Regular Working Hours Research Articles

The Cost of After-Hour Electroencephalography.

High costs associated with after-hour electroencephalography (EEG) constitute a barrier for financially constrained hospitals to provide this neurodiagnostic procedure outside regular working hours. Our study aims to deepen our understanding of the cost elements involved in delivering EEG services during after-hours. We accessed publicly available data sets and created a cost model depending on 3 most commonly seen staffing scenarios: (1) technologist on-site, (2) technologist on-call from home, and (3) a hybrid of the two. Cost of EEG depends on the volume of testing and the staffing plan. Within the various cost elements, labor cost of EEG technologists is the predominant expenditure, which varies across geographic regions and urban areas. We provide a model to explain why access to EEGs during after-hours has a substantial expense. This model provides a cost calculator tool (made available as part of this publication in eAppendix 1, links.lww.com/CPJ/A513) to estimate the cost of EEG platform based on site-specific staffing scenarios and annual volume.

ANALYSIS OF WORK FATIGUE AMONG WORKERS IN THE FORMAL AND INFORMAL SECTORS IN CENTRAL JAVA

Physical and mental fatigue resulting from continuous work over an extended period without sufficient rest. Work fatigue can affect workers in all sectors, both informal and formal, but several factors influence the fatigue levels in each sector. Informal sector workers typically operate in irregular conditions, without fixed working hours, and work for extended periods to meet their livelihood needs. Meanwhile, formal sector workers often have more regular working hours and definite rest periods. However, formal sector workers may also experience similar fatigue due to high job demands, pressure from superiors, or tight deadlines. The consequences of fatigue can lead to serious physical and mental health issues, such as stress, anxiety, sleep disturbances, and even depression. Therefore, it is crucial for workers in both sectors to pay attention to their health and well-being and take measures to prevent fatigue and cope with work-related stress. The research employed a quantitative method with a cross-sectional approach. There were 122 respondents, comprising 61 from the informal sector and 61 from the formal sector. The research findings indicated that the level of fatigue experienced by workers in both sectors was severe, with 78 (63.9%) of informal sector workers predominantly facing this fatigue

Improving adolescents’ dietary behavior through teacher-delivered cancer prevention education: a school-based cluster randomized intervention trial in urban Rajasthan

BackgroundDietary practices are one of the most common modifiable risk factors for cancers. Foods rich in dietary fibers are considered protective, meanwhile fast & junk foods are risk for common cancers. Adolescence period is marked by habit formation and is thus suited for delivering behavioral intervention. Schools offer an optimal setting for planning and executing these interventions to a large number of adolescents.ObjectiveTo assess the effectiveness of a teacher-delivered cancer-prevention education in changing dietary behaviors of school going adolescents.MethodsA cluster randomized trial was conducted in government secondary and senior secondary schools with schools as clusters. A minimum required sample of 1032 students was estimated from 16 schools with 1:1 allocation in intervention and non-intervention groups. Dietary behaviors were recorded as dichotomous variable. The determinants were recorded as per theory of planned behavior framework using Likert-scale. Two teachers from each intervention school were trained to deliver cancer prevention education with focus on role of dietary behavior. Pre-post training assessment of teachers’ knowledge towards common cancers was done using a self-administered questionnaire. Gender adjusted difference-in-difference analysis was done to assess intervention effect on both healthy and unhealthy behaviors.ResultsIn selected schools all students from classes 8 to 10 were approached and a total of 1224 students were enrolled, of whom 1096 completed the study. The study recorded significant improvement in scores of students from intervention group compared to non-intervention group for their attitude, subjective norms, perceived behavioral control and intention towards consuming healthy and avoiding unhealthy foods. The intervention was effective in significantly improving the proportion of students limiting fried/fast/packed food & sugar sweetened beverages (OR:1.51, 95%CI:1.08,2.12,p:0.017), and consuming fruits & vegetables daily (OR:1.55, 95%CI:1.08,2.22, p:0.017) while adjusting effect of gender.ConclusionClassroom-based cancer prevention education delivered through teachers during regular working hours is effective in improving dietary behaviors and its determinants among adolescent students. Thus, we recommend integrating a section focusing on the role of diet in cancer prevention and other lifestyle diseases in the existing school curriculum.Trial RegistrationThe trial was registered under Clinical Trial Registry-India with registration number CTRI/2018/12/016586, dated-10/12/2018.

