Rest Breaks Research Articles

Physiological and behavioral characteristics of SuperAgers from everyday activities: An NIH U19 SuperAging Research Initiative study protocol

AbstractBackgroundStudying factors contributing to exceptional memory performances beyond the 8th decade, can be a valuable model for understanding dementia risk, prevention, and underlying mechanisms. Age‐associated changes in biological and physiological complexity, or system responsivity, form the foundation of the loss of complexity hypothesis in aging (Lipsitz & Goldberger, JAMA, 1992). Project 1 under the multisite NIH U19 SuperAging Research Initiative uses state‐of‐the‐art wearable technology, and data from real‐world contexts, to test the supposition that SuperAgers have preserved physiologic and behavioral complexity relative to their Controls in the domains of physical activity, autonomic responsiveness, sleep, and social engagement.MethodSuperAgers are enrolling from five U.S. and Canadian sites of the SuperAging Research Initiative. SuperAgers refer to individuals aged 80 and older who have memory capacity considered average for those 2‐3 decades younger. In a fully remote data collection protocol, participants wear a multi‐sensor array comprised of 1 skin‐mounted trunk sensor (with ECG) and 2 wearable limb sensors, continuously over a 14‐day period with scheduled rest breaks every 3‐4 days. Participants complete a baseline orientation visit, and three brief check‐in visits with the study team over video conference. Using custom algorithms, developed by our research team, we will examine time‐varying changes in indices of physiologic and behavioral complexity, across multiple body systems, using both volume‐based and established multi‐scale entropy approaches to quantify differences between SuperAgers and their typically aging Controls. We plan to analyze sensor derived complexity metrics in relation to self‐reports of life‐space mobility.ResultWe will overview our remote data collection protocol and semi‐automated analytics pipeline. Barriers and facilitators to remote data collection will be discussed Preliminary data (N = ∼ 40) will be presented, with select case study examples. We will provide preliminary sensor adherence and user‐feedback from the cohort, comprised of a diverse sample of SuperAgers and Controls.ConclusionThis is the first study to test the loss of complexity hypothesis across multiple physiological and behavioral domains simultaneously and in exceptional cognitive aging. Using sensitive tools to capture dynamic and complex behaviors, we will characterize SuperAgers in a way not afforded by point‐in‐time assessments that dominate the current literature.

Trunk postural reactions to the force perturbation intensity and frequency during sitting astride in children with cerebral palsy.

The purpose of this study was to examine kinematic and neuromuscular responses of the head and body to pelvis perturbations with different intensities and frequencies during sitting astride in children with CP. Sixteen children with spastic CP (mean age 7.4 ± 2.4years old) were recruited in this study. A custom designed cable-driven robotic horse was used to apply controlled force perturbations to the pelvis during sitting astride. Each participant was tested in four force intensity conditions (i.e., 10%, 15%, 20%, and 25% of body weight (BW), frequency = 1Hz), and six force frequency conditions (i.e., 0.5Hz, 1Hz, 1.5Hz, 2Hz, 2.5Hz, and 3Hz, intensity = 20% of BW). Each testing session lasted for one minute with a one-minute rest break inserted between two sessions. Kinematic data of the head, trunk, and legs were recorded using wearable sensors, and EMG signals of neck, trunk, and leg muscles were recorded. Children with CP showed direction-specific trunk and neck muscle activity in response to the pelvis perturbations during sitting astride. Greater EMG activities of trunk and neck muscles were observed for the greater intensities of force perturbations (P < .05). Participants also showed enhanced activation of antagonistic muscles rather than direction-specific trunk and neck muscle activities for the conditions of higher frequency perturbations (P < .05). Children with CP may modulate trunk and neck muscle activities in response to greater changes in intensity of pelvis perturbation during sitting astride. Perturbations with too high frequency may be less effective in inducing direction-specific trunk and neck muscle activities.

