A lot of research has been done on the detection of mental workload using various bio-signals. Recently, deep learning has allowed for novel methods and results. A plethora of measurement modalities have proven to be valuable in this task, yet studies currently often only use a single modality to classify MWL. The goal of this research was to classify perceived mental workload using a deep neural network that flexibly makes use of multiple modalities, in order to (...) allow for feature sharing between modalities. To achieve this goal, an experiment was conducted in which MWL was simulated with the help of verbal logic puzzles. The puzzles came in five levels of difficulty and were presented in a random order. Participants had 1 h to solve as many puzzles as they could. Between puzzles, they gave a difficulty rating between 1 and 7, seven being the highest difficulty. Galvanic skin response, photoplethysmograms, functional near-infrared spectrograms and eye movements were collected simultaneously using LabStreamingLayer. Marker information from the puzzles was also streamed on LSL. We designed and evaluated a novel intermediate fusion multimodal DNN for the classification of PMWL using the aforementioned four modalities. Two main criteria that guided the design and implementation of our DNN are modularity and generalisability. We were able to classify PMWL within-level accurate on a seven-level workload scale using the aforementioned modalities. The model architecture allows for easy addition and removal of modalities without major structural implications because of the modular nature of the design. Furthermore, we showed that our neural network performed better when using multiple modalities, as opposed to a single modality. The dataset and code used in this paper are openly available. (shrink)

The aim of this chapter is to identify the most representative measures of subjective and objective mental workload in driving, and to understand how the subjective and objective levels of mental workload influence the performance as a function of situation complexity and driving experience, i.e. to verify whether the increase of situation complexity and the lack of experience increase the subjective and physiological levels of mental workload and lead to driving performance impairments. This chapter (...) will be useful to carry out an experimental study and to improve the driver training. In the first part, we will broach the theoretical approach with two factors of mental workload and performance, i.e. situation complexity and driving experience. Indeed, a low complex situation (e.g., highways), or conversely a high complex situation (e.g., town) can provoke an overload. Additionally, performing the driving tasks implies producing a high effort for novice drivers who have not totally automated the driving activity. In the second part, we will focus on subjective measures of mental workload. A comparison of questionnaires usually used in driving will allow identifying the most appropriate ones as a function of different criteria. Moreover, we will review the empirical studies to verify if the subjective level of mental workload is high in simple and very complex situations, especially for novice drivers compared to the experienced ones. In the third part, we will focus on physiological measures. A comparison of physiological indicators will be realized in order to identify the most correlated to mental workload. An empirical review will also take the effect of situation complexity and experience on these physiological indicators into consideration. Finally, a more nuanced comparison between subjective and physiological measures will be established from the impact on situation complexity and experience. (shrink)

Human mental workload is arguably the most invoked multidimensional construct in Human Factors and Ergonomics, getting momentum also in Neuroscience and Neuroergonomics. Uncertainties exist in its characterization, motivating the design and development of computational models, thus recently and actively receiving support from the discipline of Computer Science. However, its role in human performance prediction is assured. This work is aimed at providing a synthesis of the current state of the art in human mental workload assessment through (...) considerations, definitions, measurement techniques as well as applications, Findings suggest that, despite an increasing number of associated research works, a single, reliable and generally applicable framework for mental workload research does not yet appear fully established. One reason for this gap is the existence of a wide swath of operational definitions, built upon different theoretical assumptions which are rarely examined collectively. A second reason is that the three main classes of measures, which are self-report, task performance, and physiological indices, have been used in isolation or in pairs, but more rarely in conjunction all together. Multiple definitions complement each another and we propose a novel inclusive definition of mental workload to support the next generation of empirical-based research. Similarly, by comprehensively employing physiological, task-performance, and self-report measures, more robust assessments of mental workload can be achieved. (shrink)

Car driving is considered a very complex activity, consisting of different concomitant tasks and subtasks, thus it is crucial to understand the impact of different factors, such as road complexity, traffic, dashboard devices, and external events on the driver’s behavior and performance. For this reason, in particular situations the cognitive demand experienced by the driver could be very high, inducing an excessive experienced mental workload and consequently an increasing of error commission probability. In this regard, it has been (...) demonstrated that human error is the main cause of the 57 % of road accidents and a contributing factor in most of them. In this study, 20 young subjects were involved in a real driving experiment, performed under different traffic conditions (rush hour and not) and along different road types (main and secondary streets). Moreover, during the driving tasks different specific events, in particular a pedestrian crossing the road and a car entering the traffic flow just ahead of the experimental subject, were acted. A Workload Index based on the Electroencephalographic (EEG), i.e. brain activity, of the drivers has been employed to investigate the impact of the different factors on the driver’s workload. Eye-Tracking technology and subjective measures were also employed in order to have a comprehensive overview of the driver’s perceived workload and to investigate the different insights obtainable from the employed methodologies. The employment of such EEG-based Workload index confirmed the significant impact of both traffic and road types on the drivers’ behavior (increasing their workload), with the advantage of being under real settings. Also, it allowed to highlight the increased workload related to external events while driving, in particular with a significant effect during those situations when the traffic was low. Finally, the comparison between methodologies revealed the higher sensitivity of neurophysiological measures with respect to Eye-Tracking and subjective ones. In conclusion, such an EEG-based Workload index would allow to assess objectively the mental workload experienced by the driver, standing out as a powerful tool for research aimed to investigate drivers’ behavior and providing additional and complementary insights with respect to traditional methodologies employed within road safety research. (shrink)

The use of automation in cars is increasing. In future vehicles, drivers will no longer be in charge of the main driving task and may be allowed to perform a secondary task. However, they might be requested to regain control of the car if a hazardous situation occurs. Performing a secondary task might increase drivers' mental workload and consequently decrease the takeover performance if the workload level exceeds a certain threshold. Knowledge about the driver's mental state (...) might hence be useful for increasing safety in conditionally automated vehicles. Measuring drivers' workload continuously is essential to support the driver and hence limit the number of accidents in takeover situations. This goal can be achieved using machine learning techniques to evaluate and classify the drivers' workload in real-time. To evaluate the usefulness of physiological data as an indicator for workload in conditionally automated driving, three physiological signals from 90 subjects were collected during 25 min of automated driving in a fixed-base simulator. Half of the participants performed a verbal cognitive task to induce mental workload while the other half only had to monitor the environment of the car. Three classifiers, sensor fusion and levels of data segmentation were compared. Results show that the best model was able to successfully classify the condition of the driver with an accuracy of 95%. In some cases, the model benefited from sensors' fusion. Increasing the segmentation level increased the performance of the model for windows smaller than 4 min, but decreased for windows larger than 4 min. In conclusion, the study showed that a high level of drivers' mental workload can be accurately detected while driving in conditional automation based on 4-min recordings of respiration and skin conductance. (shrink)

