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Approximately 40% of Japanese physicians report working more than 960 hr of overtime annually, with 10% exceeding 1860 hr. To protect their health, annual overtime limits went into effect in 2024. The objective of this study was to investigate associations of self-reported sleep duration with psychological health and objective alertness. This was a cross-sectional National Survey for The Work Style Reform of Long Working Physicians. Physicians self-reported daily sleep duration, burnout (Abbreviated Maslach Burnout Inventory), depression (Center for Epidemiologic Studies Depression Scale) and traffic accidents. Alertness was then evaluated using the brief Psychomotor Vigilance Test. Of 20,382 physicians invited, 1226 completed the survey and brief Psychomotor Vigilance Test. Daily sleep duration was inversely associated with weekly work hours (ß = -5.4; 95% confidence interval -6.8 to -4.0, p < 0.0001). Sleep duration < 6 hr and ≥ 8 hr per day was associated with slower responses on the brief Psychomotor Vigilance Test (adjusted p < 0.05). An additional 10 hr worked per week was associated with a 0.40 point (95% confidence interval 0.08-0.72) increase in burnout severity and a 1.7% (95% confidence interval 0.1-3.3%) increase in odds of reporting a traffic accident. Increased brief Psychomotor Vigilance Test lapses, indicating lower alertness, were associated with worse symptoms of depression (ß = 0.23 points; 95% confidence interval 0.14-0.31, p < 0.0001) and burnout (ß = 0.25 points; 95% confidence interval 0.13-0.36, p < 0.0001). This study emphasizes the importance of sufficient sleep to maintain alertness, and supports limiting work hours for Japanese physicians to protect psychological health. Performance on the brief Psychomotor Vigilance Test may be a useful indicator of psychological health.

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AIMS AND OBJECTIVES: This study aimed to determine the effect of overtime on alertness at work among rotating-shift nurses in South Korea and to investigate whether these effects of overtime vary across the different types of shifts. BACKGROUND: Nurse overtime is prevalent in healthcare settings to manage nursing shortages and staffing needs; however, it negatively affects patient and nurse outcomes. Furthermore, little attention has been paid to the effects of previous overtime shifts and overtime for consecutive shifts on alertness during work. DESIGN: A prospective observational study was employed. The study followed STROBE checklist for observational studies. METHODS: Data were collected between June 2019 and February 2020 from 82 nurses who worked in acute care hospitals. An ecological momentary assessment was used to capture real-time data of overtime and alertness. Alertness scores were estimated using the sleep/wake data measured by an actigraph. Mixed-effect models were employed to investigate the association between overtime and alertness. RESULTS: A majority of the shift nurses worked overtime. Episodes of a decline in alertness scores to the level of increased accident or serious error risk (alertness score ≤80) were most frequently seen during night shifts (98.9%), followed by day (59.8%) and evening shifts (10.1%). Previous-day overtime hours and consecutive overtime days were associated with decreased alertness scores during work. A significantly positive correlation was observed between alertness scores ≤80 and previous-day overtime hours and consecutive overtime days in all shifts. CONCLUSIONS: The study findings indicate that a majority of nurses who work overtime experience decreased alertness while on duty. RELEVANCE TO CLINICAL PRACTICE: Policy development at the government, organisational and unit level is needed to guarantee adequate rest for shift nurses by adjusting work schedules and assignments and limiting overtime.

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Employees often prefer 12-hour work shifts but they can increase sleepiness and injury risk. We assessed whether sleep, sleepiness, satisfaction and need for recovery changed after changing from an 8-hour to a 12-hour shift system. The participants were 178 employees of the paper, pulp and chemical industries. Using a quasi-experimental controlled intervention design, 83 employees, who changed from an 8-hour shift schedule to a 12-hour shift schedule were compared to those who remained in the 8-hour shift schedule (n=95). Participants filled in a survey on sleep, sleepiness, satisfaction and need for recovery at baseline and 9-12 months after the shift schedule change. We used generalized estimation equation models adjusted for age, sex, shift work experience in years and baseline shift system. Sleep length was longer in the 12-hour shift schedule before the first morning shift and between morning shifts. Sleepiness during morning shifts was less frequent and satisfaction with the shift system was more prevalent in the 12-hour shift schedule. Also, perceived negative associations of the current shift system with work-life balance were less common in the 12-hour shift schedule. The differences found between the shift systems were minor and the results did not indicate significant disadvantages of the 12-hour fast forward-rotating shift system.

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Scheduled naps in the workplace are an effective countermeasure to drowsiness in safety-sensitive industries. This quasi-experimental study with a one-group, pre- and post-test design aimed to examine the effects of scheduled naps on nurses working 12-h shifts. Nurses in two pediatric intensive care units at a tertiary hospital were provided 30-min scheduled nap opportunities during their shifts. A total of 38 nurses completed pre- and post-test work diaries for sleepiness, fatigue, work demands and pace, and quality of nursing care at the end of each shift. The drowsiness of 13 nurses was continuously assessed during their shifts using infrared reflectance oculography. Nurses who reached naps reported improved levels of fatigue on the first night shift and better quality of nursing care the second night and day shifts post-test, while nurses who did not reach naps showed no significant improvements. The oculography successfully assessed drowsiness during 73% and 61% of the pre- and post-test total work hours, respectively. The total cautionary and cautionary or higher levels of drowsiness decreased. Nurse managers should consider scheduled naps in clinical settings to improve nurses' alertness during their shifts.

