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(searched for: doi:10.1080/10508414.2017.1329627)
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Pamela B Andreatta, John Christopher Graybill, Christopher H Renninger, Robert K Armstrong, Mark W Bowyer, Jennifer M Gurney
Published: 19 September 2022
Abstract:
In deployed contexts, military medical care is provided through the coordinated efforts of multiple interdisciplinary teams that work across and between a continuum of widely distributed role theaters. The forms these teams take, and functional demands, vary by roles of care, location, and mission requirements. Understanding the requirements for optimal performance of these teams to provide emergency, urgent, and trauma care for multiple patients simultaneously is critical. A team’s collective ability to function is dependent on the clinical expertise (knowledge and skills), authority, experience, and affective management capabilities of the team members. Identifying the relative impacts of multiple performance factors on the accuracy of care provided by interdisciplinary clinical teams will inform targeted development requirements. A regression study design determined the extent to which factors known to influence team performance impacted the effectiveness of small, six to eight people, interdisciplinary teams tasked with concurrently caring for multiple patients with urgent, emergency care needs. Linear regression analysis was used to distinguish which of the 11 identified predictors individually and collectively contributed to the clinical accuracy of team performance in simulated emergency care contexts. All data met the assumptions for regression analyses. Stepwise linear regression analysis of the 11 predictors on team performance yielded a model of five predictors accounting for 82.30% of the variance. The five predictors of team performance include (1) clinical skills, (2) team size, (3) authority profile, (4) clinical knowledge, and (5) familiarity with team members. The analysis of variance confirmed a significant linear relationship between team performance and the five predictors, F(5, 240) = 218.34, P < .001. The outcomes of this study demonstrate that the collective knowledge, skills, and abilities within an urgent, emergency care team must be developed to the extent that each team member is able to competently perform their role functions and that smaller teams benefit by being composed of clinical authorities who are familiar with each other. Ideally, smaller, forward-deployed military teams will be an expert team of individual experts, with the collective expertise and abilities required for their patients. This expertise and familiarity are advantageous for collective consideration of significant clinical details, potential alternatives for treatment, decision-making, and effective implementation of clinical skills during patient care. Identifying the most influential team performance factors narrows the focus of team development strategies to precisely what is needed for a team to optimally perform.
, Hector Anabalon, Kyran Tannion, Helena Purto, Cristian Jara D
Published: 1 August 2022
Frontiers in Psychology, Volume 13; https://doi.org/10.3389/fpsyg.2022.953959

Abstract:
Addressing fatigue is useful in a variety of scenarios and activities. Fatigue has recently been studied from a psychophysiological standpoint. As a result, the expression and impact of peripheral and central fatigue has been evaluated. Driving is one occupation where tiredness has disastrous consequences. BAlert is a smartphone app that approaches exhaustion with psychophysiological measures. More specifically, it evaluates the level of fatigue via heart rate variability (HRV) data and the cognitive compromise via Stroop effect. The goal of this study is to determine if there are gender differences in fatigue levels among professional drivers using the BAlert app. Statistically significant differences were found in the number of hours awake, in different parameters of HRV (AVNN, PNN50, RMSSD, and SDNN), in the level of stress, as well as in the cognitive response evaluated through the app. The results are discussed and their implications for the management of work fatigue are presented.
International Journal of Environmental Research and Public Health, Volume 19; https://doi.org/10.3390/ijerph19010120

Abstract:
Since seafarers are known to be exposed to numerous job-related stress factors that can cause fatigue, sleepiness, and disturbed sleep behaviour, the aim of this review was to provide an overview of the subjective and objective measurement methods of these strains. Using a systematic review, 166 studies were identified within the period of January 2010 to December 2020 using the PubMed database. Of the 21 studies selected, 13 used both subjective and objective measurement methods. Six studies used only subjective and two studies only objective methods. For subjective assessment, 12 different questionnaires could be identified as well as activity and sleeping logs. Actigraphy and reaction time tests (RTT) were the most common objective methods. In single cases, electrooculography (EOG), pupillometry and ambulatory polysomnography (PSG) were used. Measurement-related limitations due to vessel-related impacts were less often reported than expected. No restrictions of daily routines on board were described, and only single-measurement disturbances due to ship movements were mentioned. The present literature review reveals that there are various routines to measure fatigue, sleepiness, and sleep behaviour on board. A combination of subjective and objective methods often appears to be beneficial. The frequent use of actigraphy and RTT on board suggests good feasibility and reliable measurements with these methods. The use of ambulatory PSG in maritime-like contexts suggests that this method would also be feasible on board.
Neusa R. Adão Martins, Simon Annaheim, Christina M. Spengler,
Published: 15 December 2021
Frontiers in physiology, Volume 12; https://doi.org/10.3389/fphys.2021.790292