Highly mobile computing devices promise to improve quality of life, productivity, and performance. Increased situation awareness and reduced mental workload are two potential means by which this can be accomplished. However, it is difficult to measure these concepts in the ‘wild’. We employed an ultra-portable battery operated and wireless functional near infrared spectroscopy (fNIRS) to non-invasively measure hemodynamic changes in the brain’s prefrontal cortex. Measurements were taken during navigation of a college campus with either a hand-held display, or (...) an augmented reality wearable display. Hemodynamic measures were also paired with secondary tasks of visual perception and auditory working memory to provide behavioral assessment of situation awareness and mental workload. Navigating with an augmented reality wearable display produced the least workload during both secondary tasks. The hemodynamics associated with errors were also different between the two devices. Errors with an augmented reality wearable display were associated with increased prefrontal activity and the opposite was observed for the hand-held display. This suggests that the cognitive mechanisms underlying errors between the two devices differ. These findings show fNIRS is a valuable tool for assessing new technology in ecologically valid settings and that head-mounted displays offer benefits with regards to mental workload while navigating, and potentially superior situation awareness with improved display design. (shrink)

The goal of this study was to implement a Riemannian geometry -based algorithm to detect high mental workload and mental fatigue using task-induced electroencephalogram signals. In order to elicit high MWL and MF, the participants performed a cognitively demanding task in the form of the letter n-back task. We analyzed the time-varying characteristics of the EEG band power features in the theta and alpha frequency band at different task conditions and cortical areas by employing a RG-based framework. (...) MWL and MF were considered as too high, when the Riemannian distances of the task-run EEG reached or surpassed the threshold of the baseline EEG. The results of this study showed a BP increase in the theta and alpha frequency bands with increasing experiment duration, indicating elevated MWL and MF that impedes/hinders the task performance of the participants. High MWL and MF was detected in 8 out of 20 participants. The Riemannian distances also showed a steady increase toward the threshold with increasing experiment duration, with the most detections occurring toward the end of the experiment. To support our findings, subjective ratings and behavioral measures were also considered. (shrink)

Background: Walking while performing a secondary task walking) increases cognitive workload in young adults. To date, few studies have used neurophysiological measures in combination to subjective measures to assess cognitive workload during a walking task. This combined approach can provide more insights into the amount of cognitive resources in relation with the perceived mental effort involving in a walking task.Research Question: The objective was to examine cognitive workload in young adults during walking conditions varying in complexity.Methods: (...) Twenty-five young adults performed four conditions: usual walking, simple DT walking, complex DT walking and standing while subtracting. During the walking task, mean speed, cadence, stride time, stride length, and their respective coefficient of variation were recorded. Cognitive workload will be measured through changes in oxy- and deoxy-hemoglobin during walking in the dorsolateral prefrontal cortex and perceived mental demand score from NASA-TLX questionnaire.Results: In young adults, ΔHbO2 in the DLPFC increased from usual walking to both DT walking conditions and standing while subtracting condition. ΔHbO2 did not differ between the simple and complex DT and between the complex DT and standing while subtracting condition. Perceived mental demand gradually increased with walking task complexity. As expected, all mean values of gait parameters were altered according to task complexity. CV of speed, cadence and stride time were significantly higher during DT walking conditions than during usual walking whereas CV of stride length was only higher during complex DT walking than during usual walking.Significance: Young adults had greater cognitive workload in the two DT walking conditions compared to usual walking. However, only the mental demand score from NASA-TLX questionnaire discriminated simple from complex DT walking. Subjective measure provides complementary information to objective one on changes in cognitive workload during challenging walking tasks in young adults. These results may be useful to improve our understanding of cognitive workload during walking. (shrink)

BackgroundThe literature shows the negative psychological impact of the coronavirus disease 2019 outbreak on frontline healthcare workers. However, few are known about the mental health of physicians and nurses working in general hospitals during the outbreak, caring for patients with COVID-19 or not.ObjectivesThis survey assessed differences in mental health in physicians and nurses working in COVID-19 or non-COVID-19 medical care units.DesignA cross-sectional mixed-mode survey was used to assess burnout, insomnia, depression, anxiety, and stress.SettingA total of 1,244 physicians and (...) nurses from five general hospitals in Belgium, working in COVID-19 care units, non-COVID-19 care units, or both were informed of the study.ParticipantsSix hundred forty-seven healthcare workers participated in the survey.MeasurementsValidated instruments were used to assess the outcomes: the PFI, the ISI, and the DASS-21.ResultsResults showed high prevalence of burnout, insomnia, depression, and anxiety among participants. After adjusting for confounders, multivariate analysis of variance showed no differences between CCU, NCCU, and CCU + NCCU workers. Univariate general linear models showed higher level of burnout, insomnia, and anxiety among nurses in comparison to physicians. Being a nurse, young, isolated, with an increased workload were risk factors for worse mental health outcomes.LimitationsThe mental health of the tested sample, before the outbreak, is unknown. Moreover, this cross-sectional design provides no information on the evolution of the mental health outcomes over time.ConclusionDirectly caring for patients with COVID-19 is not associated with worse mental health outcomes among healthcare workers in general hospitals. High prevalence of burnout, insomnia, depression, and anxiety among physicians and nurses requires special attention, and specific interventions need to be implemented.Protocol RegistrationClinicalTrials.gov, identifier NCT04344145. (shrink)

The Covid-19 pandemic has led teachers to an unpredictable scenario where the lockdown situation has accelerated the shift from traditional to online educational methods, and relationships have been altered by the avoidance of direct contact with the others, with implications for their mental health. Physical activity seemed to be a factor that could prevent from mental disorders such as anxiety or depression in this peculiar situation. Therefore, the aims of this study were to explore how teachers have been (...) affected by the lockdown in respect to their mental health and their relationships in three main fields, work, family and social relationships; and to know which is the role of physical activity in the mentioned variables. For that purpose, an online survey was designed to collect quantitative and qualitative data. Results showed that indoor physical activity acts as preventive in lockdown situations, while the level of activity does not affect mental health. Also, teachers have experienced higher levels of depression and distress due to the workload generated during the lockdown. In conclusion, to prevent health problems among teachers in future similar situations it would be important to facilitate the practice of physical activity at home. Furthermore, teacher training in blended or online educational methods would be crucial for their favorable work development. (shrink)

