Changes in higher order cognitive function between four watch keeping schedules.

Maritime industries utilize many different watch keeping schedules to maintain vigilance and crew safety around the clock. These schedules can be fatiguing, negatively impacting vigilant attention. This has led to the consideration of schedules that might allow for more sleep time, but how these schedules impact higher order cognitive function remains unclear. These schedules require assessment with tasks that are relevant to real-world operations on maritime vessels. This study investigated the effect of four schedules on higher order cognitive function. N = 27 (16 female) participants were recruited to a 10-day laboratory study, comparing four schedules. The schedules investigated were eight-on/eight-off/four-on/four-off (8/8/4/4) with sleep from 09:30 to 16:00 (condition A); six-on/six-off (6/6) with sleep from 08:30 to 12:30 and 21:30 to 00:00 (condition B); four-on/four-off (4/4/4/4/4/4) with sleep from 18:00 to 00:30 (condition C); and four-on/four-off (4/4/4/4/4/4) with sleep from 01:30 to 08:00 (condition D). Higher order cognitive function was assessed 2-3× daily whilst "on watch" using tests of visual scanning, learning, working memory, mental flexibility, and visuomotor control. Conditions were ranked and stability of performance on watch was compared between conditions using Kruskal-Wallis tests. Cognitive function within condition B was ranked the worst for most of the tasks. However, the stability of higher order cognitive function was poorest across the waking day within condition A. These findings highlight the variability in cognitive capacities during different watch keeping schedules.

Evidence for a Negative Loss Spiral between Co-Worker Social Support and Burnout: Can Psychosocial Safety Climate Break the Cycle?

Previous research suggests that co-worker social support predicts burnout, but this relationship may be far more complex, with the potential for a reciprocal cycle of loss. Leading research on loss spirals has explicitly called for more research on interindividual factors such as social support and, by extension, how interventions that operate on these interpersonal resources could play a role in primary and secondary prevention (i.e., intervening in cycles of loss). In this study, we explore the reciprocal relationship between burnout and co-worker social support, with psychosocial safety climate (PSC) as an upstream predictor and moderator of this relationship. Using hierarchical linear modelling (N = 380 frontline healthcare workers, nested within N = 63 teams) on longitudinal data, we found a reciprocal relationship between burnout and co-worker support, which was both triggered and moderated by PSC. These findings provide initial evidence for a social support-burnout loss spiral, wherein individuals with poor co-worker support are more likely to become burnt-out, and in this depleted state they are subsequently less likely to reach out for those social supports when available, which would, in turn, lead to further burnout. This social support-burnout loss spiral is exacerbated when working in a low-PSC context, as the environment does not send positive safety signals about resource scarcity and replenishment. Therefore, PSC may be a potential target for intervention both in primary prevention (i.e., stopping the loss spiral in the first instance) and in secondary intervention, as high PSC signals to workers already in the burnout-support loss cycle when it is safe to reinvest resources or engage in recovery behavior.

The sleep, circadian, and cognitive performance consequences of watchkeeping schedules in submariners: A scoping review.

Watchkeeping schedules are essential for maintaining submarine operations, but come with human risk factors including, disrupted sleep, circadian misalignment, and cognitive deficits. There is now an emerging literature examining the strengths and weaknesses of submarine watchkeeping schedules trialled in the field and under simulated laboratory conditions. The aim of this scoping review was to summarise this literature. A systematic search of peer-reviewed journal articles and industry reports listed in MEDLINE, PsychINFO, PubMed, Scopus, Embase and Google Scholar undertaken in May 2023 returned 7298 papers. Following screening procedures, 13 studies were identified for inclusion. The findings revealed that sleep was sufficiently preserved regardless of watchkeeping schedule (total sleep time = 5.46-7.89 h), circadian misalignment was greater for non-24 h schedules, and longer off-watch periods were associated with better cognitive performance. Taken together, when comparing between watchkeeping schedules, the present findings suggest that the 4 h-on/8 h-off and 8 h-on/16 h-off schedules may be a good compromise when balancing human risk factors and operational demands. However, submarines are complex and challenging environments to study and there is a need to expand the literature. More research comparing watchkeeping schedules is needed. Future studies should focus on cognitive performance measures, such as problem-solving, prioritisation and executive decision-making to address present shortcomings, and an examination of sleep and circadian countermeasures to assist with adaptation either initiated pre-deployment or by modifying the submarine environment itself should be considered.

Leadership, work environment and caries prevention - what is good for the staff, is also good for the patients.

