Reduced Time Pressure Research Articles

Controlled Hypothermic Storage for Lung Preservation: Leaving the Ice Age Behind.

Controlled hypothermic storage (CHS) is a recent advance in lung transplantation (LTx) allowing preservation at temperatures higher than those achieved with traditional ice storage. The mechanisms explaining the benefits of CHS compared to conventional static ice storage (SIS) remain unclear and clinical data on safety and feasibility of lung CHS are limited. Therefore, we aimed to provide a focus review on animal experiments, molecular mechanisms, CHS devices, current clinical experience, and potential future benefits of CHS. Rabbit, canine and porcine experiments showed superior lung physiology after prolonged storage at 10°C vs. ≤4°C. In recent molecular analyses of lung CHS, better protection of mitochondrial health and higher levels of antioxidative metabolites were observed. The acquired insights into the underlying mechanisms and development of CHS devices allowed clinical application and research using CHS for lung preservation. The initial findings are promising; however, further data collection and analysis are required to draw more robust conclusions. Extended lung preservation with CHS may provide benefits to both recipients and healthcare personnel. Reduced time pressure between procurement and transplantation introduces flexibility allowing better decision-making and overnight bridging by delaying transplantation to daytime without compromising outcome.

COVID-19 Fear, Health Behaviors, and Subjective Health Status of Call Center Workers.

Background: Fear may be critical in explaining individual and social behaviors. This study investigates the association between COVID-19 fear and health behavior and subjective health status changes of call center workers in the COVID-19 era. Methods: This cross-sectional study uses an online survey with 339 call center workers. We measured COVID-19 fear, health behaviors, and subjective health, and analyzed with the Macnemar or paired t-test, ANOVA or χ2 test, Scheffe’s test, and multiple linear regression. Results: COVID-19 fear was associated with poor stress management, shorter sleep hours, and binge eating. Moreover, COVID-19 fear and time pressure at work were negatively associated with subjective health status. Conclusion: Strengthening the support system for call center workers to manage the COVID-19 fear might be essential. Moreover, there is a need to improve dense environments and reduce time pressure by ensuring adequate rest time and increasing physical activity.

Practitioners' experience of the working alliance in a blended cognitive-behavioural therapy intervention for depression: qualitative study of barriers and facilitators.

Digital technologies have been widely acknowledged as a potentially useful resource for increasing mental healthcare access. The working alliance is a key influence on outcomes in conventional psychotherapy, but little is known about therapists' experiences of forming an effective working alliance in blended interventions that involve in-person psychotherapy and a digital programme. To investigate psychological well-being practitioners' (PWPs') experiences of the working alliance in a trial of blended cognitive-behavioural therapy (b-CBT) for depression. Trial registration ISRCTN12388725. Semi-structured qualitative interviews were conducted with 13 PWPs who delivered b-CBT in a two-arm, non-inferiority randomised controlled trial investigating the effectiveness of b-CBT compared with face-to-face CBT. Thematic analysis was used to analyse the data. Participants reported four facilitating factors when building and maintaining a working alliance in b-CBT: having more time to deliver treatment, access to a wider toolkit, capacity to tailor components of b-CBT and receiving appropriate training and support. Participants also identified four barriers to building and maintaining a working alliance: time and resource constraints, usability challenges, limited flexibility to tailor the digital programme to patients' needs and lack of confidence in delivering b-CBT. Our study is the first specifically to investigate practitioners' perceived facilitators and barriers to forming a working alliance in b-CBT for depression. Findings suggest that PWPs' experiences of the working alliance can be improved by: accounting for the time required to deliver b-CBT in service workflows to reduce time pressures; increasing opportunities to tailor the digital programme through offering transdiagnostic tools and adaptable features; and providing appropriate b-CBT training and technical support.

DO L1-L2 DIFFERENCES IN DISCOURSE PROCESSING REFLECT PROCESSING DEMANDS OR DIFFICULTY OF FORM-FUNCTION MAPPING?