As was previously known, pediatric medical staff in China faced several hurdles including high occupational risk, multiple contradictions, heavy workload, and long working hours. After the outbreak of 2019 novel coronavirus, facing the overload of work and the potential risk of infection, pediatric medical workers may be under great psychological pressure. The purpose of this article was to call attention to the impact of the epidemic on the mental health of Chinese pediatric workers, and developing psychological intervention program (...) that are tailored to them. The experiences from this public health emergency should inform the efficiency and quality of future crisis intervention of the Chinese government and authorities around the world. (shrink)

When incorporating the environment into mental processing (cf., cognitive offloading), one creates novel cognitive strategies that have the potential to improve task performance. Improved performance can, for example, mean faster problem solving, more accurate solutions, or even higher grades at university.1 Although cognitive offloading has frequently been associated with improved performance, it is yet unclear how flexible problem solvers are at matching their offloading habits with their current performance goals (can people improve goal‐related instead of generic performance, e.g., when (...) being in a hurry and aiming for a “quick and dirty” solution?). Here, we asked participants to solve a cognitive task, provided them with different goals—maximizing speed (SPD) or accuracy (ACC), respectively—and measured how frequently (Experiment 1) and how proficiently (Experiment 2) they made use of a novel external resource to support their cognitive processing. Experiment 1 showed that offloading behavior varied with goals: Participants offloaded less in the SPD than in the ACC condition. Experiment 2 showed that this differential offloading behavior was associated with high goal‐related performance: fast answers in the SPD, accurate answers in the ACC condition. Simultaneously, goal‐unrelated performance was sacrificed: inaccurate answers in the SPD, slow answers in the ACC condition. The findings support the notion of humans as canny offloaders who are able to successfully incorporate their environment in pursuit of their current cognitive goals. Future efforts should be focused on the finding's generalizability, for example, to settings without feedback or with high mental workload. (shrink)

Owing to the COVID-19 pandemic, working from home promotes the importance of indoor environment qualities. With the settings and functions of home offices, an experiment was carried out to determine the interaction effects between indoor plants and traffic noise levels on the performance and environmental evaluations of English reading comprehension tasks and the performance of short-term breaks. A sample of 22 Chinese university students took part in the experiment. Two visual conditions and five TNLs were included. Participants’ accuracy rates, eye (...) movements, mental workload, and feelings about the environment were collected. The mental fatigue recovery, visual fatigue recovery, anxiety recovery, and unfriendly recovery were measured for the analysis of a 5-min short-term break. The results demonstrate plants have significant effects on ERCTs and short-term breaks, especially at 45 and 50 dBA TNL; the effects of TNLs on ERCTs’ eye movements and work environment satisfaction differ by the presence of plants, e.g., the average pupil diameter, lighting and layout satisfaction; The effects of indoor plants on ERCT differ by the range of TNLs. In conclusion, indoor plants are beneficial to home workers engaged in ERCT when TNL does not exceed 50 dBA. The current data highlight the importance of audio-visual interaction in home offices and provide insights into the interaction mechanism between indoor plants and traffic noise. (shrink)

The mental fatigue elicited by working and studying consumed mental resources, thereby eliciting a declined performance and an increased mental stress. The long-term continuous work and study, which is typical for modern workers and students, can increase mental fatigue and health risks. Previous studies reported that the natural environment has a restorative of mental resources and reducing stress. However, it is difficult for urban workers and students to take sufficient breaks in real natural environment. We (...) conducted an experiment to examine whether brief and indirect exposure to the natural environment elicits a restorative of attention and reducing stress. Twenty-five undergraduate and graduate students from the university of modern city participated in the experiment. The experiment involved measuring the changes in the task performance of the participants and the subjective mental workload, while the attention restoration was indexed from physiological response over time. The participants had two types of resting periods in the middle of the task, i.e., by looking at a blank display or by watching a nature video having scenes of, e.g., a forest, small waterfall, and rustling leaves. The results indicate that the natural environment indirectly depicted through the nature videos does not affect the task performance and the subjective mental workload but decreases the SCL. The results of the physiological response suggest that having rest periods depicting the natural environment, even if indirectly and briefly, can restore the directed attention for the task. This experiment revealed a useful method of resting for urban workers and students to restore their attention to a task. (shrink)

We present a nonparametric approach to prediction of the n-back n \in {1, 2} task as a proxy measure of mental workload using Near Infrared Spectroscopy (NIRS) data. In particular, we focus on measuring the mental workload through hemodynamic responses in the brain induced by these tasks, thereby realizing the potential that they can offer for their detection in real world scenarios (e.g., difficulty of a conversation). Our approach takes advantage of intrinsic linearity that is inherent (...) in the components of the NIRS time series to adopt a one step regression strategy. We demonstrate the correctness of our approach through its mathematical analysis. Furthermore, we study the performance of our model in an inter-subject setting in contrast with state-of-the-art techniques in the literature to show a significant improvement on prediction of these tasks (82.50% and 86.40% for female and male participants, respectively). Moreover, our empirical analysis suggest a gender difference effect on the performance of the classifiers (with male data exhibiting a higher non-linearity) along with the left-lateralized activation in both genders with higher specificity in females. (shrink)

In the selection of job candidates who have the mental ability to become professional ATCOs, psychometric testing has been a ubiquitous activity in the ATM domain. To contribute to psychometric research in the ATM domain, we investigated the extent to which spatial orientation ability (SOA), as conceptualized in the spatial cognition and navigation literature, predicted air traffic conflict detection performance in a simulated free route airspace (FRA) environment. The implementation of free route airspace (FRA) over the past few years, (...) notably in Europe, have facilitated air traffic services by giving greater flexibility to aviation operators in planning and choosing preferred air routes that can lead to quicker arrivals. FRA offers enhanced system safety and efficiency, but these benefits can be outweighed by the introduction of air traffic conflicts that are geometrically more complex. Such conflicts can arise from increased number and distribution of conflict points, as well as from elevated uncertainty in aircraft maneuvering (for instance, during heading changes). Overall, these issues will make conflict detection more challenging for air traffic controllers (ATCOs). Consequently, there is a need to select ATCOs with suitably high levels of spatial orientation ability (SOA) to ensure flight safety under FRA implementation. In this study, we tested 20 participants who are eligible for ATCO job application, and found that response time-based performance on a newly developed, open access, computerized spatial orientation test (SOT) predicted time to loss of minimum separation (tLMS) performance on an air traffic conflict detection task (AT-CDT) we designed. We found this predictive relationship to be significant to a moderately large extent under scenarios with high air traffic density (raw regression coefficient = 0.58). Moreover, we demonstrated our AT-CDT as a valid test in terms of eliciting well-known mental workload and spatial learning effects. We explained these findings in light of similar or overlapping mental processes that were most likely activated optimally under task conditions featuring approximately equal numbers of outcome-relevant stimuli. We conclude by discussing the further application of the SOT to the selection of prospective ATCOs who can demonstrate high levels of conflict detection performance in FRA during training simulations. (shrink)

