being for autistic, compared to NT, employees. To buffer demands, both autistic and NT individuals expressed relationships with management as important. Yet, autistic employees favoured non-organisational supports, compared to NT individuals who favoured collegial support. ConclusionsBy understanding individual needs and providing flexible work practices, supportive management processes can assist autistic individuals in managing workplace demands, particularly improving social interactions in the work environment. Employers might also consider adapting job roles and organisational diversity policies to better suit individual needs. As well, providing additional external supports, e.g., via employee assistance programs.

Risk Factors for Depressive Symptoms in Long-Haul Truck Drivers.

Work-related stress is a salient risk factor for depression. While long-haul truck drivers (LHTDs) face a myriad of occupational pressures and demands, little research has examined predictors of depressive symptoms in this occupational group. The purpose of this study was to identify predictors of depressive symptoms in LHTDs. A cross-sectional study was used to examine depressive symptoms, health and working conditions in a sample of 107 LHTDs (mean age of 50.7 ± 12.3; 95.6% were men) at truck stops from five Western Canadian cities. The findings show that 44% of LHTDs reported symptoms of depression in the past 12 months. Severe work-related stress, the use of psychiatric medications and broken sleep were significant predictors of depressive symptomology accounting for 41% of the variance. The findings suggest that LHTDs experience a host of occupational stressors that are embedded within the transportation industry that may increase the risk for depressive symptoms. Mental health promotion efforts that improve sleep quality, decrease work-related demands and pressures, and increase the use of psychiatric medication may reduce rates of depressive symptoms among LHTDs.

Holistic synergy analysis for building subsystem performance and innovation opportunities

The buildings sector plays a crucial role in the transition to a low-carbon society as the largest energy-consuming sector globally, accounting for over one-third of all final energy consumption, half of electricity use, and nearly one-third of total direct and indirect energy-related carbon dioxide emissions. The delivery of energy-efficient buildings requires an integrated design that considers climate, technology, operation and maintenance, and occupant behavior. Previous research to reconcile human-building interaction has focused on two or three system interactions with the occupant, improving the accuracy of building controls systems to match occupant demand or manage energy use, changing the user interface to alter human behavior, and understanding the effects of indoor environmental quality on human performance. This work presents a structured process to systematically study the complex interactions between multiple building subsystems and the occupant, as well as capture their multifaceted effects on humans and various building performance outcomes. Derived from systems theory, this process illustrates the dynamic interactions between the human and technical parts and processes of building systems to provide a holistic lens on human-building interaction, building systems integration, and the resulting building performance. The findings illustrate the opportunity to design independent building systems in view of their interactions, resulting effects on humans, and whole-building outcomes/performance goals. The findings conclude that independent building subsystem outputs have functional, social, and emotional effects on humans that are not intentionally captured in the traditional building design metrics.

Total Energy Intake and Self-Selected Macronutrient Distribution During Wildland Fire Suppression

Wildland firefighters (WLFF) work long hours in extreme environments, resulting in high daily total energy expenditure. Increasing work-shift eating episodes and/or providing rations that promote convenient eating has shown augmented self-selected work output, as has regular carbohydrate (CHO) consumption. It remains unclear how current WLFF feeding strategies compare to more frequent nutrient delivery. Our aim was to determine WLFFs' self-selected field total energy intake (TEI), composition, and feeding patterns during wildland fire suppression shifts. WLFF were deployed to fire incidents across the United States throughout the 2018 fire season. Preshift food inventories collected at basecamp provided item-specific nutrient content (kilocalories, CHO, fat, protein). Work shift consumption (TEI, feeding frequency, episodic composition) was monitored in real time by field researchers on fireline via observational data capture using mobile tablets. Shift work output was also quantified via actigraph accelerometry. Eighty-six WLFF (27.5±6.4 y; 16 female, 70 male) worked 14.0±1.1 h shifts, with a TEI of 6.3±2.5 MJ (1494±592 kcal) (51±10, 37±9, 13±4% for CHO, fat, and protein, respectively). WLFF averaged 4.3±1.6 eating episodes (1.4±1.3 MJ [345±306 kcal] and 44±38 g CHO·episode-1). WLFF who consumed >20 kcal·kg-1 averaged less sedentary activity than those consuming <16 kcal·kg-1. Data are presented as mean±SD. Not including fire camp meals (breakfast, dinner), the present work-shift TEI approximates 33% of previously determined WLFF total energy expenditure and demonstrates that current WLFF consumption patterns may not deliver adequate nutrients for occupational demands.