Exploring the effects of break nurses on nursing staff burnout

Objective: Previous studies had found that rest breaks can not only prevent or improve negative reactions to stress in healthcare staff, but also reduce turnover in understaff conditions, improve work performance, and ultimately improve patient outcomes. As a result, many inpatient units had implemented a nursing position called a Break Nurse, whose sole purpose was to provide rest breaks. However, the implementation of a Break Nurse and its effectiveness was not reported in literature. Therefore, this quality improvement QI project proposed to implement Break Nurses on an acute care unit of impatient setting and investigate its effectiveness on nursing staff.Methods: The selected unit previously utilizing a Break-Buddy model for securing rest breaks was able to start a two 8-hour shift Break Nurse model. The hypothesis is that the Two-Break-Nurse model, when compared with the Break-Buddy model, will better secure rest breaks, reduce burnout symptoms experienced by nursing staff. The validated tool used to measure burnout is the Maslach Burnout Inventory. The study utilized pre- and post-implementation self-report survey statistical analysis to report outcomes.Results: In the end, 14 individuals had responded to both pre- and post implementation surveys. The results show that there was statistically significant improvement of Emotional Exhaustion. Due to the small sample size, the measurement of Depersonalization and Personal Accomplishment did not show statistically significant improvement.Conclusions: The Two-Break-Nurse model is effective at reducing emotional exhaustion for nursing staff. Further studies are needed to measure in a larger scale the effectiveness of break nurse model on other aspects of burnout and the improvement of clinical outcomes.

Driver fatigue in taxi, ride-hailing, and ridesharing services: a systematic review

ABSTRACT Driver fatigue is a major cause of road crashes. However, there is limited knowledge regarding the potential consequences of driver fatigue in taxi (conventional and app-based), ride-hailing, and ridesharing services. Driver fatigue is likely to be significantly exacerbated in this population due to the multi-task characteristics of their jobs; thus, conducting a comprehensive study on driver fatigue in these transportation sectors is of utmost importance. This systematic review summarises the current state of knowledge about the causes and consequences of driver fatigue. We also suggested some potential control mechanisms for driver fatigue in taxi and ride-hailing services along a fatigue risk trajectory. We included studies published prior to September 2022 in three databases (Web of Science, Scopus, and PubMed) using a predefined search strategy. Eligible studies were critically appraised using the Joanna Briggs Institute (JBI) critical appraisal checklists. A total of 18 studies met our eligibility criteria as scoped from the 414 initially identified studies. Eight contributing factors to driver fatigue were revealed including long working hours, short rest breaks, limited driving experience, job demand, poor sleep, algorithmic management, traffic congestion, and additional workload. Furthermore, our review identified risk factors for driver fatigue in taxi and ride-hailing services, including road safety, work pressure and driver’s health, optimism bias, job precariousness, and lack of additional benefits. Findings to date suggest that driver fatigue in taxi and ride-hailing industries is as serious as, or more serious than, in other transportation sectors. Understanding the working conditions of these drivers is critical to establish effective policies and practices for reducing crash-related driver fatigue.

Optimising stochastic task allocation and scheduling plans for mission workers subject to learning-forgetting, fatigue-recovery, and stress-recovery effects

This study addresses the stochastic bi-objective task allocation and scheduling problems for mission workers subject to the complex (and joint) effect of learning-forgetting, fatigue-recovery, and stress-recovery processes. The mission consists of work-rest cycles with different types of tasks. Some task types are repetitive, not necessarily back-to-back, with some predecessors for other task types. The workers are multi-skilled, whose experience, learning, fatigue, and stress levels are updated, affecting their performance dynamically. A Markov Decision Process (MDP) is applied to formulate this stochastic problem, considering speed and accuracy as two measures of workforce performance. A decision could be “to repeat a task of a certain type” or “take a rest break till another worker becomes available”. The developed MDP model finds the optimal task allocation and work-break schedule for workers by minimising the sum of the tasks’ completion times and maximising their quality. Completion time is a continuous variable, and the quality index is a binary random variable, i.e., high or moderate, having a continuous probability of occurrence. The model is of a general form with a potential application in similar settings. The paper used the Sequential Greedy Assignment (SGA) and the Monte-Carlo Tree Search (MCTS) to solve the problem with their results compared. Numerical results with those from a sensitivity analysis are discussed.