Abstract:
The objective measurement of fatigue is of critical relevance in areas such as occupational health and safety as fatigue impairs cognitive and motor performance, thus reducing productivity and increasing the risk of injury. Wearable systems represent highly promising solutions for fatigue monitoring as they enable continuous, long-term monitoring of biomedical signals in unattended settings, with the required comfort and non-intrusiveness. This is a p rerequisite for the development of accurate models for fatigue monitoring in real-time. However, monitoring fatigue through wearable devices imposes unique challenges. To provide an overview of the current state-of-the-art in monitoring variables associated with fatigue via wearables and to detect potential gaps and pitfalls in current knowledge, a systematic review was performed. The Scopus and PubMed databases were searched for articles published in English since 2015, having the terms “fatigue,” “drowsiness,” “vigilance,” or “alertness” in the title, and proposing wearable device-based systems for non-invasive fatigue quantification. Of the 612 retrieved articles, 60 satisfied the inclusion criteria. Included studies were mainly of short duration and conducted in laboratory settings. In general, researchers developed fatigue models based on motion (MOT), electroencephalogram (EEG), photoplethysmogram (PPG), electrocardiogram (ECG), galvanic skin response (GSR), electromyogram (EMG), skin temperature (Tsk), eye movement (EYE), and respiratory (RES) data acquired by wearable devices available in the market. Supervised machine learning models, and more specifically, binary classification models, are predominant among the proposed fatigue quantification approaches. These models were considered to perform very well in detecting fatigue, however, little effort was made to ensure the use of high-quality data during model development. Together, the findings of this review reveal that methodological limitations have hindered the generalizability and real-world applicability of most of the proposed fatigue models. Considerably more work is needed to fully explore the potential of wearables for fatigue quantification as well as to better understand the relationship between fatigue and changes in physiological variables.
Theresa Schweizer, Thomas Wyss, Rahel Gilgen-Ammann
Published: 14 December 2021
Abstract:
Introduction: Objectively determining soldiers’ fatigue levels could help prevent injuries or accidents resulting from inattention or decreased alertness. Eye-tracking technologies, such as optical eye tracking (OET) and electrooculography (EOG), are often used to monitor fatigue. Eyeblinks—especially blink frequency and blink duration—are known as easily observable and valid biomarkers of fatigue. Currently, various eye trackers (i.e., eye-tracking glasses) are available on the market using either OET or EOG technologies. These wearable eye trackers offer several advantages, including unobtrusive functionality, practicality, and low costs. However, several challenges and limitations must be considered when implementing these technologies in the field to monitor fatigue levels. This review investigates the feasibility of eye tracking in the field focusing on the practical applications in military operational environments. Materials and Method: This paper summarizes the existing literature about eyeblink dynamics and available wearable eye-tracking technologies, exposing challenges and limitations, as well as discussing practical recommendations on how to improve the feasibility of eye tracking in the field. Results: So far, no eye-tracking glasses can be recommended for use in a demanding work environment. First, eyeblink dynamics are influenced by multiple factors; therefore, environments, situations, and individual behavior must be taken into account. Second, the glasses’ placement, sunlight, facial or body movements, vibrations, and sweat can drastically decrease measurement accuracy. The placement of the eye cameras for the OET and the placement of the electrodes for the EOG must be chosen consciously, the sampling rate must be minimal 200 Hz, and software and hardware must be robust to resist any factors influencing eye tracking. Conclusion: Monitoring physiological and psychological readiness of soldiers, as well as other civil professionals that face higher risks when their attention is impaired or reduced, is necessary. However, improvements to eye-tracking devices’ hardware, calibration method, sampling rate, and algorithm are needed in order to accurately monitor fatigue levels in the field.
Published: 13 December 2021
Journal: The TQM Journal
The TQM Journal, Volume 34, pp 303-329; https://doi.org/10.1108/tqm-06-2021-0195

