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Sprajcer M, Robinson A, Thomas MJW, Dawson D. Advancing fatigue management in healthcare: risk-based approaches that enhance health service delivery. Occup Med (Lond) 2023; 73:459-463. [PMID: 38157486 DOI: 10.1093/occmed/kqad112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Given the need for 24/7 healthcare services, fatigue is an inevitable consequence of work in this industry. A significant body of regulatory advice and hospital services have focused primarily on restricting work hours as the primary method of mitigating fatigue-related risk. Given the inevitability of fatigue, and the limited capacity of labour agreements to control risk, this commentary explores how the principles of fatigue risk management might be applied in a healthcare setting.
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Affiliation(s)
- M Sprajcer
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, South Australia, 5034, Australia
| | - A Robinson
- Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, K1H 8L1, Canada
| | - M J W Thomas
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, South Australia, 5034, Australia
| | - D Dawson
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, South Australia, 5034, Australia
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Understanding Factors Underlying Fatigue among Collegiate Aviation Pilots in the United States. SAFETY 2022. [DOI: 10.3390/safety8020046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
An increase in evidence-based studies into the deleterious effects of fatigue on flight operations has been reported by key aviation groups globally. The collegiate aviation flight training environment has not been researched at the same level when compared to military and airline operations. College aged students are unique in the sense that they are tasked with classwork, studying, participation in student organizations, social activities, and often have part time jobs within and outside of the academic environment. These conditions may cause errors, incidents, accidents, poor academic performance, and undesirable health metrics. The purpose of this study was to understand fatigue as a multi-factorial dimension and to assess potential relationships among these factors using hypothesized measurement models. The research team distributed the Collegiate Aviation Fatigue Inventory II (CAFI-II) to eight small, medium, and large collegiate aviation programs in the United States. The CAFI-II primarily focuses on fatigue awareness, causes and symptoms of fatigue, and lifestyle choices. Four hundred and twenty-two (n = 422) valid responses were obtained. Results suggested a direct predictive relationship between fatigue in collegiate flight training and the perceptions of respondents of conditions that are known to cause fatigue. Findings also suggested that respondents who had a favorable perception of fatigue risk and management programs had a better understanding of the causes of fatigue.
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Beg S, Card T, Sidhu R, Wronska E, Ragunath K. The impact of reader fatigue on the accuracy of capsule endoscopy interpretation. Dig Liver Dis 2021; 53:1028-1033. [PMID: 34016545 DOI: 10.1016/j.dld.2021.04.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Capsule endoscopy (CE) interpretation requires the review of many thousands of images, with lesions often limited to just a few frames. In this study we aim to determine whether lesion detection declines according to the number of capsule videos read. METHODS 32 participants, 16 of which were novices (NR) and 16 experienced (ER) capsule readers took part in this prospective evaluation study. Participants read six capsule cases with a variety of lesions, in a randomly assigned order during a single sitting. Psychomotor Vigilance Tests and Fatigue Scores were recorded prior to commencing and then after every two capsules read. Changes in lesion detection and measures of fatigue were assessed across the duration of the study. RESULTS Mean agreement with the predefined lesions was 48.3% (SD:16.1), and 21.3% (SD:15.1) for the experienced and novice readers respectively. Lesion detection declined amongst experienced reader after the first study (p = 0.01), but remained stable after subsequent capsules read, while NR accuracy was unaffected by capsule numbers read. Objective measures of fatigue did not correlate with reading accuracy. CONCLUSION This study demonstrates that reader accuracy declines after reading just one capsule study. Subjective and objective measures of fatigue were not sufficient to predict the onset of the effects of fatigue.
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Affiliation(s)
- Sabina Beg
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, United Kingdom
| | - Tim Card
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, United Kingdom; Population and Lifespan Sciences, School of Medicine, University of Nottingham, United Kingdom
| | - Reena Sidhu
- Academic Department of Gastroenterology and Hepatology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust, United Kingdom
| | - Ewa Wronska
- Department of Gastroenterological Oncology, Maria Sklodowska-Curie Institute‒Oncology Center, Warsaw, Poland; Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Krish Ragunath
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, United Kingdom.