Concentration levels of selected hormones in judokas and the extent of their changes during a special performance test at different ambient temperatures

BackgroundThere is little scientific literature available on the diversity of physiological responses of judokas to anaerobic interval exercises in warm environments. Understanding the dynamics of changes in the concentration of selected hormones during a special endurance test at different ambient temperatures may have significant practical value, as it provides an opportunity for optimal programming and monitoring of the training process. So, the main aim of the research was to survey interval anaerobic exercises in different ambient temperatures on Concentration levels of selected hormones in judokas.Methods15 judokas athletes (age: 20.65 ± 2.03 years; body height: 178.00 ± 6.31 cm; body mass: 76.26 ± 12.57 kg; training experience: 12.1 ± 1.57 years) volunteered for the study. The judokas performed five sequences (each lasting 7.20 min) of pulsatile exercises on a cycle ergometer and hand ergometer in a thermoclimatic chamber at temperatures of 21 ± 0.5 °C and 31 ± 0.5 °C. The exercises were different from typical interval exercises, with varying times, upper and lower limb loads, and were followed by a 15-minute break after each sequence. Total duration of the experiment, including the five sequences of pulsating exercise and four 15-minute rest breaks between each exercise sequence, amounted to 96 min and 20 s. The workload was increased by 20 W for the lower limb tests and 12 W for the upper limb tests every 2 min. Biochemical measurements of testosterone (T), cortisol (C), growth hormone (HGH), adrenocorticotropic hormone (ACTH), follicle-stimulating hormone (FSH), adrenaline (E), noradrenaline (NE), and β-endorphin (β-end)were performed using the enzyme-linked immunosorbent assay (ELISA) method on blood samples taken before and after five series of pulsatile exercises, at 1, 24, and 48 h.ResultsPulsatile exercise at ambient temperatures of 21 and 31 °C resulted in a decrease in body weight of the studied athletes (p < 0.05) and significantly reduced body volume and plasma volume after training (p < 0.05). The concentration of HGH, testosterone, cortisol and NE showed a statistically significant difference after the end of the series of pulsating exercises at both temperatures (p < 0.05) and did not significantly affect the concentration of ACTH, FSH and adrenaline concentration.ConclusionsAn increase in the concentration of growth hormone, cortisol and NE was observed after doing the work at both 21 and 31 °C ambient temperature. Physical exertion in both ambient temperatures contributed to a statistically significant decrease in testosterone concentration. Based on the obtained research results, it can be concluded that physical activity in various thermal conditions of the external environment activates the hormonal response to varying degrees, with the direction of changes depending on the external thermal factor.

Comparing thermal strain in outdoor maintenance and indoor service workers in the mining industry during summer.

While working in the heat is a common practice within the Australian mining industry, it can lead to adverse effects on cognitive function, productivity, and physical health. This study aimed to compare the thermal strain experienced by maintenance workers and service workers in the mining industry during summer. Psycho-physiological parameters, manual dexterity, and cognitive function were assessed in maintenance workers (n = 12) and service workers (n = 12) employed at mine site villages in north-west Australia. Maintenance workers had the freedom to self-select their work intensity and predominantly worked outdoors (33.9±4.2°C, 38±18% RH), whereas service workers had to work to a fixed schedule and worked intermittently indoors (∼64% of work shift; 29.5±3.4°C, 48±8% RH) and outdoors (∼36%; 35.4±4.6°C, 47±21% RH). All workers underwent assessment at the beginning (day 2/3), middle (day 7/8), and end of their swing (day 13/14), at various time points throughout their 11-12 h shift. Service workers completed more steps (11282±1794 vs. 7774±2821; p<0.001), experienced a higher heart rate (p = 0.049) and reported higher ratings of perceived exertion (p<0.001), thermal discomfort (p<0.001), thermal sensation (p<0.001), and fatigue (p<0.012) compared to maintenance workers. Urinary specific gravity values were higher (less hydrated) in service workers (1.024±0.007) compared to maintenance workers (1.018±0.006; p = 0.007), with USG being overall higher post- compared to pre-shift (1.022±0.008 vs. 1.020±0.006; p<0.05). Core temperature, working memory capacity, processing speed and manual dexterity did not differ between occupations. Workers in hot environments who cannot self-select their work intensity should be educated about the importance of hydration before, during, and after their work-shifts and provided with more scheduled rest breaks during their shift. Employers should closely monitor workers for symptoms of heat illness, discomfort, and fatigue to ensure the health and safety of the workers.