AbstractWe examined what causes L1-L2 differences in sensitivity to prominence cues in discourse processing. Participants listened to recorded stories in segment-by-segment fashion at their own pace. Each story established a pair of contrasting items, and one item from the pair was rementioned and manipulated to carry either a contrastive or presentational pitch accent. By directly comparing the current self-paced listening data to previously obtained experimenter-paced listening data, we tested whether reducing online-processing demands allows L2 learners to show a nativelike behavior, such that contrastive pitch accents facilitate later ruling out the salient alternative. However, reduced time pressure failed to lead even higher proficiency L1-Korean learners of English to reach a nativelike level, suggesting that L2 learners’ nonnativelike processing and representation of the prominence cue in spoken discourse processing can be due to the inherent difficulty of fully learning a complex form-function mapping rather than to online-processing demands.

Interaction Effects of Physical and Psychosocial Working Conditions on Risk for Sickness Absence: A Prospective Study of Nurses and Care Assistants in Sweden.

Employees in health and social care are often simultaneously exposed to both physical and psychosocial challenges that may increase their risk for sickness absence. The study examines interaction effects of physical and psychosocial work conditions on the future risk for sickness absence among nurses and care assistants in Sweden. The study was based on 14,372 participants in any of the Swedish Work Environment Surveys conducted during the years 1993–2013 with linked register information on background factors and compensated sickness absence. Adjusted hazard ratio (HR), stratified by occupation, and measures of additive interaction effects were estimated. The combinations of high psychosocial job demands and heavy physical work and strenuous postures, respectively, significantly increased the risks for sickness absence among nurses (HR 1.43; CI 1.09–1.88 and HR 1.42; CI 1.16–1.74, respectively), as well as among care assistants (HR 1.51; CI 1.36–1.67 and HR 1.49; CI 1.36–1.63, respectively). The combinations of low job control and both heavy physical work (HR 1.44; CI 1.30–1.60) and strenuous postures (HR 1.42; CI 1.30–1.56) were also associated with excess risk for sickness absence among care assistants. We also found interaction effects among care assistants but not among nurses. The results indicate that the high sickness absence rate among care workers in Sweden can be reduced if the simultaneous exposures of high psychosocial and high physical challenges are avoided. Management policies for reduced time pressure, improved lifting aids, and measures to avoid awkward work postures are recommended. For care assistants, increased influence over work arrangements is likely to lower their sickness absence risk.

Reducing caesarean section rate in an urban hospital serving women attending privately in India \u2013 a quality improvement initiative

BackgroundIn line with global trends, India has witnessed a sharp rise in caesarean section (CS) deliveries, especially in the private sector. Despite the urgent need for change, there are few published examples of private hospitals that have successfully lowered their CS rates. Our hospital, serving private patients too, had a CS rate of 79% in 2001. Care was provided by fee-for-service visiting consultant obstetricians without uniform clinical protocols and little clinical governance. Consultants attributed high CS rate to case-mix and maternal demand and showed little inclination for change. We attempted to reduce this rate with the objective of improving the quality of our care and demonstrating that CS could be safely lowered in the private urban Indian healthcare setting.MethodsWe hired full-time salaried consultants and began regular audit of CS cases. When this proved inadequate, we joined an improvement collaborative in 2011 and dedicated resources for quality improvement. We adopted practice guidelines, monitored outcomes by consultant, improved labour ward support, strengthened antenatal preparation, and moved to group practice among consultants.ResultsGuidelines ensured admissions in active labour and reduced CS (2011 to 2016) for foetal heart rate abnormalities (23 to 5%; p < 0.001) and delayed progress (19 to 6%; p < 0.001) in low-risk first-birth women. Antenatal preparation increased trial of labour, even among women with prior CS (28 to 79%; p < 0.001). Group practice reduced time pressure and stress, with a decline in CS (52 to 18%; p < 0.001) and low-risk first-birth CS (48 to 12%; p < 0.001). Similar CS rates were maintained in 2017 and 2018. Measures of perinatal harm including post-partum haemorrhage, 3rd-4th degree tears, shoulder dystocia, and Apgar < 7 at 5 min were within acceptable ranges (13, 3, 2% and 3 per thousand respectively in 2016–18,).ConclusionsIt is feasible to substantially reduce CS rate in private healthcare setting of a middle-income country like India. Ideas such as moving to full-time attachment of consultants, joining a collaborative, improving labour ward support, providing resources for data collection, and perseverance could be adopted by other hospitals in their own journey of moving towards a medically justifiable CS rate.

