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Objective: The primary objective of this study was to create a methodology for measuring transient levels of physician workload in a live emergency department (ED) environment.Background: Characterizing, defining, and measuring aspects of this interrupt-driven work environment represent the preliminary steps in addressing impending issues concerning ED overcrowding, efficiency, and patient and provider safety.Methods: A time-motion task analysis was conducted. Twenty emergency medicine (EM) physicians were observed for 180-min intervals in an ED of an academic medical center. Near continuous workload measures were developed and used to track changing workload levels in time. These measures were taken from subjective, objective, and physiological perspectives. The NASA-Task Load Index was administered to each physician after observational sessions to measure subjective workload. Physiological measurements were taken throughout the duration of the observation to measure stress response. Additional information concerning physicians' patient quantity and patient complexity was extracted from the ED information system.Results: Graphical workload profiles were created by combining observational and subjective data with system state data. Methodologies behind the creation of workload profiles are discussed, the workload profiles are compared, and quantitative and qualitative analyses are conducted.Conclusion: Using human factors methods to measure workload in a setting such as the ED proves to be challenging but has relevant application in improving the efficiency and safety of EM.Application: Techniques implemented in this research are applicable in managing ED staff and real-time monitoring of physician workload. [ABSTRACT FROM AUTHOR]

Background: Environmental factors including seasonal changes are important to guide physical activity (PA) programs to achieve or sustain weight loss. The goal was to determine seasonal variability in the amount and patterns of free-living PA in women., Methods: PA was measured in 57 healthy women from metropolitan Nashville, TN, and surrounding counties (age: 20 to 54 years, body mass index: 17 to 48 kg/m2) using an accelerometer for 7 consecutive days during 3 seasons within 1 year. PA counts and energy expenditure (EE) were measured in a whole-room indirect calorimeter and used to model accelerometer output and to calculate daily EE and intensity of PA expressed as metabolic equivalents (METs)., Results: PA was lower in winter than in summer (131+/-45 vs. 144+/-54x10(3) counts/d; P=.025) and in spring/fall (143+/-48x10(3) counts/d; P=.027). On weekends, PA was lower in winter than in summer by 22,652 counts/d (P=.008). In winter, women spent more time in sedentary activities than in summer (difference 35 min/d; P=.007) and less time in light activities (difference -29 min/d, P=.018) and moderate or vigorous activities (difference -6 min/d, P=.051)., Conclusions: Women living in the southeastern United States had lower PA levels in winter compared with summer and spring/fall, and the magnitude of this effect was greater on weekends than weekdays.