The visual cortex in the blind but not the auditory cortex in the deaf becomes multiple-demand regions.

The fate of deprived sensory cortices (visual regions in the blind and auditory regions in the deaf) exemplifies the extent to which experience can change brain regions. These regions are frequently seen to activate during tasks involving other sensory modalities, leading many authors to infer that these regions have started to process sensory information of other modalities. However, such observations can also imply that these regions are now activating in response to any task event, regardless of the sensory modality. Activating in response to task events, irrespective of the sensory modality involved, is a feature of the multiple-demands (MD) network. This is a set of regions within the frontal and parietal cortices that activate in response to any kind of control demand. Thus, demands as diverse as attention, perceptual difficulty, rule-switching, updating working memory, inhibiting responses, decision-making and difficult arithmetic all activate the same set of regions that are thought to instantiate domain-general cognitive control and underpin fluid intelligence. We investigated whether deprived sensory cortices, or foci within them, become part of the MD network. We tested whether the same foci within the visual regions of the blind and auditory regions of the deaf activated in response to different control demands. We found that control demands related to updating auditory working memory, difficult tactile decisions, time-duration judgments and sensorimotor speed all activated the entire bilateral occipital regions in the blind but not in the sighted. These occipital regions in the blind were the only regions outside the canonical frontoparietal MD regions to show such activation in response to multiple control demands. Furthermore, compared with the sighted, these occipital regions in the blind had higher functional connectivity with frontoparietal MD regions. Early deaf, in contrast, did not activate their auditory regions in response to different control demands, showing that auditory regions do not become MD regions in the deaf. We suggest that visual regions in the blind do not take a new sensory role but become part of the MD network, and this is not a response of all deprived sensory cortices but a feature unique to the visual regions.

Corticocortical and corticomuscular connectivity dynamics in standing posture: electroencephalography study.

Cortical mechanism is necessary for human standing control. Previous research has demonstrated that cortical oscillations and corticospinal excitability respond flexibly to postural demands. However, it is unclear how corticocortical and corticomuscular connectivity changes dynamically during standing with spontaneous postural sway and over time. This study investigated the dynamics of sway- and time-varying connectivity using electroencephalography and electromyography. Electroencephalography and electromyography were recorded in sitting position and 3 standing postures with varying base-of-support: normal standing, one-leg standing, and standing on a piece of wood. For sway-varying connectivity, corticomuscular connectivity was calculated based on the timing of peak velocity in anteroposterior sway. For time-varying connectivity, corticocortical connectivity was measured using the sliding-window approach. This study found that corticomuscular connectivity was strengthened at the peak velocity of postural sway in the γ- and ß-frequency bands. For time-varying corticocortical connectivity, the θ-connectivity in all time-epoch was classified into 7 clusters including posture-relevant component. In one of the 7 clusters, strong connectivity pairs were concentrated in the mid-central region, and the proportion of epochs under narrow-base standing conditions was significantly higher, indicating a functional role for posture balance. These findings shed light on the connectivity dynamics and cortical oscillation that govern standing balance.

Cardiac vagal activity changes moderated the association of cognitive and cerebral hemodynamic variations in the prefrontal cortex.

Phasic cardiac vagal activity (CVA), reflecting ongoing, moment-to-moment psychophysiological adaptations to environmental changes, can serve as a predictor of individual difference in executive function, particularly executive performance. However, the relationship between phasic CVA and executive function demands requires further validation because of previous inconsistent findings. Moreover, it remains unclear what types of phasic changes of CVA may be adaptive in response to heightened executive demands. This study used the standard N-back task to induce different levels of working memory (WM) load and combined functional Near-Infrared Spectroscopy (fNIRS) with a multipurpose polygraph to investigate the variations of CVA and its interactions with cognitive and prefrontal responses as executive demands increased in fifty-two healthy young subjects. Our results showed phasic decreases in CVA as WM load increased (t (51) = -3.758, p < 0.001, Cohen's d = 0.526). Furthermore, phasic changes of CVA elicited by increased executive demands moderated the association of cognitive and cerebral hemodynamic variations in the prefrontal cortex (B = 0.038, SE = 0.014, p < 0.05). Specifically, as executive demands increased, individuals with larger phasic CVA withdrawal showed a positive relationship between cognitive and hemodynamic variations in the prefrontal cortex (ß = 0.281, p = 0.031). No such significant relationship was observed in individuals with smaller phasic CVA withdrawal. The current findings demonstrate a decrease in CVA with increasing executive demands and provide empirical support for the notion that a larger phasic CVA withdrawal can be considered adaptive in situations requiring high executive function demands.