El aprendizaje por analogía ofrece numerosas ventajas al jugador de baloncesto, agrupando variedad de información en una única regla. El objetivo es analizar si el aprendizaje por analogía produce un efecto en el rendimiento y las acciones motrices. Participaron 18 jugadores. Se diseñaron 4 condiciones experimentales con limitación temporal, motriz y combinación de ambas. Las variables relacionadas con el espacio, el juego colectivo e individual están influenciadas por los condicionantes ambientales. El aprendizaje por analogía supone una carga menor para los (...) recursos de la memoria de trabajo, debido a la reducción del volumen de información verbal procesada. (shrink)

Background Nurses provide care to meet the complex needs of patients in the increasing workload in the health system and are at risk of compassion fatigue. The concept of compassion fatigue has begun drawing attention in the last decade, as it negatively affects nurses' physical and mental health, job performance and satisfaction, and therefore patient care quality. Objectives This study was to examine compassion fatigue and predictive factors in paediatric surgery nurses. Participants and research context The study was (...) cross-sectional, predictive and quantitative. It was conducted with the 135 paediatric surgery nurses. The data were sent to the email addresses of the members via Google Survey. Research data were collected with the Nurse Information Form, Compassion Fatigue Scale, Life Satisfaction Scale and Multidimensional Perceived Social Support Scale. Ethical considerations After obtaining the approval of the University’s ethics committee, the study was carried out after obtaining participants’ informed written and verbal consent. Results There was a difference between the level of compassion fatigue according to the paediatric surgery unit that worked the longest and the thought of changing their profession. Burn unit nurses and nurses who were considering changing professions have higher compassion fatigue scores. When the predictors of compassion fatigue were examined, the thought of changing the nursing profession and life satisfaction were significant predictors of compassion fatigue. The thought of changing the nursing profession and life satisfaction explained 22% of compassion fatigue. The same variables and the longest working period of the paediatric surgery unit were the estimators of the level of occupational burnout; explaining 29% of occupational burnout. Conclusions Compassion fatigue, life satisfaction and perceived social support of paediatric surgery nurses are moderate. Compassion fatigue is affected by working time, the thought of changing the profession, life satisfaction and perceived social support. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Why We StayVladyslava Kachkovska, Iryna Dudchenko, Anna Kovchun, and Lyudmyla PrystupaFunding. Vladyslava Kachkovska, MD, PhD is supported by the Loyola University Chicago– Ukrainian Catholic University Bioethics Fellowship Program, funded by the National Institutes of Health Fogarty International Center (D43TW011506).We are a group of physicians and professors in the Department of internal medicine at Sumy State University in Ukraine, located 20 miles from the border with Russia. We have been (...) working together for ten years and, against the background of the war, have become more than colleagues, more than a hematologist, an allergist, a pulmonologist and a rheumatologist. We are now one organism that works for the benefit of patients, coordinating humanitarian supplies, teaching medical students, and at the same time worrying incredibly about our children, but trying to maintain our psychological homeostasis.Over the past year and a half, we have learned many things. Dividing everything that surrounds us into primary and secondary concerns, we learn how to live without electricity during the winter and how to preserve the water supply. We realize material possessions are not important, as at any moment you may lose everything. After covering the basic needs of our families, we do not try to save money, but rather the opposite: we spend all the rest on drugs and supplies for those who are in need now. Of all that we have learned, one thing we have not learned is indifference, which is not possible during this time of constant loss of acquaintances, colleagues, and friends. We find balance only in our constant work. We have patients with medically complex conditions, and we prioritize them and their needs.Our multidisciplinary teamwork before the war brought us great pleasure: interesting clinical cases and successful work with our patients, frequent training abroad, scientific research, and work with medical students and residents.On February 24, 2022, our priorities changed. In addition, each of us faced a dilemma: whether to take our children to a safe place or stay. Balancing our emotional experiences and work is challenging, but mutual support, daily communication, and a heavy workload help us maintain a sense of normalcy. Still, we are sure this “normal” is adapted to our conditions and will not apply in peacetime. Moreover, since the beginning of the war, we have experienced dissonance between our established moral and bioethical principles, our virtues, and the main goal of medicine—preserving human life and dignity—with the surrounding events caused by the war. Daily deaths of Ukrainian civilians and soldiers, innocent children, domestic animals, abuse, rape of women, children, and older adults, demonstrative torture, the humiliation of human dignity, and criminal behavior of the enemy have altered our worldview. We are challenged by the central ethical and Christian dilemma, which our generation is unlikely to cope with—to accept everything we are going through and forgive.During the last year, we have noticed that the occupation, life in the border area, and daily shelling affect our patients, dividing them into two main groups. The first group includes patients with complex psychological issues who are looking for a physical explanation for their symptoms. This group in particular overloads the healthcare system. Since few mental health specialists are [End Page 158] available for consultations, other physicians often have to act as psychologists to reassure these patients. The second group of patients are those who do not seek medical help because they believe that their health problems are simply caused by the constant stress of war and thus they are indifferent to their health and ignore symptoms such as weakness, weight loss, chronic pain, or enlarged lymph nodes.Every day we work with patients whose lives have been negatively affected by war. Each has stories about the loss of loved ones, the loss of homes, or constant emotional stress related to relatives who are currently fighting in the armed forces. These stories cannot leave us indifferent. We live this experience together with our patients, in reality and not in the abstract, and we feel their emotions. To do otherwise would be impossible in our realities. In addition to qualified medical care, we take on the duties of psychologists because sometimes, this is the... (shrink)

The commodification of health care, particularly primary care, presents challenges to care and knowledge development. The purpose of this study is to examine how nurses perceive and develop their knowledge in a commodified context. A mixed‐methods study was conducted that included a closed‐question survey and in‐depth interviews with nurses in public primary care in Catalonia. There were 104 valid responses to the questionnaire and 10 in‐depth interviews. The main findings of the survey were related to workload and limited time (...) for nursing care. Six themes emerged from the in‐depth interviews: (1) limited time for nursing, (2) feelings of burnout, (3) awareness of patient and family satisfaction, (4) organizational factors that favor nurses' needs, (5) organizational factors that hinder nurses' needs, and finally (6) public administration requirements. Participants perceive excessive workload and time constraints and feel that this affects their nursing care and their physical and mental health. However, nurses purposefully use knowledge patterns to cope with the problems associated with commodification. Nurses have multidimensional, contextualized, and integrated knowledge that allows them to optimize their care based on the needs of their patients. This research examines many challenges related to nursing practice and the nursing discipline and opens the door for further research that encompasses all areas of nursing. (shrink)