Bibliometric analysis of Sci-Hub downloads by Egyptian researchers

In this study we present an in-depth bibliometric analysis of Sci-Hub downloads by Egyptian researchers based on the 2017 download log file. The study reveals that Egyptian researchers heavily rely on Sci-Hub, generating a substantial 1,357,526 download requests in 2017, with 65% of these occurring outside regular working hours. Cairo emerges as a central hub for this activity, contributing 81.58% of total downloads. Journal articles constitute the majority of downloads at 82.36%, followed by conference papers (12.89%). A discernible trend shows a preference for recent papers published between 2012 and 2017, highlighting the demand for up-to-date research. The analysis also highlights prominent publishers, including IEEE, Elsevier, Wiley, and Springer, as preferred sources for Egyptian researchers. “Journal of the American Chemical Society” and “Journal of Applied Physics” stand out among accessed journals, while IEEE-associated conferences, notably “IEEE Power and Energy Society General Meeting,” dominate conference paper downloads. Examining journal accessibility via the Egyptian Knowledge Bank (EKB) reveals that 62.84% of journals are accessible, with Science Direct as the leading provider (28.37%). However, a significant gap emerges as 87.39% of downloaded conference papers remain inaccessible through EKB. Furthermore, a semantic analysis highlights recurring themes such as “systems,” “review,” “analysis,” “treatment,” “power,” and “energy,” reflecting the key research areas of Egyptian researchers. Overall, this study offers valuable insights into Sci-Hub’s role in supplementing Egyptian researchers’ resource access and underscores the need for comprehensive resource coverage and accessibility enhancements.

Outcomes for university students following emergency care presentation for deliberate self-harm: a retrospective observational study of emergency departments in England for 2017/2018

ObjectivesIdentify university-aged students and contrast their healthcare provision and outcomes with other patients in the same age group attending emergency departments for deliberate self-harm.DesignRetrospective cross-sectional observational study.SettingPatients visiting 129 public...

Feasibility and safety of laparoscopy in acute non-traumatic emergency abdominal surgery: A prospective study

Introduction: The use of laparoscopy in emergency abdominal surgery is considered high-risk due to its elevated morbidity, requiring expertise in laparoscopic surgery. Objective: Assessing the feasibility, reproducibility, and safety of laparoscopy in non-traumatic acute abdominal surgery. Methods: Descriptive, prospective and evaluative study, conducted between February 2018 and October 2021. We have included in this study: acute appendicitis and its complications, lithiasis acute cholecystitis (LAC), peritonitis by perforation of peptic ulcer, adhesive acute intestinal obstruction, adnexal torsion, extra-uterine pregnancies, and non-specific acute abdominal pain. Results: We operated on 337 patients laparoscopically, with an average of 02 surgeries per medical shift. In 62.6%, surgeries were performed outside of regular working hours. We encountered temporary, material, and human difficulties in 10.8% of the cases. Average age of the patients is 38 years ±15 years. F/H sex ratio =1.29. Diagnostic accuracy of laparoscopy was 100 %. Intraoperative laparoscopic scanning corrected the preoperative diagnosis in 15.73% of cases. Average operative time was 52.09 min ± 24.14 min. One conversion recorded (0.3%). Rate of postoperative complications was 6.2%. These complications are classified at grade I according to the Clavien-Dindo classification in 85.71%. Only one patient (0.3%) required a second operation. Average length of overall hospitalization was 1.5 days. Conclusion: Our results suggest that emergency laparoscopy is feasible, safe, and reproducible. So it can claim to replace laparotomy in the management of acute, non-traumatic abdominal emergencies.

Diversity of kidney care referral pathways in national child health systems of 48 European countries.

