Background: Microscopy at work involves a combination of external exposures that pose an increased risk for eye-neck/shoulder symptoms such as; visually demanding near work, eye-hand coordination, static work postures and repetitive work. Objectives: To explore the pattern of fluctuations in eye-neck/shoulder symptoms and the reproducibility of these fluctuations during separate workdays and workweeks, for individuals who regularly perform microscopic duties at work. Method: Data was collected at 8 different times for all participants (n=16); Monday morning and afternoon and Friday morning and afternoon, during 2 different weeks at work. Results: Musculoskeletal complaints in the neck/shoulders and symptoms of eye strain increased significantly (∆Musculoskeletal complaints; p<0,01, ∆Symptoms of eye stain; p<0,05)  during the workweek.  The highest levels of self-reported symptoms did not correlate with the self-reported time in microscopy during the workweek (p>0.05).  The same tendency for the increments in symptoms was observed during both work weeks. Only for musculoskeletal complaints did the increments of symptoms correlated with one another (p<0.05).  Conclusion: The results indicate that microscopy at work is a risk factor, primarily for increased musculoskeletal complaints in the neck/shoulders. More studies are needed to assess the relationship between microscopy at work and the onset and development of eye-neck/shoulder complaints. / Bakgrund: Mikroskopering som arbetsuppgift medför en kombination flera aspekter av extern exponering som innebär ökad risk för muskuloskeletala besvär och besvär från ögonen; synkrävande närarbete med krav på öga-hand koordination, låsta arbetsställningar som medför långvarigt lågintensivt muskelarbete i nacke och axel/skuldra, samt repetitiva arbetsmönster. Trots det har mycket få studier publicerats inom området sedan början av 1980-talet. Syfte: Att undersöka variationer av muskuloskeletala besvär i nacke-axel/skuldra och besvär från ögonen under arbetsdagen och arbetsveckan, samt att undersöka upprepbarheten av variationer under arbetsdagen och arbetsveckan för personer som mikroskoperar i arbetet. Metod: Studien genomfördes med en webbaserad enkät. Datainsamling skedde vid 8 tillfällen; måndag förmiddag och eftermiddag samt fredag förmiddag och eftermiddag, under två separata arbetsveckor. Studiedeltagarna kom från en elektronisk industri (n=11) och en laboratoriemedicinsk enhet (n=6). Studien hade ett bortfall (n=1). Resultat: Muskuloskeletala besvär i nacke-axel/skuldra och värk/överansträngning i ögon ökade signifikant (∆Muskuloskeletala besvär; p<0,01, ∆Värk/överansträngning i ögon p<0,05) under arbetsveckan. De högsta nivåerna av besvär kunde inte relateras till deltagarnas skattade tid i mikroskopering under arbetsveckan. Samma trend av ökning i besvär kunde ses för både arbetsvecka 1 och 2. Enbart för muskuloskeletala besvär i nacke-axel/skuldra så korrelerade ökningar under arbetsvecka 1 signifikant med ökningar under arbetsvecka 2 (p<0,05). Slutsats: Resultaten indikerar att mikroskoparbete är en riskfaktor, primärt för ökade muskuloskeletala besvär i nacke-axel/skuldra. Fler studier behövs inom området, bl.a. för att undersöka förekomst av kausalitet mellan mikroskopering som arbetsuppgift och utvecklandet av muskuloskeletala besvär i nacke-axel/skuldra samt besvär i ögon.