Background Moral distress is a major issue in intensive care units that requires immediate attention since it can cause nurses to burnout. Given the special conditions of patients in intensive care units and the importance of the mental health of nurses, the present study was designed to systematically review the factors affecting moral distress in nurses working in intensive care units. Methods PubMed, EMBASE, Web of Science, Scopus, and Science Direct were systematically searched for papers published between 2009 and (...) 2019. Original articles from quantitative and qualitative studies were reviewed. The CONSORT and STROBE checklists were used to assess the quality of the quantitative papers. The JBI checklist was applied for qualitative studies. Results Factors affecting moral distress in nurses include lack of nursing staff, nurses with inadequate experience, lack of support from organizations and colleagues, inadequate education and lack of knowledge of nurses, poor collaboration of physicians with nurses, ethical insensitivity and lack of teamwork, heavy workload, poor quality of care and moral violence and they are considered as risk factors for moral distress. Conclusion Many of the related causes are due to the nature of nurses’ work and it is necessary to manage the underlying conditions of this phenomenon so that it can be effectively prevented from spreading. Levels of moral distress require more attention of authorities in the use of prevention strategies and the reduction of effective factors in distress. (shrink)

The current COVID-19 crisis may have an impact on the mental health of professionals working on the frontline, especially healthcare workers due to the increase of occupational psychosocial risks, such as emotional exhaustion and secondary traumatic stress. This study explored job demands and resources during the COVID-19 crisis in predicting emotional exhaustion and STS among health professionals. The present study is a descriptive and correlational cross-sectional design, conducted in different hospitals and health centers in Spain. The sample consisted of (...) 221 health professionals with direct involvement in treating COVID-19. An online survey was created and distributed nationwide from March 20 to April 15 which assessed: sociodemographic and occupational data, fear of contagion, contact with death/suffering, lack of material and human protection resources, challenge, emotional exhaustion, and STS. Descriptive findings show high levels of workload, contact with death/suffering, lack of MHPR and challenge, and are moderately high for fear of contagion, emotional exhaustion, and STS. We found an indirect significant effect of lack of MHPR on predicting emotional exhaustion through the workload and on STS through fear of contagion, contact with death/suffering, and workload. To conclude, this study examines the immediate consequences of the crisis on health professionals' well-being in Spain, emphasizing the job demands related to COVID-19 that health professionals are facing, and the resources available in these health contexts. These findings may boost follow-up of this crisis among health professionals to prevent them from long-term consequences. (shrink)

Following the declaration of the COVID-19 outbreak as a global pandemic in March 2020, a state of alarm was decreed in Spain. In this situation, healthcare workers experienced high levels of stress, anxiety and depression due to the heavy workload and working conditions. Although Spain experienced a progressive decline in the number of COVID-19 cases until the last week of May and the work overload among health workers was substantially reduced, several studies have shown that this work overload is (...) associated with the later emergence of psychological symptoms induced by stress. The aim of the present study was to evaluate the levels of stress, anxiety, depression, post-traumatic stress and compassionate fatigue in health professionals. The sample consisted of 973 health professionals 16.5% men, 82.9% women, and one non-binary person. The data were collected through an online questionnaire sent to the participants by e-mail. DASS-21 was used to measure anxiety, stress and depression, PCL-C to measure post-traumatic stress and ProQOL -vIV to measure compassion fatigue. In addition, other descriptive variables that could be related to these levels of psychological symptomatology were evaluated. The results reveal that after the work overload experienced during the COVID-19 pandemic, healthcare workers report psychological symptoms, post-traumatic stress and compassion fatigue. It is therefore recommended that these professionals be provided with psychological help in order to reduce the emotional impact of COVID-19, and consequently improve their mental health. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:IRBs Under the MicroscopeJonathan D. Moreno (bio)The spring and summer of 1998 were seasons in the sun for institutional review board (IRB) aficionados. Rarely have the arcana of the local human subjects review panels been treated to so much attention in both the executive and the legislative branches of government, not only at the federal but also at the state level. And it looks as if the attention will (...) continue for some time. The spate of interest is due to a series of coincidences: a powerful House of Representatives subcommittee held hearings after its chairman learned about the IRB system during a previous session on research in underdeveloped communities; the Department of Health and Human Services’s Inspector General (DHHS-IG) released a report on IRBs; the National Institutes of Health (NIH) Office of Extramural Research completed a report on clinical trial monitoring; the National Bioethics Advisory Commission (NBAC) readied a report on research involving persons with mental disorders; the states of Maryland and New York completed studies of research with subjects who lack decision-making capacity; and advocacy groups protested a psychiatric research project involving inner city children.Underlying these proximate causes for the IRB blitz is a growing realization that the already considerable clinical trial enterprise will expand significantly over the next few years. Congress is talking about giving the politically popular NIH half again the budget it currently receives, which in turn will stimulate more commercially supported research. The director of the National Cancer Institute is considering a five-fold increase in the number of subjects enrolled in oncology studies over the next several years. Phase I cancer studies are among the most ethically sensitive, so IRBs will have more work cut out for them if this goal is reached. Adding to the rush of interest in IRBs are the government’s recent apology to the survivors of the syphilis study in Tuskegee, continuing congressional dissatisfaction with the way the Pentagon handled its vaccine distribution during the Gulf War, and the controversy about AZT trials in developing countries.On the HillCongressman Christopher Shays, the moderate Connecticut Republican who has developed an interest in human research issues, convened hearings on human [End Page 329] subjects research and the IRB system on 11 June 1998. Shays chairs the House Government Reform/Human Resources Subcommittee. The committee’s ranking minority member is Edolphus Towns of Brooklyn, NY, who shares Shays’s interest in this area.The immediate rationale for the hearings was the release that day of the DHHS-IG report, Institutional Review Boards: A Time for Reform. The subtitle was changed from A System in Jeopardy apparently after some people in DHHS expressed reservations about its seemingly alarmist tone, but the IG staffers who testified before Shays’s subcommittee insisted that they stood behind the message that the IRB system is in trouble if considerable reforms are not undertaken. Among the factors in the research environment cited as support for the bleak forecast: managed care, commercialization, multi-site trials, high IRB workloads, minimal IRB oversight of approved studies, conflicts of interest, insufficient training of IRB members and investigators, and lack of IRB self-studies (DHHS-IG 1998).As is normally the case for congressional oversight hearings, the first panel of witnesses consisted of executive branch officials, including Eric Meslin, Executive Director of the National Bioethics Advisory Commission, and Gary Ellis, Director of the Office for Protection from Research Risks (OPRR). Shays pressed Ellis on the extent to which OPRR conducts on-site investigations of complaints about abuse of human subjects. Admitting that on-site investigations are rare, Ellis suggested that the agency is inadequately staffed to follow up on complaints as quickly as it might wish. The members of Congress who were present at the hearings generally expressed concern about the DHHS-IG’s findings.The second panel that day, which Shays was unable to attend, set a different tone. Four of the panelists—Paul Appelbaum of the University of Massachusetts at Worcester, Robert Levine of Yale University, Angela Bowen of the Western IRB (a private clinical trials review firm), and I—were invited as authorities on the current condition of the IRB system. Bert Spilker... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Expose of a BreakdownIngrid HindellIregard my pension as a social wage, and even though I wish it took my disability and the extra costs that brings into consideration, eighteen years ago, I felt privileged to be able to work in the community, not in a sheltered workshop.At this time, a number of us worked voluntarily for numerous little organizations when the government cut their funding and in effect, took (...) away our jobs.It was around this time that I started a “stress cough.” Foolishly, I didn’t take much notice. I was enjoying “life”—studying, working, taking part in a documentary called “Untold Desires” and being a member of the “Friendship Group”—in which a group of us tackled the subject and nature of friendship for people with and without disabilities....The processes and the cohesion of the group brought up a lot of “stuff” for me that I wasn’t able to articulate. It made me question the wisdom of my lifestyle up to then—of marrying a person without a physical disability, for example.My mother used to tell me to tell him to tidy the flat, not in the least realizing that: i) it was distressing that I couldn’t do this; ii) that given all our interests it was difficult to tidy up. (This situation was also not helped, I now realize, by us trying to live and run home businesses from my small three–roomed accommodation behind my parent’s home, without enough support worker hours....)The flat was always cluttered, not conducive to encouraging a feeling of ease in us bringing clients onto the premises. As Robert’s massage workload grew, so did our underlying tension, I see now. And when I was starting to counsel other people with disabilities the situation was made worse....Added to this, my mother had, just prior to this period in our lives, stopped giving us our main meal because we were becoming more and more interested in eating organic and vegetarian food.At the same time, listening to other group members’ stories made me realize how “undervalued” people with disabilities are in society as I had been brought up in a loving extended family and had not long been “out.”It made me realize how much people with disabilities were constrained by lack of governmental funding for recreational—especially relationship options—with each other and with able–bodied people. The government was trying to close down little advocacy organizations that could keep this issue in the forefront of policy makers’ minds. No wonder I was getting close to breaking point! [End Page E1]When I got really bad, my husband almost went mad himself trying to cope with me. I had been the outgoing partner in the relationship for the past 12 years. Now I was getting panic attacks and clinging like poison ivy....And the therapists I went to at that stage didn’t help. The Naturopath was so expensive she made me much worse. She had told a “friend” of Rob’s that she would treat me for $30.00 a time. She did not say that she would present me with an ever– increasing bill every time I had an appointment—to pay her back when I could! And that her admin assistant would keep commenting, in my hearing, that people wouldn’t pay their bills on time.... At last, when the amount got to $450.00, I paid her all my savings, and managed to quit.I now also believe she treated me with a totally inappropriate therapy—colonic irrigation—for far too long, any natural therapist would say nowadays—five weeks!I believe it made my mental state worse. People say that an unquiet mind can stress the body into illness but I believe losing too much weight too fast as I certainly did, stressed my mind, instead of other way around.By this time I wasn’t only having panic attacks. I had slipped into, what I recently discovered, was a clinical depression. This brought in its wake, a terror so real, so all encompassing that I wonder I lived through a day of it—much less four... (shrink)