Motor adaptation and immediate retention to overground gait-slip perturbation training in people with chronic stroke: an experimental trial with a comparison group.

Perturbation-based training has shown to be effective in reducing fall-risk in people with chronic stroke (PwCS). However, most evidence comes from treadmill-based stance studies, with a lack of research focusing on training overground perturbed walking and exploring the relative contributions of the paretic and non-paretic limbs. This study thus examined whether PwCS could acquire motor adaptation and demonstrate immediate retention of fall-resisting skills following bilateral overground gait-slip perturbation training. 65 PwCS were randomly assigned to either (i) a training group, that received blocks of eight non-paretic (NP-S1 to NP-S8) and paretic (P-S1 to P-S8) overground slips during walking followed by a mixed block (seven non-paretic and paretic slips each interspersed with unperturbed walking trials) (NP-S9/P-S9 to NP-S15/P-S15) or (ii) a control group, that received a single non-paretic and paretic slip in random order. The assessor and training personnel were not blinded. Immediate retention was tested for the training group after a 30-minute rest break. Primary outcomes included laboratory-induced slip outcomes (falls and balance loss) and center of mass (CoM) state stability. Secondary outcomes to understand kinematic contributors to stability included recovery strategies, limb kinematics, slipping kinematics, and recovery stride length. PwCS within the training group showed reduced falls (p < 0.01) and improved post-slip stability (p < 0.01) from the first trial to the last trial of both paretic and non-paretic slip blocks (S1 vs. S8). During the mixed block training, there was no further improvement in stability and slipping kinematics (S9 vs. S15) (p > 0.01). On comparing the first and last training trial (S1 vs. S15), post-slip stability improved on both non-paretic and paretic slips, however, pre-slip stability improved only on the non-paretic slip (p < 0.01). On the retention trials, the training group had fewer falls and greater post-slip stability than the control group on both non-paretic and paretic slips (p < 0.01). Post-slip stability on the paretic slip was lower than that on the non-paretic slip for both groups on retention trials (p < 0.01). PwCS can reduce laboratory-induced slip falls and backward balance loss outcomes by adapting their post-slip CoM state stability after bilateral overground gait-slip perturbation training. Such reactive adaptations were better acquired and retained post-training in PwCS especially on the non-paretic slips than paretic slips, suggesting a need for higher dosage for paretic slips. NCT03205527.

Poster (Clinical/Best Practice Implementation) ID 1981325

Background Many barriers prevent those with spinal cord injury or disease (SCI/D) from adhering to recommended exercise guidelines, thus increasing risks of secondary health conditions. Mainstream technology options, such as virtual reality (VR), have the potential to facilitate needed exercise participation. However, further research on VR exercise modalities is needed to determine feasibility, effectiveness and to ultimately guide practice recommendations. Objectives The goal of this pilot feasibility study was to determine whether VR exergaming is non-inferior to the current standard of care (SoC) upper extremity aerobic exercise for individuals with SCI/D. Methods/Overview 25 participants with SCI/D completed 10-minute exercise sessions with either VR or the SoC, and after a rest break, then completed 10 minutes of exercise with the other modality. Primary outcomes of heart rate (HR) and rate of perceived exertion (RPE) were collected at baseline, 5 minutes into exercise, and at 10 min (end of the exercise session) for each modality. Secondary exploratory measures included a Numeric Pain Rating Scale measured pre- and post- each exercise session, and a post-study likeability survey. Results There were no significant differences in HR or RPE between virtual reality exergaming and the standard of care, and 100% of participants preferred the VR over SoC for the exercise. Conclusions VR exergaming was non-inferior to the SoC for short duration upper extremity exercise in those with SCI/D. Implementing VR for patients with SCI/D should be studied further to observe the longer term effect on cardiovascular health and to determine feasibility and compliance for home use.