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Dawson D, Ferguson SA, Vincent GE. Safety implications of fatigue and sleep inertia for emergency services personnel. Sleep Med Rev 2020; 55:101386. [PMID: 33027747 DOI: 10.1016/j.smrv.2020.101386] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/12/2020] [Accepted: 07/13/2020] [Indexed: 12/31/2022]
Abstract
Emergency services present a unique operational environment for the management of fatigue and sleep inertia. Communities request and often expect the provision of emergency services on a 24/7/365 basis. This can result in highly variable workloads and/or significant need for on-demand or on-call working time arrangements. In turn, the management of fatigue-related risk requires a different approach than in other more predictable shift working sectors (e.g., mining and manufacturing). The aim of this review is to provide a comprehensive overview of fatigue risk management that is accessible to regulators, policy makers and organisations in the emergency services sector. The review outlines the unique fatigue challenges in the emergency services sector, examines the current scientific and policy consensus around managing fatigue and sleep inertia, and finally discusses strategies that emergency services organisations can use to minimise the risks associated with fatigue and sleep inertia.
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Affiliation(s)
- Drew Dawson
- Central Queensland University, Appleton Institute, Adelaide, South Australia, Australia.
| | - Sally A Ferguson
- Central Queensland University, Appleton Institute, Adelaide, South Australia, Australia
| | - Grace E Vincent
- Central Queensland University, Appleton Institute, Adelaide, South Australia, Australia
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Costa C, Mondello S, Micali E, Indelicato G, Licciardello AA, Vitale E, Briguglio G, Teodoro M, Fenga C. Night shift work in resident physicians: does it affect mood states and cognitive levels? J Affect Disord 2020; 272:289-294. [PMID: 32553370 DOI: 10.1016/j.jad.2020.03.139] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 02/12/2020] [Accepted: 03/29/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND The effects of night shift work on health status have been widely studied. Night workers seem to smoke more, eat badly and show a low propensity to physical activity. Night work can be associated with an increase in cardiovascular and gastrointestinal disorders, alterations in immune response, diabetes, aging, hormonal imbalance, and premature death; alteration of circadian rhythm is also regarded as a risk factor for breast cancer and neuropsychiatric disorders. Moreover, several studies have highlighted the effects of sleep deprivation on clinical performance, quality of care and personal safety of healthcare personnel. No studies have investigated the effects of night work on Italian resident physicians and compared its effect across specialties. This study aims to assess the prevalence of sleep disorders, possible cognitive impairment and mood states, in relation to night shift work among resident physicians. METHODS 80 resident physicians, attending the postgraduate training into an Hospital located in the South of Italy, were divided into 4 areas (medical, surgical, services and anaesthesia). They were recruited from July 2017 to June 2018 and participated to a survey consisting of 4 questionnaires to investigate the presence of sleep deprivation and sleep quality (Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index), their cognitive status (Mini Mental State examination) and mood profiles (Profile of Mood States, POMS). Analysis of variance was used for comparison of questionnaires scores across specialties. RESULTS Authors reported no sleep deprivation, no sleep disorders and their outcomes, no changes in intellectual efficiency and no cognitive impairment in this population, neither in the areas performing night shifts nor in those involving only day shifts. Mood states measured by POMS showed a borderline level of Anger-Hostility (A) value among the residents of the medical area and services, and an increase slightly beyond the physiological levels of the T-score 50 of Fatigue-Inertia (F) always in the same groups. An increase in the Vigour-Activity (V) value beyond T-score 50 levels was also observed among residents of all the areas considered. CONCLUSIONS Emotional involvement could be attributed to the gap between high professional demand and lack of experience and knowledge among trainees. Tutors should help their students in order to identify earlier changes in the mood. Improvement in the organization of the trainee's activity could reduce the emotional overload.
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Affiliation(s)
- Chiara Costa
- Clinical and Experimental Medicine Department, University of Messina, Messina 98125, Italy
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, Messina 98125, Italy
| | | | - Giuliano Indelicato
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, Messina 98125, Italy
| | - Antonino Andrea Licciardello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, Messina 98125, Italy
| | - Ermanno Vitale
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, Messina 98125, Italy
| | - Giusi Briguglio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, Messina 98125, Italy
| | - Michele Teodoro
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, Messina 98125, Italy.
| | - Concettina Fenga
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, University of Messina, Messina 98125, Italy
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Malik A, Dhir A, Kaur P, Johri A. Correlates of social media fatigue and academic performance decrement. INFORMATION TECHNOLOGY & PEOPLE 2020. [DOI: 10.1108/itp-06-2019-0289] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe current study aims to investigate if different measures related to online psychosocial well-being and online behavior correlate with social media fatigue.Design/methodology/approachTo understand the antecedents and consequences of social media fatigue, the stressor-strain-outcome (SSO) framework is applied. The study consists of two cross-sectional surveys that were organized with young-adult students. Study A was conducted with 1,398 WhatsApp users (aged 19 to 27 years), while Study B was organized with 472 WhatsApp users (aged 18 to 23 years).FindingsIntensity of social media use was the strongest predictor of social media fatigue. Online social comparison and self-disclosure were also significant predictors of social media fatigue. The findings also suggest that social media fatigue further contributes to a decrease in academic performance.Originality/valueThis study builds upon the limited yet growing body of literature on a theme highly relevant for scholars, practitioners as well as social media users. The current study focuses on examining different causes of social media fatigue induced through the use of a highly popular mobile instant messaging app, WhatsApp. The SSO framework is applied to explore and establish empirical links between stressors and social media fatigue.