Background The wide proliferation of Covid-19 has impacted billions of people all over the world. This catastrophic pandemic outbreak and ostracism at work have posed challenges for all healthcare professionals, especially for nurses, and have led to a significant increase in the workload, several physical and mental problems, and a change in behavior that is more negative and counterproductive. Therefore, leadership behaviors that are moral in nature serve as a trigger and lessen the adverse workplace effects on nurses’ (...) conduct. Aim this research is directed to explore the impact of post-COVID-19 workplace ostracism on nurses’ counterproductive behavior and examine the role of moral leadership as a mediating factor in post-COVID-19 workplace ostracism and nurses’ counterproductive behavior. Ethical consideration Ethical review and approval Was received from Ethical Committee at the Faculty of Nursing, Alexandria University, Egypt. Methods A cross-sectional and correlation study was implemented in all units of medical, surgical, critical and intensive care units by using three tools; moral leadership questionnaire, Workplace Ostracism Instrument (WOS), and Counterproductive Work Behaviors Questionnaire (CWBs). A convenient sample of 340 from 699 bedside nurses was granted. Results This study revealed that nurses’ perceived moderate mean percent (55.49 ± 3.46) of overall workplace ostracism and counterproductive behavior (74.69 ± 6.15). However, they perceived a low mean percentage of moral leadership. There was a significant positive correlation between workplace ostracism and counterproductive behavior. Otherwise, a significant negative correlation was found between moral leadership, workplace ostracism and counterproductive behavior. Also, this study proved the mediating effect of moral leadership in decreasing workplace ostracism by 79.3% and counterproductive behavior by 36.7%. Conclusion Hospital administrators need to be aware of the significance of moral leadership and apply integrity in the clinical setting to reduce the drawback of isolation on nurses' conduct and increase value for the organization as a whole and nurses in particular. (shrink)

BackgroundHow do the police officers perceive health risk, psychological distress, and work stress during the COVID-19 outbreak in China? This study explores the health risk perception, work stress, and psychological distress of police officers who worked at the front line to implement lockdown measures.Materials and MethodsWe conducted a large-scale field survey with police officers sample in the northwestern part of China from February 29 to March 7, 2020. Independent-sample T-test and ANOVA were used to analyze whether there are differences in (...) health risk perception, work stress, and psychological distress between different groups. The regression analysis was employed to figure out the factors that influence police officers’ psychological distress.ResultsResults showed a gender difference in perceiving work stress among police officers. Also, police officers with chronic disease perceived higher health risks, more psychological distress, and higher work stress. Additionally, police officers above 45 years old significantly perceived higher health risks than young officers did. It also revealed that working hours contribute to police officers’ health risk perception, psychological distress, and work stress. Finally, our results highlight that age, working hours, chronic disease, health risk perception, and work stress significantly contribute to police officers’ psychological distress.ConclusionOur research verifies that there is a gender difference in perceiving work stress among police officers. Police officers with ongoing medical issues and above 45 years old suffer more during the COVID-19 outbreak in China. Our research suggests that the government should pay more attention to their physical health and mental health. The heavy workload containing the COVID-19 extends police officers’ working hours, causing higher health risks, work stress, and psychological distress. This study contributes to the psychological distress literature and provides a way forward to other countries struggling to contain the COVID-19. (shrink)