Abstract:
Purpose: The purpose of the research is to conduct an exploratory investigation of the material handling activities of an Italian logistics hub. Wearable sensors and other smart tools were used for collecting human and environmental features during working activities. These factors were correlated with workers' performance and well-being.Design/methodology/approach: Human and environmental factors play an important role in operations management activities since they significantly influence employees' performance, well-being and safety. Surprisingly, empirical studies about the impact of such aspects on logistics operations are still very limited. Trying to fill this gap, the research empirically explores human and environmental factors affecting the performance of logistics workers exploiting smart tools.Findings: Results suggest that human attitudes, interactions, emotions and environmental conditions remarkably influence workers' performance and well-being, however, showing different relationships depending on individual characteristics of each worker.Practical implications: The authors' research opens up new avenues for profiling employees and adopting an individualized human resource management, providing managers with an operational system capable to potentially check and improve workers' well-being and performance.Originality/value: The originality of the study comes from the in-depth exploration of human and environmental factors using body-worn sensors during work activities, by recording individual, collaborative and environmental data in real-time. To the best of the authors' knowledge, the current paper is the first time that such a detailed analysis has been carried out in real-world logistics operations.
Engin Özel,
Bussecon Review of Social Sciences (2687-2285), Volume 3, pp 01-19; https://doi.org/10.36096/brss.v3i1.251

Abstract:
This paper aims to develop a critical approach to flight safety by assessing theoretical and empirical studies on fatigue risk factors in cockpit and cabin crew. This paper also builds a fundamental basis for managing fatigue risk factors in the aviation industry. The main contribution of the paper demonstrates the fact that primary and secondary fatigue risk factors in cockpit and cabin crew affect the level of job satisfaction, operational efficiency, and flight security.
Sanjay Rao, Tarek Benzouak, Sasha Gunpat, Rachel J Burns, Tayyeb A Tahir, Stephen Jolles,
Published: 19 October 2021
Annals of Behavioral Medicine, Volume 56, pp 219-234; https://doi.org/10.1093/abm/kaab081

Abstract:
The prevalence and prognosis of post-acute stage SARS-CoV-2 infection fatigue symptoms remain largely unknown. We performed a systematic review to evaluate the prevalence of fatigue in post-recovery from SARS-CoV-2 infection. Medline, Embase, PsycINFO, CINAHL, Web of Science, Scopus, trial registries, Cochrane Central Register of Controlled Trials, and Google Scholar were searched for studies on fatigue in samples that recovered from polymerase chain reaction (PCR) diagnosed COVID-19. English, French, and Spanish studies were included. Meta-analyses were conducted separately for each recruitment setting. We identified 41 studies with 9,362 patients that recovered from COVID-19. Post-COVID-19 patients self-report of fatigue was higher compared to healthy controls (risk ratio (RR) = 3.688, 95%CI [2.502, 5.436], p< .001). Over 50% of patients discharged from inpatient care reported symptoms of fatigue during the first (event rate [ER] = 0.517, 95%CI [0.278, 0.749]) and second month following recovery (ER = 0.527, 95%CI [0.337, 0.709]). Ten percent of the community patients reported fatigue in the first-month post-recovery. Patient setting moderated the association between COVID-19 recovery and fatigue symptoms (R2 = 0.11, p< .001). Female patients recovering from COVID-19 had a greater self-report of fatigue (odds ratio [OR] = 1.782, 95%CI [1.531, 2.870]). Patients recruited through social media had fatigue above 90% across multiple time points. Fatigue was highest in studies from Europe. Fatigue is a symptom associated with functional challenges which could have economic and social impacts. Developing long-term planning for fatigue management amongst patients beyond the acute stages of SARS-CoV-2 infection is essential to optimizing patient care and public health outcomes. Further studies should examine the impact of sociodemographic, pandemic-related restrictions and pre-existing conditions on fatigue.
Engin Ozel,
International Journal of Business Ecosystem & Strategy (2687-2293), Volume 3, pp 01-20; https://doi.org/10.36096/ijbes.v3i1.246