Returning to Work After Sick Leave – The Role of Work Demands and Resources, Self-Efficacy, and Social Support

Returning to work after sick leave is a process that begins with the initial steps of functional recovery and results in full vocational capacity. Different personal and situational factors could influence an employee’s well-being after returning. The following research was conducted in order to examine how occupational demands and resources, self-efficacy, and social engagement contribute to the return-to-work process. A total of 256 employees took part in the study, who were later divided into two groups: short- (less than 30 days), and long-term (more than 30 days) sick leave. We measured their self-efficacy at the workplace, recent job demands and resources, social engagement, and work satisfaction after returning to work after sick leave. The results showed that personal (gender, age, and self-efficacy), social (social engagement), and occupational (job demands and resources) factors are associated with the duration of sick leave. Participants who were on shorter sick leaves reported being more satisfied with their work after returning than those returning from long-term sick leave. The research presents important insights that could help employers better understand the needs of employees who are returning to work after sick leave.

The test–retest reliability of the Military Physical Loading Questionnaire (MPLQ)

IntroductionDespite the high prevalence of musculoskeletal injuries, there is a shortage of data quantifying the risk factors attributable to cumulative occupational demands among UK Military personnel. We developed a new...

A prediction model coupling occupant lighting and shading behaviors in private offices

Lighting control in office buildings is driven by occupant's demand for indoor light environment. The control behavior not only has a direct impact on occupants’ visual comfort, but also relates with the building lighting energy consumption. However, due to the effect of glare, lighting control is often associated with shading adjustment. In this regard, this paper proposed a prediction model which can accurately describe the lighting and shading coupling control behavior by fully considering the difference and diversity of occupants. The light environment preferences and the usage habits of lighting and shading system of occupants were firstly investigated and classified by means of questionnaire. Markov model and log-logistic survival model were introduced to quantitatively describe the probability distribution of various shading and lighting control behaviors. On this basis, combined with the indoor workplane illumination prediction model, the behavior of occupant's lighting and shading coupling control can be predicted. By comparing the four models considering or not considering the diversity and coupling effect, it is found that the proposed coupling prediction model shows better performance, the maxium error rate is only 13.04% for the lighting energy consumption prediction.

Risk factors for surgery due to rotator cuff disease in a population-based cohort.

Few risk factors for rotator cuff disease (RCD) and corresponding treatment have been firmly established. The aim of this study was to evaluate the relationship between numerous risk factors and the incidence of surgery for RCD in a large cohort. A population-based cohort of people aged between 40 and 69 years in the UK (the UK Biobank) was studied. People who underwent surgery for RCD were identified through a link with NHS inpatient records covering a mean of eight years after enrolment. Multivariate Cox proportional hazards regression was used to calculate hazard ratios (HRs) as estimates of associations with surgery for RCD accounting for confounders. The risk factors which were considered included age, sex, race, education, Townsend deprivation index, body mass index (BMI), occupational demands, and exposure to smoking. Of the 421,894 people who were included, 47% were male. The mean age at the time of enrolment was 56 years (40 to 69). A total of 2,156 people were identified who underwent surgery for RCD. Each decade increase in age was associated with a 55% increase in the incidence of RCD surgery (95% confidence interval (CI) 46% to 64%). Male sex, non-white race, lower deprivation score, and higher BMI were significantly associated with a higher risk of surgery for RCD (all p < 0.050). Greater occupational physical demands were significantly associated with higher rates of RCD surgery (HR = 2.1, 1.8, and 1.4 for 'always', 'usually', and 'sometimes' doing heavy manual labour vs 'never', all p < 0.001). Former smokers had significantly higher rates of RCD surgery than those who had never smoked (HR 1.23 (95% CI 1.12 to 1.35), p < 0.001), while current smokers had similar rates to those who had never smoked (HR 0.94 (95% CI 0.80 to 1.11)). Among those who had never smoked, the risk of surgery was higher among those with more than one household member who smoked (HR 1.78 (95% CI 1.08 to 2.92)). The risk of RCD surgery was not significantly related to other measurements of secondhand smoking. Many factors were independently associated with surgery for RCD, including older age, male sex, higher BMI, lower deprivation score, and higher occupational physical demands. Several of the risk factors which were identified are modifiable, suggesting that the healthcare burden of RCD might be reduced through the pursuit of public health goals, such as reducing obesity and modifying occupational demands. Cite this article: Bone Joint J 2020;102-B(3):352-359.

Low Back Pain (LBP), work and absenteeism.