Primary, secondary and tertiary healthcare services in Europe create complex networks covering pediatric subspecialties, sociology, economics and politics. Two surveys of the European Society for Paediatric Nephrology (ESPN) in 1998 and 2017 revealed substantial disparities of kidney care among European countries. The purpose of the third ESPN survey is to further identify national differences in the conceptualization and organization of European pediatric kidney health care pathways during and outside normal working hours. In 2020, a questionnaire was sent to one leading pediatric nephrologist from 48 of 53 European countries as defined by the World Health Organization. In order to exemplify care pathways in pediatric primary care nephrology, urinary tract infection (UTI) was chosen. Steroid sensitive nephrotic syndrome (SSNS) was chosen for pediatric rare disease nephrology and acute kidney injury (AKI) was analyzed for pediatric emergency nephrology. The care pathways for European children and young people with urinary tract infections were variable and differed during standard working hours and also during night-time and weekends. During daytime, UTI care pathways included six different types of care givers. There was a shift from primary care services outside standard working hours to general outpatient polyclinic and hospital services. Children with SNSS were followed up by pediatric nephrologists in hospitals in 69% of countries. Patients presenting with community acquired AKI were admitted during regular working hours to secondary or tertiary care hospitals. During nights and weekends, an immediate shift to University Children's Hospitals was observed where treatment was started by intensive care pediatricians and pediatric nephrologists. Gaps and fragmentation of pediatric health services may lead to the risk of delayed or inadequate referral of European children with kidney disease to pediatric nephrologists. The diversity of patient pathways outside of normal working hours was identified as one of the major weaknesses in the service chain.

The impact of work-related ICT use on perceived injustice: Exploring the effects of work role overload and psychological detachment

Multiple studies have provided evidence that the hospitality and tourism sector is experiencing a growing reliance on information and communication technology (ICT). Consequently, employees in this industry are facing an escalating expectation to stay connected and address work-related communication even outside their regular working hours. Little is known about how using ICTs during off-job can raise employee unfairness perceptions and job overload and how managers can control this. The primary focus of the current study is to examine the association between work-related ICT use after hours and employees' perceived injustice and the mediating role of work-role overload and the moderating role of psychological detachment in this relationship within the hospitality and tourism industry. By convenient sampling method, 400 employee responses were collected. The collected data were analyzed using structural equation modeling (SEM) with the "Partial least squares (PLS)" technique, employing SmartPLS-4 software. The empirical findings demonstrate a positive association between work-related ICT use after hours and employees' perceived injustice (EPI) and work role overload (WRO). Similarly, the mediating role of work-role overload and the moderating role of psychological detachment were supported. The study concludes by providing theoretical and practical implications and discusses how these findings can be applied within the tourism and hospitality industry.

Emergency medical services experience in King Saud University Medical City

Objective: This study aimed to assess the response time of the emergency medical services (EMS) at King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia. Methods: This cross-sectional study was conducted at KSUMC emergency department. The study included all records of emergency calls that required ambulance dispatch during the study period. Data on the times they received the call, dispatched the ambulance, arrived at the scene, left the scene, and arrived at the hospital were collected. Each call was examined to assess if it took place during normal working hours (08:00-16:00) or within 30 minutes of shift changes (08:00, 16:00, and 00:00). Results: Of all the calls received, 288 (61.7%) were made during regular working hours (08:00-16:00), while 47 (10.1%) were made during the turning shifts (30 minutes before or after the shift). The median time from receiving the call to dispatch, from receiving the call to arrival at the scene, from dispatch to hospital arrival, and the scene time was 1 minute, 7 minutes, 24 minutes, and 10 minutes, respectively. The response and transportation times for emergency responders were consistent whether the calls were received during shift changes or at other times. The differences in mean rank were not statistically significant (P-values = 0.404 and 0.262, respectively). Conclusion: The EMS team at KSUMC in Riyadh, Saudi Arabia, responded quickly. The median times between receiving a call and arriving at the scene, as well as the median scene time, were found to be adequate.