How strong is my safety net? Perceived unemployment insurance generosity and implications for job search, mental health, and reemployment.

While social science has substantially documented the individual experience of unemployment, less is known about the role of contextual variables. One contextual factor that is important for unemployed job seekers is the unemployment insurance (UI) that they receive. This study examines the relationships between job seeker perceptions of UI generosity and mental health during unemployment, reemployment speed, and reemployment quality. Drawing upon psychological construal theory, we conceptualize UI generosity as creating psychological distance from the reemployment goal, generating consequences for the job search, mental health, and reemployment. We tested our hypotheses with a four-wave survey design of job seekers looking for work in 3 different countries (United States, Germany, and the Netherlands). Perceived UI generosity was associated with slower reemployment speed, via reduced time pressure, job search priority, and job search metacognition. Perceived UI generosity was related to higher mental health, via reduced time pressure and financial strain. Finally, perceived UI generosity was related to increased reemployment quality, both directly as well as indirectly through lower time pressure and financial strain, and subsequent higher mental health. Our findings provide previously unavailable empirical insight into the mechanisms explaining the positive and negative outcomes of UI generosity. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The Stroop Negative Priming Matching Task: A New Task for the Direct Comparison of Interference Control and Inhibition.

Inhibition processing is an inherent part of cognitive and behavioral control. The aim of the present study was to develop and investigate psychometric criteria of an experimental paradigm that combines Stroop interference and negative priming, both of which involve inhibitory processes. We adopted a Stroop matching paradigm assessing interference control and implemented a negative priming condition. A nonclinical community sample of 94 volunteers performed this Stroop Negative Priming Matching paradigm. Since timing plays a role in priming, the interval between the prime and the probe has been varied in length (500 ms, 800 ms, and 3000 ms). The main results showed both, effects of Stroop interference and negative priming, as indicated by reaction times and incorrect responses. Reduced time pressure showed an effect on response speed and accuracy, but no interaction with interference and priming effects occurred. Reliability computed as internal consistency was generally high and did not differ between Stroop interference and negative priming scales. Retest-reliability was best for the prime-probe interval of 3000 ms. Concluding, the Stroop negative priming matching task provides reliable and directly comparable assessment of Stroop interference and negative priming effects.

Does part-time employment status really reduce time pressure?

Part-time employment rates are increasing in Australia, for both women and men. However, gendered patterns in part-time employment status are typically associated with mothers’, rather than fathers’, transition to parenthood. This study uses data from the 2006 Negotiating the Life Course survey to investigate whether part-time employment reduces time pressure for women compared to men, when temporal job quality is considered. Our results show that women employed in shorter part-time hours had better time pressure outcomes, overall and at work, than women employed in longer part-time hours. Yet findings show that a lack of access to temporal flexibility and irregular work schedules negatively impact time pressure outcomes for both men and women. We conclude that time pressure benefits gained from being employed part-time, may be diminished when there is poor temporal job quality.

