The Total Therapy clinical trials for myeloma, based on tandem autologous transplants, had increasing hematopoietic progenitor cells apheresis (HPC-A) collection goals over time, eventually requiring ...20-30 x 106 CD34+ cells/kg recipient body weight (RBW) and a minimum 2-day collection cryopreserved in at least 6-8 bags. Collection goals for off protocol myeloma patients were 4-20 x 106 CD34+ cells/kg RBW and non-myeloma patients were 4-10 x 106 CD34+ cells/kg RBW, both with a minimum 2-day collection requirement. Management of myeloma and other hematologic malignancies changed as CAR-T cells became available, so HPC-A collection goals were decreased for myeloma patients to 10-15 x 106 CD34+ cells/kg RBW depending on patient age, in at least 3-5 bags, and for other hematologic malignancies to 5 x 106 CD34+ cells/kg RBW in at least 2 bags. The requirement for a 2-day collection was also discontinued. The change on workload and costs in the cell therapy lab was analyzed.
The change in collection goal was implemented in March 2023. Data on the number of products collected, number of bags cryopreserved and stored, and associated costs were obtained for all autologous HPC-A collections collected for 8 months after the change (April-November 2023), with eight month control periods in 2022 and 2021. Two-sample, unidirectional, unequal variance t-tests were performed on per patient averages and compared between years.
Figure 1 shows average HPC-A collections (bar) and average cryopreserved bags (line) per patient per year. Figure 2 shows average staff hours worked (bar) and supply and reagent costs (line) per patient per year. The monthly data comparison is in Table 1 and data averages per patient is in Table 2. The average number of cryopreserved bags per patient significantly decreased from 2021 to 2022 (p<0.05) prior to the change, all other per patient parameters were not statistically significant. All per patient parameters significantly decreased in 2023 compared to 2021 and 2022 (p<0.01).
The cell therapy lab and cryostorage facility are integral parts of a stem cell transplant program. Small changes in HPC-A collection goals had large cost savings, decreased workload, and decreased the number of storage slots required for cryostorage. This institutional analysis highlights the benefits of ongoing evaluation of collection and storage goals during an era of fiscal and staffing pressures.
The effect of technology-enhanced learning (TEL) strategies in higher education has arguably been transformative despite the not-insignificant barriers existing in this context. Throughout the ...discourse very little attention has been paid to those primarily responsible for this implementation-academic teaching staff. This paper aims to highlight the impact of academic workload allocations, an often silent barrier to the uptake of TEL strategies in higher education. We will discuss the effects of academic identity and culture, preferential time allocation to associative activities, academic technological capacity, university policies and workload and funding models on the uptake, and implementation on TEL in higher education. Our aim is to highlight the risks to staff, students and institutions should these concerns not be addressed and to propose a model for utilisation by all staff responsible for implementing flexible workload models supportive of further implementation of TEL strategies across the sector.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
A survey of workload assessment algorithms Heard, Jamison; Harriott, Caroline E.; Adams, Julie A.
IEEE transactions on human-machine systems,
2018-Oct., 2018-10-00, 20181001, Letnik:
48, Številka:
5
Journal Article
Recenzirano
Odprti dostop
Supervisory control environments, such as the NASA control room can induce high workload levels in situations where a single error is capable of costing millions of dollars. An intelligent system can ...improve human supervisor performance by monitoring the human's workload levels and intelligently adapting the system capabilities, such as adapting the interaction medium or reallocating roles and responsibilities between the human and the system. Systems capable of responding promptly and accurately to the human's changes in workload require a workload assessment algorithm that can detect changes to all components of workload in real time. A review of 24 workload assessment algorithms across six task domains is provided. Each algorithm is reviewed based on four criteria: sensitivity, diagnosticity, suitability, and generalizability. The majority of the reviewed algorithms were developed for a specific task domain and are unable to generalize different tasks. Further, the majority of the algorithms do not account for individual differences, only assess one or two workload components, and do not classify underload.