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Taylor TS, Raynard AL, Lingard L. Perseverance, faith and stoicism: a qualitative study of medical student perspectives on managing fatigue. MEDICAL EDUCATION 2019; 53:1221-1229. [PMID: 31657067 DOI: 10.1111/medu.13998] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 08/28/2019] [Accepted: 08/30/2019] [Indexed: 05/25/2023]
Abstract
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.
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Affiliation(s)
- Taryn S Taylor
- Department of Obstetrics and Gynaecology, London Health Sciences Centre, Victoria Hospital, London, Ontario, Canada
- Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Alexandra L Raynard
- Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Lorelei Lingard
- Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Soukup T, Lamb BW, Weigl M, Green JSA, Sevdalis N. An Integrated Literature Review of Time-on-Task Effects With a Pragmatic Framework for Understanding and Improving Decision-Making in Multidisciplinary Oncology Team Meetings. Front Psychol 2019; 10:1245. [PMID: 31354555 PMCID: PMC6634259 DOI: 10.3389/fpsyg.2019.01245] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 05/13/2019] [Indexed: 01/04/2023] Open
Abstract
Multidisciplinary oncology team meetings (MDMs) or tumor boards, like other MDMs in healthcare, facilitate the incorporation of diverse clinical expertise into treatment planning for patients. Decision-making (DM) in relation to treatment planning in MDMs is carried out repeatedly until all patients put forward for discussion have been reviewed. Despite continuing financial pressure and staff shortages, the workload of cancer MDMs, and therefore meeting duration continue to increase (up to 5 h) with patients often receiving less than 2 min of team input. This begs the question as to whether the current set-up is conducive to achieve optimal DM, which these multi-specialty teams were set out to achieve in the first place. Much of what it is known, however, about the effects of prolonged cognitive activity comes from various subfields of science, leaving a gap in applied knowledge relating to complex healthcare environments. The objective of this review was thus to synthesize theory, evidence and clinical practice in order to bring the current understanding of prolonged, repeated DM into the context of cancer MDMs. We explore how and why time spent on a task affects performance in such settings, and what strategies can be employed by cancer teams to counteract negative effects and improve quality and safety. In the process, we propose a pragmatic framework of repeated DM that encompasses the strength, the process and the cost-benefit models of self-control as applied to real-world contexts of cancer MDMs. We also highlight promising research avenues for closing the research-to-practice gap. Theoretical and empirical evidence reviewed in this paper suggests that over prolonged time spent on a task, repeated DM is cognitively taxing, leading to performance detriments. This deterioration is associated with various cognitive-behavioral pitfalls, including decreased attentional capacity and reduced ability to effectively evaluate choices, as well as less analytical DM and increased reliance on heuristics. As a short to medium term improvement for ensuring safety, consistently high quality of care for all patients, and the clinician wellbeing, future research and interventions in cancer MDMs should address time-on-task effects with a combination of evidence-based cognitive strategies. We propose in this review multiple measures that range from food intake, short breaks, rewards, and mental exercises. As a long term imperative, however, capacity within cancer services needs to be reviewed as well as how best to plan workforce development and service delivery models to achieve population coverage whilst maintaining safety and quality of care. Hence the performance detriments that arise in healthcare workers as a result of the intensity (time spent on a task) and complexity of the workload require not only more research, but also wider regulatory focus and recognition.