Job strain, occupation, and bladder health among women.

OBJECTIVES: Lower urinary tract symptoms (LUTS) are common among employed women. An underexplored topic is whether characteristics of women's occupations may influence LUTS. The present study examined whether job strain and its individual components (psychological demands, decision latitude) were associated with greater LUTS and their impact and whether, compared to managerial and professional occupations, occupations characterized by manual labor, sales, service, nursing, and teaching were associated with greater LUTS and their impact. METHODS: Coronary Artery Risk Development in Young Adults cohort study data were analyzed. Job strain and occupation were assessed in 1987-88 and 1995-96. In 2012-13, LUTS and their impact were assessed. LUTS/impact category (a composite variable ranging from bladder health to mild, moderate, and severe LUTS/impact) was regressed on job strain and occupation in separate analyses, adjusting for age, race, parity, education, and financial hardship (n = 1006). RESULTS: Job strain and its individual components were not associated with LUTS/impact. In comparison to managerial and professional occupations, service occupations in 1987-88 and 1995-96 were both associated with greater odds of LUTS/impact in proportional odds logistic regression analyses. Employment as a nurse, health assistant, or health aide in 1995-96 was associated with greater odds of any LUTS/impact versus bladder health. Support positions in 1987-88 and sales positions in 1995-96 were associated with greater odds of moderate or severe LUTS/impact versus bladder health or mild LUTS/impact. CONCLUSIONS: Future research should examine characteristics of workplaces that may promote or constrain bladder health (e.g., time and autonomy to void when desired, infrastructure to void).

Neural evidence for age-related deficits in the representation of state spaces.

Under high cognitive demands, older adults tend to resort to simpler, habitual, or model-free decision strategies. This age-related shift in decision behavior has been attributed to deficits in the representation of the cognitive maps, or state spaces, necessary for more complex model-based decision-making. Yet, the neural mechanisms behind this shift remain unclear. In this study, we used a modified 2-stage Markov task in combination with computational modeling and single-trial EEG analyses to establish neural markers of age-related changes in goal-directed decision-making under different demands on the representation of state spaces. Our results reveal that the shift to simpler decision strategies in older adults is due to (i) impairments in the representation of the transition structure of the task and (ii) a diminished signaling of the reward value associated with decision options. In line with the diminished state space hypothesis of human aging, our findings suggest that deficits in goal-directed, model-based behavior in older adults result from impairments in the representation of state spaces of cognitive tasks.

How does carbon biased technological progress promote carbon haze collaborative Governance？Evidence from Chinese cities.

Carbon dioxide (CO2) emissions and haze pollution are often thought to have the same origin, the burning of fossil fuels. However, their relationship is not always synergistic and may even exhibit mutual constraints. Carbon-biased technological progress has emerged as a promising approach for simultaneously achieving three goals - to reduce CO2 emissions, alleviate the haze pressure, and keep economic growth. This study empirically investigates the impact and mechanisms of carbon-biased technological progress on carbon haze collaborative governance using data from 286 Chinese cities during 2006-2021. The results indicate that: (1) Carbon biased technological progress positively influences carbon haze collaborative governance. (2) This progress achieves coordination by enhancing element allocation efficiency, carbon efficiency, and responding to public environmental demands. (3) The facilitating role of carbon biased technological progress to carbon haze collaborative governance will work better if external conditions are met. Moreover, the effectiveness of carbon-biased technological progress in promoting coordination is contingent upon high levels of marketization, government intervention, environmental regulation, and technical advancements. Local and regional governments should foster conducive conditions for carbon dioxide and haze pollution coordination, optimize the allocation and flow of carbon resources, ensure harmonization between environmental regulation policies and other sectors, and bolster international cooperation and technical knowledge exchange to collectively address global environmental challenges.