OBJECTIVES: Dental caries is a health problem that can be prevented. The aim of this study is to analyse if the quality of leadership, in Swedish Public Dental Health clinics, influences the extent to which patients with caries receive preventive care, and if any such effect is mediated through a collaborative work climate, clear role expectations and a low average level of burnout among staff. METHODS: The multilevel cross-sectional design includes work environment data from surveys of 75 general public dental clinics, register-based data on preventive measures provided to 5398 patients who received a dental filling due to a caries diagnosis, and patient demographics. Using a multilevel path analysis with logistic regression, we tested a model with one direct and three indirect pathways, controlling for the potential confounding effect of patient demographic factors. RESULTS: Leadership quality, as assessed by the staff at the clinic, was associated with increased odds of patients with caries receiving prevention, controlling for patient demographic factors. Leadership quality was also positively related to a collaborative work climate, clear role expectations and a low average level of burnout among staff. Against expectations, however, no indirect effect from leadership quality on prevention through the other work environment factors was found. CONCLUSIONS: In conclusion, the quality of leadership in Swedish Public Dental Health clinics was positively related to a good work environment for staff and to delivery of preventive care to patients experiencing caries.

The Role of Staff-Assessed Care Quality in the Relationship between Job Demands and Stress in Human Service Work: The Example of Dentistry.

The aim of this study was to investigate staff-assessed care quality at the clinic as a predictor of stress and as a moderator between job demands (quantitative demands and role conflict) and stress among dental professionals as an example of human service workers. Cross-sectional questionnaire data from 1012 dental professionals (i.e., dentists, dental hygienists and dental nurses) working at 99 clinics were analysed by confirmatory factor analysis and a two-level hierarchical linear model. Stress, quantitative demands and role conflict were measured by the Swedish standard version of COPSOQ III and care quality was measured by three proprietary items. The results showed that staff-assessed care quality at the clinic was of importance for the individual workers' experiences of stress. Furthermore, the staff's joint assessment of the care quality at the clinic mitigated the negative effect of role conflict on stress among dental nurses. These results indicate that a high level of staff-assessed care quality at the clinic can contribute to reduced stress in dental professionals.

A Quick "Environment Check" for All Ages: Validating the New Age-Inclusive Work Environments Instrument.

Background and Objectives: The global aging workforce necessitates new approaches in designing work environments to cater to the needs of increasingly age-diverse work groups. The Organisation for Economic Co-operation and Development (OECD) has in reaction outlined that organizations need to provide age-inclusive work environments that support the needs of their multigenerational workforce, to ensure their sustainability and profitability. To capture the age inclusiveness of the work environment, the present study proposes and validates an age-inclusive "environment check" for organizations referred to as the Age-Inclusive Work Environment Instrument (AIWEI), which covers discrimination, inclusion, and development opportunities. Research Design and Methods: We validate the 9-item AIWEI using cross-sectional and multilevel data from 2,892 Swedish workers across 101 workplaces who completed an online survey, using confirmatory factor analyses across young, middle-age, and older workers. Using a nomological approach, we also evaluate the concurrent validity of the AIWEI with a 2-1-1 path analysis. Results: The factor analyses supported a 3-factor model comprising of inclusion, discrimination, and development opportunities, across 3 age groups (i.e., young, middle-age, and older workers). These 3 factors had high Intraclass Coefficient (ICC) scores showing consistency in responding in the workplace. In accordance with the nomological approach, the factors of the AIWEI were linked with Psychosocial Safety Climate, burnout, and engagement, demonstrating concurrent validity for the AIWEI. Discussion and Implications: This new "environment check" provides a way to capture age-inclusive work environments for both younger and older workers, in an age-diverse workforce. In the validation process, age-inclusive work environments were found to exist as a group phenomenon, through shared perceptions within an organization, as well as an individual phenomenon, as experiences specific to an individual. This is important for the development and implementation of policies and strategies designed to benefit workers and organizations.

Does workplace social capital predict care quality through job satisfaction and stress at the clinic? A prospective study.