Abstract:
Fatigue as an emerging flight safety issue in the aviation industry requires an elaborate understanding and critical approach for proactive aviation management practices. The level of flight crew stress and fatigue must be critically managed to prevent flight accidents. Additionally, stress and fatigue have a negative influence on job satisfaction levels. This paper aims to examine the critical fatigue risk factors that affect the performance and safety of airline pilots and crew in the aviation industry. This paper also analyses the relationship between burnout and job satisfaction sub-dimensions. A factor analysis with a target population of 254 international flight crew has been conducted using the Minnesota Job Satisfaction Survey and Maslach Burnout questionnaire. The main findings of the study demonstrate that (i) cockpit and cabin crews’ job satisfaction and performance have been affected by stress and fatigue, (ii) psychological depression, anxiety and personal problems of the flight crew are the main causes of emotional fatigue, (iii) extensive flight hours and dealing with problematic passengers increase flight crew fatigue, (iv) personal achievements concerns and depersonalization increase flight crew fatigue.
, Samuele M. Marcora, Aaron J. Coutts, Lee Wallace, Alan McCall, Franco M. Impellizzeri
Published: 14 September 2021
Journal: Sports Medicine
Sports Medicine, Volume 52, pp 709-724; https://doi.org/10.1007/s40279-021-01551-5

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Sanjay Rao, Tarek Benzouak, Sasha Gunpat, , Tayyeb A. Tahir, ,
Published: 26 April 2021
Abstract:
Background: The prevalence and prognosis of post-acute stage SARS-CoV-2 infection fatigue symptoms remain largely unknown.Aims: We performed a systematic review to evaluate the prevalence of fatigue in post-recovery from SARS-CoV-2 infection.Method: Medline, Embase, PsycINFO, CINAHL, Web of Science, Scopus, trial registries, Cochrane Central Register of Controlled Trials and Google Scholar were searched for studies on fatigue in samples that recovered from PCR diagnosed COVID-19. English, French and Spanish studies were included. Meta-analyses were conducted separately for each recruitment setting.Results: We identified 41 studies with 9362 patients that recovered from COVID-19. Post-COVID-19 patients self-report of fatigue was higher compared to healthy controls (RR = 3.688, 95%CI [2.502, 5.436], p < 0.001). Over 50% of patients discharged from inpatient care reported symptoms of fatigue during the first (ER = 0.517, 95%CI [0.278, 0.749]) and second month following recovery (ER = 0.527, 95%CI [0.337, 0.709]). 10% of the community patients reported fatigue in the first-month post-recovery. Patient setting moderated the association between COVID-19 recovery and fatigue symptoms (R2 = 0.11, p < 0.001). Female patients recovering from COVID-19 had a greater self-report of fatigue (OR = 1.782, 95%CI [1.531, 2.870]). Patients recruited through social media had fatigue above 90% across multiple time points. Fatigue was highest in studies from Europe.Conclusion: Fatigue is a symptom associated with functional challenges which could have economic and social impacts. Developing long-term planning for fatigue management amongst patients beyond the acute stages of SARS-CoV-2 infection is essential to optimizing patient care and public health outcomes. Further studies should examine the impact of sociodemographic, pandemic-related restrictions and pre-existing conditions on fatigue.
The International Journal of Aerospace Psychology pp 1-24; https://doi.org/10.1080/24721840.2021.1896951

