A large number of workers worldwide engage in shift work that can have significant influences upon the quality of working life. For most jurisdictions, setting and enforcing appropriate policies, ...regulations, and rules around shift work is considered essential to (a) prevent potentially negative consequences of shift work and (b) to improve worker health and well-being. However, the best ways to do this are often highly contested theoretical spaces and often culturally and historically bound. In this paper, we examine the regulatory approaches to regulating shift work in four different regions: Europe, North America, Australasia, and East Asia (Japan, China, and Korea). Despite the fact that social and cultural factors vary considerably across the regions, comparing regulatory frameworks and initiatives in one region can be instructive. Different approaches can minimally provide a contrast to stimulate discussion about custom and practice and, potentially, help us to develop new and innovative models to improve worker well-being and organizational productivity simultaneously. In this paper, our goal is not to develop or even advocate a “perfect” sets of regulations. Rather, it is to compare and contrast the diversity and changing landscape of current regulatory practices and to help organizations and regulators understand the costs and benefits of different approaches. For example, in recent years, many western countries have seen a shift away from prescriptive regulation toward more risk-based approaches. Advocates and critics vary considerably in what drove these changes and the benefit-cost analyses associated with their introduction. By understanding the different ways in which shift work can be regulated, it may be possible to learn from others and to better promote healthier and safer environments for shift-working individuals and workplaces.
Recurrence of cytomegalovirus reactivation remains a major cause of morbidity and mortality following allogeneic hematopoietic stem cell transplantation. Monitoring cytomegalovirus-specific cellular ...immunity using a standardized assay might improve the risk stratification of patients. A prospective multicenter study was conducted in 175 intermediate- and high-risk allogeneic hematopoietic stem cell transplant recipients under preemptive antiviral therapy. Cytomegalovirus-specific cellular immunity was measured using a standardized IFN-γ ELISpot assay (T-Track® CMV). Primary aim was to evaluate the suitability of measuring cytomegalovirus-specific immunity after end of treatment for a first cytomegalovirus reactivation to predict recurrent reactivation. 40/101 (39.6%) patients with a first cytomegalovirus reactivation experienced recurrent reactivations, mainly in the high-risk group (cytomegalovirus-seronegative donor/cytomegalovirus-seropositive recipient). The positive predictive value of T-Track® CMV (patients with a negative test after the first reactivation experienced at least one recurrent reactivation) was 84.2% in high-risk patients. Kaplan-Meier analysis revealed a higher probability of recurrent cytomegalovirus reactivation in high-risk patients with a negative test after the first reactivation (hazard ratio 2.73; p=0.007). Interestingly, a post-hoc analysis considering T-Track® CMV measurements at day 100 post-transplantation, a time point highly relevant for outpatient care, showed a positive predictive value of 90.0% in high-risk patients. Our results indicate that standardized cytomegalovirus-specific cellular immunity monitoring may allow improved risk stratification and management of recurrent cytomegalovirus reactivation after hematopoietic stem cell transplantation. This study was registered at www.clinicaltrials.gov as #NCT02156479.
Bei der Gestaltung der Arbeitszeit treffen unterschiedliche Interessen von Unternehmen und Beschäftigten aufeinander. Neben betrieblich vorgegebenen Zielen (z.B. Bedarf, geringe Kosten) und Recht ist ...daher die Ausgestaltung eines Schichtmodells, das ergonomische Erkenntnisse berücksichtigt und auf eine ausgewogene Verteilung von sozial nutzbarer Zeit achtet, besonders wichtig. Dieser Beitrag beschreibt am Beispiel des Softwaretools „Schichtplanassistent“, wie neuartige Optimierungsverfahren in einer Schichtplansoftware eingesetzt werden können, um die Freizeit am Wochenende sowie die gleichmäßige Verteilung von freien Wochenenden und weitere ergonomische Kriterien in Schichtplänen bestmöglich zu berücksichtigen. So wird rasch trans-parent, welche Anforderungen hinsichtlich Arbeit- und Freizeitverteilung unter welchen Einschränkungen (z.B. bedingen lange Freizeitblöcke in der Regel auch lange Arbeitsblöcke) möglich sind. In der Diskussion zwischen Arbeitgeber:innen und Arbeitnehmer:innen kann dies die Entscheidungsfindung für einen Schicht- bzw. Rahmenplan deutlich erleichtern und die ergonomische Gestaltung von Arbeitszeit unterstützen.