Nurses' Rest Breaks and Fatigue: The Roles of Psychological Detachment and Workload.

Rest breaks have been shown to reduce acute fatigue, yet not all nurses who take rest breaks report lower fatigue. Psychological detachment-letting go of work-related thoughts-during rest breaks and workload may be key factors in explaining this phenomenon. To examine the mediating role of psychological detachment during rest breaks and determine how workload moderated that pathway to lower acute fatigue among hospital nurses. In this cross-sectional study, data were collected from 1861 12-hour shift nurses who answered an online survey between July and September 2021. The survey included measures of occupational fatigue, psychological detachment from work, workload, and questions on breaks, work, health, and demographics. Structural equation modeling was used in Mplus 8.9 software to estimate the direct and indirect effects of rest breaks on acute fatigue at 3 levels of workload. Nurses, on average, reported high acute fatigue, rarely experienced psychological detachment during rest breaks, and reported heavy workloads. Around 60% were able to sit down for a break on their last shift but with patient-care responsibilities. The relationship between taking a rest break and acute fatigue was fully mediated by psychological detachment from work. However, this relationship only held in the context of manageable workloads. Our findings showed that within-shift recovery is possible when nurses can psychologically detach from work during rest breaks. However, this within-shift recovery mechanism was disrupted for nurses with heavy workloads.

A Critical Discussion on the Effectiveness of Working Time Directive 2003/88/EC

Since its implementation in 2003, Working Time Directive 2003/88/EC has brought a series of benefits to employees in the European Union. It has played a significant role in restricting working time and guaranteeing rest breaks, which truly protected the health and safety of workers. However, given the economic recession in the European Union, the widespread nature of atypical employment relationships and enlargement of the European Union, the effectiveness of Working Time Directive 2003/88/EC has been doubted in recent years. Therefore, it is essential to analyse whether Working Time Directive 2003/88/EC remains fit for the purpose more than 15 years after its adoption and propose corresponding solutions to protect the health and safety of employees in these member countries.

Role of high flow nasal therapy in Intensive Care Units

Introduction and purpose: High Flow Nasal Therapy is quite new respiratory support method, although recently it became more popular – especially during COVID-19 pandemic. Physiological mechanisms as well as main applications were observed and described in several randomized controlled trias and metaanalisys. The purpose of this review is to present fundamental studies and indicate applications of this method.&#x0D; Brief description of the state of knowladge: Breathing mixture with a maximum flow 60l/min needs to be heated and humidified to protect the airways from dryness. Optimal humidity improves mucocilary clearance, reduces inflammation of the airways and energy expenditure, especially in acute respiratory failure. High flow nasal therapy may imrpove the mechanics of breathing also by washout of nasopharyngeal dead space and generating positive airway pressure during exhalation, which keeps airways open and prevents the alveoli from collapsing. High flow therapy can be use in many different applications but at Intensive Care Unit the most important are: acute hypoxemia, during extubation or rest breaks from NIV. It is important to monitor the patient and predict the need for intubation on time. There are physiological states that we shoud focus on: respiratory rate, dyspnea or work of breathing, but it is good to know ROX index which can be helpful to assess the success of the therapy.&#x0D; Summary (conlcusions): High flow nasal therapy is a simple and safety respiratory support method that can be applicable at Intensive Care Units. It can lower the intubation numbers and help during NIV rest breaks. High flow nasal therapy is a very promising method for all patients with respiratory failure but it is important to monitor the patient and not delay the intubation.