Valuing the health of the support worker in the aged care sector

AbstractThis study explored aged care support workers’ perceptions of how their health was influenced by their job, highlighting similarities and differences of those working in community-based and institution-based care. Support workers working in two institution-based and three community-based aged care organisations were invited to participate. Semi-structured interviews were undertaken with ten participants. Open-ended questions probed participants’ perceptions of their health as it related to their work. Data were analysed with the General Inductive Approach. Four central themes were identified, many of which related to mental, as opposed to physical health. ‘Love of the job’ described various sources of satisfaction for participants. These factors commonly overrode the negative aspects. ‘Stress’ encompassed the negative influences on all aspects of health. ‘Support’ described the positive influences on health, which supported participants in their job. ‘Physicality’ described the physical nature of the job and the positive and negative impact this had on participants’ health. Support workers perform numerous tasks, which often impact upon their health. Aspects of the job that may impact the health of the worker are improved communication and support from management, as well as recognition for support workers’ contribution to society. These could be targeted to enhance support worker health. Additional training and reduced time pressure may also represent aspects for improvement, to optimise support workers’ physical health.

An observational study of hands-free communication devices mediated interruption dynamics in a nursing work system

ObjectiveThe objective of this study is to examine how the integration of Hands-free Communication Devices (HCDs) differentiates the interruption dynamics from the existing knowledge of face-to-face interruptions in a nursing work system. IntroductionMany aspects of nursing workflow and work efficiency have been improved with the implementation of HCDs; however, the frequency of interruptions in the work place has not been reduced. The complexity of HCD-mediated interruption dynamics needs to be studied using a Socio-technical Systems (STS) approach in order to holistically understand the problem and their effects. MethodsWe conducted field observations in the acute care setting. A total of 12 nurses across two units were selected as participants in this study. Each participant was shadowed for 2.5h totaling 30h of observations. We iteratively coded the data into overarching themes using content analysis. ResultsWe determined three overarching themes: (1) assessment prior to interrupting, (2) interruption content delivery, and (3) response to interruptions. Based the coding structure and the observation events in each theme, we identified facilitators and barriers for nursing work related to the HCD-mediated interruption dynamics. The facilitators included “intact workflow continuity”, “reduced time pressure”, and “increased flexibility to respond to interruptions”. The barriers included “interrupter-oriented nature”, “interruptee׳s overprotection of workflow”, “delay of information delivery”, and “inaccuracy of information communicated”. ConclusionThe findings of this study reflect the unique role of HCD in affecting interruption dynamics and nursing work. Based on the findings, we proposed system design recommendations, organizational-level interventions, and policy suggestions.

Active Travel: A Cure for the Hurry Virus

In occupational science, occupation refers to the everyday things people need, want and are expected to do. One of these things is the act of travelling from one occupation to another. Conventional wisdom in modern societies suggests that the faster we do this, the better: the faster we travel, the further we move and the more productive we become. In this paper, I question this view, exploring a paradox whereby increasing the speed of travel as a strategy to cope with time pressure can lead to a loss of time, money and health. A holistic assessment of the costs of transport reveals that active modes of travel may reduce time pressures and help people rediscover natural connections between themselves and their world. I explain how a culture of speed promotes lifestyles that minimise the chances of children engaging in the healthy occupations of walking and cycling, and leads to a situation where larger numbers of people (adults and children) are engaged in less healthy occupations. In a multitude of ways, some of which have been largely overlooked in research on health or time pressure, active travel can improve the health of individuals, cities and the planet.

UNDER PRESSURE: GENDER DIFFERENCES IN OUTPUT QUALITY AND QUANTITY UNDER COMPETITION AND TIME CONSTRAINTS

Gender gaps in income and level of position in the workplace are widespread. One explanation for this inequality is that the genders perform dierently under competi- tive conditions, as previous experimental studies have found a signi…cant gender gap in competitive tasks that are perceived to favor men. In this paper, we use a verbal task that is perceived to favor women and …nd no gender dierence under competition per se. We also reject the hypothesis that a stereotype threatexplains the inability of women to improve performance under competition. We propose an alternative expla- nation for gender inequality: namely, that women and men respond dierently to time pressure. With reduced time pressure, competition in verbal tasks greatly increases the performance of women, such that women signi…cantly outperform men. This eect appears largely due to the fact that extra time in a competition improves the quality of women's work, leading them to make fewer mistakes. On the other hand, men use this extra time to increase the quantity of work, which results in a greater number of mistakes.