Revealing Gender Disparities in Urban Green Space Utilization Using Mobile Phone Data

Urban green spaces (UGSs), such as parks and gardens, are vital for the health and well-being of city residents. However, unequal access to and utilization of UGS can impede social cohesion and sustainable development of cities. While many studies have investigated inequalities in accessibility to UGSs across various demographic groups, gender inequality in actual utilization of UGSs has received little attention largely due to the lack of data to reliably track UGS utilization by urban residents. Here, we leveraged the capacity of mobile phone data to track the movement of a large population and assessed the gender disparities in the utilization of UGSs among more than 77,000 residents residing in 2 populous communities in Beijing. We found that men spent 11% more time in UGSs and visited them 6% more frequently than women. This gender disparity varied across different socioeconomic groups. The middle-aged group exhibited an up to 46.4% greater disparity than other age groups, while the higher-income group showed a 12.4% larger disparity than the lower-income group. Additionally, the resident group with normal commuting distances had a 52.8% higher gender disparity, and the resident group with regular working hours had a 110% greater disparity compared to their respective counterpart groups. These findings contributed to environmental justice research by revealing the complex gender disparity in UGS utilization. The approach developed in the study provides an efficient way for identifying disparities in the utilization of UGS and designing effective strategies accordingly to alleviate inequalities in our study area and beyond.

Association between Work-related Communication Devices Use during Work Outside of Regular Working Hours and Depressive Symptoms in Wage Workers

BackgroundThis study aimed to investigate the relationship between work-related communication devices use during work outside of regular working hours and depressive symptoms in wage workers. MethodsData from 50,538 workers aged 15 years or older who had participated in the 6th Korean Working Condition Survey (KWCS) were used. The final sample was 32,994 wage workers. The questionnaire asked the respondents how often they used communication devices for work during work outside of regular working hours. Depressive symptoms were assessed using WHO-5 Well-Being Index. Multiple logistic regression analysis was used to analyze the association between work-related communication devices use during work outside of regular working hours and depressive symptoms. ResultsThe rate of depressive symptoms was highest among workers who did not use work-related communication devices during work outside of regular working hours. After adjusting for socio-demographic and work-related factors, the odds ratio of depressive symptoms among workers who used communication devices when working outside of regular working hours was 1.20 (95% CI: 1.09–1.32); the odds ratio of depressive symptoms in the group not using communication devices for free-time work was 1.66 (95% CI: 1.37–2.00), which was higher than that of the reference group, that is, workers who did not work outside of regular working hours, and was statistically significant. ConclusionRegardless of whether work-related communication devices are used, working outside of regular working hours increases depressive symptoms. The use of work-related communication devices during work outside of regular working hours can reduce the rate of depressive symptoms.

Survival disparities for in-hospital cardiac arrests occurring during nights and weekends

Abstract Background In-hospital cardiac arrest is a life-threatening event, often leading to poor outcomes and high mortality rates. There is limited research investigating how the time and day of arrest might impact long-term outcomes, such as mortality and functional status. Purpose To investigate the relationship between time and day of arrest and long-term outcomes in patients who experience in-hospital cardiac arrest. Methods This study included all patients who experienced an in-hospital cardiac arrest between January 1st, 2013 and December 31st, 2019, and who had a clinical indication for resuscitation. Data was obtained from the Danish in-hospital cardiac arrest registry, which was linked to other national registries to gather information on patient characteristics, such as survival, anoxic brain damage, and nursing home admission. The patients were stratified into three groups (A-C) based on time and day of the week: Group A included patients who were resuscitated during regular working hours (Monday to Friday from 08:00 to 15:59), Group B included patients who were resuscitated during off-hours (Monday to Sunday from 16:00 to 23:59 and Saturday to Sunday from 08:00 to 15:59), and Group C included patients who were resuscitated during off-hours at night (Monday to Sunday from 00:00 to 07:59). Standardized average probability of outcomes was estimated using logistic regression. Results The study population consisted of 9,225 patients, median age was 74 (1st-3rd quartile [Q1-Q3] 65-81 years) and 63.3% were men. In total, 53.6% (n = 4,909) of the patients achieved return of spontaneous circulation (ROSC). The standardized absolute chance of 30-day survival was 32.7% (95% CI 30.9%-34.5%) for group A, 27.2% (95% CI 25.7%-28.7%) for group B, and 23.6% (95% CI 22.0%-25.3%) for group C. Similarly, the chance of 1-year survival was highest for group A (27.6%; 95% CI 25.9%-29.3%) gradually decreasing to 18.9% (95% CI 17.4%-20.4%) in group C (Fig. 1). For patients who survived at least 30 days following an in-hospital cardiac arrest, the standardized absolute chance of surviving without anoxic brain damage or admission to a nursing home within one year was greatest among those in group A (81.1%; 95% CI 78.3%-83.8%), but decreased to 75.1% (95% CI 72.2%-78.1%) for those in group B, and 72.2% (95% CI 68.3%-76.1%) for those in group C (Fig. 1D). Conclusion In conclusion, this study found that patients who experience in-hospital cardiac arrest during off-hours at night have significantly lower chances of survival at both 30 days and 1 year compared to those experiencing an arrest during on-hours or off-hours. Additionally, among patients who survive the initial 30 days, those resuscitated during off-hours at night have the poorest outcomes, with lower chances of 1-year survival without anoxic brain damage or nursing home admission.Figure 1