Promotion or prevention: regulatory foci as moderators in the job demands-resources model.

BACKGROUND: Building on the job demands-resources (JD-R) model and regulatory focus theory, this study examined how regulatory foci shaped the effects of different job demands and resources on both negative and positive workplace outcomes among medical staff. METHODS: Two independent studies (NStudy 1 = 267; NStudy 2 = 350) were designed for cross-validation. Participants completed a battery of measures evaluating job demands (workload, emotional demands, interpersonal stress), job resources (psychological safety, perceived organizational support, servant leadership), and well-being (job burnout, affective commitment, job satisfaction). RESULTS: Multiple linear regression analyses showed employees' well-being was affected by job demands and resources through energetic and motivational processes, respectively. The deleterious effect of emotional demands on job burnout was pronounced in individuals with weak prevention focus (B = 0.392, standard error [SE] = 0.069, p < .001). Psychological safety (Study 1) and servant leadership (Study 2) had stronger positive associations with motivational outcomes among individuals with weak promotion focus than those with strong promotion focus (B = 0.394, SE = 0.069, p < .001; B = 0.679, SE = 0.121, p < .001; and B = 0.476, SE = 0.072, p < .001, respectively). CONCLUSION: We used two samples to examine and cross-validate the joint effects of job characteristics and personal traits on workplace well-being among Chinese medical staff. Although heterogenous, the results showed regulatory foci were especially important in determining the effects of job demands and resources on well-being when there was (autonomous) self-regulation in the workplace.

What would have made work in the COVID-19 ICU less demanding? A qualitative study from 13 Swedish COVID-19 ICUs.

BACKGROUND: The COVID-19 pandemic stretched Swedish intensive care unit (ICU) resources to an extent never experienced before, but even before the pandemic staffing was difficult and the number of staffed ICU beds was low. Studies have revealed high levels of COVID-19 ICU staff burn-out and fatigue, and as similar situations with high demands are likely to occur in the future a better understanding of resources that improve staff resilience is important. Using the job-demand resource theory as a framework, we explored ICU professionals' views on demands and resources when working in COVID-19 ICUs with the aim to highlight factors that increased the job resources. METHODS: Data were collected via a web survey distributed to COVID-19 ICU professionals, including both regular and temporary roles, working in 13 COVID-19 ICU wards in Stockholm and Sörmland counties during the spring 2021. A total of 251 written responses to the question "What would have made work in the COVID-19 ICU less demanding?" were analyzed using thematic analysis. One year later a member-checking focus group interview was conducted to validate and further explore staff experiences. RESULTS: The main themes were work strategy, fairness and support, continuity, accessible leadership, introduction/information, and crisis preparedness. The analysis of the focus group conducted confirmed the main results and the extreme demands on ICU staff during the initial stages of the pandemic. CONCLUSION: To increase staff health and performance in a long-term crisis our results suggest; maintaining workplace leadership, scheduling work in advance and, when possible, schedule for recovery.

Effects of Occupational and Leisure-Time Physical Activity on the Risk of Dementia: Results From the Copenhagen City Heart Study.

Leisure-time physical activity (LTPA) decreases the risk of dementia, whereas occupational physical activity (OPA) possibly increases the risk. Yet, previous findings are mixed. We therefore aimed to investigate the effect of LTPA and OPA, respectively, on dementia among men and women. In this observational, longitudinal study, we used data from the second wave of a population-based cohort from the municipality of Copenhagen as baseline. Data were collected in 1981-1983, and 10 343 participants were followed until the end of 2016. LTPA and OPA were self-reported, and information on dementia diagnoses and redemption of dementia medication was obtained at an individual level from national health registers. We used Poisson regression to analyze the association between LTPA/OPA and dementia and adjusted for self-reported age, socioeconomic factors, stress, and cardiovascular risk factors (smoking, alcohol, body mass index, and blood pressure). A higher level of LTPA was associated with a lower dementia risk among men, but we found no clear association among women. OPA and dementia were not associated among men, but occupationally active women who reported OPA in terms of walking, lifting, and heavy work had a higher risk of dementia than women with sedentary jobs. This study supported earlier findings of a protective effect of LTPA on dementia among men. Women in physically demanding jobs possibly have a higher risk of dementia, yet this finding warrants further investigation in future studies.

