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Mengelkoch S, Moriarity DP, Novak AM, Snyder MP, Slavich GM, Lev-Ari S. Using Ecological Momentary Assessments to Study How Daily Fluctuations in Psychological States Impact Stress, Well-Being, and Health. J Clin Med 2023; 13:24. [PMID: 38202031 PMCID: PMC10779927 DOI: 10.3390/jcm13010024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 01/12/2024] Open
Abstract
Despite great interest in how dynamic fluctuations in psychological states such as mood, social safety, energy, present-focused attention, and burnout impact stress, well-being, and health, most studies examining these constructs use retrospective assessments with relatively long time-lags. Here, we discuss how ecological momentary assessments (EMAs) address methodological issues associated with retrospective reports to help reveal dynamic associations between psychological states at small timescales that are often missed in stress and health research. In addition to helping researchers characterize daily and within-day fluctuations and temporal dynamics between different health-relevant processes, EMAs can elucidate mechanisms through which interventions reduce stress and enhance well-being. EMAs can also be used to identify changes that precede critical health events, which can in turn be used to deliver ecological momentary interventions, or just-in-time interventions, to help prevent such events from occurring. To enable this work, we provide examples of scales and single-item questions used in EMA studies, recommend study designs and statistical approaches that capitalize on EMA data, and discuss limitations of EMA methods. In doing so, we aim to demonstrate how, when used carefully, EMA methods are well poised to greatly advance our understanding of how intrapersonal dynamics affect stress levels, well-being, and human health.
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Affiliation(s)
- Summer Mengelkoch
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90095, USA
| | - Daniel P. Moriarity
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90095, USA
| | - Anne Marie Novak
- Department of Health Promotion, School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel;
| | - Michael P. Snyder
- Department of Genetics, Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90095, USA
| | - Shahar Lev-Ari
- Department of Health Promotion, School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel;
- Department of Genetics, Stanford University School of Medicine, Stanford, CA 94305, USA;
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Roh T, Esomonu C, Hendricks J, Aggarwal A, Hasan NT, Benden M. Examining workweek variations in computer usage patterns: An application of ergonomic monitoring software. PLoS One 2023; 18:e0287976. [PMID: 37410732 PMCID: PMC10325041 DOI: 10.1371/journal.pone.0287976] [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] [Received: 04/18/2023] [Accepted: 06/19/2023] [Indexed: 07/08/2023] Open
Abstract
Alternative work arrangements have emerged as potential solutions to enhance productivity and work-life balance. However, accurate and objective measurement of work patterns is essential to make decisions about adjusting work arrangements. This study aimed at evaluating objective computer usage metrics as a proxy for productivity using RSIGuard, an ergonomics monitoring software. Data were collected from 789 office-based employees over a two-year period between January 1, 2017 and December 31, 2018 at a large energy company in Texas. A generalized mixed-effects model was utilized to compare computer usage patterns across different days of the week and times of the day. Our findings demonstrate that computer output metrics significantly decrease on Fridays compared to other weekdays, even after controlling for total active hours. Additionally, we found that workers' output varied depending on the time of day, with reduced computer usage observed in the afternoons and a significant decrease on Friday afternoons. The decrease in the number of typos was much less than that in the number of words typed, indicating reduced work efficiency on Friday afternoons. These objective indicators provide a novel approach to evaluating the productivity during the workweek and can help optimize work arrangements to promote sustainability for the benefit of employers, employees, and the environment.