Akutsjukvården i Sverige är en samhällsviktig verksamhet i vardag, kris och i händelse av krig. Den operativa ledningen på akutmottagningar sköts av en sjuksköterska med ledningsansvar, vars uppdrag är att leda och fördela arbetet under ett skift. På akutmottagningar i Sverige arbetar såväl tillsvidareanställd ordinarie personal med olika erfarenhetsnivå, liksom bemanningsanställd personal under förhållanden som kan definieras som påfrestande. Syftet med denna studie har varit att bidra med förståelse av ledarskap i akutsjukvårdens kontext genom att undersöka upplevelser av ledarskap av tillfälliga grupper under påfrestande förhållanden i rollen som ledningssjuksköterska. Med en kvalitativ ansats genomfördes sex semistrukturerade intervjuer med ledningssjuksköterskor från olika akutmottagningar i Region Stockholm. Resultatet analyserades genom en tematisk analys där en i Sverige etablerad ledarskapsmodell användes. Analysen genererade fyra teman som beskriver rollen och sammanhanget ledningssjuksköterskor verkar i, vad som kännetecknar påfrestande förhållanden i akutsjukvården och vilka omgivnings- och ledarfaktorer som påverkar ledarskapet hos ledningssjuksköterskor. Ett resultat av studien är en empirisk tillämpning av generell ledarskapsteori i akutsjukvårdens kontext. Studiens viktigaste bidrag är att ledningssjuksköterskor anpassar sitt ledarskap efter graden av påfrestning och personalgruppens kompetens, erfarenhet och behov av stöd. Resultatet indikerar också att kännedom om personalgruppens kompetens kan vara av särskilt betydelse under påfrestande förhållanden med tidsbrist, osäkerhet och psykiska påfrestningar som följd. / Emergency healthcare in Sweden holds a vital societal function in ordinary circumstances, crisis situations, and in the event of war. The operational management within emergency departments is lead by a nurse in charge, tasked with the responsibility of leading and allocating work during a shift. Within Swedish emergency departments there is a mix of permanently employed regular staff with varying levels of experience and temporary staff working under conditions that can be defined as demanding. The aim of this study has been to contribute to an understanding of leadership within the context of emergency healthcare by examining experiences of leadership of temporary groups during demanding conditions in the role of a charge nurse. A qualitative study involved conducting six semi-structured interviews with charge nurses from various emergency departments in the Stockholm Region. The results were analyzed using a thematic analysis utilizing a well-established leadership model in Sweden. This analysis generated four themes describing the role and context in which chargenurses operate, what characterizes demanding conditions in emergency healthcare, and which environmental and leadership factors affect the leadership of charge nurses. An outcome of the study involves the empirical application of general leadership theory. The primary contribution of this study is that charge nurses adapt their leadership based on levels of adversity and the competence, experience and support needs of the staff group. The results also suggest that awareness of the staff group’s competence can be particularly significant under demanding conditions, including time constraints, uncertainty and stress.

The diploma thesis on the topic Changes in the programming scheme of the ČT 2 channel after the amendment to the Czech Television Act of 2011 examines whether this television channel was commercialized after the law changed the rules for placing advertisements and advertising messages on public service television channels. The ČT 2 channel was conceived as an alternative channel intended for a more demanding audience. From the logic of its focus, such a channel does not aim at high viewership. Nevertheless, the amendment to the law designated it for the sale of advertising time as the only full-format channel of Czech Television. The search provided a wealth of information regarding television broadcasting by law and the effects it has on public service television. Czech Television was included in the media system as a public service television. The work deals with the technique and principles of creating a television program and its individual components, which undoubtedly have an impact on the resulting media product, which is the program scheme of the channel. Professional publications of Czech and world media experts enabled the author to create his own definition of terms, the description of which clearly does not agree with the professional public. It is mainly about defining a program that...

This dissertation originates in research project Potřeby a podpora pracovníků poskytujících paliativní péči v hospicích (FHS_P19_2014_068) (Paliative Hospices Care Staff Needs and Support) which was implemented in 2015. The dissertation deals with needs of hospices staff. These are derived from demands and requirements placed on the staff and correlate with their workload. I express management strategies and attitudes related to staff support. In the theoretical part of the dissertation I survey organization culture and ways and means of staff care. One of the care forms may be supervision. I⁠ focus on its possible form (shape) and supervisor's function. The empirical part of the dissertation is based on the research performed in two hospices. I focus on facility description and provided care. It is based on conversations with staff and management of these facilities. I try to depict the way management views the staff support, demanding situations they are exposed to and their idea of management support. Last but not least I⁠ focus on the supervision area, the way the staff perceives it, to what extent they see it as a contribution (benefit) and what do they expect of it. Powered by TCPDF (www.tcpdf.org)

Diploma thesis Assistance to the handicapped people and their families deals with demanding challenges which parents with children born with handicap are faced. Concerning the exacting situations that aren't one - time but long-term, parents are grateful for each support or help. Therefore a sensitive assistance to these families is very important. To make it effective, it's necessary to understand both thinking, feelings, handicapped child's needs and members of their broad surroundings. That's why this thesis occupies with challenging life situations, stress and stress coping in general, child's handicap, accepting this child and related unexpected new situations by parents. The thesis deals with issues related to children with autism and with Down's syndrome. It presents significant role of support for children with handicap and their families provided by the self-governed associations and groups. It occupies with assistance to these families with handicapped children by means of challenge for pastoral work and evangelization. Key words: Stress, demanding situation, handicap, family, autism, Down's syndrome, pastoral work, assistance, self-governed associations, social network.