Controlling posture to see the world: The integration of visual task demands and postural sway in sitting and standing infants.

Our ability to integrate posture with visually demanding tasks is a critical aspect of motor behavior flexibility. When looking at a small object, excessive body movements impair an individual's ability to visually attend to the object. To overcome this problem, we adjust our postural sway to successfully focus on the object. The goal of the current study was to assess whether infants also adjust postural sway when engaged in a challenging visual task. The participants, 19 independently sitting infants (Sitters) and 21 newly independently standing infants (Standers), sat or stood on a force plate while viewing differently sized images displayed on a monitor (smaller images: 8 × 6.5 cm or 3 × 3 cm; larger images: 13 × 16 cm or 13 × 13 cm). Regardless of image size, Standers were less stable than Sitters with larger sway areas and faster sway velocities. Both Sitters and Standers adjusted sway area but not sway velocity, based on image size. Sitters and Standers differed in how they controlled sway dynamics. Standers but not Sitters altered sway dynamics based on image size. Overall, infants used posture-specific adaptive control strategies to make fine-grained adjustments based on image size. The development of the ability to integrate posture with a visually demanding task further emphasizes the capability of advanced complex motor behaviors during infancy, enabling infants to flexibly attend to important aspects of their environment at different postural positions.

Continuity in false belief understanding from 33 to 52 months of age.

Conceptual continuity in children's false belief understanding from toddlerhood to childhood was investigated in a longitudinal study of 75 children. Performance in a low-demands false belief task at 33 months of age was significantly correlated with performance in a content false belief task at 52 months independent of language ability and executive function. In contrast, there was no correlation with performance in a location false belief task, which differed from the "Sally-Anne" format of the low-demands task and was high in executive demands. These findings support the view that explicit false belief understanding may be continuous from toddlerhood to childhood and that developmental change may be characterized in terms of enrichment and increasing stability of core conceptual understanding rather than in terms of fundamental change.

Effects of workday characteristics and job demands on recovery from work among Finnish home care nurses: a multi-source cross-sectional study.

OBJECTIVE: Ageing populations and poor care workforce availability are causing increasing job demands for home care nurses across Europe. While recovery from work helps sustain work ability and wellbeing, past research has relied mainly on self-reported measures of health, stressors, and recovery. This study aims to examine how objective and subjective job demands are associated with measured day-time recovery among home care nurses. METHODS: Heart rate variability recording was conducted for 95 Finnish home care nurses. The study participants documented their work tasks throughout the workday and filled a wellbeing questionnaire. The amount of care time, breaktime, number of different weekly clients, and their care needs were obtained from the survey. The associations between job demands and measured day-time recovery were analysed using multivariate linear regression. RESULTS: The amount of day-time recovery was on average 75 min. The number of different clients during the workday (e.g., care continuity) and higher care needs of the clients were associated with lower day-time recovery. Additionally, something slightly disrupting the course of the workday was associated with increased recovery. CONCLUSIONS: Our findings indicate that reducing especially the objective job demands (workday characteristics) can contribute to better day-time recovery among home care nurses. To help sustain work ability and improve wellbeing, day-time recovery can be promoted with better work scheduling that supports care continuity and ensures sufficient care resources and support for nurses with many clients or clients with high care needs.

Associations between person-environment fit and mental health - results from the population-based LIFE-Adult-Study.