Localization Technique for Frameless Image-guided Robotic Radiosurgery of Arteriovenous Malformations

Purpose/Objective(s): To integrate three-dimensional digital rotation angiography (3D DRA) and two-dimensional digital subtraction angiography (2D DSA) imaging in a localization technique that enables frameless image-guided robotic radiosurgery of arteriovenous malformations (AVMs). Materials/Methods: The geometric integrity of the 3D DRA images generated by a clinical flat panel detector Carm neuroangiography system was evaluated and quantified by imaging a phantom with embedded markers. Dedicated DSA acquisition modes with preset C-arm positions were configured. The geometric reproducibility of the C-arm presets was investigated and its impact on localization accuracy evaluated. An imaging protocol comprising anterior-posterior (AP) and lateral (LAT) 2D DSA series combined with 3D DRA without couch displacement between acquisitions was introduced. A software environment (Angio-Localize) was developed for 2D-3D registration of the 3D DRA and the 2D DSA images to correct for: (i) small misalignments of the C-arm with respect to the assumed geometry of the preset imaging positions and (ii) potential patient motion between the image series. Within the same environment, correlated navigation of the registered 3D DRA and DSA images was incorporated so that an AVM could be localized and contoured within the 3D DRA coordinate space. AVM contours were then transferred onto a planning CT by CT-3D DRA registration. The subsequent treatment planning and delivery followed the standard process for frameless image-guided robotic radiosurgery treatments. Results: The magnitude of the 3D DRA spatial distortions was smaller than 0.3 mm throughout a 140 mm x 140 mm x 140 mm field of view. Localization uncertainties resulting from the achievable reproducibility of the C-arm preset positions were reduced to less than 0.2 mm with 3D-2D image registration. Overall system-related localization uncertainty within the DRA coordinate space was estimated to be 0.4-0.5 mm. The localization protocol was implemented clinically and image-guided frameless robotic radiosurgical treatments with this technique were initiated. Conclusions:The integration of three-dimensional digital rotation angiography (3D DRA) and two-dimensional digital subtraction angiography (2D DSA) imaging in a localization technique that enables frameless image-guided robotic radiosurgery of arteriovenous malformations (AVMs) is possible. Clinically it is expected to result in increased patient comfort; reduced time pressure on clinical and technical staff, and possible reduction of the number of neuro-angiography procedures for particular patient.

Gender Differences in Output Quality and Quantity Under Competition and Time Constraints: Evidence from a Pilot Study

Gender gaps in income and level of position in the workplace are widespread. One explanation for this inequality is that the genders perform differently under competitive conditions, as previous experimental studies have found a significant gender gap in competitive tasks that are perceived to favor men. In this paper, we use a verbal task that is perceived to favor women and find no gender difference under competition per se. We also reject the hypothesis that a .stereotype threat. explains the inability of women to improve performance under competition. We propose an alternative explanation for gender inequality: namely, that women and men respond differently to time pressure. With reduced time pressure, competition in verbal tasks greatly increases the performance of women, such that women significantly outperform men. This effect appears largely due to the fact that extra time in a competition improves the quality of women’s work, leading them to make fewer mistakes. On the other hand, men use this extra time to increase the quantity of work, which results in a greater number of mistakes.

Working Condition Factors Associated with Time Pressure of Nurses in Japanese Hospitals

In Japan, the most common reason for medical errors is a lack of cross-checking. To prevent errors, efforts to strengthen cross-checking behaviors are being adopted. However, time pressures also lead to errors, and increasing cross-checking activities leads to an increased workload and even greater time pressures. The purpose of this study was to identify working conditions that lead to time pressure for nurses, and to find ways to reduce time pressure and prevent subsequent errors. Self-reporting questionnaires were distributed over 10 days to 416 nurses working in 17 wards at two hospitals; 357 nurses (85.8%) responded anonymously, providing data on 2,150 person-days. In multivariate analyses, medical support services and the number of nurse calls answered were associated with subjective assessments of time pressures and nursing service delays due to busyness. Moreover, working the "evening-day shift" (when a nurse works a day shift after working the evening shift with no days off in between) led to a high level of fatigue before work and was associated with nursing service delays due to busyness. Reducing time pressures and preventing errors requires an adequate number of nurses, shift plans that consider rest periods and order of rotation, increased task discretion for nurses, and the prevention of chronic fatigue.