Beyond working hours: the association between long working hours, the use of work-related communication devices outside regular working hours, and anxiety symptoms.

The present study aimed to identify and compare the associations between long working hours and use of work-related communication devices outside regular working hours and anxiety symptoms, thereby providing insight into redefining working hours. Based on the cross-sectional data from the sixth Korean Working Conditions Survey (KWCS), specifically the responses from 46 055 workers, the use of work-related communication devices outside of regular working hours, long working hours, and anxiety symptoms were assessed. To investigate the associations between using work-related communication devices outside regular working hours or long working hours with anxiety symptoms, odds ratios (ORs) and 95% CIs were calculated using multiple logistic regression models. Among 46 055 participants, 25 659 (55.7%) used work-related communication devices outside working hours, 8145 (17.7%) worked long hours, and 2664 (5.8%) experienced anxiety symptoms. Compared with the reference group, those who used work-related communication devices outside regular working hours without working long hours, had higher OR of anxiety symptoms (OR: 2.18; 95% CI, 1.97-2.41) than those who worked long hours without using work-related communication devices during off-hours (OR: 1.32; 95% CI, 1.09-1.59). Furthermore, the group that both worked long hours and used work-related communication devices outside working hours exhibited the highest OR of anxiety symptoms (OR: 2.57; 95% CI, 2.24-2.97). Using work-related communication devices outside regular working hours is associated with a higher risk of anxiety symptoms compared with long working hours. This result suggests that using work-related devices outside regular working hours, in addition to regular work time, should be considered when redefining working hours.

Application of a Digital Mental Health Clinic in Secondary Schools: Functionality and Effectiveness Evaluation.

Adolescents experience relatively more stress than other populations as they are facing rapid physical changes and adapting to complex social environments. However, access for this population to professional service providers is limited. Therefore, there is an increasing need for access to mental health services and new mental health care resources tailored to adolescents. The aim of this study was to evaluate the functionality and effectiveness of a school digital mental health clinic (DMHC) created by a Chinese psychiatric hospital and provided to secondary school students for a trial. The trial period of the DMHC was from January to July 2021 at three secondary schools in Taizhou City, China. Under a collaborative agreement between the local educational bureau and provider, use of the DMHC was free to all students, teachers, and staff of the schools. The functionality of the DMHC was compared with existing digital health interventions introduced in the literature and its effectiveness was quantitatively analyzed in terms of the volume of received counseling calls, number of calls per 100 students, length and time of calls, and reasons for the calls. The mini course video views were analyzed by topics and viewing time. The design functions of the DMHC are well aligned with required factors defined in the literature. The first advantage of this DMHC is its high accessibility to students in the three schools. All functions of the DMHC are free to use by students, thereby eliminating the economic barriers to seeking and receiving care. Students can receive virtual counseling during or after regular working hours. Acceptability of the DHMC was further ensured by the full support from a national top-tier mental health facility. Any audio or video call from a student user would connect them to a live, qualified professional (ie, a psychiatrist or psychologist). Options are provided to view and listen to resources for stress relief or tips to help address mental health needs. The major reasons for the counseling calls included difficulties in learning, interpersonal relationships, and emotional distress. The three topics with the highest level of interest for the mini course videos were emotional assistance, personal growth, and family member relationships. The DMHC served as an effective tool for crisis prevention and intervention during nonworking hours as most of the live calls and mini video viewing occurred after school or over the weekend. Furthermore, the DMHC helped three students at high risk for suicide and self-injury through live-call intervention. The DMHC is an effective complementary solution to improve access to professional mental health care facilities, especially during nonworking hours, thereby helping adolescents meet their mental health needs. Extension of the DMHC into more schools and other settings is recommended.