Within occupational settings, mental health of employees can be affected by complex interactions between individuals and their work environment. The aim of this cross-sectional analysis was to investigate the association between person-environment fit and mental health in employees. Data of n = 568 participants from the LIFE adult cohort study was analysed, including socio-demographic characteristics, three dimensions of person-environment fit (P-E fit), symptoms of depression and anxiety. Assessment took place between 2017 and 2021. Statistical analysis included descriptive analyses as well as generalized linear regression models adjusted for age, gender, socioeconomic status, marital status, and job status. Correlational analysis revealed significant associations between age, marital status, SES, employment status, symptoms of depression and anxiety and P-E fit. According to regression models, greater perceived fit between person and organization was associated with lower depression scores and lower symptoms of anxiety. Higher perceived fit between demands and abilities was significantly related to lower severity of depression and anxiety. Similarly, participants reporting a higher fit between needs and supplies, exhibited less symptom severity regarding depression and anxiety. These results underline the importance of person-environment fit regarding mental health. Finding ways to obtain an optimal balance should not only be recognized as an important factor for health and well-being, but might also be beneficial for organizations and employers in the long-term.

Managers in the context of small business growth: a qualitative study of working conditions and wellbeing.

PURPOSE: In view of the importance of managers' wellbeing for their leadership behaviour, employee health, and business effectiveness and survival, a better understanding of managers' wellbeing and working conditions is important for creating healthy and sustainable businesses. Previous research has mostly provided a static picture of managers' wellbeing and work in the context of small businesses, missing the variability and dynamism that is characteristic of this context. Therefore, the purpose of this study is to explore how managers in small companies perceive their working conditions and wellbeing in the context of business growth. METHODS: The study is based on qualitative semi-structured interviews with 20 managers from twelve small companies. Content and thematic analysis were applied. RESULTS: The findings indicate that a manager's working environment evolves from its initial stages and through the company's growth, leading to variations over time in the manager's experiences of wellbeing and work-life balance as well as changes in job demands and resources. Managers' working situation becomes less demanding and more manageable when workloads and working hours are reduced and a better work-life balance is achieved. The perceived improvement is related to changes in organizational factors (e.g. company resources), but also to individual factors (e.g. managers' increased awareness of the importance of a sustainable work situation). However, there were differences in how the working conditions and wellbeing changed over time and how organizational and individual resources affected the studied managers' wellbeing. CONCLUSIONS: This study shows that, in the context of small business, managers' working conditions and wellbeing are dynamic and are linked to growth-related changes that occur from the start of organizational activities and during periods of growth. In addition, the findings suggest that changes in managers' working conditions and wellbeing follow different trajectories over time because of the interaction between organizational and personal factors.

"The magic triangle between bed, office, couch": a qualitative exploration of job demands, resources, coping, and the role of leadership in remote work during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has necessitated many employees to work from home with immediate effect for several months, regardless of their workplace preference or situation at home. Against this backdrop, this study explores perceived job demands and resources as well as the role of leadership and coping strategies of employees and managers with little or no prior experience with working from home in the altered work environment. METHODS: Based on the job demands-resources model, we developed an interview guide and conducted thirty-four semi-structured interviews. The interviews were transcribed and analyzed deductively-inductively using qualitative content analysis. RESULTS: Experienced job demands include, e.g., challenging, insufficient digital communication, and lack of social exchange, while greater flexibility and work-life balance were identified as valuable resources. Regarding the role of leadership, signaling trust, keeping regular contact, and supporting employees are important. To cope with the unforeseen yet persistent work situation, participants applied creative strategies by setting up offices at home with what they had at disposal. Differences were observed between employee and managerial perceptions as well as over time during the pandemic. CONCLUSIONS: The results expand our knowledge about healthy remote work by adding specific demands, resources, and coping strategies employees and managers experienced during the extreme situation of the COVID-19 pandemic to the picture as well as specifying the role of leadership. Moreover, our findings provide a foundation for guidelines for healthy remote work design and collaboration in times of abrupt change and crises.

Comprehensive analysis of performance, physiological, and perceptual responses during an entire sprint cross-country skiing competition.