Abstract
Limited research exists on the relationship between changes in physical activity levels and injury in children. In this study, we investigated the prognostic relationship between changes in ...activity, measured by the acute:chronic workload ratio (ACWR), and injury in children. We used data from the Childhood Health, Activity, and Motor Performance School Study Denmark (2008–2014), a prospective cohort study of 1,660 children aged 6–17 years. We modeled the relationship between the uncoupled 5-week ACWR and injury, defined as patient-reported musculoskeletal pain, using generalized additive mixed models. These methods accounted for repeated measures, and they improved model fit and precision compared with previous studies that used logistic models. The prognostic model predicted an injury risk of approximately 3% between decreases in activity level of up to 60% and increases of up to 30%. Predicted risk was lower when activity decreased by more than 60% (minimum of 0.5% with no recreational activity). Predicted risk was higher when activity increased by more than 30% (4.5% with a 3-fold increase in activity). Girls were at significantly higher risk of injury than boys. We observed similar patterns but lower absolute risks when we restricted the outcome to clinician-diagnosed injury. Predicted increases in injury risk with increasing activity were much lower than those of previous studies carried out in adults.
This study attempted to multimodally measure mental workload and validate indicators for estimating mental workload. A simulated computer work composed of mental arithmetic tasks with different ...levels of difficulty was designed and used in the experiment to measure physiological signals (heart rate, heart rate variability, electromyography, electrodermal activity, and respiration), subjective ratings of mental workload (the NASA Task Load Index), and task performance. The indices from electrodermal activity and respiration had a significant increment as task difficulty increased. There were no significant differences between the average heart rate and the low-frequency/high-frequency ratio among tasks. The classification of mental workload using combined indices as inputs showed that classification models combining physiological signals and task performance can reach satisfying accuracy at 96.4% and an accuracy of 78.3% when only using physiological indices as inputs. The present study also showed that ECG and EDA signals have good discriminating power for mental workload detection.
Practitioner summary: The methods used in this study could be applied to office workers, and the findings provide preliminary support and theoretical exploration for follow-up early mental workload detection systems, whose implementation in the real world could beneficially impact worker health and company efficiency.
Abbreviations: NASA-TLX: the national aeronautics and space administration-task load index; ECG: electrocardiographic; EDA: electrodermal activity; EEG: electroencephalogram; LDA: linear discriminant analysis; SVM: support vector machine; KNN: k-nearest neighbor; ANNs: artificial neural networks; EMG: electromyography; PPG: photoplethysmography; SD: standard deviation; BMI: body mass index; DSSQ: dundee stress state questionnaire; ANOVA: analysis of variance; SC: skin conductance; RMS: root mean square; AVHR: the average heart rate; HR: heart rate; LF/HF: the ratio between the low frequencies band and the high frequency band; PSD: power spectral density; MF: median frequency; HRV: heart rate variability; BPNN: backpropagation neural network
Primary care physicians spend nearly 2 hours on electronic health record (EHR) tasks per hour of direct patient care. Demand for non-face-to-face care, such as communication through a patient portal ...and administrative tasks, is increasing and contributing to burnout. The goal of this study was to assess time allocated by primary care physicians within the EHR as indicated by EHR user-event log data, both during clinic hours (defined as 8:00 am to 6:00 pm Monday through Friday) and outside clinic hours.
We conducted a retrospective cohort study of 142 family medicine physicians in a single system in southern Wisconsin. All Epic (Epic Systems Corporation) EHR interactions were captured from "event logging" records over a 3-year period for both direct patient care and non-face-to-face activities, and were validated by direct observation. EHR events were assigned to 1 of 15 EHR task categories and allocated to either during or after clinic hours.
Clinicians spent 355 minutes (5.9 hours) of an 11.4-hour workday in the EHR per weekday per 1.0 clinical full-time equivalent: 269 minutes (4.5 hours) during clinic hours and 86 minutes (1.4 hours) after clinic hours. Clerical and administrative tasks including documentation, order entry, billing and coding, and system security accounted for nearly one-half of the total EHR time (157 minutes, 44.2%). Inbox management accounted for another 85 minutes (23.7%).