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Affiliation(s)
- Tayana Soukup
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Benjamin W. Lamb
- Department of Urology, Cambridge University Healthcare NHS Foundation Trust, Cambridge, United Kingdom
| | - Matthias Weigl
- Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - James S. A. Green
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Whipps Cross University Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Nick Sevdalis
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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Affiliation(s)
- L Reinke
- Department of Critical Care, University of Groningen, University Medical Center Groningen, NL-9713AV Groningen, The Netherlands
| | - J E Tulleken
- Department of Critical Care, University of Groningen, University Medical Center Groningen, NL-9713AV Groningen, The Netherlands
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Determining the likelihood that fatigue was present in a road accident: A theoretical review and suggested accident taxonomy. Sleep Med Rev 2018; 42:202-210. [DOI: 10.1016/j.smrv.2018.08.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 07/17/2018] [Accepted: 08/23/2018] [Indexed: 11/17/2022]
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Zaslona JL, O’Keeffe KM, Signal TL, Gander PH. Shared responsibility for managing fatigue: Hearing the pilots. PLoS One 2018; 13:e0195530. [PMID: 29782533 PMCID: PMC5962095 DOI: 10.1371/journal.pone.0195530] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 03/23/2018] [Indexed: 11/25/2022] Open
Abstract
In commercial aviation, fatigue is defined as a physiological state of reduced mental or physical performance capability resulting from sleep loss, extended wakefulness, circadian phase, and/or workload. The International Civil Aviation Organisation mandates that responsibility for fatigue risk management is shared between airline management, pilots, and support staff. However, to date, the majority of research relating to fatigue mitigations in long range operations has focused on the mitigations required or recommended by regulators and operators. Little research attention has been paid to the views or operational experience of the pilots who use these (or other) mitigations. This study focused on pilots’ views and experiences of in-flight sleep as the primary fatigue mitigation on long range flights. It also sought information about other fatigue mitigation strategies they use. Thematic analysis was used to explore written comments from diary and survey data collected during long range and ultra-long range trips (N = 291 pilots on three different aircraft types, 17 different out-and-back trips, and four airlines based on three continents). The findings indicate that the recommended fatigue mitigation strategies on long-haul flights (particularly in-flight sleep) are effective and well-utilised, consistent with quantitative findings from the same trips. Importantly however, the analyses also highlight areas that require further investigation, including flight preparation strategies in relation to the uncertainty of in-flight break allocation. There were two strategies for sleep prior to a flight: maximising sleep if pilots were expecting later breaks in the flight; or minimising sleep if they were expecting breaks earlier or at unfavourable times in the circadian cycle. They also provide a broader view of the factors that affect the amount and quality of pilots’ in-flight sleep, about which evidence has previously been largely anecdotal. The study underscores the value of including the views and experience of pilots in fatigue risk management.
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Affiliation(s)
- Jennifer L. Zaslona
- Sleep/Wake Research Centre, Massey University, Wellington, New Zealand
- * E-mail:
| | - Karyn M. O’Keeffe
- Sleep/Wake Research Centre, Massey University, Wellington, New Zealand
| | - T. Leigh Signal
- Sleep/Wake Research Centre, Massey University, Wellington, New Zealand
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Van Dongen HPA. Evidence-Based Guidelines for Fatigue Risk Management in Emergency Medical Services: A Significant Step Forward and a Model for Other High-Risk Industries. PREHOSP EMERG CARE 2018; 22:110-112. [PMID: 29324057 DOI: 10.1080/10903127.2017.1380098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Raith EP, Roodenburg O. Novel supports for Junior Medical Officers during out-of-hours work. Intern Med J 2017; 47:236-237. [PMID: 28201863 DOI: 10.1111/imj.13344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 11/25/2016] [Accepted: 11/27/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Eamon P Raith
- Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.,Discipline of Surgery, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Owen Roodenburg
- Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Eastern Health, Intensive Care Services, Melbourne, Victoria, Australia
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Roach GD, Roberts P, Dawson D, Ferguson S, Meuleners L, Brook L, Sargent C. Controlling fatigue risk in safety-critical workplaces: A summary of selected papers from the 9th International Conference on Managing Fatigue in Transportation, Resources and Health. ACCIDENT; ANALYSIS AND PREVENTION 2017; 99:379-382. [PMID: 27555462 DOI: 10.1016/j.aap.2016.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Gregory D Roach
- Appleton Institute for Behavioural Science, Central Queensland University, PO Box 42, Goodwood, SA 5034, Australia.
| | - Paul Roberts
- ARRB Group Ltd., 191 Carr Place, Leederville, WA 6007, Australia.
| | - Drew Dawson
- Appleton Institute for Behavioural Science, Central Queensland University, PO Box 42, Goodwood, SA 5034, Australia.
| | - Sally Ferguson
- Appleton Institute for Behavioural Science, Central Queensland University, PO Box 42, Goodwood, SA 5034, Australia.
| | - Lynn Meuleners
- Curtin Monash Accident Research Centre, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.
| | - Libby Brook
- School of Psychology and Exercise Science, Murdoch University, 90 South Street, Murdoch, WA 6150, Australia.
| | - Charli Sargent
- Appleton Institute for Behavioural Science, Central Queensland University, PO Box 42, Goodwood, SA 5034, Australia.
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