Who, When, Why?-Traumatological Patients in the Emergency Department of a Maximum Care Provider.

Nationwide, there is an annual increase in the number of patients in German emergency departments resulting in a growing workload for the entire emergency department staff. Several studies have investigated the situation in emergency departments, most of which were interdisciplinary, but there are no data on a solely traumatological patient population. The present study therefore aims to investigate the situation in a university-based trauma surgery emergency department. A total of 8582 traumatological patients attending a university hospital from 1 January 2019 to 31 December 2019 were studied. Various variables, such as reason for presentation, time of accident, diagnosis, and diagnostic as well as therapeutic measures performed were analyzed from the admission records created. The mean age was 36.2 years, 60.1% were male, 63.3% presented on their own to the emergency department, and 41.2% presented during regular working hours between 8:00 a.m. and 6:00 p.m., Monday through Friday. The most common reason for presentation was outdoor falls at 17.4%, and 63.3% presented to the emergency department within the first 12 h after the sustained trauma. The most common diagnosis was bruise (27.6%), and 14.2% of patients were admitted as inpatients. Many of the emergency room patients suffered no relevant trauma sequelae. In order to reduce the number of patients in emergency rooms in the future, existing institutions in the outpatient emergency sector must be further expanded and effectively advertised to the public. In this way, the emergency medical resources of clinics, including staff, can be relieved to provide the best possible care for actual emergency patients.

Effect of Delayed Endoscopy Protocol on Timing and Safety of Endoscopy for Foreign Body Ingestion and Esophageal Food Impaction.

Endoscopic procedures for foreign body ingestion (FBI) and esophageal food impactions (EFI) performed during on-call hours are associated with increased stress, risk, and cost. We implemented a Foreign Body Algorithm (FBA) designed to delay all but the most urgent endoscopy for EFI and FBI until regular working hours. Using endoscopy records from multiple academic and community hospitals within a large integrated health system in the United states, we identified esophagogastroduodenoscopy (EGD) performed for food impactions and foreign body ingestions occurring between May 2011 and February 2021. We identified 479 EGDs performed for FBI and EFI. The introduction of the FBA was associated with a shorter length of stay (LOS) for overall cases (0.35 vs. 0.8d P<0.001), day cases (0.16 vs. 1.0d P<0.001), and night cases (0.40 vs. 0.6d P=0.03). The introduction of the FBA did not change the rate of overall adverse events (AE) or night AE. AE from the entire cohort was rare (3%; 16 total). Of the AE, most were sedation related. The introduction of the FBA did not affect the overall rate of night cases or AE, but the rate of after-hours endoscopy for intentional ingestions decreased from 17.2% to 3.1% (P=0.01). This is one of the largest studies of esophageal impactions and foreign bodies in adults in the United States, and the first to examine the effects of a protocol designed to avoid after-hours endoscopy. These results suggest that postponing after-hours EGD until the daytime is not associated with adverse safety outcomes or increased LOS.

Integrating Neuromonitoring in Pediatric Emergency Medicine: Exploring Two Options for Point-of-Care Electroencephalogram (pocEEG) via Patient Monitors-A Technical Note.

Central nervous system (CNS) disorders are among the most frequent presentations in critically ill children. Status epilepticus (SE) is a frequent scenario in the resuscitation bay. In patients with altered mental status, non-convulsive SE (NCSE) is often underrecognized and critically impacts the neurological outcome and duration of hospitalization. An electroencephalogram (EEG) is required to diagnose NCSE. However, standard EEG recordings are time- and staff-intensive, and their availability is limited, especially outside regular working hours. We aimed to improve patient care by developing a simplified EEG recording method, using a reduced lead montage (point-of-care EEG-pocEEG), that is suitable for use in pediatric emergency departments. The objective was to devise a cost-effective unit with low space requirements that fitted the existing technical infrastructure. We present two technical options for clinical pocEEG acquisition using patient monitors (GE Carescape, Philips IntelliVue) that enable data collection for educational and research purposes. A simplified, rapid response EEG like the pocEEG enables neuromonitoring of patients with CNS disorders in pediatric emergency settings, facilitating timely diagnosis and treatment initiation when standard EEG is not readily available.