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Affiliation(s)
- Taehyun Roh
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, Texas, United States of America
| | - Chukwuemeka Esomonu
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, Texas, United States of America
| | - Joseph Hendricks
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, Texas, United States of America
| | - Anisha Aggarwal
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, Texas, United States of America
| | - Nishat Tasnim Hasan
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, Texas, United States of America
| | - Mark Benden
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, Texas, United States of America
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Pyatak EA, Spruijt-Metz D, Schneider S, Hernandez R, Pham LT, Hoogendoorn CJ, Peters AL, Crandall J, Jin H, Lee PJ, Gonzalez JS. Impact of Overnight Glucose on Next-Day Functioning in Adults With Type 1 Diabetes: An Exploratory Intensive Longitudinal Study. Diabetes Care 2023; 46:1345-1353. [PMID: 36862940 PMCID: PMC10300522 DOI: 10.2337/dc22-2008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/13/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVE While there is evidence that functioning, or ability to perform daily life activities, can be adversely influenced by type 1 diabetes, the impact of acute fluctuations in glucose levels on functioning is poorly understood. RESEARCH DESIGN AND METHODS Using dynamic structural equation modeling, we examined whether overnight glucose (coefficient of variation[CV], percent time <70 mg/dL, percent time >250 mg/dL) predicted seven next-day functioning outcomes (mobile cognitive tasks, accelerometry-derived physical activity, self-reported activity participation) in adults with type 1 diabetes. We examined mediation, moderation, and whether short-term relationships were predictive of global patient-reported outcomes. RESULTS Overall next-day functioning was significantly predicted from overnight CV (P = 0.017) and percent time >250 mg/dL (P = 0.037). Pairwise tests indicate that higher CV is associated with poorer sustained attention (P = 0.028) and lower engagement in demanding activities (P = 0.028), time <70 mg/dL is associated with poorer sustained attention (P = 0.007), and time >250 mg/dL is associated with more sedentary time (P = 0.024). The impact of CV on sustained attention is partially mediated by sleep fragmentation. Individual differences in the effect of overnight time <70 mg/dL on sustained attention predict global illness intrusiveness (P = 0.016) and diabetes-related quality of life (P = 0.036). CONCLUSIONS Overnight glucose predicts problems with objective and self-reported next-day functioning and can adversely impact global patient-reported outcomes. These findings across diverse outcomes highlight the wide-ranging effects of glucose fluctuations on functioning in adults with type 1 diabetes.
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Affiliation(s)
- Elizabeth A. Pyatak
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA
| | - Donna Spruijt-Metz
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA
- Keck School of Medicine, University of Southern California, Los Angeles, CA
- Department of Psychology, University of Southern California, Los Angeles, CA
| | - Stefan Schneider
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA
- Department of Psychology, University of Southern California, Los Angeles, CA
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA
| | - Raymond Hernandez
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA
| | - Loree T. Pham
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA
| | - Claire J. Hoogendoorn
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
- Fleischer Institute for Diabetes and Metabolism, Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Anne L. Peters
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Jill Crandall
- Fleischer Institute for Diabetes and Metabolism, Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Haomiao Jin
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA
- Faculty of Health and Medical Sciences, School of Health Sciences, University of Surrey, Guildford, U.K
| | - Pey-Jiuan Lee
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA
| | - Jeffrey S. Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
- Fleischer Institute for Diabetes and Metabolism, Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
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Hernandez R, Jin H, Pyatak EA, Roll SC, Schneider S. Workers' whole day workload and next day cognitive performance. CURRENT PSYCHOLOGY 2023; 43:1-14. [PMID: 37359695 PMCID: PMC9982770 DOI: 10.1007/s12144-023-04400-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 03/06/2023]
Abstract
Workload experienced over the whole day, not just work periods, may impact worker cognitive performance. We hypothesized that experiencing greater than typical whole day workload would be associated with lower visual processing speed and lower sustained attention ability, on the next day. To test this, we used dynamic structural equation modeling to analyze data from 56 workers with type 1 diabetes. For a two-week period, on smartphones they answered questions about whole day workload at the end of each day, and completed cognitive tests 5 or 6 times throughout each day. Repeated smartphone cognitive tests were used, instead of traditional one- time cognitive assessment in the laboratory, to increase the ecological validity of the cognitive tests. Examples of reported occupations in our sample included housekeeper, teacher, physician, and cashier. On workdays, the mean number of work hours reported was 6.58 (SD 3.5). At the within-person level, greater whole day workload predicted decreased mean processing speed the next day (standardized estimate=-0.10, 95% CI -0.18 to -0.01) using a random intercept model; the relationship was not significant and only demonstrated a tendency toward the expected effect (standardized estimate= -0.07, 95% CI -0.15 to 0.01) in a model with a random intercept and a random regression slope. Whole day workload was not found to be associated with next-day mean sustained attention ability. Study results suggested that just one day of greater than average workload could impact next day processing speed, but future studies with larger sample sizes are needed to corroborate this finding.