BACKGROUND: Welfare societies like Sweden face challenges in balancing the budget while meeting the demand for good quality healthcare. The aim of this study was to analyse whether care quality, operationalized as survival of dental fillings, is predicted by workplace social capital and if this effect is direct or indirect (through stress and/or job satisfaction among staff at the clinic), controlling for patient demographics. METHODS: The prospective design includes A) work environment data from surveys of 75 general public dental clinics (aggregated data based on 872 individual ratings), and B) register-based survival of 9381dental fillings performed during a 3-month period around the time of the survey, and C) patient demographics (age, gender, income level and birth place). Using a multi-level discrete-time proportional hazard model, we tested whether clinic-level social capital, stress, and job satisfaction could predict tooth-level filling failure, controlling for patient demographics. One direct and two indirect pathways, moderated by filling tooth, location, and filling type, were tested. RESULTS: High workplace social capital reduced the risk of early failure of fillings in molar teeth, mediated by group-perceived job satisfaction (indirect path: OR = 0.93, p < .05, direct path from job satisfaction: OR = 0.89, p < .05). Contrary to expectations, we found no support for a direct effect from social capital on care quality or for the indirect pathway via stress at the clinic level. CONCLUSIONS: Workplace social capital boosted the quality of dental fillings through increased levels of job satisfaction. In addition, staff at clinics with higher social capital reported less stress and higher levels of job satisfaction. These results indicate that promotion of social capital may improve both occupational health and care quality.

Not All Emotional Demands Are the Same: Emotional Demands from Clients' or Co-Workers' Relations Have Different Associations with Well-Being in Service Workers.

There has been an increased interest in the study of emotional demands (ED) at work and its impact on workers' well-being. However, ED have been conceptualized as a unitary concept, focused on interactions with clients, and excluding other potential sources of ED at work. Therefore, the aim of the current study is to explore the relation between ED from different relational sources (clients/patients/customers and colleagues, supervisors, and employees) and service workers' exhaustion and engagement. Cross-sectional data from a sample of 2742 service workers were analysed using structural equation modelling. Results showed that ED from both sources (clients and colleagues) were associated with more emotional exhaustion, particularly if dealing with clients was not an integrated part of the role. Further, ED from clients' relations were negatively associated with engagement for managers with staff responsibility, but positively for managers without staff responsibility. We also found moderating effects of psychosocial safety climate (PSC), whereby ED had the strongest effect on emotional exhaustion when PSC was low. This study suggests that different relational sources of ED at work have a different impact on employees' well-being. Strategies that promote a reduction of extra-role ED, and the development of a PSC in the organization, could therefore offer possible solutions to promote employees' psychological well-being and motivation.

Does staff-assessed care quality predict early failure of dental fillings? A prospective study.

OBJECTIVES: The aim of this study was to evaluate staff-assessed care quality as an indicator of register-based measures of care quality at dental clinics, more specifically register-based measures of survival of dental fillings and initiation of preventive treatments for caries patients. METHODS: This prospective study includes data from cross-sectional workplace psychosocial risk assessment surveys at dental clinics and register data on survival of dental fillings, and initiation of preventive treatment for caries patients obtained from the Swedish Quality Registry for Caries and Periodontal Disease (SKaPa) Demographic background data on the age, gender, income level and place of birth of patients was obtained from Statistics Sweden (SCB). The data were analysed using discrete-time multilevel survival analysis and multiple linear regression analysis. RESULTS: The results showed that staff-assessed care quality rated by the total staff or by dental nurses at the clinic predicted the risk of replacement of dental fillings made due to a caries diagnosis during the 3-year follow-up period, controlling for potential confounding due to patient demographic characteristics (age, sex, income and country of birth). In contrast, the better the staff-assessed care quality at the clinic, the smaller the proportion of the patients received preventive care in addition to operative caries therapy when controlling for potential confounding due to patient demographics. Care quality assessed by dentists at the clinic did not predict either of these outcome measures. CONCLUSIONS: Premature failure of dental fillings is costly for both patients and society, which leads to a need for relevant measures for following dental care quality. Our findings indicate that staff-assessed care quality - a cheap and easy measure to collect and follow continuously in dental practice - can be used to monitor aspects of quality in real time in order to facilitate continuous improvement and quickly amend quality problems. Also, it can be used for integrating quality improvement in systematic work environment risk management.

A Qualitative Investigation of Gerontological Practice: The Views of Social Work and Psychology Students, Faculty, and Practitioners.

Recently there has been an increase in the population of older adults; however, this increase has not been reflected in the helping professions. The aim of this study was to qualitatively investigate barriers to working with older adults within the human service professions. An online survey was sent to students, academic faculty, and practitioners from the disciplines of social work and psychology throughout Australia, addressing issues related to work with older adults. Thematic analysis was used to extract themes and subthemes from the responses (N = 252). The most important finding was that a barrier to working with older adults appears to be a consequence of a perpetuating cycle among students, academic faculty, and professionals collectively. Faculty members did not feel knowledgeable in the area of gerontology and were therefore not able to educate students in this area appropriately, leading to students to enter the workforce as either faculty members and/or practitioners without expertise to work with older adults. This study highlighted the importance of including more comprehensive gerontological information within social sciences' curriculum, which may promote more realistic images of older adults and help alleviate barriers to working with this population.