Occupational physical demands are commonly assumed the cause of work-related Low Back Pain (LBP) and absenteeism. To analyse relationships between LBP at work, physical demands and absenteeism. Workers filled out a questionnaire on socio-demographic and work-related factors, general health, LBP (number of episodes in a 12-month period, pain severity and intensity), and occupational hazards related with physical demands. 735 workers completed the questionnaire (male n = 359). A high proportion of workers n = 507 (69%), from different occupational backgrounds, reported at least one LBP episode in the previous 12-month period. The highest ratio of subjects with more than 6 episodes of LBP per year was found among public services employees (31.8%) and the lowest ratio among administrative workers (10.3%). The highest ratio of workers (39%) were classified as sedentary workers, 34% of workers having a low or moderate level of physical demands in their work, and 27% reported high levels of physical demands in their work. There was a 4 % absenteeism rate in a 12-month period, which was significantly higher in the group with physically demanding work. Those subjects with higher physical requirements at work have increased odds of having more than 3 episodes of LBP during the previous year (p < 0.05) in comparison with subjects with more sedentary jobs and those with low or moderate physical demands. High intensity work, compared to sedentary work, is associated with an increased probability of being absent of work because of LBP in a previous 12-month period (OR = 3.12; CI 1.23-7.89; p = 0.016). Our findings suggest there is an association between highly physically demanding jobs, LBP and absenteeism. These results may contribute to the improvement of LBP assessment and prevention programs in Occupational Health Services.

Risk of slaughterhouse workers developing work-related musculoskeletal disorders in different organizational working conditions

Job rotation is defined as workers rotating between tasks with different exposure levels and occupational demands. The aim of the present study was to analyze the risk factors for the development of upper-limb work-related musculoskeletal disorders (UL-WMSDs) in poultry slaughterhouse workers as well as compare the score of the OCRA Checklist in different organizational working conditions. In this cross-sectional study, 118 workers were involved, 68 women (32.3 ± 10.7 years) and 50 men (29.5 ± 10.5 years). Three organizational configurations (“without job rotation”, “with job rotation – tasks >1h” and “with job rotation - tasks <1h”) were evaluated using the OCRA Checklist method, totaling 36 tasks and 28 job rotation schemes composed of 2–3 tasks. The OCRA score of the right upper limbs (17.8 ± 3.2) was significantly higher (p = 0.046) relative to the left upper limbs (16.4 ± 3.6). The median score was significantly lower in the “with job rotation - tasks <1h” condition (18.6) when compared to the “job rotation – tasks >1h” (19.4) (p < 0.001) and the “without job rotation” (19.0) (p = 0.038) conditions. However, there was no significant difference between the condition “with job rotation - tasks >1h” and “without job rotation” (p = 0.155). Thus, job rotations with intervals <1h reduced the risk of developing UL-WMSDs. Job rotations with <1 h intervals in poultry slaughterhouses are recommended along with further studies to verify the effectiveness of rotations with more than two tasks, involving mild or non-repetitive tasks.

Disability and Pain are the Best Predictors of Sick Leave After a Distal Radius Fracture in Men

Purpose Distal radius fracture often compromises working ability, but clinical implications are less studied in men due to its lower incidence. This study therefore describes sick leave in men with distal radius fracture, specifically exploring the impact of patient- and fracture-related factors. Methods Professionally active men aged 20–65 with distal radius fracture were followed prospectively for 1-year (n = 88). Data included treatment method, radiographic parameters pre/post treatment, complications, health, lifestyle and occupational demand. Patient outcomes were self-reported sick leave; Disability of the Arm, Shoulder and Hand (DASH) score; pain (5 likert scale); SF-36: Physical Component Scale (PCS) and Mental Component Scale (MCS). Results Median sick leave was 4 weeks (IQR 0; 8); almost a third reported taking no sick leave. Categorizing sick leave into 3 groups (0–6, 7–12 and > 12 weeks), men with the longest sick leave had 22 points higher DASH score (p = 0.001) and 5 points lower PCS (p = 0.02) at 1 week and the difference remained over time; they were also older and more often treated surgically. The strongest predictors of length of sick leave were one-week post-fracture DASH score (rs = 0.4, p < 0.001), pain intensity (rs = 0.4, p < 0.001) and PCS (rs = − 0.4, p = 0.002). The correlation between sick leave and pain was even stronger analyzing treatment groups separately (closed reduction and cast rs = 0.56, p = 0.007, surgery rs = 0.42, p = 0.04). Conclusions Self-reported disability, pain and global health measurements as early as 1 week post-fracture are the strongest predictors of length of sick leave regardless of treatment; an important finding easily transferrable to clinical management of distal radius fractures.

