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OBJECTIVE. We assessed the efficacy and clinical utility of a new occupational time-use intervention, Action Over Inertia, designed to improve occupational balance and engagement among community-dwelling people with serious mental illness. METHOD. Using a randomized controlled design, we assigned 24 participants to an intervention group or standard care group. Participants were community-dwelling people with serious mental illness receiving assertive community treatment services. Data on time use, occupational balance, and engagement were collected and compared at baseline and 12-wk posttest. RESULTS. Eighteen participants completed the pilot study. Treatment group participants increased their occupational balance by spending an average of 47 min more per day in activity than the control group (p = .05). Differences in occupational engagement were not shown, but evidence of clinical utility was found. CONCLUSION. This pilot study of Action Over Inertia has shown evidence of efficacy and clinical utility.

Background Patients want all their concerns heard, but physicians fear losing control of time and interrupt patients before all concerns are raised. Objective We hypothesized that when physicians were trained to use collaborative upfront agenda setting, visits would be no longer, more concerns would be identified, fewer concerns would surface late in the visit, and patients would report greater satisfaction and improved functional status. Design and Participants Post-only randomized controlled trial using qualitative and quantitative methods. Six months after training (March 2004—March 2005) physician-patient encounters in two large primary care organizations were audio taped and patients (1460) and physicians (48) were surveyed. Intervention Experimental physicians received training in upfront agenda setting through the Establishing Focus Protocol, including two hours of training and two hours of coaching per week for four consecutive weeks. Main Measures Outcomes included agenda setting behaviors demonstrated during the early, middle, and late encounter phases, visit length, number of raised concerns, patient and physician satisfaction, trust and functional status. Key Results Experimental physicians were more likely to make additional elicitations (p < 0.01) and their patients were more likely to indicate agenda completion in the early phase of the encounter (p < 0.01). Experimental group patients and physicians raised fewer concerns in the late encounter phase (p < 0.01). There were no significant differences in visit length, total concerns addressed, patient or provider satisfaction, or patient trust and functional status Conclusion Collaborative upfront agenda setting did not increase visit length or the number of problems addressed per visit but may reduce the likelihood of “oh by the way” concerns surfacing late in the encounter. However, upfront agenda setting is not sufficient to enhance patient satisfaction, trust or functional status. Training focused on physicians instead of teams and without regular reinforcement may have limited impact in changing visit content and time use.

ABSTRACT BACKGROUND The 2003 and 2011 Accreditation Council for Graduate Medical Education (ACGME) common program requirements compress busy inpatient schedules and increase intern supervision. At the same time, interns wrestle with the effects of electronic medical record systems, including documentation needs and availability of an ever-increasing amount of stored patient data. OBJECTIVE In light of these changes, we conducted a time motion study to determine how internal medicine interns spend their time in the hospital. DESIGN Descriptive, observational study on inpatient ward rotations at two internal medicine residency programs at large academic medical centers in Baltimore, MD during January, 2012. PARTICIPANTS Twenty-nine interns at the two residency programs. MAIN MEASURES The primary outcome was percent of time spent in direct patient care (talking with and examining patients). Secondary outcomes included percent of time spent in indirect patient care, education, and miscellaneous activities (eating, sleeping, and walking). Results were analyzed using multilevel regression analysis adjusted for clustering at the observer and intern levels. KEY RESULTS Interns were observed for a total of 873 hours. Interns spent 12 % of their time in direct patient care, 64 % in indirect patient care, 15 % in educational activities, and 9 % in miscellaneous activities. Computer use occupied 40 % of interns’ time. There was no significant difference in time spent in these activities between the two sites. CONCLUSIONS Interns today spend a minority of their time directly caring for patients. Compared with interns in time motion studies prior to 2003, interns in our study spent less time in direct patient care and sleeping, and more time talking with other providers and documenting. Reduced work hours in the setting of increasing complexity of medical inpatients, growing volume of patient data, and increased supervision may limit the amount of time interns spend with patients.

Start the new year by sorting out your lab’s cold storage, to simplify purchasing, improve experiment planning and reduce the frequency of lost samples. Start the new year by sorting out your lab’s cold storage, to simplify purchasing, improve experiment planning and reduce the frequency of lost samples.

Time management isn’t taught at graduate school, but a better understanding of how you pass the hours can help you achieve your goals. Time management isn’t taught at graduate school, but a better understanding of how you pass the hours can help you achieve your goals. Credit: Mariam Al kassar/Shutterstock Six small coloured sand timers on a wooden box

Do fewer things, work at a natural pace and obsess over quality, says computer scientist Cal Newport, in his latest time-management book. Do fewer things, work at a natural pace and obsess over quality, says computer scientist Cal Newport, in his latest time-management book.