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Affiliation(s)
- Raymond Hernandez
- Dornsife Center for Economic & Social Research, University of Southern California, 90089 Los Angeles, CA USA
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 90089 Los Angeles, CA USA
- USC Center for Economic & Social Research, 635 Downey Way, VPD 405 Los Angeles, CA USA
| | - Haomiao Jin
- Dornsife Center for Economic & Social Research, University of Southern California, 90089 Los Angeles, CA USA
- School of Health Sciences, University of Surrey, GU2 7YH Guildford, UK
| | - Elizabeth A. Pyatak
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 90089 Los Angeles, CA USA
| | - Shawn C. Roll
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 90089 Los Angeles, CA USA
| | - Stefan Schneider
- Dornsife Center for Economic & Social Research, University of Southern California, 90089 Los Angeles, CA USA
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Shih KK, Anderson A, Dai J, Fellman B, Rozman de Moraes A, Stanton P, Nelson C, DeLa Cruz V, Bruera E. Hybrid Work from Home Clinical Academic Environment: A One-Year Follow-Up Survey of Attitudes and Beliefs of Members of a Department of Palliative Care, Rehabilitation, and Integrative Medicine. J Palliat Med 2023; 26:342-352. [PMID: 36108159 DOI: 10.1089/jpm.2022.0203] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Context: Palliative, Rehabilitation, and Integrative Medicine (PRIM) department members anonymously reported a positive experience with work from home (WFH) two months after its rapid pandemic transition in March 2020. Data are limited on the stability of such preferences and experiences over time. Objectives: The objectives of this study were to survey the attitudes and beliefs of PRIM employees toward remote work 16 months after the start of the coronavirus disease 2019 (COVID-19) pandemic since vaccines and to determine changes in perceptions of WFH. Methods: All 138 PRIM employees were invited to participate in an anonymous survey from mid-July to mid-August 2021. The 30-question survey included demographics, perceptions toward WFH, and the pandemic. Results: One hundred fifteen (83%) employees completed the survey: 29 (74%) research, 62 (83%) clinicians, and 24 (100%) administrative personnel. Most were female (76%), 30-59 years old (88%), PRIM employees before May 2020 (89%), shared office space (52%), and had received either first or second dose of the COVID-19 vaccine (88%). Overall experience (86%) and emotional response (74%) with WFH were positive and not significantly different from 2020 (p = 0.128 and 0.782, respectively). Positive experience was associated with having adequate equipment (p = 0.002), perception of productivity (p = 0.002), financial advantage (p = 0.002), and time demands caring for dependents (p = 0.038). Clinicians reported less positive response (78%, p = 0.002) and less productivity (49%, p = 0.002) with WFH and higher level of stress (54%, p = 0.026) since COVID-19. Employees continued to support WFH permanently (79%) for two or more days/week (82%). There was continued increased emotional exhaustion (71%) similar to 2020 (p = 0.868), and being asked to work partially or completely from home permanently was favored by 64% versus 97% and 96% of clinicians, research, and administrative, respectively (p = 0.002). Conclusions: Support for WFH was sustained a year later and after three pandemic waves. These findings serve as a model for future rapid work transitions and can help elucidate factors associated with stress and emotional exhaustion in a new post-COVID-19 work environment.
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Affiliation(s)
- Kaoswi Karina Shih
- Department of Palliative, Rehabilitation, and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Aimee Anderson
- Department of Palliative, Rehabilitation, and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jianliang Dai
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Bryan Fellman
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Aline Rozman de Moraes
- Department of Palliative, Rehabilitation, and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Penny Stanton
- Department of Palliative, Rehabilitation, and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Christina Nelson
- Department of Palliative, Rehabilitation, and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Vera DeLa Cruz
- Department of Palliative, Rehabilitation, and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation, and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Hernandez R, Jin H, Pyatak EA, Roll SC, Gonzalez JS, Schneider S. Perception of Whole Day Workload as a Mediator Between Activity Engagement and Stress in Workers with Type 1 Diabetes. THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2022; 25:67-85. [PMID: 38116540 PMCID: PMC10727486 DOI: 10.1080/1463922x.2022.2149878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022]
Abstract
Associations between various forms of activity engagement (e.g. work, leisure) and the experience of stress in workers have been widely documented. The mechanisms underlying these effects, however, are not fully understood. Our goal was to investigate if perceived whole day workload accounted for the relationships between daily frequencies of activities (i.e. work hours and leisure/rest) and daily stress. We analyzed data from 56 workers with type 1 diabetes (T1D) who completed approximately two weeks of intensive longitudinal assessments. Daily whole day workload was measured with an adapted version of the National Aeronautics and Space Administration Task Load Index (NASA-TLX). A variety of occupations were reported including lawyer, housekeeper, and teacher. In multilevel path analyses, day-to-day changes in whole day workload mediated 67% (p<.001), 61% (p<.001), 38% (p<.001), and 55% (p<.001) of the within-person relationships between stress and work hours, rest frequency, active leisure frequency, and day of week, respectively. Our results provided evidence that whole day workload perception may contribute to the processes linking daily activities with daily stress in workers with T1D. Perceived whole day workload may deserve greater attention as a possible stress intervention target, ones that perhaps ergonomists would be especially suited to address.