Abstract:
Objective: To illustrate how fatigue affects the workload, situation awareness, and control strategy of air traffic controllers. Background: As air traffic control becomes more complex and demanding due to the increasing number of aircraft movements in major airport hubs, the need to particularly look into the interplay of performance shaping factors has also intensified. Despite the previous efforts of scholars to understand the framework of air traffic control based on factors on workload and situation awareness (SA) and its impact to shift in control strategy, the role of fatigue in such factors is ignored notwithstanding its relative impact on air traffic controllers as tasks are carried out in varying workload and work shift. Method: A case study is conducted in an actual tower control center in the Philippines to demonstrate the hypothesized relations among fatigue, workload, SA, and control strategy. Questionnaires based on SPAM, SASHA, Samn-Perelli fatigue scale, and visual attention self-report are deployed to measure air traffic controllers’ fatigue levels, SA, and control strategy. Results: Fatigue has an inverse relationship with workload and has a significant effect on SA. Furthermore, fatigue is also found to have a significant relationship with some areas of interest including visual display terminal. Conclusion: Such results underpin the resource allocation decisions of stakeholders in the commercial aviation industry geared toward fostering the welfare of air traffic controllers.
, Brianne Kimura, Kristen Nicholson
Published: 6 March 2021
by 10.1007
Sn Comprehensive Clinical Medicine, Volume 3, pp 1148-1164; https://doi.org/10.1007/s42399-021-00831-5

The publisher has not yet granted permission to display this abstract.
, Miguel Perez-Machado
Published: 5 March 2020
by BMJ
Journal of Clinical Pathology, Volume 73, pp 523-523; https://doi.org/10.1136/jclinpath-2020-206488

Abstract:
The role of human factors (HFs) in medical error is now widely acknowledged, although there are few publications that deal with pathology-specific HF issues. A definition of HF that is widely accepted is as follows: ‘ environmental, organisational and job factors in human and individual characteristics which influence behaviour at work in a way which can affect health and safety’ .1 HF analysis has been widely applied in aviation and aerospace industries but has been increasingly seen as important in medicine, particularly in critical care and acute medical settings to explain and reduce rates of clinical error and improve decision-making in areas that are of high clinical risk.2–4 There has been little discussion of the role of HF in diagnostic specialties such as cytology, pathology or radiology. Published HF studies in diagnostic specialties have primarily addressed …
Published: 1 January 2020
by SciELO
BAR - Brazilian Administration Review, Volume 17; https://doi.org/10.1590/1807-7692bar2020190031

Abstract:
In the organizational context, the study of occupational stress encompasses constructs of fatigue at work. Within the air transportation sector, fatigue at work is a potential issue influencing both safety and occupational stress. The objective of the present study was to perform a convergent-discriminant validity analysis of the Feeling of Fatigue scale in the area of Administration. Data from an observational cross-sectional study involving a sample of 1,066 airline pilots were analyzed using quantitative modeling. Confirmatory factor analysis with the structural equations model was performed to determine the validity of a Portuguese version of the Feeling of Fatigue scale in the organizational context of civil aviation. This study fills a gap in the literature on occupational stress in Administration, highlighting the relevance of research on fatigue at work. The results confirmed the validity of a Portuguese version of a mature scale for subjective assessment of fatigue in Administration, thereby contributing to fatigue management in organizational settings.
, Marika Melin
The International Journal of Aerospace Psychology, Volume 28, pp 84-97; https://doi.org/10.1080/24721840.2018.1553567

Abstract:
Objective: The purpose of this cross-sectional survey study was to investigate the prevalence of presenteeism, attending work when ill, among Swedish commercial airline pilots and how presenteeism relates to mental health and flight safety. Background: Pilots are regulated to refrain from duty when their mental or physical state could endanger safety. Still, the human factor is the greatest contributor to aviation accidents, and mishaps are attributed to human unfitness (physical or mental state of the operator), suggesting that pilots might engage in presenteeism. Presenteeism and its consequences have been studied across several occupational groups, but until now pilots have been neglected. Method: Data were collected using an online self-report questionnaire (N = 1,133) consisting of items investigating presenteeism, mental health, and self-reported error rates. Results: Results demonstrated that 63% of the pilots exhibited acts of inappropriate presenteeism in the past year. Inappropriate presentee pilots and pilots with poor recovery in terms of feelings of rest, physical and mental tiredness, and work-related worry, were also more likely to report committing 5 or more errors when on flight duty in the past 12 months. This relationship was not mediated by mental health, as shown in previous research. Conclusion: This study indicates that pilots operate in states that could jeopardize flight safety and that current regulations might be insufficient to ensure safe flight operations.
Runqi Liang, Michael Kent, Robin Wilson,
Published: 26 September 2018
Building and Environment, Volume 147, pp 199-210; https://doi.org/10.1016/j.buildenv.2018.09.044

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