Noise, screaming and shouting: Classroom acoustics and teachers’ perceptions of their voice in a developing country

Background: The vocal demand on teachers may predispose them to vocal difficulties. This concern is exacerbated by unfavourable classroom acoustics and a large number of learners in a classroom in developing countries such as South Africa. There is a dearth of classroom acoustic protocols in South Africa, which intensifies the effect of noise on teachers as well as learners.Aims: The aims of this study were to determine the acoustic properties within the teaching environments and to fix the foundation-phase teachers’ perceptions of their voice.Setting: The study was conducted in Foundation Phase classrooms in South Africa.Methods: A classroom acoustical screening survey was utilised to conduct classroom observations. A voice handicap questionnaire was used to determine teachers’ perceptions.Results: There were two sample groups: ten schools with 31 foundation-phase classrooms and 31 teachers. Teachers perceived that their voices are affected by occupational demands, with predominantly physical symptoms being reported. Excessive background noise levels were evident in all classrooms. Air traffic noise and noise from adjoining classrooms were the main contributors.Conclusions: The need for classroom acoustic specifications and design of classrooms are essential as both teachers and learners experience the effects of noise exposure. The implementation of noise reduction in classrooms has the potential to improve the performance of teachers and learners. In a developing country, schools are unique institutions in terms of structure, and therefore additional research is required to determine what building structures may be beneficial for future school buildings. The findings could assist developing countries in the formulation of polices that align with the best practices for acoustically suitable educational settings that benefit both teachers and learners.

Short-Term Forecasting of Heat Demand of Buildings for Efficient and Optimal Energy Management Based on Integrated Machine Learning Models

The increasing growth in the energy demand calls for robust actions to design and optimize energy-related assets for efficient and economic energy supply and demand within a smart grid setup. This article proposes a novel integrated machine learning (ML) technique to forecast the heat demand of buildings in a district heating system. The proposed short-term (24h-ahead) heat demand forecasting model is based on the integration of empirical mode decomposition (EMD), imperialistic competitive algorithm (ICA), and support vector machine (SVM). The proposed model also embeds an ML-based feature selection (FS) technique combining binary genetic algorithm and Gaussian process regression to obtain the most important and nonredundant variables that can constitute the input predictor subset to the forecasting model. The model is developed using a two-year (2015–2016) hourly dataset of actual district heat demand obtained from various buildings in the Otaniemi area of Espoo, Finland. Several variables from different domains such as seasonality (calendar), weather, occupancy, and heat demand are used to construct the initial feature space for FS process. Short-term forecasting models are also implemented using the Persistence approach as a reference and other eight ML approaches: artificial neural network (ANN), genetic algorithm combined with ANN (GA-ANN), ICA-ANN, SVM, GA-SVM, ICA-SVM, EMD-GA-ANN, and EMD-ICA-ANN. The performance of the proposed EMD-ICA-SVM-based forecasting model is tested using an out-of-sample one-year (2017) hourly dataset of district heat consumption of various building types. Comparative analysis of the forecasting performance of the models was performed. The obtained results demonstrate that the devised model forecasts the heat demand with improved performance evaluated using various accuracy metrics. Moreover, the devised model achieves outperformed forecasting accuracy enhancement, compared to the other nine evaluated models.

Exploring demands of hemodialysis patients in Taiwan: A two-step cluster analysis.

Aims and objectivesTo classify hemodialysis patients into subgroups via cluster analysis according to the Somatic Symptoms Disturbance Index, Taiwanese Depression Scale, and Herth Hope Index scores. Patient demands in each cluster were also examined.BackgroundOverall patient demands among hemodialysis patients have been demonstrated in numerous reports; however, variables among subgroups have not been explored.MethodsData were analyzed from a cross-sectional survey of 114 hemodialysis patients recruited from dialysis centers in Northern Taiwan. Hope, depression, and symptom disturbance were used as parameters for clustering because they have been shown to be important factors affecting patient demands. A two-step cluster analysis was performed to classify participants into clusters. Patient demands in each cluster were analyzed.ResultsAmong the 114 participants, there was a negative correlation between hope and depression as well as between hope and symptom disturbance; there was a positive correlation between depression and symptom disturbance. Two clusters were identified: Cluster 1 (n = 49) included patients with moderate levels of hope and symptom disturbance, and high levels of depression; and Cluster 2 (n = 65) included patients with low levels of depression and symptom disturbance and high levels of hope. Demographic profiles differed between the two clusters. Regarding patient demands, medical demand showed the highest average score; whereas, occupational demand exhibited the lowest average score. Psychological and occupational demands differed significantly between the two clusters. The two clusters were defined as subgroups: Cluster 1 was labeled “resting”; Cluster 2 was labeled “active”.ConclusionsCluster analysis may further classify hemodialysis patients into distinct subgroups base on their specific patient demands. A better understanding of patient demands may help health professionals to provide a holistic individualized treatment to improve patients’ outcomes.