Musculoskeletal disorders (MSD) are leading causes for sick days and long-term disability, and nurses are amongst the most affected. While long weekly work hours can increase MSD risk, the role of ...specific shift schedule characteristics in healthcare is poorly understood. For this narrative review, 236 abstracts published since 2008 were screened, and 15 retained manuscripts are summarized for an updated synthesis of the current evidence. In addition to long work hours, we identified night and shift work as MSD risk factors, the latter especially for low back pain. Some studies showed workload and individual factors as effect modifiers. Evidence for specific work schedule characteristics was often not available or of limited quality, hampering the ability to draw further conclusions.
Bei der Arbeitszeitgestaltung treffen öfters betriebliche Anforderungen wie erweiterte Betriebs- und Öffnungszeiten auf den deutlichen Wunsch der Mitarbeitenden nach mehr Gestaltungsfreiräumen bei ...der Arbeitszeit, um ihre Work-Life-Balance zu ver-bessern. Eine mögliche Lösung für diese auf den ersten Blick widersprüchlichen An-forderungen besteht aus der Kombination von Schichtarbeit mit Gleitzeit oder Gleit-zeitelementen. Dieser Praxisbeitrag zeigt auf, wie und unter welchen Umständen eine solche Kombination von Schichtplänen mit Gleitzeit möglich ist. Die notwendigen Schritte zur Vorbereitung und Durchführung werden beschrieben. Praxisbeispiele aus verschiedenen Branchen werden vorgestellt, ergänzt um eine Analyse fördernder und hinderlicher Rahmenbedingungen für die Umsetzung.
Die aktuelle Regulierung von Arbeitszeiten schafft Anreize für belastende Zeiten und berücksichtigt nur unzureichend wissenschaftliche Erkenntnisse zu den Auswirkungen dieser Belastungen. Dieser ...Beitrag stellt einen neuen Ansatz vor: Ausgehend von einer einerseits weit verbreiteten und andererseits auch sozial- und gesundheitspolitisch wünschenswerten ‚Neuen Normalarbeitszeit‘, nämlich der Gleitzeit von Montag bis Freitag tagsüber, sollen abweichende Arbeitszeiten hinsichtlich ihrer Belastung bewertet werden. Eine angemessene Kompensation in zusätzlicher Freizeit statt finanzieller Zulagen soll dann diese Belastung ausgleichen statt sie finanziell abzugelten. Damit würden auch bestehende Anreize für ein freiwilliges Verbleiben in belastenden Arbeitszeiten reduziert.
Cytomegalovirus (CMV) infection is a major cause of morbidity and mortality following hematopoietic stem cell transplantation (HSCT). Measuring CMV-specific cellular immunity may improve the risk ...stratification and management of patients. IFN-γ ELISpot assays, based on the stimulation of peripheral blood mononuclear cells with CMV pp65 and IE-1 proteins or peptides, have been validated in clinical settings. However, it remains unclear to which extend the T-cell response to synthetic peptides reflect that mediated by full-length proteins processed by antigen-presenting cells. We compared the stimulating ability of pp65 and IE-1 proteins and corresponding overlapping peptides in 16 HSCT recipients using a standardized IFN-γ ELISpot assay. Paired qualitative test results showed an overall 74.4% concordance. Discordant results were mainly due to low-response tests, with one exception. One patient with early CMV reactivation and graft-versus-host disease, sustained CMV DNAemia and high CD8
counts showed successive negative protein-based ELISpot results but a high and sustained response to IE-1 peptides. Our results suggest that the response to exogenous proteins, which involves their uptake and processing by antigen-presenting cells, more closely reflects the physiological response to CMV infection, while the response to exogenous peptides may lead to artificial in vitro T-cell responses, especially in strongly immunosuppressed patients.