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OBJECTIVES: The mining industry is increasingly adopting extended workdays of 10-12 hour shifts. Studies demonstrate that long work hours are associated with psychomotor impairments caused by fatigue and an increased risk of injury. However, studies involving miners remain limited. This analysis aimed to identify risk factors associated with long working hour injuries and to determine if long working hour incidents were associated with being killed or incidents involving multiple injured workers. METHODS: Data from US Mine Safety and Health Administration Part 50 reports, 1983-2015, were used to identify long working hour injuries, which were defined as incidents occurring nine or more hours after the start of a shift. RESULTS: A total of 52 206 injuries (9.6%) occurred during long working hours. The proportion of long working hour injuries increased from 5.5% of all injuries in 1983 to its peak in 2015 at 13.9% (p<0.001). Risk factors associated with long working hour injuries included irregular shift starts, being newly employed, employment by a contractor, metal/non-metal operations and mines with <100 employees. In two separate adjusted models, long working hour injuries were associated with a higher odds of death (adjusted OR [aOR]=1.32; 95% CI 1.18 to 1.48) and single incidents resulting in two or more workers injured (aOR=1.73; 95% CI 1.58 to 1.89). CONCLUSIONS: Long working hour injuries were associated with a lack of routine, being new at the mine and specific mining activities. An international shift towards using contract labour and extended workdays indicates that injuries during long working hours will likely continue to grow as a problem in the mining industry.

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BACKGROUND: More people will probably continue working into old age in the future due to the increased size of aging populations in many countries. We therefore need to know more about older workers' health in relation to their work situation and retirement. This study is a part of a theoretical development of older workers' situations. Older workers' situations are theoretically themed in nine areas by the authors of this study. The aims of the study were to investigate the relationship between: i) diagnosed disease and factors in older workers' situations, theoretically themed in nine areas; ii) self-rated health and factors in older workers' situations, theoretically themed in nine areas; iii) diagnosed disease and self-rated health; and iv) the relationships between these health measures and retirement. METHODS: A questionnaire-based cross-sectional study, using logistic regression, with 1,756 health care personnel aged 55-64 years. The questionnaire used gave an overview of most different areas in the older workers' situations. RESULT: There was a difference in the participants' frequency of objectively specified diagnosed disease and their subjectively experienced self-rated health. A bad self-rated health was related higher to early retirement than diagnosed diseases. In the multivariate model, having 'Diagnosed disease' was not significantly related to whether older workers thought they could not work beyond 65 years of age. A bad 'Self-rated health' was also more highly related to whether older workers thought they could not work beyond 65 years, than if the respondents stated that a 'Diagnosed disease is a hindrance in my daily work' in the multivariate model. CONCLUSION: This study showed an important difference between older workers' own experiences and the effect of their self-rated health and their diagnosed diseases. Subjective self-rated health seems to be more important to people's retirement planning than diagnosed disease. The most important factors affecting older workers' self-rated health was the degree to which they felt physically and mentally fatigued, their possibilities for revitalization, and issues of work satisfaction, age discrimination and attitudes of managers to them as seniors.

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The mutual compatibility of Hamaker constants, solubility parameters or cohesive energy densities (CED) and surface/interface tensions are evaluated. It is shown that the partial contributions (dispersive, Lifshitz-van der Waals, dipolar induction, dipolar orientation, polar, acid, base and hydrogen bond) to Hamaker constants, solubility parameters or cohesive energy densities and surface/interface tensions are mutually inconsistent. The published reference data for a single set of liquids is moreover shown to be exceedingly scattered; making the parallel use of these scales challenging. Reference processes designed for bringing two and three phases into mutual contact are conflicting. The two-phase processes within Hamaker and exchange energy density (EED) frameworks agree, but the three-phase models differ. As a free-standing parameter the EED is however comparable. The two-phase adhesion process is shown to be incompatible with the other contact processes and the three-phase adhesion process is opposite to them. One reason for this controversy is the different averaging of interfacial properties. While interfacial Hamaker constants and solubility parameters or cohesive energy densities are geometric averages of corresponding intervening phase properties, this practice is replaced by the work of adhesion being geometrically averaged as works of cohesion. As a result, there exist three conflicting models for the adhesion process: the Dupré work of adhesion, the Girifalco-Good geometric averaged works of cohesion and Fowkes reduced interfacial or interphasial tension process. None of these agree with the commonly accepted standard Hamaker contact processes and they should be replaced with the compatible extended work of adhesion process originally suggested by Dupré. The models offered for the conversion of Hamaker constants and solubility parameters or cohesive energy densities to surface tensions involve conversion factors and equilibrium distances between planes of molecules in liquids. The equilibrium distance for different close packings derived from molar liquid volumes are about 2-5 times larger than the cutoff distances obtained from simulations. Using volumetric equilibrium distances, the conversion factors for dispersive, polar and total Hamaker constant and solubility parameter or cohesive energy densities to surface tensions become nearly equal but they are different for each liquid.