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Worker fatigue has been the focus of research for many years. However, there is limited research available on the evaluation and measurement of fatigue for prolonged mentally demanding activities. The objectives of the study are (1 )to evaluate fatigue for prolonged, mentally demanding work-tasks by considering task-dependent, task-independent and personal factors, (2) to identify effective subjective and objective fatigue measures, (3) to establish a relationship between time and factors that affect fatigue (4) to develop models to predict fatigue. A total of 16 participants, eight participants with western cultural backgrounds and eight participants with eastern cultural backgrounds, currently employed in mentally demanding work-tasks (e.g., programmers, computer simulation experts, etc.) completed the study protocols. Each participant was evaluated during normal working hours in their workplace for a 4-hour test session, with a 15-minute break provided after two hours. Fatigue was evaluated using subjective questionnaires (Borg Perceived Level of Fatigue Scale and the Swedish Occupational Fatigue Index (SOFI)); and objective measures (change in resting heart rate and salivary cortisol excretion). Workload was also assessed using the NASA-TLX. Fatigue and workload scales were collected every 30 minutes, cortisol at the start and finish of each 2-hour work block, and heart rate throughout the test session. Fatigue significantly increased over time (p-value <0.0001). All measures, except cortisol hormone, returned to near baseline level following the 15-minute break (p-value <0.0001). Ethnicity was found to have limited effects on fatigue development. Poor to moderate (Rho = 0.35 to 0.75) significant correlations were observed between the subjective and objective measures. Time and fatigue load (a factor that impacts fatigue development) significantly interact to explain fatigue represented by a hyperbolic relationship. Predictive models explained a maximum of 87% of the variation in the fatigue measures. As expected, fatigue develops over time, especially when considering other factors that can impact fatigue (e.g. hours slept, hours of work), providing further evidence of the complex nature of fatigue. As the 15-minute break was found to reduce all measures of fatigue, the development of appropriate rest breaks may mitigate some of the negative consequences of fatigue.

Det uppskattas att ungefär en tredjedel av arbetsmarknaden består av röstkrävande yrken, det vill säga yrken där rösten är ett viktigt och nödvändigt redskap för att utföra sitt arbete. Tidigare forskning har identifierat lärare, sångare och präster som yrken med röstkrävande arbetsuppgifter. Forskningen är dock över 20 år gammal, och aktuell forskning om vilka röstkrav som ställs på arbetsmarknaden, särskilt hos grupper som inte är överrepresenterade vad gäller röstproblem, saknas. Syftet med den här studien är att identifiera vilka röstkrav som ställs inom yrkesgrupper i Sverige idag. Totalt 477 deltagare besvarade en enkät med frågor om uppskattad talartid under en arbetsdag, samt vilka röstkrävande arbetsuppgifter och röstkrävande arbetsmiljöfaktorer som förekom på deras arbetsplats. Resultatet från den här deskriptiva tvärsnittsstudien visar att flera yrken som tidigare blivit identifierade som röstkrävande yrken, även är röstkrävande yrken idag. Ytterligare identifierade yrken i den här studien var till exempel arbetstagare inom museum- och biblioteksverksamhet, sjuksköterskor med vidareutbildning, till exempel barnsjuksköterskor, chefer inom utbildning, och yrkesgruppen ”författare, journalister och tolkar”. De mest förekommande röstkraven var att muntligt instruera eller informera kollegor, prata i telefon och att kommunicera muntligt med kunder eller klienter. Vidare forskning med ett större deltagarantal behövs för att ytterligare identifiera röstkrävande yrkesgrupper och röstkrav på den moderna arbetsmarknaden, där rösten förväntas hålla under allt fler arbetsverksamma år. / It is estimated that approximately one third of the labour market consists of vocally demanding occupations, namely occupations where the voice is an important and necessary tool to execute one’s work. Previous research has identified teachers, singers, and priests as occupations with vocally demanding work. However, the research is over 20 years old, and current research about vocal requirements on the labour market, especially amongst groups that are not overrepresented regarding voice problem, are missing. The purpose of this study is to identify which vocal requirements are essential on the modern Swedish labour market. A total of 477 participants completed a survey with questions about estimated speaking time during a workday, as well as which vocally demanding work tasks and vocally challenging work environmental factors occured at their workplace. The result from the descriptive cross-sectional study shows that several occupations that previously have been identified as vocally demanding occupations, also are vocally demanding occupations today. Further identified occupations in this study were employees working within libraries and museums, nursing professionals with continued education such as pediatric nurses, education managers, and the occupational group “authors, journalists, and interpreters”. The most occurring vocal demands in the Swedish labour market today were verbally instructing or informing colleagues, speaking on the phone, and verbally communicating with customers/clients/patients/users/visitors. Further research with a larger number of participants is needed to identify vocally demanding occupational groups and vocal requirements on the modern Swedish labour market, where the voice is expected to last during an increasing amount of working years.