Artificial intelligence (AI) has emerged as an innovative technology that is increasingly used in healthcare. In the nursing profession, AI offers several advantages, including time savings through accelerated care processes, reduced error rates, and enhanced patient safety. This study aimed to describe undergraduate nursing students' attitudes toward AI and their time management skills and to examine the relationship between these variables. This cross-sectional study was conducted with 360 undergraduate nursing students enrolled at a state university in northwestern Turkey. The data were collected between September and December 2024 using the Individual Identification Form, the General Attitude Scale Towards AI, and the Time Management Questionnaire. The study was conducted in accordance with the principles of the Declaration of Helsinki. Among participants, 58.9% were aged 21 years and above, 83.3% were female, and 32.5% were first-year students. The mean score on the General Attitudes Toward AI Scale was 68.92 ± 9.21, while the mean score on the Time Management Questionnaire was 85.02 ± 12.61. A statistically significant positive correlation was found between attitudes toward AI and time management skills (r = 0.119, p < 0.05). Nursing students demonstrated high levels of positive attitudes toward AI and strong time management skills. As students' attitudes toward AI increased, their time management skills also improved. Further controlled and longitudinal studies are needed to confirm the mechanisms and long-term effects of AI-based time efficiency. Integrating AI literacy and ethical use modules into undergraduate nursing curricula is recommended to promote the responsible and effective use of AI tools in the context of patient safety and academic integrity.

Background Persons with dementia (PwD) experience difficulties in daily time management (DTM), which restricts their participation in valued activities. Time management products (TMPs) are assistive devices that support DTM and functional independence. Most previous research on TMP has been based on developed regions of the world. Given the limited research in low- and middle-income countries, the present study aimed to explore the use of TMP by PwD and caregivers in India. Methods We conducted a mixed-methods, explanatory sequential study. We first undertook a single-group, prospective, prepost, interventional study involving 38 dyads of persons with mild to moderate dementia and their caregivers. We assessed the self-reported and caregiver-reported DTM, performance and satisfaction in valued daily activities, time processing abilities, and well-being of the PwD and the caregivers’ well-being and ability to cope. The participants were then encouraged to use the TMP provided as an intervention. We reassessed the participants after three months and conducted semistructured interviews with three PwD and 12 caregivers to understand their experience of using the TMP. Results Within-group analysis revealed minimal but statistically insignificant changes in the scores of the PwD and caregiver on all the assessments. These findings suggest that TMP may help maintain the ability of PwD, especially those with mild dementia, and support caregivers to some extent. Thematic analysis revealed benefits to PwD, including reduced annoyance with caregivers’ prompts, improved confidence in knowing the time and doing valued activities more independently, increased caregiver involvement in supporting device use, complex operation of some products, and suggestions to make the products more suitable for use in India. The study also identified salient factors that may influence the use of TMPs, including PwD and caregivers’ need and priority for DTM; personal characteristics; and contextual factors, especially living arrangements and prevalent sociocultural attitudes towards time, devices, and elders. An increased demand for such products in the future is also anticipated. Conclusion This study provides encouraging evidence on the usefulness and acceptance of TMP by PwD and caregivers in India, although DTM may not be a priority for most individuals. The adoption of such products would entail a person-centred, context-specific approach to the development and provision of assistive technology. Trial registration The trial was registered with the Clinical Trail Registry - India (CTRI/2017/06/008916) on 27 June 2017.

The active phase of conventional static composting systems varies dramatically, ranging from several weeks to several months. Therefore, this study was to examine the effect of a combined continuous aeration-rotation process on shortening the active phase of composted material. A mixture of tomato plant residues with 20%-chicken manure (v/v) was composted in two identical pilot-scale bioreactors. One of them was static, and the other was continuously rotated at 3 rpm; each was supplied with continuous aeration. Compost temperatures (Tc) were measured throughout the composting process; the moisture content (MC) and carbon/nitrogen ratio (C/N) were measured at the beginning and end of the experiment. The quality and stage of compost were evaluated at the end of the experiment using Dewar, Solvita, and visual tests. Continuous aeration-rotation significantly reduced the active phase period to 4.5 days, increased the compost temperature (Tc) to 60°C after 3 days of operation, and remained at 50-65°C for approximately 3 consecutive days (thermophilic stage). In contrast, compost in the static bioreactor remained in the mesophilic stage (Tc < 45°C). During the composting process, the C/N ratio was reduced from 30/1 to 23/1 in the rotating bioreactor, while it remained at 30/1 in the static bioreactor, indicating that the nitrogen content was not a limiting factor affecting the composting process. The MC was within the optimum range for microorganisms (58-61%) for both bioreactors. After the active phase had ended in the rotating bioreactor, the compost was inactive and ready for further maturation, while compost from the static bioreactor was still immature and active. These results show that the proposed method can be done on a commercial scale to significantly reduce the composting period and to enhance the compost stability and productivity.