This article describes a study on capacity limitations that affect the construction of spatial mental models. A process model is presented, according to which the construction of a mental model in Ehrlich and Johnson-Laird's (1982) spatial descriptions task places a workload of six information chunks for continuous and semi-continuous descriptions, and seven chunks for discontinuous descriptions. Participants (48 undergraduate students) performed the spatial descriptions task and the figural intersections test (FIT), which yields a capacity score. The pattern (...) of errors and sentence reading times in the spatial descriptions task confirmed that participants were using mental models. The FIT score was positively correlated with accuracy in the spatial descriptions task. Prediction analysis of cross-classification tables showed that, for successful performance in continuous and semi-continuous descriptions, a FIT score of 6 was necessary, and a score of 7 in discontinuous descriptions. These results are in agreement with theoretical predictions. The issue of integrating mental models theory with analyses of capacity limitations in performance is discussed. (shrink)

Much research has been done on the economic effects of self-employment, environmental conditions for entrepreneurial success, as well as attributes if the person him-/herself fits to this career path. To successfully run a business, however, is contingent on the health of the entrepreneur. In particular, small business owners (being solo self-employed without personnel) face financial uncertainties, a high workload, long working hours, and are often unable to call in sick. This study aimed at exploring the working situation considering resources (...) (e.g., autonomy), strain (e.g., dependency on contracts with clients) and health and career outcomes of small business owners. This study used a qualitative approach to comprehensively mirror the working situation. Participants who were 29 small business owners from Germany gave permission for recording expert interviews in which they reported, for example, on health complaints, recovery opportunities, obstacles and resources while running their businesses. The interviews emphasize the meaning of active actions and own responsibility for creating working conditions and enabling autonomy. Small business owners yet have to be able to use the autonomy. Besides personal preferences regarding the career path as being pulled into self-employment and not pushed by situational circumstances also marketability and flexibility played a role and explained health and career issues. Our findings underline that the social network is of utmost importance to small business owners and that social support – even or despite of being solo self-employed – is a key to sustaining health and satisfaction. As voluntariness played an essential role for selecting this specific career path those being pulled into self-employment as no other jobs are available should receive particular support through career counseling. One shortcoming of prior research is that the concrete working situation of small business owners and its impact on health and career has not adequately been taken into account. Based on work-related stress models we developed a frame model specific for the situation of small business owners which allows concrete hypotheses for further quantitative research. (shrink)

Clinical genetics encompasses a wider range of activities than discussion of reproductive risks and options. Hence, it is possible for a clinical geneticist to reduce suffering associated with genetic disease without aiming to reduce the birth incidence of such diseases. Simple cost-benefit analyses of genetic-screening programmes are unacceptable; more sophisticated analyses of this type have been devised but entail internal inconsistencies and do not seem to result in changed clinical practice. The secondary effects of screening programmes must be assessed before (...) they can be properly evaluated, including the inadvertent diagnosis of unsought conditions, and the wider social effects of the programmes on those with mental handicap. This has implications for the range of prenatal tests that should be made available. While autonomy must be fully respected, it cannot itself constitute a goal of clinical genetics. The evaluation of these services requires interdepartmental comparisons of workload, and quality judgements of clients and peers. (shrink)

An Amnesty International briefing, published in July 2020, highlights the grave risks health workers are facing globally, particularly in the face of the COVID-19 pandemic.1 The report uses data from 63 countries across the world from January to June 2020 and is rich with examples. While recognising that information about the pandemic is constantly evolving, and each country is in a separate phase of the outbreak, Amnesty International draws attention to several troubling trends. By virtue of the role undertaken by (...) health workers, they face a greater exposure to COVID-19, which has contributed to many of the concerns they now deal with. The briefing notes the evidence of the higher death rate from health workers compared with the general population in countries ranging from Denmark to Argentina, while also pointing out the significantly higher death rate in BAME health workers raised by the BMA in the UK.2 PPE shortages had been reported in nearly all of the 63 countries analysed. Many health workers globally stated that they had to buy their own PPE and others described cases of ‘improvisation’, when suitable PPE was not available, such as using bin bags or raincoats. Furthermore, health workers in several countries had experienced increases in workload with formal measures to extend health workers’ contracted hours passed in some countries as well as further changes to their terms and conditions of service. There were also reports of increased mental stress, particularly from those working in ICUs; the increased work and stress is not being matched with suitable compensation or remuneration. Despite many countries passing special benefits for health workers, it was commonly stated that these benefits had not been received yet or that they did not apply to all health workers, with cleaners and other lower-paid yet vital roles excluded. Deeply concerning …. (shrink)

Background:Nursing is an occupation that deals with humans and relies upon human relationships. Nursing care, which is an important component of these relationships, involves protection, forbearance, attention, and worry.Objectives:The aim of this study is to evaluate the ethical beliefs of psychiatric nurses and ethical problems encountered.Research Design:The study design was descriptive and cross-sectional.Research context:Methods comprised of a questionnaire administered to psychiatric nurses (n = 202) from five psychiatric hospitals in Istanbul, Turkey, instruction in psychiatric nursing ethics, discussion of reported ethical (...) problems by nursing focus groups, and analysis of questionnaires and reports by academicians with clinical experience.Participants:Participants consist of the nurses who volunteered to take part in the study from the five psychiatric hospitals (n = 202), which were selected with cluster sampling method.Ethical considerations:Written informed consent of each participant was taken prior to the study.Findings:The results indicated that nurses needed additional education in psychiatric ethics. Insufficient personnel, excessive workload, working conditions, lack of supervision, and in-service training were identified as leading to unethical behaviors. Ethical code or nursing care -related problems included (a) neglect, (b) rude/careless behavior, (c) disrespect of patient rights and human dignity, (d) bystander apathy, (e) lack of proper communication, (f) stigmatization, (g) authoritarian attitude/intimidation, (h) physical interventions during restraint, (i) manipulation by reactive emotions, (j) not asking for permission, (k) disrespect of privacy, (l) dishonesty or lack of clarity, (m) exposure to unhealthy physical conditions, and (n) violation of confidence.Discussion:The results indicate that ethical codes of nursing in psychiatric inpatient units are inadequate and standards of care are poor.Conclusion:In order to address those issues, large-scale research needs to be conducted in psychiatric nursing with a focus on case studies and criteria for evaluation of service, and competency and responsibility needs to be established in psychiatric nursing education and practice. (shrink)

