Proportion Of Shifts Research Articles

How incremental video training did not guarantee implementation due to fluctuating population prevalence

Patients with stroke admitted at the neurology/neurosurgery ward of the Academic Medical Centre in Amsterdam, The Netherlands, may experience problems in communication, such as aphasia, severe confusion/delirium or severe language...

How do different definitions of night shift affect the exposure assessment of night work?

ABSTRACTThe aim is to show how different definitions affect the proportion of shifts classified as night shifts. The Danish Working Hour Database was used to calculate number of night shifts according to eight definitions. More than 98% of the total night shifts were night shifts by use of both the reference definition (at least 3 h of work between 24:00 and 05:00) and definitions using a period during the night. The overlap with definitions based on starting and ending time was less pronounced (64–71 %). The proportion of classified night shifts differs little when night shifts are based on definitions including a period during the night. Studies based on other definitions may be less comparable.

Sleepiness, sleep, and use of sleepiness countermeasures in shift-working long-haul truck drivers

Driver sleepiness is a prevalent phenomenon among professional drivers working unconventional and irregular hours. For compromising occupational and traffic safety, sleepiness has become one of the major conundrums of road transportation. To further elucidate the phenomenon, an on-road study canvassing the under-explored relationship between working hours and sleepiness, sleep, and use of sleepiness countermeasures during and outside statutory rest breaks was conducted. Testing the association between the outcomes and working hours, generalized estimating equations models were fitted on a data collected from 54 long-haul truck drivers (mean 38.1±10.5 years, one female) volunteering in the 2-week study. Unobtrusive data-collection methods applied under naturalistic working and shift conditions included the Karolinska Sleepiness Scale (KSS) measuring sleepiness, a combination of actigraphy and sleep-log measuring sleep, and self-report questionnaire items incorporated into the sleep-log measuring the use of sleepiness countermeasures during and outside statutory rest breaks. Drivers’ working hours were categorized into first and consecutive night, morning and day/evening shifts based on shift timing. The results reveal severe sleepiness (KSS≥7) was most prevalent on the first night (37.8%) and least on the morning (10.0%) shifts. Drivers slept reasonably well prior to duty hours, with main sleep being longest prior to the first night (total sleep time 7:21) and shortest prior to the morning (total sleep time 5:43) shifts. The proportion of shifts whereby drivers reported using at least one sleepiness countermeasure outside statutory rest breaks was approximately 22% units greater for the night than the non-night shifts. Compared to the day/evening shifts, the odds of severe sleepiness were greater only on the first night shifts (OR 6.4–9.1 with 95% confidence intervals, depending on the statistical model), the odds of insufficient daily sleep were higher especially prior to the consecutive night shifts (OR 3.5 with 95% confidence intervals), and the odds of using efficient sleepiness countermeasures outside statutory rest breaks were greater on the first as well as consecutive night shifts (OR 4.0–4.6 with 95% confidence intervals). No statistically significant association was found between shift type and use of efficient sleepiness countermeasures during statutory rest breaks. In all, the findings demonstrate marked differences in the occurrence of severe sleepiness at the wheel, sleep preceding duty hours, and the use of sleepiness countermeasures between different shift types. In addition, although drivers slept reasonably well in connection with different shift types, the findings imply there is still room for improvement in alertness management among this group of employees.

Service configuration, unit characteristics and variation in intervention rates in a national sample of obstetric units in England: an exploratory analysis

ObjectivesTo explore whether service configuration and obstetric unit (OU) characteristics explain variation in OU intervention rates in ‘low-risk’ women.DesignEcological study using funnel plots to explore unit-level variations in adjusted intervention...

Increase in prevalence of adiposity between the ages of 7 and 11 years reflects lower remission rates during this period

What is already known about this subject? A considerable increase in the prevalence of overweight during the primary school years (7-11 years) has been reported. What this study adds? This reflects lower remission rates of excess body fat (i.e. the proportion of shifts from excess to normal body fat) between the ages of 7 and 11 years as compared with nearly balanced incidence and remission rates of excess body fat between the ages of 3 and 7 years. This study aimed to compare the age-specific balance between incidence and remission of excess body fat between the ages of 3-7 and 7-11 years using the data from a longitudinal study. Longitudinal analysis based on the data from the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study, an ongoing, open cohort study in healthy children, conducted in Dortmund, Germany. Excess body fat was defined by the sum of triceps and subscapular skin-fold measurements above the 90th reference percentile of the new German standard; overweight was defined using different national and international standards. The main outcome parameters were incidence and remission rates of excess body fat (n = 496) and overweight (n = 518) between the ages of 3 and 7 years and between the ages of 7 and 11 years. The incidence rates of excess skin-fold thickness between the ages of 3 and 7 years (4.2 [2.4, 6.2]%) and between the ages of 7 and 11 years (4.3 [2.6, 6.2]%) were almost identical. By contrast, remission rates were significantly lower during the age period of 7-11 years (primary school age) than during the age period of 3-7 years (pre-school age): 37.5 (21.9, 53.1%) compared with 72.3 (59.6, 85.1%). These data point to the low remission of excess body fat as an important driving force for the increasing prevalence of excess body fat in children between the ages of 7 and 11 years. Public health initiatives in children should encompass both primary prevention and interventions targeted at children already overweight at school entry.