PURPOSE: To investigate performance, physiological, and perceptual responses of an entire sprint cross-country skiing competition in the skating style. METHODS: Eighteen national-level male junior skiers participated in a simulated competition comprising an individual time trial (TT), followed by three heats (quarterfinals [QF], semifinals [SF], and final [F]). Participants' heart rate (HR) was continuously monitored while perceived readiness (RED, 1-10), rating of perceived exertion (RPE, 6-20), and blood lactate [La-] were assessed at standardized time points. RESULTS: The total duration and distance covered were 03:30 ± 00:06 h and 25.2 ± 2.9 km, respectively. The participants spent 02:19 ± 00:27 h > 60% of their maximal HR (HRmax) and 00:16 ± 00:04 h > 85% of HRmax. Average HR decreased from TT to F (89.3 ± 2.0% vs. 86.9 ± 3.0% of HRmax, P < 0.01). [La-] levels were highest before (4.6 ± 2.0 vs. 2.9 ± 1.2, 3.2 ± 2.0 and 2.5 ± 1.3 mmol·L-1, all P < 0.01) and after (10.8 ± 1.4 vs. 9.8 ± 1.6, 9.1 ± 1.8 and 8.7 ± 1.7 mmol·L-1, all P < 0.05) F compared to TT, QF, and SF, respectively. RED was lowest before F compared to TT, QF, and SF (6.6 ± 1.4 vs. 7.9 ± 1.1, 7.6 ± 1.1, and 7.4 ± 1.4, respectively, all P < 0.05) while RPE was highest after TT compared to QF, SF, and F (17.8 ± 0.9 vs. 15.1 ± 2.0, 16.5 ± 1.2 and 16.6 ± 1.8, respectively, all P < 0.01). The six best-performing skiers demonstrated higher RED before F (7.2 ± 0.9 vs. 5.3 ± 1.2, P < 0.05) and higher [La-] after F (11.2 ± 0.2 vs. 10.2 ± 0.3, mmol·L-1, P < 0.05) than lower-performing competitors. CONCLUSION: This study provides novel insights into physiological demands of an entire sprint cross-country skiing competition, which involves repeated 3-min high-intensity efforts interspersed with > 2 h (25 km) of low- to moderate-intensity exercise.

A healthy balance: the ratio of social support-to-demands is associated with metabolic syndrome.

Metabolic syndrome is associated with increased risk for negative health events, decrements in quality of life, and greater health costs. The current study sought to identify whether the ratio of social support to social demands across multiple relationship types (spouse, friends, children, or other family members) were associated with concurrent metabolic syndrome in a nationally representative sample of US adults ages 32-40. Results indicate that the ratio of total social support to social demands was associated with a greater likelihood of meeting criteria for metabolic syndrome, even after statistically controlling for the effects of race, ethnicity, sex, age, income, and prior metabolic syndrome. When considering the relative contributions of each relationship type, greater support relative to demands from friends was the only relationship type that was significantly independently associated with lower likelihood of metabolic syndrome. Although not statistically significant, a trend-level negative association with spousal support/demands emerged, as did a trend-level positive association with support/demands from children. Taken together, the current study reaffirms the relevance of considering social support and demands with regards to metabolic syndrome and highlights the ways in which specific relationships may differentially relate to health risk.

The role of job strain in the relationship between depression and long-term sickness absence: a register-based cohort study.

PURPOSE: Though individuals with depression and those with poor working conditions are more likely to be on long-term sickness absence (LTSA), less is known about how working conditions may modify the associations between depression status and LTSA. This study aims to examine the association between depression and LTSA among Swedish workers with different levels of job strain and its individual components (job demands and job control). METHODS: All Swedish workers 30 - 60 years old (N = 3,065,258) were studied in 2005. At baseline (2005-2010), workers were categorized as: without depression, being prescribed antidepressants, and being in inpatient/outpatient care. Job strain was measured using a Swedish Job Exposure Matrix, and data on LTSA were obtained from 2011 to 2021. The association between depression and LTSA was assessed using Cox proportional-hazards regression stratified by categories of job strain. RESULTS: Compared to workers without depression, workers with depression had higher risk of LTSA across all job strain levels. Depression was associated with the highest hazards of LTSA in active jobs, but a similar population attributable fraction (PAF) was found across categories of job strain, indicating similarities between the different categories. CONCLUSION: There was evidence of a moderating effect of job strain in the relationship between depression and LTSA, but also evidence that this was due to differences in baseline depression prevalence in the different job strain categories. Future research is needed to determine alternative factors which could be relevant for reducing LTSA among those who have already developed depression.

