Alternative work schedule interventions in the Australian construction industry: A comparative case study analysis

Project-based construction workers in the Australian construction industry work long and irregular hours and experience higher levels of work-to-family conflict and burnout than office-based workers, giving rise to an interest in alternative work schedules as a means of supporting work-life balance. Alternative work schedules were implemented in four case study construction projects in Australia. Interventions differed between projects, with two implementing a compressed work week, and the others introducing reduced hours schedules (one of which was optional). Data were collected from each case study project, using various combinations of focus groups, surveys, interviews and daily diary collection methods. The results were mixed. The compressed work week appears to have been favourably received where it was introduced. However, waged workers still expressed concerns about the impact on their weekly 'take-home' pay. Attempts to reduce work hours by changing from a six- to a five-day schedule (without extending the length of the working day between Monday and Friday) were less favourably received. Waged workers, in particular, did not favour reduced hours schedules. The results confirm the existence of two distinct labour markets operating in the Australian construction industry and markedly different responses to alternative work schedules, based upon whether workers are waged or salaried. The results clearly show that attempts to improve work-life balance must take the structural characteristics of the industry's labour markets into consideration in the design of interventions. The impact of alternative work schedules is likely to be moderated by institutional working time regimes within the construction industry

Perseverance, faith and stoicism: a qualitative study of medical student perspectives on managing fatigue

CONTEXT: Fatigue risk management (FRM) strategies offer a potential solution to the widespread problem of fatigued trainees in the clinical workplace. These strategies assume a shared perception that fatigue is hazardous. Despite the growing body of evidence suggesting that fatigue leads to burnout and medical errors, previous research suggests that residents perceive fatigue as a personal, surmountable burden rather than an occupational hazard. Before we can implement FRM, we need a better understanding of when and how such problematic notions of fatigue are adopted by medical trainees. Thus, we sought to explore how third-year medical students understand and manage the workplace fatigue they experience during their first year of clinical rotations. METHODS: A total of 22 third-year medical students participated in semi-structured interviews exploring their perspectives of workplace fatigue. Data collection and analysis occurred iteratively in keeping with constructivist grounded theory methodology and were informed by theoretical sampling to sufficiency. RESULTS: Our participants described unprecedented levels of sleep deprivation combined with uncertainty and confusion that led to significant fatigue during training. Drawing on their workplace experience, trainees believed that fatigue posed three distinct threats, which evoked different coping strategies: (i) threat to personal health, managed by perseverance; (ii) threat to patients, managed by faith in the system, and (iii) threat to professional reputation, managed by stoicism. CONCLUSIONS: Our findings highlight how senior medical students grapple with fatigue, as they understand it, within a training context in which they are expected to deny the impact of their fatigue on patients and themselves. Despite empirical evidence to the contrary, the prevailing assumption amongst our participants is that an ability to withstand sleep deprivation without impairment will develop naturally over time. Efforts to implement FRM strategies will need to address this assumption if these strategies are to be successfully taken up and effective

The relationship between pre-construction decision-making and the quality of risk control: Testing the time-safety influence curve

Purpose - The purpose of this paper is to explore the relationship between the timing with which decisions are made about how to control work health and safety (WHS) risks in construction project (i.e. either pre- or post-construction) and the quality of risk control outcomes. Design/methodology/approach - Data were collected from 23 construction projects in Australia and the USA. Totally, 43 features of work were identified for analysis and decision making in relation to these features of work was mapped across the life of the projects. The quality of risk control outcomes was assessed using a classification system based on the "hierarchy of control". Within this hierarchy, technological forms of control are preferable to behavioural forms of controls. Findings - The results indicate that risk control outcomes were significantly better in the Australian compared with the US cases. The results also reveal a significant relationship between the quality of risk controls and the timing of risk control selection decisions. The greater the proportion of risk controls selected during the pre-construction stages of a project, the better the risk control outcomes. Research limitations/implications - The results provide preliminary evidence that technological risk controls are more likely to be implemented if WHS risks are considered and controls are selected in the planning and design stages of construction projects. Practical implications - The research highlights the need for WHS risk to be integrated into decision making early in the life of construction projects. Originality/value - Previous research has linked accidents to design. However, the retrospective nature of these studies has not permitted an analysis of the effectiveness of integrating WHS into pre-construction decision making. Prospective studies have been lacking. This research provides empirical evidence in support of the relationship between early consideration of WHS and risk control effectiveness