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Affiliation(s)
- Raymond Hernandez
- Dornsife Center for Economic & Social Research, University of Southern California, Los Angeles, CA 90089, USA
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA
| | - Haomiao Jin
- Dornsife Center for Economic & Social Research, University of Southern California, Los Angeles, CA 90089, USA
- School of Health Sciences, University of Surrey, Guildford GU2 7YH, United Kingdom
| | - Elizabeth A. Pyatak
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA
| | - Shawn C. Roll
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA
| | - Jeffrey S. Gonzalez
- Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY 10461, USA
| | - Stefan Schneider
- Dornsife Center for Economic & Social Research, University of Southern California, Los Angeles, CA 90089, USA
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Hernandez R, Roll SC, Jin H, Schneider S, Pyatak EA. Validation of the National Aeronautics and Space Administration Task Load Index (NASA-TLX) adapted for the whole day repeated measures context. ERGONOMICS 2022; 65:960-975. [PMID: 34766872 PMCID: PMC9124236 DOI: 10.1080/00140139.2021.2006317] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/01/2021] [Indexed: 06/13/2023]
Abstract
Our objective was to investigate the validity of four-item and six-item versions of the National Aeronautics and Space Administration Task Load Index (NASA-TLX, or TLX for short) for measuring workload over a whole day in the repeated measures context. We analysed data on 51 people with type 1 diabetes from whom we collected ecological momentary assessment and daily diary data over 14 days. The TLX was administered at the last survey of every day. Confirmatory factor analysis fit statistics indicated that neither the TLX-6 nor TLX-4 were a unidimensional representation of whole day workload. In exploratory analyses, another set of TLX items we refer to as TLX-4v2 was sufficiently unidimensional. Raw sum scores from the TLX-6 and TLX-4v2 had plausible relationships with other measures, as evidenced by intra-person correlations and mixed-effects models. TLX-6 appears to capture multiple factors contributing to workload, while TLX-4v2 assesses the single factor of 'mental strain'. Practitioner Summary: Using within-person longitudinal data, we found evidence supporting the validity of a measure evaluating whole-day workload (i.e. workload derived from all sources, not only paid employment) derived from the NASA-TLX. This measure may be useful to assess how day-to-day variations in workload impact quality of life among adults.Abbreviations: NASA-TLX or TLX: National Aeronautics and Space Administration Task Load Index; TLX-6: six item version of the NASA-TLX; TLX-4: four item version of the NASA-TLX, TLX-4v2: four item NASA-TLX version two; NIOSH: National Institute for Occupational Safety and Health; CFA: confirmatory factor analysis; T1D: type 1 diabetes; EMA: ecological momentary assessment; BG: blood glucose; SD: standard deviation; CV: coefficient of variation; RMSEA: root mean square error of approximation; CFI: comparative fit index; TLI: Tucker-Lewis Index; SRMR: standardized root mean square residual; AIC: Akaike information criterion; BIC: Bayesian information criterion; χ2: Chi-square statistic.
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Affiliation(s)
- Raymond Hernandez
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar St, Los Angeles, CA 90089 United States
| | - Shawn C. Roll
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar St, Los Angeles, CA 90089 United States
| | - Haomiao Jin
- Dornsife Center for Self-Report Science and Center for Social & Economic Research, University of Southern California, Los Angeles, California, USA
| | - Stefan Schneider
- Dornsife Center for Self-Report Science and Center for Social & Economic Research, University of Southern California, Los Angeles, California, USA
| | - Elizabeth A. Pyatak
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar St, Los Angeles, CA 90089 United States
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Tamers SL, Streit JMK, Chosewood C. Promising Occupational Safety, Health, and Well-Being Approaches to Explore the Future of Work in the USA: An Editorial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1745. [PMID: 35162768 PMCID: PMC8834959 DOI: 10.3390/ijerph19031745] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/30/2022] [Indexed: 01/09/2023]
Abstract
The future of work continues to undergo profound and fundamental changes in response to shifting social, technological, economic, environmental, and political contexts [...].
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Affiliation(s)
- Sara L. Tamers
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, 395 E Street SW, Washington, DC 20201, USA
| | - Jessica M. K. Streit
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, 1090 Tusculum Avenue, Cincinnati, OH 45226, USA;
| | - Casey Chosewood
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, 1600 Clifton Rd., Atlanta, GA 30329, USA;
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