Under Pressure: Gender Differences in the Relationship Between Free Time and Feeling Rushed

Free time has the potential to reduce time pressures, yet previous studies paradoxically report increases in free time concurrent with increases in feeling rushed. Using U.S. time diary data from 708 individuals in 1975 and 964 individuals in 1998, we review the evidence on trends in free time and subjective perceptions of feeling rushed, and reexamine the relationship between free time and time pressure. We find that women's time pressure increased significantly between 1975 and 1998 but men's did not. In addition, the effects of objective time constraints vary by gender. Whereas more free time reduces men's perceptions of feeling rushed at both time points, among women, free time marginally reduced time pressure in 1975 but no longer reduced time pressure in 1998. Our findings suggest that persistent inequality in gendered time‐use patterns is paralleled by gendered experiences of time pressure.

Quality dimensions that most concern people with physical and sensory disabilities.

People with physical and sensory disabilities face important challenges in obtaining high-quality health care. We examined whether persons who are blind or have low vision, who are deaf or hard of hearing, or who have mobility impairments or manual dexterity problems are satisfied with the technical and interpersonal aspects of their care. By using a 1996 nationally representative survey of 16 403 community-dwelling elderly and disabled Medicare beneficiaries, we identified persons with disabling conditions. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) controlled for demographic characteristics and managed care membership in predicting dissatisfaction with 12 dimensions of care. Of an estimated 33.58 million noninstitutionalized Medicare beneficiaries, 64.1% (an estimated 21.51 million) reported at least 1 potential disability and 29.5% (an estimated 9.89 million) reported more than 1 potential disability. Roughly 98% of people with and without disabilities believed their physicians were competent and well trained. But statistically significantly more people with disabilities reported dissatisfaction with care for 10 of the 12 quality dimensions. Persons reporting any major disability were more likely to be dissatisfied with physicians completely understanding their conditions (AOR, 2.4; 95% CI, 1.9-3.1), physicians completely discussing patients' health problems (AOR, 2.4; 95% CI, 1.9-2.9), physicians answering all patients' questions (AOR, 2.3; 95% CI, 1.7-3.1), and physicians often seeming hurried (AOR, 1.6; 95% CI, 1.4-1.9). Persons with disabilities generally reported positive views of their care, although they were significantly more likely to report poor communication and lack of thorough care. These findings held regardless of the disabling condition. Thoughtful systematic approaches are required to improve communication and to reduce time pressures that might compromise the health care experiences of people with disabilities.

Creative ideas take time: business practices that help product managers cope with time pressure

States that the ongoing success of a mature product depends largely on the product manager’s ability to identify creative new ways to market the product. Suggests that one reason why many marketing programs lack creative initiatives is that product managers operate under significant time pressure, and time pressure kills creativity. Highlights four business practices (formal planning process, use of teams, interaction with other functional areas, experience with the product category) which were expected to help product managers to cope with time pressure. Finds, however, through a survey of consumer goods product managers, that only experience with the product category worked as expected. Concludes, therefore, that top management must directly reduce time pressure by examining policies on practices such as frequent product reassignment and downsizing, and the proliferation of line extensions.

Strategies Used by Working and Nonworking Wives to Reduce Time Pressures

There appear to be limited differences between employed and nonemployed wives in their use of strategies to relieve time pressures. Holding income and life-cycle stage constant, neither wives' employment nor recent entry into the labor force are significant determinants of the purchase or ownership of labor-saving durables, such as microwave ovens and dishwashers. Although working wives prepare fewer meals, if income or life cycle is held constant, working wives and nonworking wives are generally similar with respect to method of meal preparation and shopping behavior.