Arbeitszeiten können das Fehler- und Unfallrisiko der Beschäftigten beeinflussen. Um die Risiken verschiedener Arbeitszeit- bzw. Schichtmodelle zu bewerten, wurden fünf häufig anzutreffende ...„Standardmodelle“ mit dem XIMES-Risikorechner analysiert und verglichen. Inkludiert wurden kurz vorwärts und lang rückwärts rotierte Schichtpläne, 12-Stunden-Modelle und lange Tagarbeit. Die Ergebnisse zeigen bei allen untersuchten Systemen erhöhte Risiken im Vergleich zu Tagarbeit mit 8-Stunden-Schichten, jedoch treten sowohl im Gesamtrisiko als auch in den Spitzen an einzelnen Arbeitstagen große Unterschiede auf. Das kurz vorwärts rotierte System schneidet dabei auf beiden Dimensionen am besten ab. Die Ergebnisse können für die Evaluierung und präventive Arbeitszeitgestaltung genutzt werden. Working time arrangements can affect the risk of injuries and accidents at work. To evaluate the risk associated with common shift schedules, five different schedules were analyzed and compared regarding their inherent accident risks, using the XIMES Risk Calculator. We included fast forward and slow backward rotated shift schedules, 12-hour-shift systems and long daily working hours. Results show elevated accident risks in all schedules compared to day work with 8-hour-shifts. However, different risks are estimated for each schedule both for the overall risk and maximum risks at day level. The short forward rotated system achieves the best results on both dimensions. These results can be used for risk assessment, as well as prevention through work hour optimization.
Arbeitszeiten können das Fehler- und Unfallrisiko der Beschäftigten beeinflussen. Um die Risiken verschiedener Arbeitszeit- bzw. Schichtmodelle zu bewerten, wurden fünf häufig anzutreffende ...„Standardmodelle“ mit dem XIMES-Risikorechner analysiert und verglichen. Inkludiert wurden kurz vorwärts und lang rückwärts rotierte Schichtpläne, 12-Stunden-Modelle und lange Tagarbeit. Die Ergebnisse zeigen bei allen untersuchten Systemen erhöhte Risiken im Vergleich zu Tagarbeit mit 8-Stunden-Schichten, jedoch treten sowohl im Gesamtrisiko als auch in den Spitzen an einzelnen Arbeitstagen große Unterschiede auf. Das kurz vorwärts rotierte System schneidet dabei auf beiden Dimensionen am besten ab. Die Ergebnisse können für die Evaluierung und präventive Arbeitszeitgestaltung genutzt werden. Working time arrangements can affect the risk of injuries and accidents at work. To evaluate the risk associated with common shift schedules, five different schedules were analyzed and compared regarding their inherent accident risks, using the XIMES Risk Calculator. We included fast forward and slow backward rotated shift schedules, 12-hour-shift systems and long daily working hours. Results show elevated accident risks in all schedules compared to day work with 8-hour-shifts. However, different risks are estimated for each schedule both for the overall risk and maximum risks at day level. The short forward rotated system achieves the best results on both dimensions. These results can be used for risk assessment, as well as prevention through work hour optimization.
Disruptive technological change can contribute to a more abundant world. However, potentially disruptive technologies often struggle to significantly influence practice. One prominent example is ...additive manufacturing (AM). Although AM is often regarded as the next great technological revolution in waiting, it has not yet established itself on a large scale in many fields of application. We investigate the reasons behind those challenges by looking at the various fields in which AM is applied and relating them to the specific challenges AM faces, as well as the opportunities it offers in those fields. Our findings rely on a multi-perspective technology foresight process that is based on a discourse analytic approach and that comprises data tomography covering the biggest German-language online magazine on AM and qualitative interview data collected from a range of AM stakeholders. The findings provide an empirically well-founded evaluation and explanation of the link between the challenges and opportunities offered by AM and the extent to which this disruptive technology is leveraged in specific fields. The findings prompt recommendations on how new potentially disruptive technologies can foster abundance in traditional, well established market economies based on the example of the well-developed but traditional market economy of Austria.
•AM materials used must suit to the product and its production process.•AM can be competitive if firms consider full life-cycle costs.•AM allows firms to focus on the very product.•AM application will increase if fostered in education and research.•AM service providers and research institutions support knowledge transfer.
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