Influence of off-hours admission on outcomes of ischemic stroke: a systematic review and meta-analysis of contemporary studies.

The aim of this study was to document pooled evidence on the association between admission during off-hours and/or weekends and the risk of mortality and poor functional outcome in patients with ischemic stroke, as compared to admission during regular working hours and/or weekdays. We conducted a systematic search using PubMed, EMBASE, and Scopus databases. Observational studies published between 2013 and 2023 that investigated the association between weekend/off-hours admission and outcomes (mortality and functional outcomes) of ischemic stroke were considered for inclusion. A random effects model was used to conduct the analysis, and effect sizes were reported as pooled odds ratio (OR) or hazards ratio (HR) with corresponding 95% confidence intervals. The analysis consisted of 31 studies and found that patients admitted during weekend/off-hours had a higher risk of in-hospital (OR 1.12, 95% CI: 1.06, 1.18), and 1-month post-admittance mortality (OR 1.13, 95% CI: 1.06, 1.20). However, the risk of mortality after 3, 6, and 12 months was not statistically different between the two patient groups. Patients admitted during weekends/off-hours had a slightly higher risk of poor functional outcomes (modified Rankin Scale score of ≥3) at 1-month post-admittance (OR 1.06, 95% CI: 1.00, 1.11). However, after 3, 6, and 12 months, the risk of poor functional outcomes was similar in both patient groups. Egger's test did not suggest the presence of publication bias for any of the outcomes. Individuals who suffer from ischemic stroke and present outside of regular working hours or on weekends have a higher likelihood of experiencing short-term mortality and unfavorable functional outcomes.

Penerapan kapasitas produk melalui perencanaan agregat: Studi kasus pada konveksi kaos polos Cijoged Subang

Businesses that want to compete globally and grow their operations must prioritize planning. This includes planning for production processes, sourcing materials, labor availability, and quality control. Planning product capacity is essential for small and medium-sized enterprises (MSMEs) because it impacts their costs and profits. However, limited capital can make this challenging. Businesses can use aggregate planning to optimize their operations to address this issue. In this study, we analyzed the application of product capacity through aggregate planning at the Cijoged Subang Plain T-shirt Convection. We used the Smooth Production method and POM QM for Windows software to collect and process data. Our findings suggest that implementing aggregate planning can help businesses map their costs and meet product demand capacity, including expenses related to regular and overtime working hours, subcontracting, and inventory.

An Analysis of Human Resource Needs for the Functional Position of Goods/Services Procurement Manager in the Ministry of Agrarian and Spatial Planning/National Land Agency

Human resources serve as a cornerstone for the continuity of an organization or company, emphasizing the importance of human resource planning to overcome challenges in the human resources domain and achieve organizational objectives. The purpose of this study is to analyze the ideal number of human resources needed for the Functional Position of Goods/Services Procurement Manager in the Ministry of Agrarian Affairs and Spatial Planning/National Land Agency. The method used in this study is qualitative research, which is used to investigate natural object conditions (as opposed to experiments) where the researchers serve as the key instrument for data collection using triangulation, inductive/qualitative analysis, and placing emphasis on meaning rather than generalization. The focus of the study is based on job analysis and workload analysis. Data collection techniques involve data reduction, data presentation, and drawing conclusions. The results of the study show that the human resource needs for the Functional Position of Goods/Services Procurement Manager in the Ministry of Agrarian Affairs and Spatial Planning/National Land Agency have not been fully met or there are still shortages, resulting in civil servants occupying the position having to work beyond regular working hours. There are several obstacles in planning and developing human resources, including a lack of interest in the position, incomplete documentation as a requirement for job transfers, and civil servants interested in the position but lacking the Goods/Services Procurement Certificate. The Ministry of Agrarian Affairs and Spatial Planning/National Land Agency takes steps to address these issues through inpassing procedures and selection of candidates from external organizations who wish to pursue a career in the ministry. Keywords: Human Resource Needs, Job Analysis, Workload Analysis