The effect of selected rest break activities on reaction time, balance, and perceived discomfort after one hour of simulated occupational whole-body vibration exposure in healthy adults

Background & Objective : Negative health effects from occupational whole-body vibration (WBV) exposure during machinery operation include alterations in proprioception, vestibular function, reaction time, stress, motor response, and decrements in musculoskeletal health. To reduce WBV exposure during machinery operation, it may be possible to incorporate short rest break activities throughout the day. This study aims to determine if there are intervention activities that can minimize decrements in cognitive, proprioceptive, and musculoskeletal effects related to WBV exposure during machine operation. Materials & Methods Eleven healthy adults participated in four 1-hour sessions of ecologically valid WBV exposure followed by one of four 5-minute activities: sitting, walking, 2 min of gaze stabilization exercise (GSE) coupled with 3 min of trunk mobility exercise (GSE + MOBIL), or 2 min of GSE coupled with a 3-minute walk (GSE + WALK). Baseline and post-activity measurements (rating of perceived discomfort, balance and postural sway measurements, 5-minute psychomotor vigilance task test) were submitted to a paired t-test to determine the effect of WBV exposure and activities on physical, cognitive, and sensorimotor systems and to a repeated measures ANOVA to determine any differences across activities. Results We observed degradation of the slowest 10% reaction speed outcomes between baseline and post-activity after walking (7.3%, p < 0.05) and sitting (8.6%, p < 0.05) but not after GSE + MOBIL or GSE + WALK activities. Slowest 10% reaction speed after GSE + MOBIL activity was faster than all other activities. The rating of perceived discomfort was higher after SIT and WALK activities. There were no notable differences in balance outcomes. Conclusion When compared to sitting for 5 min, an activity including GSE and an active component, such as walking or trunk mobility exercises, resulted in maintenance of reaction time after WBV exposure. If confirmed in occupational environments, GSE may provide a simple, rapid, effective, and inexpensive means to protect against decrements in reaction time after WBV exposure.

Prevalence and Factors Associated with Occupational Musculoskeletal Disorders among the Nurses of a Tertiary Care Center of Nepal

Introduction: Musculoskeletal disorders (MSDs) are injuries or pain in the human musculoskeletal system which could lead to temporary or permanent impairments. The nature of nursing jobs makes nurses vulnerable to MSDs. This study aimed to assess the prevalence and potential risk factors associated with MSDs among nurses. Methods: In between March to June 2021, a cross-sectional study was conducted among 165 nurses using self-administered questionnaires. A standardized Nordic Questionnaire was used to measure MSDs. Pearson’s chi-square test and binary logistic regression at a 5% level of significance were performed to identify factors associated with upper extremities and spinal musculoskeletal disorders (UMSD) and lower extremities musculoskeletal disorders (LMSD). Variables associated with UMSD and LMSD in bivariate analysis were subjected to multiple logistic regression. Results: The prevalence of UMSD and LMSD experienced by nurses was 86.1% (95% CI: 79.4%-90.9%) and 66.1% (95% CI: 58.9%-74.3%), respectively. Among several factors, working in same position for long periods (AOR: 4.16, 95% CI: 1.2-13.4), not receiving training in injury prevention programs (AOR: 3.15, 95% CI: 1.0-9.2), not enough rest breaks during the day (AOR: 4.65, 95% CI: 1.3-15.9) and moderate to higher job stress (AOR: 3.62, 95% CI: 1.2-10.8) were found to be significantly associated with UMSD. Not having enough rest breaks during the day (AOR: 2.19, 95% CI: 1.0-4.7) was significantly associated with LMSD. Conclusion: Higher prevalence of MSDs among nurses is a serious concern that threatens individual health as well as the overall healthcare system. Sensitization and capacity enhancement programs on the issue could prevent MSDs among nurses.