Primary care physicians spend more than one-half of their workday, nearly 6 hours, interacting with the EHR during and after clinic hours. EHR event logs can identify areas of EHR-related work that could be delegated, thus reducing workload, improving professional satisfaction, and decreasing burnout. Direct time-motion observations validated EHR-event log data as a reliable source of information regarding clinician time allocation.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The distinction between several components of mental workload is often made in the ergonomics literature. However, measurements used are often established from a global score, notably with several ...questionnaires that originally reflect several dimensions. The present study tested the effect of driving situation complexity, experience and subjective levels of tension and alertness on each dimension of the NASA-TLX questionnaire of workload, in order to highlight the potential influence of intrinsic, extraneous and germane load factors. The results showed that, in complex situation, mental, temporal and physical demand (load dimensions) increased, and that novice drivers presented high physical demand when subjective tension was low on performance. Moreover, increase of mental and physical demand increased effort. It thus, appears essential to distinguish the different components of mental workload used in the NASA-TLX questionnaire.
Practitioner Summary: Currently, global score of NASA-TLX questionnaire is used to measure mental workload. Here, we considered independently each dimension of NASA-TLX, and results showed that mental load factors (driving situation complexity, experience, subjective tension and alertness) had a different effect on dimensions, questioning global score use to evaluate workload.
Mental workload (MWL) is one of the most widely used concepts in ergonomics and human factors and represents a topic of increasing importance. Since modern technology in many working environments ...imposes ever more cognitive demands upon operators while physical demands diminish, understanding how MWL impinges on performance is increasingly critical. Yet, MWL is also one of the most nebulous concepts, with numerous definitions and dimensions associated with it. Moreover, MWL research has had a tendency to focus on complex, often safety-critical systems (e.g. transport, process control). Here we provide a general overview of the current state of affairs regarding the understanding, measurement and application of MWL in the design of complex systems over the last three decades. We conclude by discussing contemporary challenges for applied research, such as the interaction between cognitive workload and physical workload, and the quantification of workload 'redlines' which specify when operators are approaching or exceeding their performance tolerances.
Practitioner Summary: The study of workload in ergonomics has risen in popularity since the 1980s. Applied problems, particularly in transport, have taken centre stage in recent years. New developments in neuroergonomics measurement techniques offer promise in quantifying both the interaction of physical and mental workload, as well as the elusive 'redline' performance limit for overload.
Aim
This study aimed to identify determinants of physical, mental and emotional nursing workloads.
Background
Workload has a physical, mental and emotional dimension. It influences employees' ...well‐being and quality of care. Nevertheless, studies of specific predictors for each dimension of nurses' workload are scarce.
Methods
We used a cross‐sectional prospective design based on the Job Demand‐Resources theory. We asked nurses to describe workload perceived at the end of every shift over three consecutive weeks. Data were gathered from two academic hospitals, in seven medical–surgical wards. We received 259 responses and tested 2 multivariate regression models.
Results
Physical workload was predicted from all variables tested; mental workload was determined by patient complexity or isolation, adequacy of nurse staffing and skill‐mix, and unscheduled activities; and emotional workload was predicted by all variables except adequacy of staffing and other people's education.
Conclusions
Patient, nurse and workflow aspects influenced nurse's shift workload differently for each specific dimension.
Implications for Nursing Management
Measurement and definition of predictors of workload in the work environment are essential. Recognizing the determinants of specific dimensions of workload facilitates identification of the most appropriate interventions to improve nurses' well‐being in health care settings.
This paper reports on research exploring the academic workload and performance practices of Australian universities. This research has identified a suite of activities associated with teaching, ...research and service, each with an
associated time value (allocation). This led to the development of the academic workload estimation tool (AWET). In 2020, to validate the findings, we contacted academics willing to participate further and conducted interviews. We used
the AWET to estimate workload for each individual for the previous year and compared it to the workload allocated according to their institutional workload model. Discrepancies were then discussed to ascertain to what extent the AWET was
able to capture their work. In general, the participants thought the AWET provided a more realistic estimate of their actual work and highlighted how much is underestimated or unaccounted for by the workload models used within their
institutions. It also showed how academic performance policies, focussed primarily on research output, disadvantaged many individuals because they ignored or minimised many scholarly, teaching and service-related tasks inherent in the
academic role. Overall, the findings showed the AWET was a useful tool to discuss academic work and assisted them to better capture the complexity and extent of what they did. We offer the AWET as a validated approach for academics to
estimate their workload in a holistic and transparent manner. We suggest its implementation institution-wide, along with an aligned performance policy, will facilitate negotiation of reasonable performance expectations. This will rebuild
trust in the processes and improve a university's effectiveness. Author abstract
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