Although most studies investigated the impact of infertility and its treatment on the couple, a small body of evidence suggested that infertility care providers may experience different sources of stress related for instance to excessive workload, the complexity of the technique, and relational difficulties with patients. The current study aimed at providing further insight into the understanding of the subjective experience of infertility care providers by highlighting their feelings and emotions, personal meanings, challenges, and opportunities. Following the methodological guidelines (...) of Interpretative Phenomenological Analysis, we conducted individual semi-structured interviews with 23 members of two different fertility units. Interviews were audiotaped and transcribed verbatim. Textual analysis was then conducted to identify emerging dominant themes and subthemes. Three main themes were extracted: dealing with infertile patients and their specificities, performing assisted reproductive technology, being part of a team. These themes related to participants experiencing: difficulties in establishing an empathic connection and communicating with couples, such that women were sometimes perceived as “particular patients” and men as poorly involved in the process; difficulties in dealing with a complex procedure in which errors are not allowed, with a growing number of women aged > 40 seeking assisted reproduction, despite the risks for their health; being part of a team as a resource, although the huge amount of time spent together can involve conflicts and organizational problems. These findings suggested that patients’ overpersistence represents an important source of stress for infertility care providers. At the same time, the concept of particular or difficult patient derives from the combination of multiple factors, including providers’ own history and subjective experience. The presence of mental health professionals in fertility units is essential to help providers improve the quality of doctor-patient communication and relieve the stress related to organizational issues and conflicts. (shrink)

The purpose of this study is to take preliminary steps to unify psychoacoustic techniques with reaction-time methodologies to address the perceptual mechanisms responsible for the detection of one vs. multiple sounds. We measured auditory redundancy gains for auditory detection of pure tones widely spaced in frequency using the tools of Systems Factorial Technology to evince the system architecture and workload capacity in two different scenarios. We adopted an experimental design in which the presence or absence of a target at (...) each of two frequencies was combined factorially with two stimulus levels. Replicating previous work, results did not allow an assessment of system architecture due to a failure to observe factor influence at the level of distribution ordering for dual-target stimuli for both SOFT and LOUD scenarios. All subjects demonstrated very modest redundancy gains for the dual-target compared to the single-target stimuli, and results were similar for both LOUD and SOFT. We propose that these results can be predicted by a mental architecture that falls into the class of integrated subadditive parallel systems, using a well-supported assumption that reaction time is driven by loudness. We demonstrate that modeled loudness of the experimental sounds is highly correlated with mean reaction time, and we provide a proof-of-concept model based on Steven’s Power law that predicts both a failure of distributional ordering for dual-target stimuli and very modest redundancy gains. (shrink)

Demanding work-life and excessive workload, the conflict between professional and personal lives, problems with patients and those related to the occurrence of death and high risk for their own life are a few factors causing burnout, disengagement, and dissatisfaction in the professional lives of healthcare professionals. The situation worsened during the COVID-19 pandemic. It is of utmost importance to find effective solutions to mitigate the stress and anxiety adversely affecting the mental well-being and professional lives of HCPs. This (...) study was designed to examine the efficacy of Sudarshan Kriya Yoga for alleviating work exhaustion, improving Professional Fulfillment, and influencing positivity among HCPs during COVID-19. In a comparative observation before the intervention, after the intervention, and 30 days after the intervention in the Experimental Group and Control Group, it was found that immediately after SKY, HCPs experienced a significant improvement in Professional Fulfillment, work exhaustion, positive affect, and negative affect compared to the Control Group. The effect of SKY continued until Day 30 for Professional Fulfillment and had positive and negative effects. Findings suggest that SKY elevated Professional Fulfillment among HCPs during the COVID-19 pandemic and reduced their work exhaustion and the negative effect on their mental health. SKY can aid HCPs in maintaining their well-being when faced with unprecedented challenges. (shrink)

IntroductionFew studies have examined psychological distress in healthcare workers across the care continuum. This study describes distress levels reported by HCWs across care settings and factors associated with distress.MethodsA cross-sectional survey of HCWs from Windsor, Ontario, was conducted between May 30th, 2020, and June 30th, 2020. The survey included the Kessler Psychological Distress Scale, sociodemographic, frontline status, perceptions of training, protection, support, respect among teams, and professional and personal stressors. Univariate analyses were used to compare across settings and multivariate logistic (...) regression assessed factors associated with distress.ResultsFour hundred and three HCWs from the hospital, community health and social service, first responder, primary care, home, and long-term care participated in the survey. Common concerns included fear of transmitting COVID-19 to family, safety on the job, and balancing personal care with work demands. LTC and home-care HCWs reported greater concern about workload and staffing levels, whereas community health workers were more anxious about their financial security. Overall, 228 HCWs who completed the K10 reported high distress, with greater rates among hospital and LTC HCWs. Distress was more likely in HCWs who identified as female, younger than 55, perceived lower respect among team, and experienced greater worry about physical and mental health and managing high workloads.ConclusionResults showed a high degree of distress experienced by HCWs across care settings and the impact of the COVID-19 pandemic on personal and work-related stress. Promoting self-care and supportive and collaborative healthcare teams are promising avenues for mitigating symptoms of distress. (shrink)

Various countries have alternative pathway policies for 2-year community college graduates to articulate to 2-year university study, forming a “2+2” pathway. However, few studies have explored university staff members’ perceptions of this “2+2” transfer pathway and their understanding of transfer students’ transition experiences. This descriptive qualitative study addressed this research gap. Forty-two academic and supporting staff participated in the focus group interviews. Specifically, the study explored the assets and challenges of the “2+2” pathway from the university staff perspective in Hong (...) Kong. The articulation pathway and TSs are highly recognized for their prior learning, academic performances, and the value of the second chance. However, while the university staff were sympathetic to the challenges filling these transfer pathways, their offering of help was limited by government funding and policies restrictions. It is recommended that policies should be established at government and university levels to recognize and tackle TSs’ unique needs to alleviate their heavy workloads through better articulation between community college and university studies. Improving articulation will allow TSs time for social involvement in university life and thus enhance their mental well-being. (shrink)

The potential to collect brain data more directly, with higher resolution, and in greater amounts has heightened worries about mental and brain privacy. In order to manage the risks to individuals posed by these privacy challenges, some have suggested codifying new privacy rights, including a right to “mental privacy.” In this paper, we consider these arguments and conclude that while neurotechnologies do raise significant privacy concerns, such concerns are—at least for now—no different from those raised by other well-understood (...) data collection technologies, such as gene sequencing tools and online surveillance. To better understand the privacy stakes of brain data, we suggest the use of a conceptual framework from information ethics, Helen Nissenbaum’s “contextual integrity” theory. To illustrate the importance of context, we examine neurotechnologies and the information flows they produce in three familiar contexts—healthcare and medical research, criminal justice, and consumer marketing. We argue that by emphasizing what is distinct about brain privacy issues, rather than what they share with other data privacy concerns, risks weakening broader efforts to enact more robust privacy law and policy. (shrink)