The Immediate Effect of 90 sec. Duration Plantar Myofascial Release on Static and Dynamic Balance and Injury Risk in Female Volleyball Players

Background. Self-administered plantar myofascial release with a tennis ball is a widely used technique to increase flexibility and range of motion, but it is unclear how effective this technique is on static and dynamic balance and injury risk in volleyball players.&#x0D; The aim of the study is to determine the immediate effect of short-term (90 s duration) plantar myofascial release on the static and dynamic balance and injury risk of females playing volleyball.&#x0D; Methods. The study involved 26 female volleyball players who were randomly assigned to one of two groups. Subjects in the control group (n=13) received no intervention and were retested for 180 s. since initial testing. The participants of the study group received self-administered plantar myofascial release of 90 s duration with tennis ball for one leg and 90 s duration on the other leg (all together duration 180 s). A modified star excursion (Y test) test was used to assess dynamic balance. Static balance was assessed by the Flamingo test.&#x0D; Results. Myofascial release improved (p&lt;0.05) the result of dynamic balance in only one direction – anterior, standing on both the left and right leg, in the control group – posterolateral, standing on the right and left leg, posteromedial – standing on the right leg (p&lt;0.05). No differences were found between groups. The static balance of subjects in both groups during the retest did not differ (p&gt;0.05) from the initial assessment. The combined dynamic balance score improved (p&lt;0.05) only in the control group that had a rest break instead of the intervention. No significant differences were found in static balance results either between groups or within groups.&#x0D; Conclusions. Immediate short duration plantar myofascial release was not effective on static and dynamic balance and injury risk in volleyball players. The effect of short-term myofascial release did not differ from that of no intervention.&#x0D; Keywords: balance, volleyball, myofascial release, injury risk.

Rest breaks aid directed attention and learning

ABSTRACT Objective When students learn or solve problems, attentional resources are depleted; rest breaks may restore cognitive functioning in support of learning. Research framed by attention restoration theory holds that exposure to natural environments may be another means to restore attentional resources. The study investigated the effects of alternative rest break formats on learning a challenging mental mathematics strategy. Method Students first completed a series of timed arithmetic tests expected to deplete attentional resources. Students in the control condition proceeded directly onto a mental mathematics lesson, while students in the unstructured rest and nature-based rest conditions took a 5-min break before the lesson. All students then completed a self-reported questionnaire on directed attention levels during the lesson, then completed a problem-solving post-test. Results The unstructured rest condition reported higher levels of directed attention during the lesson than the control condition; no other comparisons were statistically significant. The unstructured rest condition solved more post-test problems than the control condition, and the nature-based rest condition also solved more problems than the control condition. The post-test score difference between the two rest conditions was not statistically significant. Conclusions The study provided clearer evidence for the general benefits of rest than for the additional benefits of nature-based rest.

Creating a Culture to Improve Nurse Breaks on the Perinatal Unit

In 2022, perinatal nursing leadership identified a recurrent problem within the perinatal unit that nursing staff were not taking an uninterrupted rest and/or meal break consistently. This culture was perpetuated by inadequate staffing, hesitance to leave an intrapartum patient, and lack of trust in the covering nurse to complete required tasks. Without a clear break structure, nurses showed increased burnout and overall dissatisfaction with work.

“Make it the done thing”: an exploration of attitudes towards rest breaks, productivity and wellbeing while working from home

ObjectiveTaking regular rest breaks while working positively impacts productivity and wellbeing. While home and hybrid working styles have become a popular choice for employees, the impact of, and perceptions towards, taking breaks while working at home is poorly understood. The current research aimed to explore attitudes towards taking rest breaks while working from home and capture levels of breaks taken, wellbeing and productivity in a sample of UK white-collar workers.MethodsA mixed method approach was applied where self-report data from an online survey were gathered from individuals (N = 140) from one organisation. Open-ended questions regarding attitudes and perceptions towards rest break behaviours were obtained. Further quantitative measures included the number of breaks taken while working from home, levels of productivity (measured by the Health and performance Presenteeism subscale) and mental wellbeing (measured by the Short Warwick-Edinburgh Mental wellbeing scale). Both quantitative and qualitative analysis approaches were applied.ResultsQualitative responses indicated two overarching themes (1) Personal and (2) Organisational sat above four further themes including Movement outside, Structure of home working, Home environment and Digital presence. Additionally, quantitative findings indicated that the number of breaks taken outside was associated with positive changes in wellbeing.ConclusionEmployers could aim to support employees working from home in taking outside breaks through flexible working patterns, authentic leadership, and a change in company social norms around break behaviours. Such organisational changes could help to improve workforce productivity and wellbeing.