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BACKGROUND: Nursing shortages have been associated with increased nurse workloads that may result in work errors, thus impacting patient, nurse and organizational outcomes. AIM: To examine for the first time in Thailand nurses' extended work hours (working more than 40 h per week) and its relationship to patient, nurse and organizational outcomes. METHODS: Using multistage sampling, 1524 registered nurses working in 90 hospitals across Thailand completed demographic forms: the Nurses' Extended Work Hours Form; the Patient, Nurse, Organizational Outcomes Form; the Organizational Productivity Questionnaire and the Maslach Burnout Inventory. The data were analysed using descriptive statistics, Spearman's rank correlation and logistic regression. RESULTS: The average extended work hour of respondents was 18.82 h per week. About 80% worked two consecutive shifts. The extended work hours had a positive correlation with patient outcomes, such as patient identification errors, pressure ulcers, communication errors and patient complaints and with nurse outcomes of emotional exhaustion and depersonalization. Furthermore, we found a negative correlation between extended work hours and job satisfaction as a whole, intent to stay and organizational productivity. Nurses who had extended work hours of >16 h per week were significantly more likely to perceive all four adverse patient outcomes than participants working an extended ≤8 h per week. LIMITATIONS: Patient outcomes were measured by respondents' self-reports. This may not always reflect the real occurrence of adverse events. CONCLUSIONS: Associations between extended work hours and outcomes for patients, nurses and the organization were found. The findings demonstrate that working two shifts (16 h) more than the regular work hours lead to negative outcomes for patients, nurses and the organization. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Our findings add to increasing international evidence that nurses' poor working conditions result in negative outcomes for professionals, patients and health systems. Policymakers need to be aware of the issues regarding nurses' extended work hours, which has been found to contribute to burnout. Urgently, nurse and health administrators need to develop and implement appropriate nursing overtime policies and strategies to help reduce this phenomenon, including measures to overcome the nursing shortage.

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Effective on-call clinical staffing is critical to providing perioperative services to patients requiring emergency surgical care. Without careful monitoring of continuous work hours and hours worked per week, staffing practices can adversely affect the ability of personnel to function and provide care. Managers and perioperative personnel must carefully evaluate their on-call schedule to ensure the provision of safe medical care for their patients. Perioperative leaders at two hospitals partnered to create a safety guideline for on-call staffing practices, which includes zone guides for determining workload intensity. This guideline has served to help managers evaluate the general safety of their staffing plan and identify on-call practices that may need improvement or support in their areas of responsibility. Key recommendations from the guideline can help perioperative managers at other facilities establish clinical staffing plans and on-call practices that are safe and effective.

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PURPOSE: Healthcare organizations often have to provide patient care around the clock. Shift work (any shift outside of 7 a.m. to 6 p.m) and long work hours increase the risk for short sleep duration and sleep disturbances. Thirty-two percent of healthcare workers report they do not get enough sleep. The purpose of the article is to give an overview of the wide range of risks to nurses, patients, and employers that are linked to shift work, long work hours, and poor sleep from other sources. FINDINGS: Shift work and long work hours increase the risk for reduced performance on the job, obesity, injuries, and a wide range of chronic diseases. In addition, fatigue-related errors could harm patients. Fatigued nurses also endanger others during their commute to and from work. CONCLUSION AND CLINICAL RELEVANCE: The key strategy to reduce these risks is making sleep a priority in the employer's systems for organizing work and in the nurse's personal life.

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Este artigo procura fundamentar a escuta analítica como método de investigação tanto em relação à situação do tratamento psicanalítico quanto à abordagem do sujeito enredado nos fenômenos sociais. Para tanto, baseia-se numa experiência psicanalítica que se desenrolou na vigilância em saúde do trabalhador (VST) da cidade de São Paulo – o caso de uma escola de educação infantil. Com isso a autora pretende mostrar a viabilidade da escuta analítica como um dos métodos na intervenção da VST, assim como apresentar um contribuição da pesquisa psicanalítica no desvelar das relações sujeito e trabalho(AU)

This article aims to affer the foundations for the anaçytical listening as a method of investigation both in relation to the psychoanalytical treatment and the approach of the subject entangled in the social phenomena. For that, it is based in a psychoanalytical experience that was develop in the workers´health surveillance in São Paulo city, whose case belong to a primary school. Thus, the author intends to show the viability of the psychoanalytical listening as one of the methods of intervention used in the workers´health surveillance, as well as to presente a contribution to the psychoanalytical research in the sense of the relations between the subject and work