Syftet med denna studie var att studera sjukvårdsledares upplevelser av beslutsfattande under påfrestande förhållanden inom den prehospitala särskilda sjukvårdsledningen. Frågeställningarna bestod av vilka aspekter sjukvårdsledare upplevde som ogynnsamma respektive gynnsamma för beslutsfattande under påfrestande förhållanden. Totalt har 13 sjukvårdsledare intervjuats semistrukturerat med stöd av Critial Decision Method. Intervjumaterialet har databearbetats genom tematisk analys. Detta resulterade i två huvudteman samt sju subteman som redogör ogynnsamma samt gynnsamma aspekter för sjukvårdsledares beslutsfattande under påfrestande förhållanden. Den huvudsakliga slutsatsen i denna studie är att erfarenhet är gynnsamt för beslutsfattande under påfrestande förhållanden. De andra ogynnsamma och gynnsamma aspekterna står i kontrast gentemot varandra. / The purpose of this study was to study medical incident commanders experiences of decision-making under demanding conditions within the special major incident medical management- and support team. The research questions consisted of which aspects medical incident commanders experienced as unfavorable and favorable for decision-making under demanding conditions. A total of 13 medical incident commanders were interviewed semi-structured with the support of the Critial Decision Method. The interview material has been data processed through a thematic analysis. This resulted in two main themes with seven subthemes that describe unfavorable and favorable aspects of medical incident commanders decision-making under demanding conditions. The main conclusion of this study is that experience is beneficial for decision making under demanding conditions. The other unfavorable and favorable aspects stand in contrast to each other.

<p>Surface electromyography (sEMG) has been used to monitor muscle activity and predict fatigue in the workplaces. However, objectively measuring fatigue is challenging in complex work with unpredictable work cycles, where sEMG may be influenced by the dynamically changing posture demands. The sEMG is affected by various variables and substantial change in mean power frequencies (MPF), and a decline over 8-9% is primarily considered musculoskeletal fatigue. These MPF thresholds have been frequently used, and there were limited efforts to test their appropriateness in determining musculoskeletal fatigue in live workplaces (which predominantly consist of complex tasks). In addition, the techniques that consider both muscular and postural measurements that incorporate dynamic posture changes observed in complex work have not yet been explored. The overall objective of this work is to leverage both postural and muscular cues to identify musculoskeletal fatigue in complex tasks/jobs (i.e., tasks involving different levels of exertions, durations, and postures). The work was completed in two studies.</p> The first study aimed to (1) predict subjective fatigue using objective measurements in non-repetitive tasks, (2) determine whether the musculoskeletal fatigue thresholds in non-repetitive tasks differed from the previously reported threshold, and (3) utilize the empirically calculated thresholds to test their appropriateness in determining musculoskeletal fatigue in live surgical workplaces. The findings showed that the multi-modal measurements indicate better sensitivity than single-modality (sEMG) measurements in detecting decreases in MPF, a predictor of fatigue. In addition, the results showed that the thresholds in dynamic non-repetitive tasks, like surgery, are different than the previously reported 8% threshold. Additionally, implementing muscle-specific thresholds increased the likelihood of more accurately reporting subjective fatigue. The second study aimed to develop a multi-modal fatigue index to detect musculoskeletal fatigue. A controlled laboratory study was performed to simulate the non-repetitive physical demands at different postures. A series of experiments were conducted to test the effectiveness of various metrics/models to identify subjective fatigue in complex tasks. Next, the composite fatigue index (CFI) function was developed using the time-synced integration of both muscular signals (measured with sEMG sensors) and postural signals (measured with Inertial Measurement Unit (IMU) sensors). The variables from sEMG (amplitude, frequency, and the number of muscles showing signs of fatigue) and IMU (the prevalence of static and demanding postures and the number of shoulders in static/demanding posture) sensors were integrated to generate the CFI function. The prevalence of static/demanding postures was developed using the cumulative exposures to static/demanding postures based on the material fatigue failure theory. The single value fatigue index was obtained using the resultant CFI function, which incorporates both muscular and postural variables, to quantify the muscular fatigue in dynamic non-repetitive tasks. The findings suggested that the propagation of musculoskeletal fatigue can be detected using the multi-modal composite fatigue index in complex tasks. The resultant CFI function was then applied to surgery tasks to differentiate the fatigued and non-fatigued groups. The findings showed that the multi-modal fatigue assessment techniques could be utilized to incorporate the muscular and postural measurements to identify fatigue in complex tasks beyond single-modality assessment approaches.