From Stressful to Mindful: Reactions to a Proposed Emergency Department Design for Enhancing Mindfulness and Stress Reduction Among Healthcare Clinical Staff.

This study explored design solutions that can help clinicians manage work-related stress, pursue mindful work, and practice relaxation and coping strategies. Clinicians are experiencing burnout at increasingly higher rates, leading to compromised patient care. While self-care and stress management strategies are shown to be effective in healthcare settings, little is known about how the design of healthcare settings can facilitate these strategies. Using findings of a preceding study by the authors, a virtual walk-through video of a design proposal for a free-standing emergency department was built. Feedback data were collected from clinicians in 10 in-depth interviews, and emerging themes were identified using qualitative content analysis. Our findings suggest that work environments that reflect intentional efforts to meet clinicians' needs for stress management can enhance their feeling of being valued and sense of professional worth. Clinicians are more likely to step away from work if there are multiple spaces for bio breaks and rest breaks. Primary break rooms are preferred to be close to patient care areas, but respite/escape spaces are preferred to be distant and private from patient care areas. Participants endorsed the provision of at least one staff bathroom large enough for extra seating and one outdoor respite space. Multiple workspaces should allow the completion of various tasks with adjustable levels of privacy. We suggest special attention to non-institutional aesthetics, providing choice and control, increasing flexibility, promoting privacy for focused work, maximizing access to daylight and outdoors, and providing opportunities for grief support.

Musculoskeletal disorders among doctors and nursing officers : an occupational hazard of overstrained healthcare delivery system in western Rajasthan, India

BackgroundThe present study was conducted to estimate the prevalence and distribution of MSDs in different anatomical regions among Doctors and NO and to determine their ergonomic risk factors and predictors.MethodsThis cross-sectional study was conducted in an apex institution in Western India. The socio-demographic information, medical and occupational history, and other personal and work-related attributes were captured using a semi-structured questionnaire, which was developed and finalized by piloting on 32 participants (who were not part of the study). Nordic Musculoskeletal and International Physical Activity Questionnaires were used to assess MSDs and Physical activity. Data were analyzed using SPSS v.23. Prevalence of Musculoskeletal Symptoms (M.S.), Multisite Musculoskeletal Symptoms (MMS), and Widespread Musculoskeletal Symptoms (WMS) were calculated. A comparison was made to estimate the burden and distribution of MSD among Doctors and Nursing officers. Logistic regression was applied to identify the predictors of MSDs and pinpoint the risk factors associated with MSDs.ResultsA total of 310 participants, of which 38.7% were doctors, and 61.3% were Nursing Officers (NOs) were included in the study. The mean age of the respondents was 31.63 ± 4.9 years. Almost 73% (95%CI: 67.9–78.1) of participants had MSD in the last 12 months, with approximately 41.6% (95%CI: 36.1–47.3) suffering from MSDs in the previous seven days of the survey. The lower back (49.7%) and the neck (36.5%) were the most affected sites. Working in the same position for a long time (43.5%) and not taking adequate breaks (31.3%) were the highest self-reported risk factors. Females had significantly higher odds of having pain in the upper back [aOR:2.49(1.27–4.85)], neck [aOR:2.15(1.22–3.77)], shoulder [aOR:2.8 (1.54–5.11)], hips [aOR:9.46 (3.95–22.68)] and knee [aOR:3.8(1.99–7.26)].ConclusionsFemales, who are NOs, work for > 48 h per week, and fall in the obese category were significantly at more risk of developing MSDs. Working in an awkward position, treating an excessive number of patients in a day, working in the same position for a long period, performing repeated tasks, and not having enough rest breaks were significant risk factors for MSDs.