Interprofessional communication with hospitalist and consultant physicians in general internal medicine : a qualitative study

This study helps to improve our understanding of the collaborative environment in GIM, comparing the communication styles and strategies of hospitalist and consultant physicians, as well as the experiences of providers working with them. The implications of this research are globally important for understanding how to create opportunities for physicians and their colleagues to meaningfully and consistently participate in interprofessional communication which has been shown to improve patient, provider, and organizational outcomes

Похибка розрахунку характеристик гармонійного сигналу

Встановлено основні джерела похибок програм визначення коефіцієнта гармонік для звичайної та подвійної точності розрахунку. Аналізуються похибки заокруглення, пов’язані із знаходженням тригонометричних функцій стандартними програмами, похибки розрахунку коефіцієнта гармонік гармонійного сигналу, на який накладено постійний складник, похибки розрахунку коефіцієнта гармонік від кількості дискретних відліків на періоді сигналу, похибки квантування по рівню, величина яких залежить від розрядності аналогово-цифрового перетворювача (АЦП). Шляхом моделювання визначено величину порогу чутливості по коефіцієнту гармонік.The basic sources of the errors of software for calculation of the harmonic factor for an ordinary and double accuracy of calculation are established. Errors in rounding, related to the calculation of trigonometric functions by standard programs, errors of calculation of the harmonic factor of a harmonic signal with an imposed permanent constituent, errors of calculation of the harmonic factor from the number of discrete counts on the signal period, errors of quantum by level the value which depends from the value ADC bits are analyzed. The threshold value of sensitivity by a harmonic factor was evaluated by modelling.Рассмотрены основные источники погрешностей программ расчета коэффициента гармоник с обычной и двойной точностью вычислений. Анализируются погрешности округления, связанные с вычислением тригонометрических функций стандартными программами, погрешности расчета коэффициента гармоник гармонического сигнала с постоянной составляющей, погрешности расчета коэффициента гармоник от количества дискретных отсчетов на периоде гармонического сигнала, погрешности квантования по уровню, величина которых зависит от разрядности аналого-цифрового преобразователя (АЦП). Путем моделирования определена величина порога чувствительности по коэффициенту гармоник

An immunotherapy survivor population: health-related quality of life and toxicity in patients with metastatic melanoma treated with immune checkpoint inhibitors

© The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Purpose The immune checkpoint inhibitors (ICIs) have resulted in subgroups of patients with metastatic melanoma achievinghigh-quality durable responses. Metastatic melanoma survivors are a new population in the era of cancer survivorship. The aimofthis study was to evaluate metastatic melanoma survivors in terms of health-related quality of life (HRQoL), immune-relatedadverse events (irAEs) and exposure to immunosuppressive agents in a large single centre in the UK.Methods We defined the survivor population as patients with a diagnosis of metastatic melanoma who achieved a durableresponse to an ICI and had been followed-up for a minimum of 12 months from initiation of ICI without disease progression.HRQoL was assessed using SF-36. Electronic health records were accessed to collect data on demographics, treatments, irAEsand survival. HRQoL data was compared with two norm-based datasets.Results Eighty-four metastatic melanoma survivors were eligible and 87% (N = 73) completed the SF-36. ICI-related toxicity ofany grade occurred in 92%of patients and 43%had experienced a grade 3 or 4 toxicity. Almost half (49%) of the patients requiredsteroids for the treatment of ICI-related toxicity, whilst 14% required treatment with an immunosuppressive agent beyondsteroids.Melanoma survivors had statistically significant lower HRQoL scores with regard to physical, social and physical rolefunctioning and general health compared with the normative population. There was a trend towards inferior scores in patientswith previous exposure to ipilimumab compared with those never exposed to ipilimumab.Conclusions Our results show that metastatic melanoma survivors have potentially experienced significant ICI-related toxicityand experience significant impairments in specific HRQoL domains. Future service planning is required to meet this population’sunique survivorship needs.Peer reviewe