Assessing the evidence for response time mixture distributions

I describe a technique for comparing two simple accounts of a distribution of response times: A mixture model and a generalized-shift model. In the mixture model, a target distribution is assumed to be a mixture of response times from two other (reference) distributions. In the generalized-shift model, the target distribution is assumed to be a quantile average of the reference distributions. In order to distinguish these two possibilities, quantiles for the target distribution are estimated from the quantiles of the reference distributions assuming either a shift or a mixture, and the predicted quantiles are used to calculate the multinomial likelihood of the obtained data. Monte Carlo simulations reported here demonstrate that the index is relatively unbiased, is effective with moderate sample sizes and modest spreads between the reference distributions, is relatively unaffected by changes in the number of bins or by data trimming, can be used with data aggregated across subjects, and is relatively insensitive to a range of subject variations in distribution shape and in mixture or shift proportion. As an illustration, the index is applied to the interpretation of three effects from distinct paradigms: residual switch costs in the task-switching paradigm, the psychological refractory period effect, and sequential effects in the Simon task. I conclude that the multinomial likelihood index provides a useful and easily applied tool for the interpretation of effects on response time distributions.

Evaluating the effectiveness of a tailored multifaceted performance feedback intervention to improve the quality of care: protocol for a cluster randomized trial in intensive care

BackgroundFeedback is potentially effective in improving the quality of care. However, merely sending reports is no guarantee that performance data are used as input for systematic quality improvement (QI). Therefore, we developed a multifaceted intervention tailored to prospectively analyzed barriers to using indicators: the Information Feedback on Quality Indicators (InFoQI) program. This program aims to promote the use of performance indicator data as input for local systematic QI. We will conduct a study to assess the impact of the InFoQI program on patient outcome and organizational process measures of care, and to gain insight into barriers and success factors that affected the program's impact. The study will be executed in the context of intensive care. This paper presents the study's protocol.Methods/designWe will conduct a cluster randomized controlled trial with intensive care units (ICUs) in the Netherlands. We will include ICUs that submit indicator data to the Dutch National Intensive Care Evaluation (NICE) quality registry and that agree to allocate at least one intensivist and one ICU nurse for implementation of the intervention. Eligible ICUs (clusters) will be randomized to receive basic NICE registry feedback (control arm) or to participate in the InFoQI program (intervention arm). The InFoQI program consists of comprehensive feedback, establishing a local, multidisciplinary QI team, and educational outreach visits. The primary outcome measures will be length of ICU stay and the proportion of shifts with a bed occupancy rate above 80%. We will also conduct a process evaluation involving ICUs in the intervention arm to investigate their actual exposure to and experiences with the InFoQI program.DiscussionThe results of this study will inform those involved in providing ICU care on the feasibility of a tailored multifaceted performance feedback intervention and its ability to accelerate systematic and local quality improvement. Although our study will be conducted within the domain of intensive care, we believe our conclusions will be generalizable to other settings that have a quality registry including an indicator set available.Trial registrationCurrent Controlled Trials ISRCTN50542146

Development and evaluation of an observational Back-Exposure Sampling Tool (Back-EST) for work-related back injury risk factors

We developed and evaluated an observational Back-Exposure Sampling Tool. A literature review suggested 53 exposure variables; these were reduced to 20 following field trials. Kappas for agreement beyond chance between six observers assessing exposures in 72 photos ranged from 0.21 to 1.0, with the highest values for posture type, trunk angle, manual materials handling, hands on item, and load weight. Intraclass correlations for agreement between pairs observing 17 workers once per minute for a full-shift were >0.74 for most postural, trunk angle, and manual materials handling variables. In validity testing, the proportions of shifts in flexion/extension and lateral bending observed for 169 full-shifts were compared to inclinometer measurements. Pearson correlations were 0.42 for 45–60° flexion and 0.9 for >60° flexion, but only 0.11–0.19 for lateral bending and trunk flexion less than 45°. When lower flexion angles were collapsed to include trunk extension, correlations increased to >0.5.

Visual recognition memory in infant rhesus monkeys: Effects of dietary taurine

The effects of dietary taurine on visual recognition memory and visual attention were measured with visual paired comparison tests in infant rhesus monkeys. Infants (6 per group) were fed one of two human infant soy-protein formulas: taurine-free (-T) or taurine-supplemented (+T). The infants were tested at 2.0, 3.5, 5.0, and 9.0 weeks of age using eight pairs of patterns and eight pairs of photographs of primate faces. The -T infants had higher novelty preference for faces, higher total looks at faces and patterns at 2 weeks and at patterns at 9 weeks, and a higher number and proportion of shifts between pattern stimuli at 9 weeks. They also showed increased attention, as estimated by the total time looking during the tests at 2 weeks and decreased time to reach a criterion of 10 s of fixation during familiarization at 9 weeks. Thus, contrary to expectation, -T infants had higher scores on several measures associated with more advanced cognitive functioning.