Management of pain in cancer patients- lessons from practices during the COVID-19: a qualitative study of cancer care providers' perspectives.

BACKGROUND: The ongoing COVID-19 pandemic has impacted health systems globally and affected managing many chronic conditions, including cancer. This study aimed to explore the perceptions of multi-disciplinary cancer care providers on how cancer pain management was affected by the COVID-19 pandemic. METHODS: Participants were eligible if they were cancer care providers of any specialty and discipline from two tertiary hospitals in Australia. Data were collected using semi-structured interviews to explore cancer care providers' perspectives on cancer pain management within COVID-19. Thematic analysis of interview transcripts used an integrated approach that started with inductive coding before coding deductively against a behaviour framework called the COM-B Model, which proposes that 'capability', 'motivation' and 'opportunity' are requisites for any behaviour. RESULTS: Twenty-three providers participated. Five themes were developed and interpreted from the analysis of data, namely: "Telehealth enables remote access to cancer pain management but also created a digital divide", "Access to cancer pain management in the community is compromised due to the pandemic", "COVID-19 negatively impacts hospital resource allocation", "Patients were required to trade off cancer pain management against other health priorities" and "Hospital restrictions result in decreased social and psychological support for patients with cancer pain". CONCLUSIONS: The landscape of cancer pain management in the Australian health system underwent substantial shifts during the COVID-19 pandemic, with lasting impacts. Cancer care providers perceived the pandemic to have significant adverse effects on pain management across multiple levels, with repercussions for patients experiencing cancer-related pain. A more adaptive health system model needs to be established in the future to accommodate vulnerable cancer patients.

The role of workday characteristics on perceived stress and time pressure among nurses in Finnish long-term care - a cross-sectional study.

BACKGROUND: Aging populations and nursing workforce issues are causing challenges for long-term care globally, and therefore, improving the work-related wellbeing and retention of nurses is crucial. As such, gaining a further understanding of the factors that affect work strain in long-term care is important. Previously, the effect of job demands on the wellbeing of nurses has been researched principally by subjective instruments. In this study, we examined the relationship between indirectly measured workday characteristics and perceived stress and time pressure among nurses working in Finnish long-term care (assisted living facilities with 24-hour assistance). METHODS: A total of 503 nurses from 44 assisted living facilities across Finland completed time measurement surveys and wellbeing questionnaires. The data were linked with client characteristics from the Resident Assessment Instrument register. The relationships between the measured number of care events during the workday, clients' care needs, and the amount of breaktime and perceived stress and time pressure were analyzed using multivariate logistic regression. RESULTS: Nurses who had more care events and clients with greater care needs were at higher odds of having high stress. More care events and reduced breaktime were associated with high time pressure. Disruptions during the workday were strongly associated with both high stress and time pressure. Last, nurses who were under high stress and time pressure worked more often in teams with lower team autonomy. CONCLUSIONS: Our findings on indirectly measured job demands indicate that dividing the workload equally among nurses through better work division can help reduce the stress and time pressure of nurses in long-term care. In addition, ensuring sufficient breaktime and preventing unnecessary disruptions is important. To help recruit and retain the care workforce, fair management of work that accounts for varying client care needs and workload is needed. In addition, legislative and governance tools, such as staffing level regulation, and further consideration of job demands might aid in reducing the job strain of nurses. PATIENT OR PUBLIC CONTRIBUTION: Patients or nurses were not involved in the design of the study, analysis, or interpretation of the results, or in the preparation of the manuscript.